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Sample records for carcinosarcoma initially presenting

  1. Bronchial carcinosarcoma

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    Carcano, Carolina; Savage, Edward; Diacovo, Maria Julia; Kirsch, Jacobo

    2012-01-01

    Carcinosarcoma is an uncommon mixed tumor of the lung. We present the case of a 65 year-old-male with cough and a right lower lobe radio-opacity who underwent resection, showing a large endobronchial tumor with an epithelial component of non-small cell carcinoma and malignant mesenchymal elements. The radiologic and histopathologic features are reviewed with reference to relevant literature. PMID:23378874

  2. Mammary carcinosarcoma in cat: a case report

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    J.D.G. Paniago; A.L.S. Vieira; N.M. Ocarino; S.A. França; C. Malm; Cassali, G.D.; R. Serakides

    2010-01-01

    A case of mammary carcinosarcoma is reported in a 13-year-old, mixed breed female cat, which was not spayed and had not received contraceptives. The patient presented extensive and coalescent nodules in all mammary glands. Based on the histological and immunohistochemical findings, the diagnosis of mammary carcinosarcoma was confirmed.

  3. Carcinosarcoma of the penis

    International Nuclear Information System (INIS)

    Carcinosarcoma is a rare disease and postirradiation sarcoma is seldom seen in the urogenital organs. A case of penile tumor, which is thought to have consisted of recurrent cancer and postirradiation sarcoma, is described. (author)

  4. A Case of Giant Bladder Carcinosarcoma without Submucosal Invasion

    OpenAIRE

    Koji Mikami; Mariko Yamanoi; Masayoshi Zaitsu; Akiko Tonooka; Toshimasa Uekusa; Takumi Takeuchi

    2011-01-01

    Carcinosarcoma is a rare biphasic neoplasia containing both malignant mesenchymal and epithelial elements. Bladder carcinosarcoma commonly presented as high-grade, advanced stage, and aggressive behavior with a poor prognosis. An 83-year-old male presented with painless gross hematuria to our hospital. Cystoscopy revealed massive nonpapillary bladder tumor on the right wall. The 91 g tumor could be completely removed with transurethral resection. Histology of the tumor was diagnosed as carcin...

  5. Rapidly Growing Esophageal Carcinosarcoma Reduced by Neoadjuvant Radiotherapy Alone

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    Naotaka Ogasawara

    2014-06-01

    Full Text Available Esophageal carcinosarcoma is a rare malignant neoplasm consisting of both carcinomatous and sarcomatous components. It is generally treated by surgery, radiotherapy and chemotherapy according to the protocols used for other esophageal cancers. However, the treatment of esophageal carcinosarcoma by radiotherapy alone before surgery has not been previously described. We report a patient with a rapidly growing esophageal carcinosarcoma that was efficiently reduced by neoadjuvant radiotherapy alone. A previously healthy 69-year-old man was admitted with dysphagia. Initial esophagogastroduodenoscopy (EGD revealed a small nodular polypoid lesion of about 10 mm in the middle esophagus. A second EGD 1 month later showed that the tumor had expanded into a huge mass. A biopsy specimen revealed that the tumor comprised squamous cell carcinoma with spindle cell components, and the tumor was diagnosed as carcinosarcoma which was diagnosed as stage I (T1bN0M0. Due to renal dysfunction, the patient was treated with neoadjuvant radiotherapy (40 Gy without chemotherapy. A third EGD 1 month later revealed remarkable tumor reduction. He then underwent total esophagectomy with regional lymph node dissection (pStage 0, pT1aN0M0. After surgical operation, the patient was followed up without adjuvant therapy. Whole body computed tomography revealed lung metastasis 14 months after surgery, and the patient died 2 months later. The neoadjuvant radiotherapy for esophageal carcinosarcoma was considered to have contributed to the subsequent surgery and his prolonged survival time. Thus, radiotherapy alone might be a suitable neoadjuvant therapy for esophageal carcinosarcomas.

  6. Primary hepatic carcinosarcoma:a case report

    Institute of Scientific and Technical Information of China (English)

    王细文; 梁平; 李洪艳

    2004-01-01

    @@ Primary hepatic carcinosarcoma is defined as a malignant hepatic tumour containing both carcinomatous and sarcomatous elements. Strictly, it should be distinguished from collision tumour and carcinoma with foci of spindle-shaped epithelial cells. Primary hepatic carcinosarcoma is rare, and less than 11 adequately documented cases have been reported. In this article, a case of primary hepatic carcinosarcoma was discussed as to its potential histogenesis.

  7. Carcinosarcoma of the Liver: A Case Report

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    Kwon, Jung Hyeok; Kang, Yu Na; Kang, Koo Jeong [Dongsan Medical Center, Keimyung University School of Medicine, Daegu (Korea, Republic of)

    2007-08-15

    A 46-year-old woman was referred after having general weakness for one month. Biochemical indices of liver function were normal. The tumor markers revealed the following: alpha-fetoprotein level, 2.1 ng/mL (< 9.6 ng/mL); carcinoembryonic antigen level, 1.5 ng/mL (< 5.0 ng/mL); serum carbohydrate antigen 19 9 level, 13.2 U/mL (< 39 U/mL). Serum markers for hepatitis B and C were negative. Ultrasonography showed a lobulate heterogeneous echogenic solid mass with a highly echogenic lesion with posterior acoustic shadowing within the mass in the left lobe of the liver. Computed tomographic analysis of the mass revealed peripheral enhancing viable portions, large internal non-enhancing necrotic portions, and a dense radiopaque lesion. In conclusion, the imaging findings of hepatic carcinosarcoma presented in this report showed a large mass with large necrotic portions, small cystic portions, calcifications and bone formations. Although, from a clinical standpoint, establishing an accurate preoperative diagnosis is difficult, carcinosarcoma should be included in the differential diagnosis of a large necrotic hepatic mass, especially if rocky calcifications or bone formations are seen.

  8. Carcinosarcoma of the Lung Associated with Neurofibromatosis Type 1: A Case Re

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    Rana ÇİTİL

    2012-01-01

    Full Text Available Neurofibromatosis or von Recklinghausen's disease is the most common inherited syndrome predisposing to neoplasia. Carcinosarcoma is a rare malignant mixed tumor of the lung. Association of carcinosarcoma of lung with Neurofibromatosis-1 is not common. A 57-year-old man presented with history of fever, cough, hemoptysis, breathlessness, weight loss, chest pain. Multiple cutaneous neurofibromas and café au lait spots were revealed by physical examination. A homogeneous opacity was found in the right middle and right upper zone on posterior-anterior chest radiography. A 8x8x7 cm mass that had irregular borders in right upper posterior and apical segment was seen on contrast enhanced chest computed tomography. On bronchoscopy, the lumen of right upper apical segment was obstructed with vegetating tumoral lesion. The biopsy taken from this region was diagnosed as carcinosarcoma by histopathological and immunohistochemical examination.A rare case with carcinosarcoma of the lung and Neurofibromatosis-1 was reported.

  9. Uterine Carcinosarcoma in a Patient with Didelphys Uterus

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    Iavazzo, C.; F. Kokka; Sahdev, A; Singh, N.; Reynolds, K.

    2013-01-01

    Background. Didelphys uterus is a noncommon finding in women. Till now, few cases with benign mesenchymal tumors in patients with didelphys uterus are described. We present a case of a patient with carcinosarcoma arising in a didelphys uterus. Case. A 73-year-old patient presented with profuse watery postmenopausal bleeding. On examination under anesthesia, left and right cervixes were identified. Tumor extended from the left cervix into the lower third of the vagina and was adherent to the r...

  10. Carcinosarcoma arising in a dermoid cyst of the ovary.

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    Arora, D S; Haldane, S

    1996-01-01

    A case of carcinosarcoma arising within an otherwise benign cystic teratoma is reported. The patient, a 78 year old nulliparous woman, presented with right sided abdominal pain of short duration and subsequently underwent a bilateral salphingo-oophorectomy. Slicing of the left ovary revealed a unilocular cyst containing hair admixed with soft yellow material with a thin wall apart from a solid area at one pole. Extensive areas of necrosis and cystic degeneration were present within this mass....

  11. True carcinosarcoma of the tongue. A case report

    International Nuclear Information System (INIS)

    Carcinosarcoma is a rare malignancy consisting of both carcinomatous and sarcomatous tissue. Its histological nature and clinical course remain controversial. A 70-year-old man presented with a large pedunculated lingual mass. Two years ago, the patient underwent preoperative radiation therapy and surgery of total removal of squamous cell carcinoma of the floor of mouth with left radical neck dissection and right upper neck dissection. After local excision, no recurrence of the tumor was observed for three months. (author)

  12. Uterine Carcinosarcoma in a Patient with Didelphys Uterus

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    C. Iavazzo

    2013-01-01

    Full Text Available Background. Didelphys uterus is a noncommon finding in women. Till now, few cases with benign mesenchymal tumors in patients with didelphys uterus are described. We present a case of a patient with carcinosarcoma arising in a didelphys uterus. Case. A 73-year-old patient presented with profuse watery postmenopausal bleeding. On examination under anesthesia, left and right cervixes were identified. Tumor extended from the left cervix into the lower third of the vagina and was adherent to the right vaginal sidewall. There was no evidence of parametrial extension. Tissue was sent for biopsy which revealed high-grade uterine carcinosarcoma. Two uterine fundi and two vaginas in keeping with uterine didelphys were identified on imaging. The patient underwent vaginal excision of the protruding tumor measuring  cm with harmonic scalpel followed by total abdominal hysterectomy and bilateral salpingooophorectomy. Although a number of pelvic and paraaortic lymph nodes were also identified on imaging, she was not planned for lymphadenectomy after MDT (multidisciplinary team discussion because of her comorbidities. The final histology confirmed the diagnosis. Conclusion. According to our knowledge, this is the second case of carcinosarcoma arising in didelphys uterus in the world literature.

  13. Uterine carcinosarcoma in a patient with didelphys uterus.

    Science.gov (United States)

    Iavazzo, C; Kokka, F; Sahdev, A; Singh, N; Reynolds, K

    2013-01-01

    Background. Didelphys uterus is a noncommon finding in women. Till now, few cases with benign mesenchymal tumors in patients with didelphys uterus are described. We present a case of a patient with carcinosarcoma arising in a didelphys uterus. Case. A 73-year-old patient presented with profuse watery postmenopausal bleeding. On examination under anesthesia, left and right cervixes were identified. Tumor extended from the left cervix into the lower third of the vagina and was adherent to the right vaginal sidewall. There was no evidence of parametrial extension. Tissue was sent for biopsy which revealed high-grade uterine carcinosarcoma. Two uterine fundi and two vaginas in keeping with uterine didelphys were identified on imaging. The patient underwent vaginal excision of the protruding tumor measuring 8 × 6 cm with harmonic scalpel followed by total abdominal hysterectomy and bilateral salpingooophorectomy. Although a number of pelvic and paraaortic lymph nodes were also identified on imaging, she was not planned for lymphadenectomy after MDT (multidisciplinary team) discussion because of her comorbidities. The final histology confirmed the diagnosis. Conclusion. According to our knowledge, this is the second case of carcinosarcoma arising in didelphys uterus in the world literature. PMID:23533863

  14. Which is worse: uterine papillary serous carcinomas or carcinosarcomas?

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    Song, Taejong; Choi, Chel Hun; Lee, Yoo-Young; Kim, Tae-Joong; Lee, Jeong-Won; Kim, Byoung-Gie; Bae, Duk-Soo

    2011-01-01

    Objective It is clear that uterine carcinosarcomas and uterine papillary serous carcinomas (UPSC) have an adverse impact on outcome, but whether carcinosarcomas are worse than UPSC is unclear. The purpose of this study is to compare the pathology, survival, and disease recurrence of patients with carcinosarcomas to patients with UPSC. Methods The medical records of patients diagnosed with carcinosarcomas and UPSC between 1996 and 2009 at Samsung Medical Center were retrospectively analyzed. I...

  15. Thyroid carcino-sarcoma in a dog

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    Antonio Giuliano

    2013-04-01

    Full Text Available An adult male greyhound was diagnosed with a thyroid carcino-sarcoma by means of histopathology and positive immuno-histochemistry staining for cytokeratin and vimentin. Surgery and radiotherapy of the area were successful in local tumour control. Adjuvant chemotherapy was recommended to treat and prevent further metastasis. The use of carboplatin, metronomic cyclophosphamide chemotherapy and toceranib failed to control the progression of distant metastasis. The survival time was seven months from the time of diagnosis. This is the eighth case of carcino-sarcoma of the thyroid documented in veterinary medicine and the first one treated with a multimodal approach based on surgery, radiotherapy and chemotherapy. As documented in human medicine, chemotherapy appeared to be ineffective to prevent or delay the progression of the metastatic disease in this case.

  16. Thyroid carcino-sarcoma in a dog

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    Antonio Giuliano

    2013-02-01

    Full Text Available An adult male greyhound was diagnosed with a thyroid carcino-sarcoma by means of histopathology and positive immuno-histochemistry staining for cytokeratin and vimentin. Surgery and radiotherapy of the area were successful in local tumour control. Adjuvant chemotherapy was recommended to treat and prevent further metastasis. The use of carboplatin, metronomic cyclophosphamide chemotherapy and toceranib failed to control the progression of distant metastasis. The survival time was seven months from the time of diagnosis. This is the eighth case of carcino-sarcoma of the thyroid documented in veterinary medicine and the first one treated with a multimodal approach based on surgery, radiotherapy and chemotherapy. As documented in human medicine, chemotherapy appeared to be ineffective to prevent or delay the progression of the metastatic disease in this case.

  17. Thyroid carcino-sarcoma in a dog.

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    Giuliano, Antonio; Grant, Jessica; Benoit, Jerome

    2013-01-01

    An adult male greyhound was diagnosed with a thyroid carcino-sarcoma by means of histopathology and positive immuno-histochemistry staining for cytokeratin and vimentin. Surgery and radiotherapy of the area were successful in local tumour control. Adjuvant chemotherapy was recommended to treat and prevent further metastasis. The use of carboplatin, metronomic cyclophosphamide chemotherapy and toceranib failed to control the progression of distant metastasis. The survival time was seven months from the time of diagnosis. This is the eighth case of carcino-sarcoma of the thyroid documented in veterinary medicine and the first one treated with a multimodal approach based on surgery, radiotherapy and chemotherapy. As documented in human medicine, chemotherapy appeared to be ineffective to prevent or delay the progression of the metastatic disease in this case. PMID:23718201

  18. Thyroid carcino-sarcoma in a dog

    OpenAIRE

    Antonio Giuliano; Jessica Grant; Jerome Benoit

    2013-01-01

    An adult male greyhound was diagnosed with a thyroid carcino-sarcoma by means of histopathology and positive immuno-histochemistry staining for cytokeratin and vimentin. Surgery and radiotherapy of the area were successful in local tumour control. Adjuvant chemotherapy was recommended to treat and prevent further metastasis. The use of carboplatin, metronomic cyclophosphamide chemotherapy and toceranib failed to control the progression of distant metastasis. The survival time was seven months...

  19. Carcinosarcoma of the Ureter with a Small Cell Component: Report of a Rare Pathologic Entity and Potential for Diagnostic Error on Biopsy

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    Kent Newsom

    2014-01-01

    Full Text Available Carcinosarcomas of the ureter are rare biphasic neoplasms, composed of both malignant epithelial (carcinomatous and malignant mesenchymal (sarcomatous components. Carcinosarcomas of the urinary tract are exceedingly rare. We report a unique case of a carcinosarcoma of the ureter with a chondrosarcoma and small cell tumor component arising in a 68-year-old male who presented with microscopic hematuria. CT intravenous pyelogram revealed right-sided hydroureter and hydronephrosis with thickening and narrowing of the right ureter. The patient underwent robot-assisted ureterectomy with bladder cuff excision and subsequent adjuvant chemotherapy. The patient is disease-free at 32 months after treatment. We provide a brief synoptic review of carcinosarcoma of the ureter and bladder with utilization of immunohistochemical (IHC stains and potential diagnostic pitfalls.

  20. Gastric carcinosarcoma with rhabdomyosarcomatous differentiation: a case report and review.

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    Fujiie, Masashi; Yamamoto, Manabu; Taguchi, Kenichi; Iwanaga, Ayako; Ohgaki, Kippei; Egashira, Akinori; Minami, Kazuhito; Toh, Yasushi; Oda, Yoshinao; Okamura, Takeshi

    2016-12-01

    We report an unusual case of gastric carcinosarcoma with rhabdomyosarcomatous and neudoendocrinal differentiation in a 71-year-old Japanese female. Gastric carcinosarcoma with rhabdomyosarcomatous and neuroendocrinal differentiation is a rare tumor. The tumor developed in the body of the stomach and was exophytic in appearance. By histochemical analysis, the tumor was shown a part of positive for desmin and myoglobin and a part of positive for synaphtophysin and vimentin.We conclude that, though rare, gastric carcinosarcoma with rhabdomyosarcomatous and neuroendocrinal differentiation thus is reviewed in the English literatures. PMID:27250580

  1. Gynaecomastia as the initial presentation of thyrotoxicosis

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    Triranjan Sanyal

    2012-01-01

    Full Text Available Gynaecomastia is a well-recognized manifestation of thyrotoxicosis occurring in a widely variable percentage. Some studies have reported the percentage to be high as 40% while others report it being around 10%. The variation can be attributed to the difference in the criteria used to define gynae-comaslia or racial factors. However, thyrotoxicosis presenting with gynaceomastia as an intial manifestation is very rare. Only handful case reports are found in literature. Here we present a case of 35-year-old Indian male, with thyrotoxcosis who presented initially with painful bilateral gynaceomastia.

  2. Carcinosarcoma of the stomach: A case report and review of the literature

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Carcinosarcomas are rare, malignant, biphasic tumors. We report the case of a 62-year-old man with gastric carcinosarcoma, along with its clinical, macroscopic and histopathological features. Macroscopically, a specimen of deformed stomach was obtained that measured 200 mm × 150 mm × 100 mm. A 150 mm × 100 mm ×50 mm exophytic tumoral mass (Borrmann type Ⅰ)was found, which involved the posterior wall from the cardia to the antrum. Histopathologically, a mixed type of malignancy was revealed: an adenocarcinoma with intestinal metaplasia, with interposed fascicles of fusiform atypical cells and numerous large, rounded and oval cells. The tumor showed positive histochemistry for cytokeratin 18, epithelial membrane antigen, carcinoembryonic antigen, chromogranin A and vimentin. Liver metastases were diagnosed 8 mo postoperatively, and the patient died 4 mo later. A review of the available literature is also presented.

  3. Carcinosarcoma of the colon: report of a case with morphological, ultrastructural and molecular analysis

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    Ferrero Stefano

    2006-07-01

    Full Text Available Abstract Background Carcinosarcoma of the colon is a rare histopathological entity with uncertain histogenesis, that shows both epithelial and mesenchymal malignant differentiation. Carcinosarcoma rarely affects the gastrointestinal tract and only few cases are reported in the colon. Herein we describe a carcinosarcoma of the ascending colon, with morphological, ultrastructural and molecular analysis. Case presentation An 81-year-old man was hospitalised for asthenia, weight loss and iron-deficiency anaemia. The patient underwent colonoscopy and adenocarcinoma was diagnosed by endoscopic biopsy. A right hemicolectomy was performed and, during surgical operation, liver metastases were detected. Histological examination of the surgical specimen revealed areas of both carcinomatous and sarcomatous differentiation, completely separated by fibrous septae. The sarcomatous component exhibited areas of smooth muscle and osteoblastic differentiation, with focal osteoid material deposition. Molecular analysis conducted separately on the epithelial and mesenchymal components revealed the same p53 gene mutation (R282W in exon 8 and identical polymorphisms in p53 exon 4, in EGFR exons 20 and 21, and in c-kit exon 17. Microsatellite markers analysis revealed a common loss of heterozygosis on 18q. Overall, the data are consistent with a common origin of the two tumor components. The patient was treated with 8 cycles of oral capecitabine (1250 mg/m2 twice a day for 14 days repeated every 28 days and two years after surgery is alive with liver metastases. Conclusion Carcinosarcoma of the colon is a rare tumour with both epithelial and sarcomatous components. Molecular analysis of the current case suggests the histogenesis from a common cell progenitor.

  4. Congenital Leukemia Initially Presenting with Leukemia Cutis

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    Melike Sezgin Evim

    2012-12-01

    Full Text Available Introduction: Congenital leukemia represents less than 1% of childhood leukemia. Its prognosis is poor. Myeloid form is the most common type, and leukemia cutis has been observed in 25-30% of the patients. These skin lesions are defined as ‘blueberry muffin’ type which are blue-violaceous and usually multiple and diffuse nodules. Case Report: She had diffuse blue-violaceous nodules since birth. She hospitalized due to sepsis for 35 days. She was referred to our center with the suspicion of immune deficiency. The initial physical findings were severe pallor, diffuse blue-violaceous subcutanose nodules and hepatosplenomegaly. The leucocyte count was found 363 000/mm3. Acute monositer leukemia (AML-M5 was determined with morphologic and flow cytometric evaluation of the peripheral blood. Conclusion: Congenital leukemia must be thought in differential diagnosis from other underlying disease presenting with blueberry muffin skin lesions. (Jo­ur­nal of Cur­rent Pe­di­at­rics 2012; 10: 103-6

  5. Carcinosarcoma arising from uterine adenomyosis: A case report.

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    Kiuchi, Kaori; Hasegawa, Kiyoshi; Kanamori, Anriko; Machida, Hiromi; Kojima, Masaru; Fukasawa, Ichio

    2016-03-01

    Carcinosarcoma arising from uterine adenomyosis is extremely rare. We encountered such a patient and herein provide a review of the literature. A 56-year-old woman was referred for a huge pelvic tumor, suspected to be an advanced uterine leiomyosarcoma. Intraoperative inspection revealed a mass, mainly located in the uterine myometrium, invading the uterine serosa. The tumor had previously spontaneously ruptured and disseminated to the pelvic cavity. Pathological and immunohistochemical examination revealed an infiltrative pattern of biphasic tumor cells composed of endometrioid adenocarcinoma and a nonepithelial component with rhabdomyosarcomatous differentiation. Benign endometrial glands with stromal cells were found adjacent to the area of the carcinosarcoma. The endometrium and both ovaries and fallopian tubes were microscopically free of tumor cells. The final diagnosis was heterologous type carcinosarcoma with rhabdomyosarcomatous differentiation, originating from uterine adenomyosis. PMID:26663238

  6. Key Features in the Management of Pulmonary Carcinosarcoma

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    Nikolaos Panagiotopoulos

    2016-01-01

    Full Text Available Pulmonary carcinosarcoma represents a category of extremely rare tumours accounting for 0.1% of all lung malignancies. It is defined as a poorly differentiated non-small-cell carcinoma that contains a component of sarcoma or sarcoma-like elements. These biphasic tumours typically have a poor prognosis due to late diagnosis and early metastases. Preoperative tissue diagnosis is usually difficult due to the heterogeneity of the tumour, with biopsies often just reflecting one element of the tumour. By means of a case illustration and review of the literature, we discuss the optimal management of patients with pulmonary carcinosarcoma.

  7. Cardiac tamponade: an initial presentation of SLE

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    Cheng, Wilson; Balachandar, Ramya; Mistry, Paresh

    2013-01-01

    A 45-year-old woman presented with dyspnoea, chest pain, orthopnoea and bilateral leg oedema. On admission, she was found to have nephrotic syndrome and global pericardial effusion with impending tamponade for which pericardiocentesis was performed. The diagnosis of systemic lupus erythematosus was made based on the clinical and biochemical findings. She was also started on dialysis and immunosuppressants for lupus nephritis.

  8. A rare case of true carcinosarcoma of the breast

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    Antonello Accurso

    2016-01-01

    Discussion: The most appropriate therapeutic regimens for breast carcinosarcoma are still unclear because of the rarity of this condition, but Breast Conserving Treatment (BCT followed by adjuvant chemotherapy seems to provide a prognosis equalling that of usual Invasive Ductal Carcinoma of the breast.

  9. Rectal carcinosarcoma: A case report and review of literature

    Institute of Scientific and Technical Information of China (English)

    Dimitrios Konstantinos Tsekouras; Stylianos Katsaragakis; Dimitrios Theodorou; Georgia Kafiri; Fotis Archontovasilis; Panagiotis Giannopoulos; Panagiotis Drimousis; John Bramis

    2006-01-01

    A 60-years old male was admitted to our department for investigation of constipation and hypogastric discomfort intensified during defecation of a few weeks duration.The cause proved to be a rectal carcinosarcoma that was treated by abdominoperineal resection and postoperative chemo-radiotherapy. The patient died 6 months later due to hepatic failure, showing evidence of disseminated disease. In general colonic carcinosarcomas constitute a rare category of malignant neoplasms whose nature is still incompletely understood. No specific treatment guidelines exist. Surgery is the mainstay of treatment and regardless of the addition of adjuvant therapy the prognosis is very poor. Systematic genetic analysis may be the clue for understanding the pathogenesis of these mysterious tumors.

  10. 18F-fluorodeoxyglucose positron emission tomography in uterine carcinosarcoma

    International Nuclear Information System (INIS)

    Uterine carcinosarcomas clinically confined to the uterus usually harbor occult metastases. We conducted a pilot study to evaluate the value of 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) in uterine carcinosarcoma. Patients with histologically confirmed uterine carcinosarcoma were enrolled. Abdominal and pelvic magnetic resonance imaging (MRI)/whole-body computed tomography (CT) scan, and whole-body 18F-FDG PET or PET/CT were undertaken for primary staging, evaluating response, and restaging/post-therapy surveillance. The clinical impact of 18F-FDG PET was determined on a scan basis. A total of 19 patients were recruited and 31 18F-FDG PET scans (including 8 scans performed on a PET/CT scanner) were performed. Positive impacts of scans were found in 36.8% (7/19) for primary staging, 66.7% (2/3) for monitoring response, and 11.1% (1/9) for restaging/post-therapy surveillance. PET excluded falsely inoperable disease defined by MRI in two patients. Aggressive treatment applying to three patients with PET-defined resectable stage IVB disease seemed futile. Two patients died of disease shortly after salvage therapy restaged by PET. With PET monitoring, one stage IVB patient treated by targeted therapy only was alive with good performance. Using PET did not lead to improvement of overall survival of this series compared with the historical control (n = 35) (P 0.779). The preliminary results suggest that 18F-FDG PET is beneficial in excluding falsely inoperable disease for curative therapy and in making a decision on palliation for better quality of life instead of aggressive treatment under the guidance of PET. PET seems to have limited value in post-therapy surveillance or restaging after failure. (orig.)

  11. Identical TP53 mutations in pelvic carcinosarcomas and associated serous tubal intraepithelial carcinomas provide evidence of their clonal relationship.

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    Ardighieri, Laura; Mori, Luigi; Conzadori, Sara; Bugatti, Mattia; Falchetti, Marcella; Donzelli, Carla Maria; Ravaggi, Antonella; Odicino, Franco E; Facchetti, Fabio

    2016-07-01

    Pelvic carcinosarcomas (PCSs) are rare aggressive biphasic tumors that localize in the ovary, fallopian tube, or peritoneum and present frequently as bilateral disease. We undertook a morphological, p53 immunohistochemical and TP53 gene mutational analysis study in a single institution cohort of 16 PCSs in order to investigate the nature of bilateral tumors and to shed light on their origin and pathogenesis. Of the 16 patients, 10 presented with bilateral disease, 6 with a carcinosarcoma in both adnexa, and the remaining cases with a carcinosarcoma in one adnexum and a carcinoma in the opposite. The carcinoma component showed high-grade serous features in 13/16 of cases (81 %). In 10 patients (63 %), a serous tubal intraepithelial carcinoma (STIC) was found, in one case bilateral, making a total of 11 STICs. STIC was found only in cases with a carcinoma component with high-grade serous features. All 10 bilateral tumors and all 11 PCS-associated STICs showed a similar p53 immunostaining pattern. At mutation analysis of the TP53 gene, all five bilateral PCS contained an identical mutation in both localizations. Furthermore, a TP53 mutation was found in 8 of 10 STICs, with an identical mutation in the associated PCS. The finding of similar p53 immunostaining in all bilateral cases and identical TP53 mutations in most PCS-associated STIC provides evidence for a clonal relation between these neoplastic lesions, supporting a metastatic nature of bilateral PCS and suggesting that they have an extraovarian origin in a STIC. PMID:27059324

  12. Pancreatic mass as an initial presentation of severe Wegener's granulomatosis

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    Valerieva, Yana; Golemanov, Branimir; Tzolova, Nadezhda; Mitova, Rumiana

    2013-01-01

    Acute pancreatitis or a pancreatic mass is a very rare initial presentation of Wegener's granu-lomatosis. A 62-year-old woman presented with tumor-like pancreatitis and otitis media Abdominal ultrasound and magnetic resonance suggested the presence of pancreatic tumor. Ultrasound-guided fine needle aspiration was negative. Distal pancreatic resection and splenectomy were performed and histopathology proved Wegener's vasculitis of the pancreas and spleen. Azathioprine and steroids were subsequ...

  13. Histopathological, immunohistochemical and special stain unraveling the enigmatic carcinosarcoma - A case report

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    Moidin Shakil

    2015-01-01

    Full Text Available Carcinosarcoma is an extremely rare, highly malignant tumor having a characteristic of both epithelial and mesenchymal components; the epithelial component exhibiting focal squamous cell carcinoma and mesenchymal component having sarcomatoid stroma. The occurrence of carcinosarcoma in the oral cavity is very rare and only few cases have been reported in the literature, although its occurrence in other parts of the body has been widely reported.

  14. Cardiac Tamponade as Initial Presentation of Hodgkin Lymphoma

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    Adrija Hajra

    2015-01-01

    Full Text Available Cardiac involvement in malignant lymphoma is one of the least investigated subjects. Pericardial effusion is rarely symptomatic in patients of Hodgkin lymphoma (HL. Few case reports are available in the literature. There are case reports of diagnosed HL patients presenting with pericardial effusion. HL patients who present with recurrent episodes of pericardial effusion have also been reported. Pericardial effusion has also been reported in cases of non HL. However, pericardial effusion leading to cardiac tamponade as an initial presentation of HL is extremely rare. Very few such cases are there in the literature. Here, we present a case of a 26-year-old male patient who presented with cardiac tamponade and in due course was found to be a case of classical type of HL. This case is interesting because of its presentation.

  15. Metastatic Renal Cell Carcinoma Initially Presented as a Tongue Mass

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    Altinel, Deniz; Demet ETİT; Tan, Ayça; Ümit BAYOL; Volkan BULUT; Gökçöl Erdoğan, Işın; Beyhan, Rafet; Yusuf YALÇIN

    2010-01-01

    Renal cell carcinoma is one of the most common tumours after lung and breast cancer to metastasize to the head and neck. Initial presentation by tongue metastasis is extremely rare. A 67-year-oldmale presented with a 4.8 cm mass on his tongue. The result of the punch biopsy from the tongue was diagnosed as a clear cell variant of squamous cell carcinoma. The biopsy was reevaluated due to the renal mass found during the check-up and the rapid enlargement of the mass. The excision of the tongue...

  16. Acute anterior uveitis as the initial presentation of alkaptonuria

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    Padhan P

    2009-01-01

    Full Text Available Alkaptonuria is a rare autosomal recessive metabolic disorder that may present with multi-system involvement such as ochronotic arthropathy, renal, urethral and prostatic calculi, cardiac valvular lesions and pigmentation of the skin, sclera, cartilage and other connective tissues. An association of the disease with uveitis has never been reported. We report the first case of alkaptonuria with ochronotic arthropathy presenting with recurrent acute anterior uveitis as the initial manifestation. The possible common link with the HLA-B27 gene is discussed.

  17. Present status of initial core fuel fabrication for the HTTR

    International Nuclear Information System (INIS)

    This paper describes present status of initial core fuel fabrication for the HTTR in Japan. The High Temperature Engineering Test Reactor (HTTR) is being constructed satisfactorily, aiming the first criticality in October 1997. Fuel fabrication for the HTTR was started in June 1995 at Tokai works of Nuclear Fuel Industries, Ltd. (NFI). The fabrication technologies have been developed through cooperation works of NFI and Japan Atomic Energy Research Institute. The initial core fuel of the HTTR consists of 150 fuel assemblies. An HTTR fuel assembly is so-called a pin-in-block type of hexagonal graphite block containing 31 or 33 fuel rods. A fuel rod consists of a graphite sleeve and of 14 fuel compacts. In a fuel compact about 13,000 TRISO coated fuel particles are dispersed densely. Fabrication of the fuel is being carried out at NFI's facility, and a half of the initial fuels have been completed. The results of inspection for the size, the density and the sphericity of coated fuel particle, and the as-manufactured particle failure fractions in fuel compacts, which are most important inspection items from the view point of quality assurance, are quite satisfactory. Transportation and assembling of the fuel rods will be carried out at the reactor site from the middle of 1997. (author)

  18. Metastatic Renal Cell Carcinoma Initially Presented as a Tongue Mass

    Directory of Open Access Journals (Sweden)

    Deniz ALTINEL

    2010-09-01

    Full Text Available Renal cell carcinoma is one of the most common tumours after lung and breast cancer to metastasize to the head and neck. Initial presentation by tongue metastasis is extremely rare. A 67-year-oldmale presented with a 4.8 cm mass on his tongue. The result of the punch biopsy from the tongue was diagnosed as a clear cell variant of squamous cell carcinoma. The biopsy was reevaluated due to the renal mass found during the check-up and the rapid enlargement of the mass. The excision of the tongue mass and the radical nephrectomy material confirmed the diagnosis of a metastatic renal cell carcinoma in the tongue and renal cell carcinoma in the kidney. Since metastasis of renal cell carcinoma to the tongue is uncommon it may cause difficulties in diagnosis and proper management. The metastasis of renal cell carcinoma should always be considered in the differential diagnosis among the clear cell neoplasms.

  19. Abdominal pain as initial presentation of lung cancer

    Science.gov (United States)

    Eisa, Naseem; Alhafez, Bishr; Alraiyes, Abdul Hamid; Alraies, M Chadi

    2014-01-01

    Isolated spleen metastasis (ISM) in general is very rare with a reported incidence of 2.3–7.1% for all solid cancers. Lung cancers rarely metastasise to the spleen. It is very atypical for ISM to be the initial presentation of lung cancer as well. In our case, a 55-year-old woman presented with a 3-week history of left-sided abdominal fullness and dull pain. Workup was remarkable for splenic mass that turns out to be adenocarcinoma with unknown primary tumour. Biopsy of the mass with immunohistochemistry and whole body position emission tomography scan was able to identify lung cancer as the primary tumour. The patient underwent splenectomy, wedge resection of the lung mass along with short-course of chemotherapy. She never had any recurrences since then. PMID:24835801

  20. Cryptogenic Organising Pneumonia As The Initial Presenting Manifestation of SLE

    Directory of Open Access Journals (Sweden)

    Neena Mampilly

    2015-07-01

    Full Text Available Cryptogenic Organising Pneumonia (COP, also called idiopathic Bronchiolitis Obliterans Organising Pneumonia( BOOP, is a distinct entity among the idiopathic interstitial pneumonias defined histopathologically by intraalveolar buds of granulation tissue. The etiology includes idiopathic, infectious, drug induced radiation induced and connective tissue diseases. Organising pneumonia occurs particularly in patients with dermatomyositis-polymyositis where it may be the presenting manifestation, and rarely in SLE, rheumatoid arthritis, scleroderma and other connective tissue diseases. We describe a 30 yr old lady who initially presented with respiratory symptoms, not responding to antibiotics. She was subsequently diagnosed as SLE and HRCT thorax showed consolidation involving both lung fields. A percutaneous lung biopsy revealed features of Cryptogenic Organising Pneumonia.

  1. Fanconi Syndrome: A Rare Initial Presentation of Acute Lymphoblastic Leukemia.

    Science.gov (United States)

    Sahu, Kamal Kant; Law, Arjun Datt; Jain, Nidhi; Khadwal, Alka; Suri, Vikas; Malhotra, Pankaj; Varma, Subhash Chander

    2016-06-01

    A-14-year old boy, presented with a short history of excessive thirst and increased urine output. Clinical examination showed pallor, generalized lymphadenopathy and hepatosplenomegaly. For evaluation of his polyuric state he underwent routine laboratory investigations, including renal function test, acid-base studies, urine analysis. Blood tests suggested hypokalemia, hypouricemia, hypocalcemia and hyperchloremia with normal liver and kidney function tests. The arterial blood gas analysis was suggestive of normal anion gap metabolic acidosis. Urine analysis was suggestive of hyperuricosuria, hypercalciuria and glycosuria with a positive urine anion gap. His hemogram showed pancytopenia with differential count showing 88% blasts. Bone marrow examination and flowcytometry confirmed the diagnosis of B cell acute lymphoblastic leukemia. Hence this case was atypical and very interesting in the sense that the Fanconi syndrome is very rare to be an initial presenting feature of acute lymphoblastic leukemia. The patient was started on oral as well intravenous supplementation with potassium, bicarbonate, calcium and phosphorus. Simultaneously, as per the modified BFM -90 protocol (four drug based regimen-Prednisolone, vincristine, daunorubicin, cyclophosphamide along with l-asparaginase), he was started on induction protocol. By the end of 3rd week of induction therapy, his urine output started normalizing and finally settled at the end of induction therapy. At present he is in the maintenance phase of chemotherapy. PMID:27408343

  2. Memory Impairment at Initial Clinical Presentation in Posterior Cortical Atrophy.

    Science.gov (United States)

    Ahmed, Samrah; Baker, Ian; Husain, Masud; Thompson, Sian; Kipps, Christopher; Hornberger, Michael; Hodges, John R; Butler, Christopher R

    2016-04-23

    Posterior cortical atrophy (PCA) is characterized by core visuospatial and visuoperceptual deficits, and predominant atrophy in the parieto-occipital cortex. The most common underlying pathology is Alzheimer's disease (AD). Existing diagnostic criteria suggest that episodic memory is relatively preserved. The aim of this study was to examine memory performance at initial clinical presentation in PCA, compared to early-onset AD patients (EOAD). 15 PCA patients and 32 EOAD patients, and 34 healthy controls were entered into the study. Patients were tested on the Addenbrooke's Cognitive Examination (ACE-R), consisting of subscales in memory and visuospatial skills. PCA and EOAD patients were significantly impaired compared to controls on the ACE total score (p skills (p skills compared to EOAD patients (p presentation. The findings suggest that memory impairment must be considered in assessment and management of PCA. Further study into memory in PCA is warranted, since the ACE-R is a brief screening tool and is likely to underestimate the presence of memory impairment. PMID:27128371

  3. Curcumin augments the cytostatic and anti-invasive effects of mitoxantrone on carcinosarcoma cells in vitro.

    Science.gov (United States)

    Luty, Marcin; Kwiecień, Edyta; Firlej, Magdalena; Łabędź-Masłowska, Anna; Paw, Milena; Madeja, Zbigniew; Czyż, Jarosław

    2016-01-01

    Numerous adverse effects limit the applicability of mitoxantrone for the treatment of drug-resistant tumors, including carcinosarcoma. Here, we estimated the additive effects of mitoxantrone and curcumin, a plant-derived biomolecule isolated from Curcuma longa, on the neoplastic and invasive potential of carcinosarcoma cells in vitro. Curcumin augmented the cytostatic, cytotoxic and anti-invasive effects of mitoxantrone on the Walker-256 cells. It also strengthened the inhibitory effects of mitoxantrone on the motility of drug-resistant Walker-256 cells that had retained viability after a long-term mitoxantrone/curcumin treatment. Thus, curcumin reduces the effective doses of mitoxantrone and augments its interference with the invasive potential of drug-resistant carcinosarcoma cells. PMID:27390785

  4. Inguinal lymphadenopathy as the initial presentation of sarcoidosis

    OpenAIRE

    George, Jim; Graves, Reese; Meador, Robert

    2013-01-01

    Sarcoidosis is a multisystem disease of unknown etiology characterized by granuloma formation. Despite pulmonary involvement in most patients, sarcoidosis can have a varied presentation. Lymph node involvement is rarely found in isolation. Even rarer are cases of sarcoidosis presenting with peripheral edema. We describe a case of sarcoidosis presenting with isolated unilateral peripheral edema.

  5. Multiple cystic swelling: Initial presentation of multiple myeloma

    OpenAIRE

    Kumar Sunil; Jain A; Waghmare Swati

    2010-01-01

    Multiple myeloma, a disease allied to malignancy of reticuloendothelial cells, is not an uncommon condition. However, the diagnosis is often made quite late because the disease has multiple modes of presentation. We are reporting a case of multiple myeloma in a 55-year-old male who presented with multiple cystic swellings on the chest.

  6. Respiratory symptoms as an initial presentation of choriocarcinoma

    Directory of Open Access Journals (Sweden)

    Ramandeep Singh

    2015-01-01

    Full Text Available Chronic dyspnea, chest pain, cough, and hemoptysis for more than 2 weeks often indicate a diagnosis of infective etiology of the respiratory tract in a tropical country. However, in a young reproductive female, these complaints with an episode of hemoptysis may rarely be the presenting symptomatology of pulmonary metastasis of choriocarcinoma. A young female of reproductive age group presented with hemoptysis, cough, and breathlessness. Chest X-ray revealed bilateral lower lobe opacities. Fine-needle aspiration cytology of the lung lesions depicted choriocarcinoma metastasis. Ultrasonography and magnetic resonance imaging revealed endomyometrial mass lesion suggestive of invasive gestational trophoblastic disease. β hCG levels were high. Dilatation and curettage and histopathological analysis of the mass confirmed the diagnosis of choriocarcinoma. This young female who presented with respiratory complaints was finally diagnosed to be a case of choriocarcinoma with lung metastasis. Therefore, choriocarcinoma metastasis must be considered as a differential diagnosis in a female of childbearing age presenting with respiratory complaints and hemoptysis.

  7. Cryptogenic Organising Pneumonia As The Initial Presenting Manifestation of SLE

    OpenAIRE

    Neena Mampilly; Manoj, G.; Paul, Binoy J.

    2015-01-01

    Cryptogenic Organising Pneumonia (COP), also called idiopathic Bronchiolitis Obliterans Organising Pneumonia( BOOP), is a distinct entity among the idiopathic interstitial pneumonias defined histopathologically by intraalveolar buds of granulation tissue. The etiology includes idiopathic, infectious, drug induced radiation induced and connective tissue diseases. Organising pneumonia occurs particularly in patients with dermatomyositis-polymyositis where it may be the presenting manifestat...

  8. Cloudy corneas as an initial presentation of multiple myeloma

    Directory of Open Access Journals (Sweden)

    Sharma P

    2014-04-01

    Full Text Available Priyanka Sharma,1 Haifa A Madi,1 Richard Bonshek,2 Stephen J Morgan11Sunderland Eye Infirmary, Sunderland, UK; 2National Specialist Ophthalmic Pathology Service, Department of Histopathology, Manchester Royal Infirmary, Manchester, UKSummary: We report a case of previously unsuspected myeloma, presenting with cornea verticillata due to intracorneal paraprotein deposition.History: An 85-year-old female presented via her optician with a 4-month history of cloudy vision. She had undergone an uneventful bilateral phacoemulsification surgery 7 years earlier. Extensive spiraling corneal epithelial opacification was noted on slit-lamp examination. On further investigation, she was found to have a previously unsuspected low-grade multiple myeloma. We established the nature of the corneal deposits with corneal epithelial biopsy histopathology and electron microscopy. It is very rare for multiple myeloma to present in this fashion. Ophthalmologists should be aware that such a presentation may rarely be due to systemic multiple myeloma.Keywords: corneal crystals, multiple myeloma, crystalline keratopathy, vortex keratopathy

  9. Status Cataplecticus as Initial Presentation of Late Onset Narcolepsy

    OpenAIRE

    Panda, Samhita

    2014-01-01

    Narcolepsy, one of the important causes of hypersomnia, is an under diagnosed sleep disorder. It has a bimodal age of onset around 15 and 35 years. It is characterized by the tetrad of excessive daytime sleepiness, cataplexy, hypnagogic/ hypnopompic hallucinations, and sleep paralysis. Cataplexy is by far the most predictive feature of narcolepsy. Status cataplecticus is the occurrence of cataplexy repeatedly for hours or days, a rare presentation of narcolepsy. This report describes an elder...

  10. Kaposi sarcoma as initial presentation of HIV infection

    Directory of Open Access Journals (Sweden)

    Bhushan Malhari Warpe

    2014-01-01

    Full Text Available Context: Kaposi′s sarcoma (KS, a vascular tumor that manifests as nodular lesions on the skin and to a lesser extent, the visceral organs, is the most common neoplasm encountered in human immunodeficiency virus (HIV-infected patients. It consists of an angiosarcomatous change of not only the epithelial and mucous membrane-associated connective tissue in various sites, for example, skin, gastrointestinal system, lungs, and so on, but may also involve non-epithelial organs, such as lymph nodes. Surgical excision is the line of management for the tumor. Case Report: We present one case of a 65-year-old heterosexual Indian male, clinically unsuspected for acquired immunodeficiency syndrome (AIDS who presented with multiple non-blanching, bluish-red nodules on all extremities, chest, back and bilateral submandibular and cervical lymphadenopathy. Fine needle aspiration cytology (FNAC was performed from subcutaneous nodule and lymph node. Smears showed hypercellular plump spindle cell groups in a hemorrhagic background. Diagnosis was given as low-grade spindle cell neoplasm consistent with KS, which was later confirmed on histopathology. Conclusion: The first line diagnostic aid of FNAC has several advantages over the traditional biopsy in testing such vascular tumors. The latter is generally needed for confirmation of KS. However, FNAC of such vascular tumors has advantages of better patient compliance, ease of procedure, no recurrences, and safety in immuno-compromised patients. Ancillary studies can be done on aspirates along with polymerase chain reaction (PCR amplification techniques in confirming the detection of associated human herpes virus-8 (HHV-8 infection with KS.

  11. Carcinosarcoma of the colon: report of a case with morphological, ultrastructural and molecular analysis

    International Nuclear Information System (INIS)

    Carcinosarcoma of the colon is a rare histopathological entity with uncertain histogenesis, that shows both epithelial and mesenchymal malignant differentiation. Carcinosarcoma rarely affects the gastrointestinal tract and only few cases are reported in the colon. Herein we describe a carcinosarcoma of the ascending colon, with morphological, ultrastructural and molecular analysis. An 81-year-old man was hospitalised for asthenia, weight loss and iron-deficiency anaemia. The patient underwent colonoscopy and adenocarcinoma was diagnosed by endoscopic biopsy. A right hemicolectomy was performed and, during surgical operation, liver metastases were detected. Histological examination of the surgical specimen revealed areas of both carcinomatous and sarcomatous differentiation, completely separated by fibrous septae. The sarcomatous component exhibited areas of smooth muscle and osteoblastic differentiation, with focal osteoid material deposition. Molecular analysis conducted separately on the epithelial and mesenchymal components revealed the same p53 gene mutation (R282W in exon 8) and identical polymorphisms in p53 exon 4, in EGFR exons 20 and 21, and in c-kit exon 17. Microsatellite markers analysis revealed a common loss of heterozygosis on 18q. Overall, the data are consistent with a common origin of the two tumor components. The patient was treated with 8 cycles of oral capecitabine (1250 mg/m2 twice a day for 14 days repeated every 28 days) and two years after surgery is alive with liver metastases. Carcinosarcoma of the colon is a rare tumour with both epithelial and sarcomatous components. Molecular analysis of the current case suggests the histogenesis from a common cell progenitor

  12. HER2/neu as a potential target for immunotherapy in gynecological carcinosarcomas

    Science.gov (United States)

    Guzzo, Federica; Bellone, Stefania; Buza, Natalia; Hui, Pei; Carrara, Luisa; Varughese, Joyce; Cocco, Emiliano; Betti, Marta; Todeschini, Paola; Gasparrini, Sara; Schwartz, Peter E.; Rutherford, Thomas J.; Angioli, Roberto; Pecorelli, Sergio; Santin, Alessandro D.

    2011-01-01

    Carcinosarcomas of the female genital tract are rare tumors with aggressive clinical behavior. Trastuzumab, a humanized monoclonal antibody, acts by binding to HER2/neu extracellular domain and exhibits therapeutic efficacy in HER2/neu over-expressing cancers. Two uterine carcinosarcomas (UMMT-ARK-1, UMMT-ARK-2) and two ovarian carcinosarcomas (OMMT-ARK-1, OMMT-ARK-2) were established as primary tumor cell lines in vitro and evaluated for HER2/neu expression by immunohistochemistry (IHC), fluorescent-in-situ-hybridization-analysis (FISH), quantitative-real-time-polymerase-chain-reaction and for membrane-bound-complement-regulatory-proteins (mCRP) CD46, CD55 and CD59 by flow-cytometry. Sensitivity to trastuzumab-dependent-cell-mediated-cytotoxicity (ADCC) and complement-dependent-cytotoxicity (CDC) was studied in 5-hour-chromium-release-assays. HER2/neu expression was demonstrated in OMMT-ARK-1 and OMMT-ARK-2. OMMT-ARK-2 demonstrated amplification of the c-erbB2 gene by FISH and a high sensitivity to ADCC (mean killing 45.6%; range: 32.3–72.6%). Lower level of killing was detected against the FISH-negative OMMT-ARK-1 cell line (mean 26.5%; range: 21.0–31.8%). CD46, CD55 and CD59 mCRP were expressed at high levels in all primary MMT cell lines and all these tumors were found highly resistant to CDC with or without trastuzumab. Addition of untreated and heat-inactivated-plasma did not significantly decrease ADCC against OMMT-ARK-2 cell line suggesting that while the cell line is highly resistant to complement, irrelevant IgG do not significantly alter the ability of trastuzumab to mediate ADCC. Our results suggest that HER2/neu may represent a novel target for the immunotherapy of a subset of human carcinosarcomas refractory to salvage chemotherapy. PMID:22498937

  13. Carcinosarcoma of monoclonal origin arising in a dermoid cyst of ovary: a case report

    International Nuclear Information System (INIS)

    Transformation of a cystic benign teratoma of the ovary into a 'carcinosarcoma' has very rarely been reported and its histogenetic origin is still debated. A case of carcinosarcoma arising from a dermoid cyst is reported. The tumor showed cystic areas delimited by normal squamous epithelium, with transitional areas through dysplastic epithelium to 'in situ' and infiltrating squamous cell carcinoma (SCC). The sarcomatous component showed compact tissue composed of round cells concentrically arranged around small vessels, spindle, and pleomorphic cells with a high nuclear-cytoplasmic ratio. Positive staining for vimentin, alpha smooth muscle actin and CD10, as well as P53 and P63, was found in the sarcomatous component and in some atypical basal cells of the squamous epithelium, which also showed the usual epithelial markers. To the best of our knowledge, this is the first case of carcinosarcoma arising from a dermoid cyst in which a histogenetic origin from totipotent stem cells, located in the basal squamous layer, is supported by immunohistochemical findings

  14. Uterine Carcinosarcoma Confined to the Pelvis: A Retrospective Review and Outcome Analysis

    International Nuclear Information System (INIS)

    Objective. We compared the treatments of uterine carcinosarcoma at our institution and evaluated their impact on survival. Methods. A retrospective analysis was performed on 60 eligible patients with carcinosarcoma limited to the pelvis. Subjects were divided into four categories: surgery, surgery plus chemotherapy, surgery plus radiation therapy, and a combination of surgery, chemotherapy, and RT. The most commonly used chemotherapy was cisplatin and/or carboplatin and taxol. Radiotherapy included external beam radiation therapy (EBRT) alone or with high dose rate (HDR) brachytherapy or HDR brachytherapy alone. Survival probability data were computed using the Kaplan-Meier method. The differences between groups were compared using the log-rank test. Results. The combination of surgery and radiation therapy with or without chemotherapy is seen to improve overall survival (OS) compared to surgery alone (Ρ =0.044 and Ρ =0.028 resp.). Brachytherapy involving three HDR vaginal cylinder fractions shows an equally effective reduction in local recurrence compared to EBRT. Conclusion. Our study of a relatively large number of carcinosarcoma patients suggests that adjuvant radiation therapy improves OS compared to surgery alone. Brachytherapy with 3 HDR vaginal cylinder fractions is preferred because of its time-saving, better tolerance, low toxicity and equivalent OS, and local control compared to EBRT.

  15. Uterine Carcinosarcoma Confined to the Pelvis: A Retrospective Review and Outcome Analysis

    Directory of Open Access Journals (Sweden)

    Hualei Li

    2014-01-01

    Full Text Available Objective. We compared the treatments of uterine carcinosarcoma at our institution and evaluated their impact on survival. Methods. A retrospective analysis was performed on 60 eligible patients with carcinosarcoma limited to the pelvis. Subjects were divided into four categories: surgery, surgery plus chemotherapy, surgery plus radiation therapy, and a combination of surgery, chemotherapy, and RT. The most commonly used chemotherapy was cisplatin and/or carboplatin and taxol. Radiotherapy included external beam radiation therapy (EBRT alone or with high dose rate (HDR brachytherapy or HDR brachytherapy alone. Survival probability data were computed using the Kaplan-Meier method. The differences between groups were compared using the log-rank test. Results. The combination of surgery and radiation therapy with or without chemotherapy is seen to improve overall survival (OS compared to surgery alone (P=0.044 and P=0.028, resp.. Brachytherapy involving three HDR vaginal cylinder fractions shows an equally effective reduction in local recurrence compared to EBRT. Conclusion. Our study of a relatively large number of carcinosarcoma patients suggests that adjuvant radiation therapy improves OS compared to surgery alone. Brachytherapy with 3 HDR vaginal cylinder fractions is preferred because of its time-saving, better tolerance, low toxicity and equivalent OS, and local control compared to EBRT.

  16. The Haiti Breast Cancer Initiative: Initial Findings and Analysis of Barriers-to-Care Delaying Patient Presentation

    Directory of Open Access Journals (Sweden)

    Ketan Sharma

    2013-01-01

    Full Text Available Background. In Haiti, breast cancer patients present at such advanced stages that even modern therapies offer modest survival benefit. Identifying the personal, sociocultural, and economic barriers-to-care delaying patient presentation is crucial to controlling disease. Methods. Patients presenting to the Hôpital Bon Sauveur in Cange were prospectively accrued. Delay was defined as 12 weeks or longer from initial sign/symptom discovery to presentation, as durations greater than this cutoff correlate with reduced survival. A matched case-control analysis with multivariate logistic regression was used to identify factors predicting delay. Results. Of N=123 patients accrued, 90 (73% reported symptom-presentation duration and formed the basis of this study: 52 patients presented within 12 weeks of symptoms, while 38 patients waited longer than 12 weeks. On logistic regression, lower education status (OR = 5.6, P=0.03, failure to initially recognize mass as important (OR = 13.0, P<0.01, and fear of treatment cost (OR = 8.3, P=0.03 were shown to independently predict delayed patient presentation. Conclusion. To reduce stage at presentation, future interventions must educate patients on the recognition of initial breast cancer signs and symptoms and address cost concerns by providing care free of charge and/or advertising that existing care is already free.

  17. HER2/neu as a potential target for immunotherapy in gynecologic carcinosarcomas.

    Science.gov (United States)

    Guzzo, Federica; Bellone, Stefania; Buza, Natalia; Hui, Pei; Carrara, Luisa; Varughese, Joyce; Cocco, Emiliano; Betti, Marta; Todeschini, Paola; Gasparrini, Sara; Schwartz, Peter E; Rutherford, Thomas J; Angioli, Roberto; Pecorelli, Sergio; Santin, Alessandro D

    2012-05-01

    Carcinosarcomas of the female genital tract are rare tumors with an aggressive clinical behavior. Trastuzumab, a humanized monoclonal antibody, acts by binding to HER2/neu extracellular domain and exhibits therapeutic efficacy in HER2/neu-overexpressing cancers. Two uterine carcinosarcomas (UMMT-ARK-1, UMMT-ARK-2) and 2 ovarian carcinosarcomas (OMMT-ARK-1, OMMT-ARK-2) were established as primary tumor cell lines in vitro and evaluated for HER2/neu expression by immunohistochemistry, fluorescent in situ hybridization analysis, quantitative real-time polymerase chain reaction, and for membrane-bound complement regulatory proteins CD46, CD55, and CD59 by flow cytometry. Sensitivity to trastuzumab-dependent cell-mediated cytotoxicity (ADCC) and complement-dependent cytotoxicity was studied in 5-hr chromium release assays. HER2/neu expression was demonstrated in OMMT-ARK-1 and OMMT-ARK-2. OMMT-ARK-2 demonstrated an amplification of the c-erbB2 gene by fluorescent in situ hybridization analysis and a high sensitivity to ADCC (mean killing, 45.6%; range, 32.3%-72.6%). A lower level of killing was detected against the fluorescent in situ hybridization analysis-negative OMMT-ARK-1 cell line (mean, 26.5%; range, 21.0%-31.8%). CD46, CD55, and CD59 membrane-bound complement regulatory proteins were expressed at high levels in all primary mixed müllerian tumor cell lines, and all these tumors were found to be highly resistant to complement-dependent cytotoxicity with or without trastuzumab. Addition of untreated and heat-inactivated plasma did not significantly decrease ADCC against OMMT-ARK-2 cell line, suggesting that while the cell line is highly resistant to complement, irrelevant IgG does not significantly alter the ability of trastuzumab to mediate ADCC. Our results suggest that HER2/neu may represent a novel target for the immunotherapy of a subset of human carcinosarcomas refractory to salvage chemotherapy. PMID:22498937

  18. Pulmonary Kaposi's sarcoma as the initial presentation of human immunodeficiency virus infection

    OpenAIRE

    Tasnim F. Imran; Ziyaad Al-Khateeb; Jin Jung; Stephen Peters; Lisa L. Dever

    2014-01-01

    Kaposi's sarcoma (KS) usually presents in HIV-infected patients with cutaneous lesions that may advance to extensive visceral disease. There have been only a few documented cases in which the initial presentation of Kaposi's sarcoma involved the bronchopulmonary system. We describe a newly diagnosed patient who presented with pulmonary KS as his initial presentation of the disease. Our report is intended to increase clinicians’ awareness that pulmonary Kaposi's sarcoma should be considered in...

  19. The Haiti Breast Cancer Initiative: Initial Findings and Analysis of Barriers-to-Care Delaying Patient Presentation

    Science.gov (United States)

    Sharma, Ketan; Costas, Ainhoa; Damuse, Ruth; Hamiltong-Pierre, Jean; Pyda, Jordan; Ong, Cecilia T.; Shulman, Lawrence N.; Meara, John G.

    2013-01-01

    Background. In Haiti, breast cancer patients present at such advanced stages that even modern therapies offer modest survival benefit. Identifying the personal, sociocultural, and economic barriers-to-care delaying patient presentation is crucial to controlling disease. Methods. Patients presenting to the Hôpital Bon Sauveur in Cange were prospectively accrued. Delay was defined as 12 weeks or longer from initial sign/symptom discovery to presentation, as durations greater than this cutoff correlate with reduced survival. A matched case-control analysis with multivariate logistic regression was used to identify factors predicting delay. Results. Of N = 123 patients accrued, 90 (73%) reported symptom-presentation duration and formed the basis of this study: 52 patients presented within 12 weeks of symptoms, while 38 patients waited longer than 12 weeks. On logistic regression, lower education status (OR = 5.6, P = 0.03), failure to initially recognize mass as important (OR = 13.0, P educate patients on the recognition of initial breast cancer signs and symptoms and address cost concerns by providing care free of charge and/or advertising that existing care is already free. PMID:23840209

  20. Amyotrophic Lateral Sclerosis Presenting Respiratory Failure as the Sole Initial Manifestation

    OpenAIRE

    Tateno, Fuyuki; Sakakibara, Ryuji; Kawashima, Kengo; Kishi, Masahiko; Tsuyusaki, Yohei; Aiba, Yosuke; Ogata, Tsuyoshi

    2014-01-01

    It is rare that amyotrophic lateral sclerosis (ALS) presents with respiratory failure as the sole initial manifestation. A 72-year-old man with mild chronic obstructive pulmonary disease developed exertional dyspnea for 13 months. He then progressed to limb weakness that led to the diagnosis of ALS. Although rare, ALS can present with respiratory failure as the sole initial manifestation more than 1 year prior to limb weakness.

  1. Presence of both Mesenchymal and Carcinomatous Features in an In-vitro Model of Ovarian Carcinosarcoma Derived from Patients' Ascitic Fluid

    OpenAIRE

    2015-01-01

    ABSTRACT We have refined the technique for isolating and propagating cultures of primary ovarian carcinosarcoma cells (OSCs) derived from ascites, which allowed the cells to obtain the biphasic features of carcinosarcoma in cell culture conditions (presence of both carcinoma and mesenchymal morphologic types). This protocol involves a simple yet rapid method for the growth and propagation of ascites OSC in a basal culture medium. Autologous ascitic fluid was used as source of growth factors, ...

  2. Cauda equina syndrome as the initial presenting clinical feature of medulloblastoma: a case report

    Directory of Open Access Journals (Sweden)

    Al-Otaibi Faisal

    2012-05-01

    Full Text Available Abstract Introduction Medulloblastoma is one of the most common pediatric brain malignancies. The usual presenting clinical features are related to posterior fossa syndrome or/and hydrocephalus. Cauda equina syndrome is a very rare presentation for this disease. Case presentation We describe the case of a three-year-old boy with cauda equina syndrome as the initial presenting clinical feature for medulloblastoma. He was initially diagnosed as having a spinal tumor by magnetic resonance imaging scan. Subsequently, a cranial magnetic resonance imaging scan revealed a posterior fossa tumor with features of dissemination. He had substantial improvement after treatment. This case report is complemented by a literature review related to this unusual presentation. Conclusions Medulloblastoma primarily presenting with cauda equina syndrome is very rare. However, spinal drop metastasis should be considered in the pediatric age group to avoid suboptimal management.

  3. Radiology of Fractures in Intoxicated Emergency Department Patients: Locations, Mechanisms, Presentation, and Initial Interpretation Accuracy

    OpenAIRE

    MORITA, Yuka; Nozaki, Taiki; Starkey, Jay; Okajima, Yuka; Ohde, Sachiko; Matsusako, Masaki; Yoshioka, Hiroshi; Saida, Yukihisa; Kurihara, Yasuyuki

    2015-01-01

    Abstract The purpose of this study was to investigate the relationship of alcohol intoxication to time-to-presentation following injury, fracture type, mechanism of injury leading to fracture, and initial diagnostic radiology interpretation performance of emergency physicians versus diagnostic radiologists in patients who present to the emergency department (ED) and are subsequently diagnosed with fracture. Medical records of 1286 patients who presented to the ED and were diagnosed with fract...

  4. Lower extremity necrotizing fasciitis: A unique initial presentation of Crohn's disease

    Directory of Open Access Journals (Sweden)

    Anna Weiss

    2015-09-01

    Full Text Available Crohn's disease is a disease of the bowel, typically presenting with diarrhea, weight loss, and abdominal pain. Complications such as abscesses, fistulas, and strictures may require surgical intervention. We would like to report a patient with Crohn's disease who presented for the first time with left lower extremity necrotizing fasciitis. There are very few reports of necrotizing fasciitis in Crohn's disease as the initial presentation.

  5. [Hydrocephalus as initial presentation of a spinal cord tumour in a child

    DEFF Research Database (Denmark)

    Jorgensen, L.M.; Nysom, K.; Lavard, L.D.

    2008-01-01

    We report a previously healthy two-year-old girl who initially presented with signs of increased intracranial pressure of vomiting, lethargy and unstable gait. She had communicating hydrocephalus and a ventriculoperitoneal shunt was placed. Two years later the girl developed signs of myelopathy and...

  6. A neonatal case of chronic granulomatous disease, initially presented with invasive pulmonary aspergillosis.

    Science.gov (United States)

    Saito, Sachiko; Oda, Arata; Kasai, Masashi; Minami, Kisei; Nagumo, Haruo; Shiohara, Masaaki; Ogiso, Yoshifumi; Kawakami, Yoshiyuki

    2014-03-01

    Chronic granulomatous disease (CGD) often presents with infectious illness, such as repeating bacterial and fungal infections, due to the inability to generate superoxide, which would destroy certain infectious pathogens, and is usually diagnosed in childhood. We describe a CGD case diagnosed in neonatal period, who initially presented with invasive aspergillosis. Neonatal invasive pulmonary aspergillosis is very rare and, to the best of our knowledge, this might be the youngest case in Japan. PMID:24674387

  7. Sternal metastasis as an initial presentation of renal cell carcinoma: a case report

    OpenAIRE

    Batista, Raquel Ribeiro; Marchiori, Edson; Takayassu, Tatiana Chinem; Cabral, Fernanda Caseira; Cabral, Rafael Ferracini; Zanetti, Gláucia

    2009-01-01

    Renal cell carcinoma accounts for 85% of all solid renal tumors in adults. Nearly one quarter of patients has distant metastasis at presentation while another 50% develop metastasis during follow-up. A small percentage of these are solitary metastasis. We report here a case of solitary bone sternal metastasis as an initial presentation of clear-cell renal cell carcinoma in a 56-year-old woman. The prognosis for patients with metastasized renal cell carcinoma is poor; treatment of metastasis i...

  8. Pulmonary Langerhans cell histiocytosis: the many faces of presentation at initial CT scan

    OpenAIRE

    Castoldi, M. C.; A. Verrioli; De Juli, E.; Vanzulli, A.

    2014-01-01

    Objectives Pulmonary Langerhans cell histiocytosis (PLCH) is a rare interstitial granulomatous disease that usually affects young adults who are smokers. Chest computed tomography (CT) allows a confident diagnosis of PLCH only in typical presentation, when nodules, cavitated nodules and cysts coexist and predominate in the upper and middle lungs. Methods This article includes a pictorial essay of typical and atypical presentations of PLCH at initial chest CT. Various appearances of PLCH are i...

  9. Acute Transverse Myelitis (Ascending Myelitis) as the Initial Manifestation of Japanese Encephalitis: A Rare Presentation

    OpenAIRE

    Varshney Ankur Nandan; Kumar Nilesh; Behera Dibyaranjan; Tiwari Ashutosh; Anand Ravi; Anand Arvind

    2013-01-01

    Japanese encephalitis, an inflammatory brain disease prevalent in Southeast Asia, usually presented with fever, headache, convulsions, brain stem signs with pyramidal and extrapyramidal features, and altered sensorium. Acute transverse myelitis, as the initial manifestation of Japanese encephalitis, is an unusual manifestation and is seldom reported. We hereby report a case of 13-year-old adolescent boy who presented to us with fever and acute onset paraparesis with urinary retention initiall...

  10. IAEA Technical Meeting on Status of IAEA Fast Reactor Knowledge Preservation Initiative. Presentations

    International Nuclear Information System (INIS)

    The objectives of the technical meeting were to: • exchange information between the Member States/International Organizations on national and international initiatives addressing knowledge preservation and data retrieval/collection in the field of fast neutron systems; • present and discuss the Member States’/International Organizations’ policies and conditions for releasing to the IAEA both publicly available and confidential information on fast neutron systems; • collect data on fast neutron systems provided by participating Member States/International Organizations and encourage participants to contribute in data collection; • provide recommendations for further IAEA initiatives in the field of fast reactor knowledge preservation

  11. Painless Legs and Moving Toes as an Initial Presentation of Ischemic Stroke

    Directory of Open Access Journals (Sweden)

    Se Mi Oh

    2009-05-01

    Full Text Available Painless legs and moving toes is an unusual syndrome, which has not previously been reported as an initial presentation of ischemic stroke. We encountered a 78-year-old woman who developed dysarthria and involuntary movement of her left toes that was clinically regarded as painless legs and moving toes. These symptoms appeared abruptly and simultaneously as the initial symptoms of stroke, and improved gradually with conservative management by intravenous hydration for a month. We suggest that, in our case, a cortical brain lesion caused by ischemic stroke might be associated with the development of painless legs and moving toes.

  12. Chronic inflammatory demyelinating polyneuropathy-like neuropathy as an initial presentation of Crohn’s disease

    OpenAIRE

    Kim, Suji; Kang, Seok-Jae; Oh, Ki-Wook; Ahn, Byung Kyu; Lee, Hang Lak; Han, Dong Soo; Jang, Kiseok; Kim, Young Seo

    2015-01-01

    Background Chronic inflammatory demyelinating polyneuropathy (CIDP) is a rare complication of Crohn's disease (CD), and it is uncertain whether it is associated with CD itself or with its treatment. We describe a case of CIDP-like neuropathy as an initial symptom of CD. The neurologic symptoms of the patient which responded partially to intravenous immunoglobulin (IVIG) recovered after resection of the appendiceal CD. Case presentation A 17-year-old male had experienced three separate attacks...

  13. Acute embolic cerebral ischemia as an initial presentation of polycythemia vera: a case report

    OpenAIRE

    Zoraster, Richard M; Rison, Richard A

    2013-01-01

    Introduction Patients with polycythemia vera are at high risk for vaso-occlusive events including cerebral ischemia. Although unusual, acute ischemic stroke may be an initial presentation of polycythemia vera. It had been previously assumed that cerebral ischemic events were due to increased blood viscosity and platelet activation within the central nervous system arterial vessels. However, there are now a few isolated case reports of probable micro-embolic events originating from outside of ...

  14. Relationship between initial clinical presentation and the molecular cytogenetic classification of myeloma

    OpenAIRE

    Greenberg, Alexandra J; Rajkumar, S. Vincent; Therneau, Terry M.; Singh, Preet P; Dispenzieri, Angela; Kumar, Shaji K.

    2013-01-01

    Multiple Myeloma (MM) consists of several distinct cytogenetic subtypes, and we hypothesized that each subtype may have a unique mode of initial presentation and end-organ damage. We studied 484 patients with newly diagnosed MM were to determine the relationship between specific myeloma-defining event (MDE) and the cytogenetic subtype. Patients were divided into 4 non-overlapping groups based on the MDE at diagnosis: isolated renal failure, isolated anemia, isolated lytic bone disease, or a c...

  15. Tongue metastasis as an initial presentation of renal cell carcinoma: a case report and literature review

    OpenAIRE

    Azam Faisal; Abubakerr Muneer; Gollins Simon

    2008-01-01

    Abstract Introduction Primary tumour of the kidney metastasizing to the tongue is very unusual and only anecdotal cases have been reported. An exhaustive literature review covering the period from 1911 onwards disclosed 28 cases. Out of those, only 3 cases presented initially with tongue metastases before the diagnosis of primary renal cell carcinoma. The prognosis for patients with lingual metastasis of renal cell carcinoma is poor. Treatment of tongue metastasis is usually palliative and ai...

  16. Digital Acrometastasis as Initial Presentation in Carcinoma of Lung A Case Report and Review of Literature.

    Science.gov (United States)

    Sahoo, Tapan Kumar; Das, Saroj Kumar; Majumdar, Saroj Kumar Das; Senapati, Surendra Nath; Parida, Dillip Kumar

    2016-06-01

    Bony metastases develop in 30% of all the cancers, but out of which only 1% to 3% occurs in the hand. Lung is the most common site for acrometastasis, followed by breast and renal cell cancer. Metastases to the digits are with non-specific presentation. We reported a case of 79-year-old male patient with initial presentation of swelling over left index finger, which was found to be squamous cell carcinoma of finger on histopathological examination. He was subsequently diagnosed as a case of squamous cell carcinoma of lung with acrometastasis. PMID:27504389

  17. Optimizing management in autoimmune hepatitis with liver failure at initial presentation

    Institute of Scientific and Technical Information of China (English)

    Jonathan R Potts; Sumita Verma

    2011-01-01

    Autoimmune hepatitis (AIH) is a disease of unknown etiology, its hallmark being ongoing hepatic inflamma-tion. By its very nature, it is a chronic condition, al-though increasingly, we are becoming aware of patients with acute presentations, some of whom may have liver failure. There are very limited published data on patients with AIH with liver failure at initial diagnosis, which consist mostly of small retrospective studies. As a consequence, the clinical features and optimal management of this cohort remain poorly defined. A subset of patients with AIH who present with liver failure do respond to corticosteroids, but for the vast majority, an urgent liver transplantation may offer the only hope of long-term survival. At present, there is uncertainty on how best to stratify such a cohort into responders and non-responders to corticosteroids as soon as possible after hospitalization, thus optimizing their management. This editorial attempts to answer some of the unre-solved issues relating to management of patients with AIH with liver failure at initial presentation. However, it must be emphasized that, at present, this editorial is based mostly on small retrospective studies, and it is an understatement that multicenter prospective studies are urgently needed to address this important clinical issue.

  18. Bilateral Pleural Effusions as an Initial Presentation in Primary Sjögren’s Syndrome

    Directory of Open Access Journals (Sweden)

    Go Makimoto

    2012-01-01

    Full Text Available Sjögren’s syndrome (SS is a systemic autoimmune disease characterized by sicca symptoms. Interstitial pulmonary fibrosis and tracheobronchial sicca are the most common symptoms of pulmonary involvement in primary SjS, and they are rarely accompanied by serositis such as pleuritis or pericarditis. We report a case of SS presenting initially with bilateral pleural effusions. A 63-year old man was admitted to our hospital with a one-month history of cough, dyspnea, and right chest pain. Chest-computed tomography revealed bilateral pleural effusions. Serum anti-SS-A antibody titer was 1 : 256. Ophthalmological examination revealed a positive Schirmer test. Lip biopsy showed atrophy and plasmacytic infiltration of the salivary gland. Corticosteroid treatment was initiated. Pleural effusions were almost completely resolved by day 30. The patient has not experienced any recurrence.

  19. CLL/SLL with initial presentation as a longstanding cutaneous plaque: a rare case.

    Science.gov (United States)

    Fulton, Edward; Alapat, Daisy; Mabry, Andrea; Gao, Ling; Shalin, Sara C

    2016-08-01

    While chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) is the most common leukemia in the western world, it uncommonly initially presents as a cutaneous lesion. When it does, it is often found incidentally in the context of another distinct lesion. We present a case of CLL/SLL that initially presented as a solitary nodular erythematous plaque on the left flank of a healthy 60-year-old man without lymphadenopathy or constitutional symptoms. The lesion had been present for many years, but had recently begun to grow and become pruritic and painful. Excisional biopsy revealed a large nodular aggregate of variably sized CD20(dim), CD5(+), CD23(+), BCL-2(+) atypical lymphocytes in the dermis without epidermotropism. The lymphocytes were negative for BCL-1/cyclinD1, BCL-6, and CD10, and no other background lesion was identified. This constellation of biopsy findings was consistent with CLL/SLL. This case emphasizes the potential for involvement by CLL/SLL in the cutaneous biopsies of otherwise asymptomatic patients. PMID:27147484

  20. Direct Liver Invasion from a Gastric Adenocarcinoma as an Initial Presentation of Extranodal Tumor Spread

    Directory of Open Access Journals (Sweden)

    Mitanshu Shah

    2012-01-01

    Full Text Available Gastric cancer often carries a poor prognosis, with an estimated 740,000 deaths from the malignancy occurring yearly worldwide (Dicken et al., 2005. The mortality of disease is largely dependent on the extent of tumor spread, as gastric cancer has a predilection to metastasize to other visceral secondaries via hematogenous and lymphatic dissemination. Direct invasion of a gastric adenocarcinoma to adjacent organs secondary to gastric wall perforation does occur; however, it is often present in the setting of advanced disease. Rarely does direct tumor invasion to adjacent organs from a gastric adenocarcinoma present as the initial manifestation of extranodal tumor spread. We present a case of a 40-year-old male with direct tumor extension to the liver as an initial presentation of extranodal tumor spread from a gastric adenocarcinoma. Clinicians should be aware of such an occurrence, as treatment modalities in direct liver extension from a gastric adenocarcinoma vary and may be directed towards palliation rather than curative intent.

  1. Spontaneous acute subdural hematoma as an initial presentation of choriocarcinoma: A case report

    Directory of Open Access Journals (Sweden)

    Rocque Brandon G

    2008-06-01

    Full Text Available Abstract Introduction Diverse sequelae of central nervous system metastasis of choriocarcinoma have been reported, including infarction, intra or extra axial hemorrhages, aneurysm formation and carotid-cavernous fistula. Here we report a case of subdural hematoma as the first presentation of choriocarcinoma. Case presentation The patient is a 34-year-old woman whose initial presentation of widely metastatic choriocarcinoma was an acute subdural hematoma, requiring decompressive craniectomy. Histopathologic examination of the tissue showed no evidence of choriocarcinoma, but the patient was found to have diffuse metastatic disease and cerebrospinal fluid indices highly suggestive of intracranial metastasis. Conclusion Choriocarcinoma frequently metastasizes intracranially. We review the diverse possible manifestations of this process. In addition, the cerebrospinal fluid:serum beta-human chorionic gonadotropin ratio is an important factor in diagnosing these cases. Finally, the role of the neurosurgeon is discussed.

  2. Bilious pericardial effusion at initial presentation in a patient with lung cancer

    Directory of Open Access Journals (Sweden)

    Kostikas Konstantinos

    2003-11-01

    Full Text Available Abstract Background Cardiac tamponade as the initial manifestation of metastatic cancer is a rare clinical entity. Furthermore, a thoraco-biliary fistula is another rare complication of echinococcosis due to rupture of hydatid cysts located at the upper surface of the liver to the pleural or pericardial cavity. We report a case of non-small cell lung cancer with a coexisting hepatic hydatid cyst presenting as a bilious pericardial effusion. Case report A 66-year-old patient presented with cardiac tamponade of unknown origin. Chest CT-scan demonstrated a left central lung tumor, a smaller peripheral one, bilateral pleural effusions and a hydatid cyst on the dome of the liver in close contact to the diaphragm and pericardium. Pericardiotomy with drainage was performed, followed by bleomycin pleurodesis. The possible mechanism for the bilious pericardial effusion might be the presence of a pericardio-biliary fistula created by the hepatic hydatid cyst. Conclusions This is the first case of a bilious pericardial effusion at initial presentation in a patient with lung cancer with coexisting hepatic hydatid cyst.

  3. Gastric cryptococcal infection as an initial presentation of AIDS:a rare case report

    Institute of Scientific and Technical Information of China (English)

    Rupashree Sundar; Lakshmi Rao; Geetha Vasudevan; Pruthvi Baise Chandrappa Gowda; Rau Neeleshwar Radhakrishna

    2011-01-01

    Cryptococcus neoformans has been recognized as a human pathogen over centuries. This has achieved new prominence in the recent years as it is an opportunistic fungi causing fatal, deep mycotic infections in immunocompromised states. Although cryptococcus is principally a pathogen of central nervous system, wide variety of other organs may also be involved. Gastrointestinal cryptococcosis is rarely reported either as an isolated finding or in a disseminated disease. However, even with the strikingly increased incidence of the disease, occurrence of obvious gastrointestinal symptoms directly attributable to cryptococcosis is outstandingly rare. We report a case of gastric cryptococcal infection with esophageal herpes as an initial presentation in an AIDS patient.

  4. Initial presentation of CNS-restricted acute lymphoblastic B cell leukaemia as peripheral polyneuropathy.

    Science.gov (United States)

    Piovezani Ramos, Guilherme; Villasboas Bisneto, Jose C; Chen, Dong; Pardanani, Animesh

    2016-01-01

    We report a case of a 58-year-old woman who presented with a 1-month course of progressive lower and upper extremity weakness in addition to binocular diplopia. Diagnostic lumbar puncture revealed atypical lymphoid cells with 28% blasts. Immunophenotype was consistent with B cell acute lymphoblastic leukaemia (B-ALL). Further work up showed no systemic involvement but extensive thoracolumbar-sacral leptomeningeal disease. The patient was treated with several courses of intrathecal and systemic chemotherapy followed by craniospinal irradiation for consolidation. There was initial steady improvement in neurological symptoms and leptomeningeal disease, the latter being ascertained through radiological studies and cerebrospinal fluid examination. After 10 months of response, the patient relapsed with central nervous system (CNS) and systemic disease. B-ALL is a rare precursor lymphoid neoplasm that generally presents with systemic disease. While CNS involvement is not uncommon, isolated involvement of this compartment without systemic disease is exceedingly rare. PMID:27095809

  5. Massive retroperitoneal ganglioneuroma presenting with small bowel obstruction 18 years following initial diagnosis.

    LENUS (Irish Health Repository)

    Cronin, E M P

    2012-02-03

    BACKGROUND: Ganglioneuroma is a rare tumour of neural crest origin, which arises from maturation of a neuroblastoma. While previously considered to be non-functioning, they are now known to be frequently endocrinologically active. AIMS AND METHODS: We report a case of a massive retroperitoneal ganglioneuroma presenting with small bowel obstruction in an adult, 18 years after initial diagnosis. Urinary dopamine levels were elevated, but other catecholamines were within normal limits. This is the first report in the English-language literature of a retroperitoneal ganglioneuroma presenting with or causing intestinal obstruction. We also review the metabolic, radiological, and histological features of these tumours. Relevant publications were identified from a Medline search using the MeSH headings \\'ganglioneuroma\\

  6. TGFβ-pathway is down-regulated in a uterine carcinosarcoma: a case study.

    Science.gov (United States)

    Semczuk, Andrzej; Zakrzewski, Piotr K; Forma, Ewa; Cygankiewicz, Adam I; Semczuk-Sikora, Anna; Bryś, Magdalena; Rechberger, Tomasz; Krajewska, Wanda M

    2013-11-01

    Data assessing the role of various genetic alterations in uterine carcinosarcoma (CS), particularly the transforming growth factors-β (TGFβ) that play a crucial role in many cellular processes, including proliferation, differentiation, adhesion and migration, are scarce. TGFβ exert their effects through specific receptors and associated auxiliary receptors. In the current study, we investigated the expression of TGFβ isoforms and their receptors, as well as selected genes in a case of CS. We applied the real-time fluorescence detection PCR method with FAM dye-labeled TaqMan specific probes. In a comparison to the normal counterpart, TGFB1, TGFB2, TGFBRII, TGFBR3, ENG and CD109 were all down-regulated in uterine CS samples at different extents. BIRC5 and hTERT, markers of tumor survival, were up-regulated in CS as compared with normal counterparts. A concomitant increase of the hypoxia marker HIF1A expression pattern was noted, whereas the expression of GPR120, responsible for free fatty acids sensing, was not different in both counterparts evaluated. In conclusion, deregulation of various cellular mechanisms in uterine CS is associated with alterations at many levels - cell growth and proliferation, apoptosis, and impaired response to stimuli from extracellular environment. PMID:23932095

  7. Bilateral proliferative retinopathy as the initial presentation of chronic myeloid leukemia

    Directory of Open Access Journals (Sweden)

    Mafalda S. F. Macedo

    2013-01-01

    Full Text Available The authors report a rare case of a 48-year-old male with chronic myeloid leukemia (CML who initially presented with a bilateral proliferative retinopathy. The patient complained of recent visual loss and floaters in both eyes (BE. Ophthalmologic evaluation revealed a best corrected visual acuity (BCVA of 20/50 in the right eye and 20/200 in the left eye (LE. Fundoscopy showed the presence of bilateral peripheral capillary dropout with multiple retinal sea fan neovascularisations, which were confirmed on fluorescein angiography. Full blood count revealed hyperleukocytosis, thrombocytosis, anemia, and hyperuricemia. Bone marrow aspiration and biopsy showed the reciprocal chromosomal translocation t (9;22, diagnostic of CML. The patient was started on hydroxyurea, allopurinol and imatinib mesylate. He received bilateral panretinal laser photocoagulation and a vitrectomy was performed in the LE. The patient has been in complete hematologic, cytogenetic, and major molecular remission while on imatinib and his BCVA is 20/25 in BE.

  8. Acute embolic cerebral ischemia as an initial presentation of Polycythemia Vera

    Directory of Open Access Journals (Sweden)

    Chhatwani Chirag M

    2016-06-01

    Full Text Available Introduction-Patients with Polycythemia vera (PV are at high risk for vaso-occlusive events including cerebral ischemia. Ischemic stroke may be the first presenting symptom of PV in 15% or more of those affected. It had been previously assumed that cerebral ischemic events were due to increased blood viscosity and platelet activation within the central nervous system arterial vessels. However, there are now a few isolated case reports of probable micro-embolic events originating from outside of the brain. Case report- A 45-year old man presented with left sided hemiperesis (recovered within 12 hours in our Medicine OPD. Hematologic investigation revealed a hyperviscous state (Hemoglobin 21.9gm% and PCV 66%. Acute infarction in right corona radiata and basal ganglia was found in magnetic resonance imaging(MRI of brain. Conclusion- Although unusual, acute embolic cerebral ischemia may be an initial presentation of PV. The etiology of stroke in polycythemic patients is likely to be multifactorial. All clinicians involved in the care of stroke patients should be aware of the association of PV and ischemic stroke. [Natl J Med Res 2016; 6(2.000: 210-211

  9. Streptococcus pneumoniae sepsis as the initial presentation of systemic lupus erythematosus

    Directory of Open Access Journals (Sweden)

    Erdem I

    2016-09-01

    Full Text Available Ilknur Erdem,1 Senay Elbasan Omar,1 Ridvan Kara Ali,1 Hayati Gunes,2 Aynur Eren Topkaya2 1Department of Infectious Diseases, 2Department of Medical Microbiology, Faculty of Medicine, Namik Kemal University, Tekirdag, Turkey Objective: Infections are among the most important causes of morbidity and mortality in patients with systemic lupus erythematosus (SLE but are rare initial presentation of the disease. Therefore, in this study, we describe a case of Streptococcus pneumoniae sepsis in a young woman with previously undiagnosed SLE. Case report: A 23-year-old female patient was admitted to our outpatient clinic complaining of high fever (40°C, chills, fatigue, generalized myalgia, and cough with brown sputum for 5 days. Blood cultures grew gram-positive coccus defined as S. pneumoniae using standard procedures. Antinuclear antibody was positive at a titer of 1/1,000, and anti-double-stranded DNA was positive at 984 IU/mL. She was diagnosed with SLE. Her respiratory symptoms and pleural effusion were considered to be due to pulmonary manifestation of SLE. Conclusion: The underlying immunosuppression caused by SLE could have predisposed the patient to invasive pneumococcal disease. It may also occur as a primary presenting feature, although a rare condition. Keywords: Streptococcus pneumoniae, sepsis, systemic lupus erythematosus

  10. Survey for primary tumor site in patients with initial clinical presentation of bone metastasis

    International Nuclear Information System (INIS)

    Among the patients who were examined with bone scintigraphy between April 1985 and March 1991, there were 27 patients whose initial clinical manifestation was bone metastasis and who were surveyed for the primary tumor site. The primary tumor site could be identified in 20 patients (74%), consisting of 9 patients with lung cancer, 3 with prostate cancer, 3 with hepatoma, 2 with renal cancer, and one each with thyroid cancer, adrenal cancer, and pleural malignant mesothelioma. In 17 of the 20 patients, the primary site had been detected within two months after presentation. Examinations which were helpful in identifying the primary site included chest radiography, sputum cytology, abdominal sonography, serum prostatic acid phosphatase level and pathologic examination of biopsy specimens. 99mTc-pyridoxylenemethyl tryptophan (99mTc-PMT) scintigraphy was useful in the diagnosis of the hepatoma when accumulation was observed at the metastatic sites. In 2 patients, lung cancer had been recognized using follow-up chest, radiography 3 and 6 months after presentation, respectively. One patient was diagnosed at autopsy as having adrenal cancer. In 7 patients the primary site remains unknown. Histology examination of the biopsy specimen performed in 6 of these patients revealed 4 to be adenocarcinoma and 2 undifferentiated carcinoma. The average survival period of the 17 patients who died was 9.5 months. Four patients are alive, and the outcome in the remaining 6 could not be determined. (author)

  11. Presentation of an infant with nutritional deficiency dermatitis as the initial manifestation of cystic fibrosis

    Directory of Open Access Journals (Sweden)

    Stojković Anđelka

    2013-01-01

    Full Text Available Introduction. Cystic fibrosis (CF is a multisystemic autosomal recessive disease most frequently recognized by characteristic respiratory and/or digestive manifestations. Exceptionally rare, as is the case with the infant we are presenting, the initial sign of the disease can be nutritional deficiency dermatitis (NDD. Case Outline. A three-month-old male infant of young and healthy non-consanguineous parents, born at term after the first uneventful pregnancy, was hospitalized due to atopic dermatitis (AD-like skin changes, failure to thrive and normochromic anemia (Hb 60 g/L. As exclusively breast-fed, failure to thrive was attributed to hypogalactia and skin changes to nutritional allergy, so that, besides exclusion of cow’s milk protein and other highly allergenic foods in mother’s diet, hypoallergenic milk formula was added to the child’s diet. However, dietetic measures were without effect, and the child was re-hospitalized at age 4.5 months, this time in the condition of severe malnutrition with hypoproteinemic edemas, extensive dermatitis, moderate hepatosplenomegaly and recurrent normochromic anemia (Hb 57 g/L. After plasma-free erythrocyte transfusion, correction of hypoalbuminemia and two-week parenteral and semi-elementary nutrition resulted in gradual recovery of the child, also including the resolution of skin changes. Having in mind the clinical course of the disease, as well as the response to applied therapeutic measures, CF was suspected as the cause of the child’s problems, which was also confirmed by a high level of sweat chlorine (92 mmol/L and DNA analysis (∆F508/∆F508. Conclusion. Our experience indicates that NDD, as the initial manifestation of CF, should be also kept in mind in differential diagnosis of the infant’s AD-like changes.

  12. From light to mass: accessing the initial and present-day Galactic globular cluster mass functions

    CERN Document Server

    Bonatto, Charles

    2012-01-01

    The initial and present-day mass functions (ICMF and PDMF, respectively) of the Galactic globular clusters (GCs) are constructed based on their observed luminosities, the stellar evolution and dynamical mass-loss processes, and the mass-to-light ratio (MLR). Under these conditions, a Schechter-like ICMF is evolved for approximately a Hubble time and converted into the luminosity function (LF), which requires finding the values of 5 free parameters: the mean GC age (\\tA), the dissolution timescale of a $10^5 \\ms$ cluster ($\\tau_5$), the exponential truncation mass (\\mc) and 2 MLR parametrising constants. This is achieved by minimising the residuals between the evolved and observed LFs, with the minimum residuals and realistic parameters obtained with MLRs that increase with luminosity (or mass). The optimum PMDFs indicate a total stellar mass of $\\sim4\\times10^7$ \\ms\\ still bound to GCs, representing $\\sim15%$ of the mass in clusters at the beginning of the gas-free evolution. The corresponding ICMFs resemble ...

  13. Subtotal resection of an intradural mature teratoma in an adult presenting with difficulty initiating micturition

    Directory of Open Access Journals (Sweden)

    Maria Kristina Vanguardia

    2014-01-01

    Full Text Available Background: Teratomas are tumors comprised of tissues from all three germ layers. Teratomas within the spine are exceedingly rare especially in the absence of either spinal dysraphism, congenital abnormalities of the spine, spinal surgery, or history of lumbar punctures. Virchow was the first to describe this occurrence in the spine in 1863 and since then, only a handful of cases have been reported. Case description: A 41-year-old male presented with a longstanding history of difficulty initiating micturition and lower back pain with recent onset of saddle paraesthesia and bilateral leg pain. He did not have a history suggestive of spinal trauma nor congenital abnormalities. Neurological examination was unremarkable. Magnetic resonance imaging (MRI confirmed the presence of an intradural extra axial lesion in the region of the cauda equine. At surgery, the lesion was found to be densely adherent to the conus and a subtotal resection was performed. Histological examination confirmed the lesion to be a mature teratoma. Postoperatively, he made a good recovery and there is no evidence of recurrence at one year follow-up. Conclusion: This case demonstrates that a teratoma without immature elements can be subtotally excised to reduce the risk of neurological morbidity.

  14. Presentation of main results of Phase I of the SMPR project initiation study

    International Nuclear Information System (INIS)

    As a result of a first Technical Committee Meeting held in Vienna in August 1983 the IAEA launched a new SMPR Project Initiation Study with the objective of surveying the available designs, examining the major factors influencing the decision-making processes in developing countries and thereby also arriving at an estimate of the potential market. The Nuclear Energy Agency of OECD offered its assistance in making a study of the potential market in industrialized countries. Two questionnaires were used to obtain information from potential suppliers and buyers. Suppliers responded with an overwhelming 23 design concepts which could be offered for export but with varying levels of readiness and provenness. From potential buyers 17 responses were received, 16 of which were from the developing countries. The analysis of the responses which was done by the Agency with the help of experts from Member States gave the basis for a draft report including the OECD/NEA part. This draft was discussed during a second Technical Committee Meeting held in Vienna in March 1985. The meeting was characterized by a strong supplier interest but also by hesitation of potential buyers to make any kind of commitments relating to the market introduction of SMPRs. All new information has been incorporated into the report together with a number of expressed comments, especially related to the presentation of the economics of SMPRs, the necessity of a reference plant, provenness of major components and systems etc. The results of the study are presented here with direct reference to the SMPR supply situation and the potential market for SMPRs in terms of the decision-making factors: the financial factors, the economical factors, and the technological factors were identified as the most important ones. The economic competitiveness is not the only decision-making factor and consequently it was decided to end the general study called Phase I by the publication of a report. Specific case studies

  15. Presentations

    International Nuclear Information System (INIS)

    The presented materials consist of presentations of international workshop which held in Warsaw from 4 to 5 October 2007. Main subject of the meeting was progress in manufacturing as well as research program development for neutron detector which is planned to be placed at GANIL laboratory and will be used in nuclear spectroscopy research

  16. Initiatives in experimental nuclear physics at Variable Energy Cyclotron Centre: past, present and future

    International Nuclear Information System (INIS)

    We discuss briefly the initiatives in low energy nuclear physics experiments, viz., nuclear reaction studies, nuclear structure studies, detector developments carried out at the Variable Energy Cyclotron Centre, Kolkata since its inception. Developments leading to radioactive ion beam facility as well as the preparations for the utilization of the super-conducting cyclotron under construction at Kolkata are also discussed. (author)

  17. Primary hyperaldostronisim as initial presentation of adrenal cortical carcinoma with liver metastasis: a case report.

    Science.gov (United States)

    Aghamohammadzadeh, Naser; Faraji, Afsaneh; Bozorgi, Farshid; Faraji, Ismail; Moghadaszadeh, Majid

    2013-01-01

    Adrenocortical carcinoma (ACC) is a rare tumor and usually a fatal disease which can develop at any age in either sex. Differential diagnosis between malignant and benign adrenal mass is not easy which leads to significant clinical challenge for optimal treatment. Here we report a 22-year-old woman diagnosed with primary hyper aldostronism initially but disease relapsed during six months and magnetic resonance imaging revealed tumor with metastasis to the liver. PMID:24505527

  18. Primary Hyperaldostronisim as Initial Presentation of Adrenal Cortical Carcinoma with Liver Metastasis: A Case Report

    OpenAIRE

    Aghamohammadzadeh, Naser; Faraji, Afsaneh; Bozorgi, Farshid; Faraji, Ismail; Moghadaszadeh, Majid

    2013-01-01

    Adrenocortical carcinoma (ACC) is a rare tumor and usually a fatal disease which can develop at any age in either sex. Differential diagnosis between malignant and benign adrenal mass is not easy which leads to significant clinical challenge for optimal treatment. Here we report a 22-year-old woman diagnosed with primary hyper aldostronism initially but disease relapsed during six months and magnetic resonance imaging revealed tumor with metastasis to the liver.

  19. Presentations

    International Nuclear Information System (INIS)

    The PARIS meeting held in Cracow, Poland from 14 to 15 May 2007. The main subjects discussed during this meeting were the status of international project dedicated to gamma spectroscopy research. The scientific research program includes investigations of giant dipole resonance, probe of hot nuclei induced in heavy reactions, Jacobi shape transitions, isospin mixing and nuclear multifragmentation. The mentioned programme needs Rand D development such as new scintillations materials as lanthanum chlorides and bromides as well as new photo detection sensors as avalanche photodiodes - such subjects are also subjects of discussion. Additionally results of computerized simulations of scintillation detectors properties by means of GEANT- 4 code are presented

  20. Presentation

    OpenAIRE

    Eduardo Vicente; Rosana de Lima Soares; Eduardo Victorio Morettin

    2013-01-01

    In the present edition of Significação – Scientific Journal for Audiovisual Culture and in the others to follow something new is brought: the presence of thematic dossiers which are to be organized by invited scholars. The appointed subject for the very first one of them was Radio and the invited scholar, Eduardo Vicente, professor at the Graduate Course in Audiovisual and at the Postgraduate Program in Audiovisual Media and Processes of the School of Communication and Arts of the University ...

  1. Presentation

    Directory of Open Access Journals (Sweden)

    Paulo Henrique Freire Vieira

    2013-12-01

    Full Text Available This dossier focuses on one of the essential debate topics today about the territorial dimension of the new development strategies concerned with the worsening of the global socioecological crisis, that is: the challenges related to the activation and integration in networks of localized agri-food systems. For its composition, some contributions presented and debated during the VI International Conference on Localized Agri-food System - The LAFS facing the opportunities and challenges of the new global context have been gathered. The event took place in the city of Florianópolis, from May 21th to 25th of 2013. The event was promoted by the Federal University of Santa Catarina (UFSC and by the Center for the International Cooperation on Agricultural Research for Development (CIRAD. Besides UFSC and CIRAD, EPAGRI, State University of Santa Catarina (UDESC, as well as research institutes and universities from other states (UFMG, IEA/SP, UFS, UFRGS and Mexican and Argentinian partners from the RED SIAL Latino Americana also participated in the organization of lectures, discussion tables and workshops.

  2. Left ventricular aneurysm and ventricular tachycardia as initial presentation of cardiac sarcoidosis

    Directory of Open Access Journals (Sweden)

    Ashraf Jmeian

    2015-01-01

    Full Text Available Context: Cardiac sarcoidosis (CS is a rare, potentially fatal disease. It has a wide range of clinical presentations that range from asymptomatic electrocardiogram changes to sudden cardiac death. Ventricular aneurysms and ventricular tachycardia are seen late in the disease, and are rarely the presenting manifestation of the disease. Diagnosis of CS is challenging and often missed or delayed. Case Report: We report a 35-year-old patient who presented with sustained ventricular tachycardia and ST-elevation on electrocardiogram. Cardiac catheterization showed normal coronaries and left ventricular aneurysm. Subsequent 2D-echocardiography showed an infiltrative disease pattern. Cardiac MRI was done and showed late gadolinium enhancement in the septum, apex and lateral wall. The patient was diagnosed with cardiac sarcoidosis and treated with immune suppression and antiarrhythmic agent. In addition underwent AICD implantation. Conclusion: Our case highlights the importance of suspecting cardiac sarcoidosis in young patients presenting with electrocardiogram changes, and present an atypical presentation of this disease.

  3. Presentation

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    Isidor Marí Mayans

    2004-04-01

    Full Text Available As was the case at the conference, "Humanities professions in the knowledge society", the Director of Humanities and Philology Studies at the UOC, Isidor Marí, presents this Dossier, and the subsequent virtual debate, with the aim of gaining useful conclusions, with specific repercussions on the organisation of the degree studies and its professional projection, especially at this time, which requires study plans to be redesigned in line with the Bologna process. In the author's opinion, we can only make the right operative decisions when we are able to understand the transformations taking place in the humanistic culture framed by the knowledge society, and to do so, debate has to be opened in which students, graduates, academics, researchers, professionals and analysts can all take part.In this article, Isidor Marí analyses the tensions and contradictions that arise when attempts are made to relate the concepts of the professional world, Humanities and the knowledge society. Firstly, neither are Humanities a profession nor the study of Humanities seen by students or society to be adaptable to the definition of professional profiles. However, this highlights an important paradox, as the culture economy, (and, thus, occupations in the cultural sector, is growing increasingly throughout western societies. Likewise, in terms of the relationship between Humanities and the knowledge society, the author describes and analyses how there currently coexist voices foreseeing the worst alongside those that see information and communications technologies opening the way for an enormously positive transformation in human civilisation and a new cultural era.

  4. Presentation

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    Eduardo Vicente

    2013-06-01

    Full Text Available In the present edition of Significação – Scientific Journal for Audiovisual Culture and in the others to follow something new is brought: the presence of thematic dossiers which are to be organized by invited scholars. The appointed subject for the very first one of them was Radio and the invited scholar, Eduardo Vicente, professor at the Graduate Course in Audiovisual and at the Postgraduate Program in Audiovisual Media and Processes of the School of Communication and Arts of the University of São Paulo (ECA-USP. Entitled Radio Beyond Borders the dossier gathers six articles and the intention of reuniting works on the perspectives of usage of such media as much as on the new possibilities of aesthetical experimenting being build up for it, especially considering the new digital technologies and technological convergences. It also intends to present works with original theoretical approach and original reflections able to reset the way we look at what is today already a centennial media. Having broadened the meaning of “beyond borders”, four foreign authors were invited to join the dossier. This is the first time they are being published in this country and so, in all cases, the articles where either written or translated into Portuguese.The dossier begins with “Radio is dead…Long live to the sound”, which is the transcription of a thought provoking lecture given by Armand Balsebre (Autonomous University of Barcelona – one of the most influential authors in the world on the Radio study field. It addresses the challenges such media is to face so that it can become “a new sound media, in the context of a new soundscape or sound-sphere, for the new listeners”. Andrew Dubber (Birmingham City University regarding the challenges posed by a Digital Era argues for a theoretical approach in radio studies which can consider a Media Ecology. The author understands the form and discourse of radio as a negotiation of affordances and

  5. Temporoparietal Headache as the Initial Presenting Symptom of a Massive Aortic Dissection

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    Manan Parikh

    2015-01-01

    Full Text Available Aortic dissection is a life-threatening medical emergency often presenting with severe chest pain and acute hemodynamic compromise. The presentation of aortic dissection can sometimes be different thus leading to a challenge in prompt diagnosis and treatment as demonstrated by the following presentation and discussion. We present a case of a 71-year-old male who presented to the emergency department with complaints of left sided temporoparietal headache and was eventually diagnosed with a thoracic aortic dissection involving the ascending aorta and descending aorta, with an intramural hematoma in the descending aorta. This case illustrates the importance of keeping in mind aortic dissection as a differential diagnosis in patients with acute onset headaches in which any intracranial source of headache is not found.

  6. The importance of reliability to the SunShot Initiative (Presentation Recording)

    Science.gov (United States)

    Jones-Albertus, Rebecca

    2015-09-01

    The U.S. Department of Energy's SunShot Initiative was launched in 2011 to make subsidy-free solar electricity cost competitive with conventional energy sources by the end of the decade. Research in reliability can play a major role in realizing the SunShot goal of 0.06/kWh. By improving photovoltaic module lifetime and reducing degradation rates, a system's lifetime energy output is increased. Increasing confidence in photovoltaic performance prediction can lower perceived investment risk and thus the cost of capital. Accordingly, in 2015, SunShot expects to award more than $40 million through its SunShot National Laboratory Multiyear Partnership (SuNLaMP) and Physics of Reliability: Evaluating Design Insights for Component Technologies in Solar (PREDICTS) 2 funding programs, for research into reliability topics such as determining acceleration factors, modeling degradation rates and failure mechanisms, improving predictive performance models, and developing new test methods and instrumentation.

  7. Presentation

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    Nicanor Lopes

    2010-11-01

    Full Text Available The Journal Caminhando debuts with a new editorial format: eachmagazine will have a Dossier.In 2010 Christianity celebrated the centenary of Edinburgh. TheWorld Missionary Conference in Edinburgh in 1910 is regarded by manyas missiological watershed in the missionary and ecumenical movement.So the Faculty of Theology of the Methodist Church (FATEO decidedto organize a Wesleyan Week discussing the issue of mission. For anevent of this magnitude FATEO invited the Rev. Dr. Wesley Ariarajah,Methodist pastor and teacher of Sri Lanka with extensive experience inpastoral ministry in local churches and professor of History of Religionsand the New Testament at the Theological College of Lanka, maintainedby the Protestant Churches in Sri Lanka. In 1981 he was invited to jointhe World Council of Churches, where he presided for over ten years theCouncil of Interreligious Dialogue. From 1992 he served as Deputy GeneralSecretary of the WCC.The following texts are not the speeches of the Rev. Dr. WesleyAriarajah, for they will be published separately. Nevertheless, the journaldialogs with the celebrations of the centenary of Edinburgh, parting formthe intriguing theme: "Mission in the 21st century in Brazil". After all, howis it that mission takes place among us in personal, church, and communityactivities?Within the Dossier, as common to the journal, the textos are organizedas follows: Bible, Theology / History and Pastoral Care. Other items thatdo not fit within the Dossier, but, do articulate mission, can be found inthe section Declarations and Documents and Book Reviews.The authors of the Dossier have important considerations in buildinga contemporary missiological concept considering Brazilian reality.Anderson de Oliveira, in the Bible-Section, presents a significantexegeses of Matthew 26.6-13. What does it mean when Jesus is quotedwith the words: "For the poor always ye have with you, but me ye havenot always." Is this declaration challenging the gospels

  8. Initial experience with a group presentation of study results to research participants

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    Bent Stephen

    2008-03-01

    Full Text Available Abstract Background Despite ethical imperatives, informing research participants about the results of the studies in which they take part is not often performed. This is due, in part, to the costs and burdens of communicating with each participant after publication of the results. Methods Following the closeout and publication of a randomized clinical trial of saw palmetto for treatment of symptoms of benign prostatic hyperplasia, patients were invited back to the research center to participate in a group presentation of the study results. Results Approximately 10% of participants attended one of two presentation sessions. Reaction to the experience of the group presentation was very positive among the attendees. Conclusion A group presentation to research participants is an efficient method of communicating study results to those who desire to be informed and was highly valued by those who attended. Prospectively planning for such presentations and greater scheduling flexibility may result in higher attendance rates. Trial Registration Number Clinicaltrials.gov #NCT00037154

  9. Sudden unilateral visual loss as an initial presentation of chronic myelogenous leukemia

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    Len V Hua

    2010-03-01

    Full Text Available Len V Hua, Salisa K WilliamsPacific University Eye Clinic, Forest Grove, OR, USAAbstract: Leukemia is a cancer of the white blood cells. Many patients with leukemia are  unaware of their disease until routine blood work up for other conditions reveals incidental findings leading to a diagnosis of leukemia. Up to 50% of patients with leukemia have ocular manifestations. In fact, floaters or decreased vision may be the initial symptom of leukemia.Case study: A 51-year-old Caucasian female patient with sudden unilateral visual loss in the left eye was found to have bilateral retinal neovascularization and Roth spot hemorrhages. Blood work up and cytological analyses confirmed the Philadelphia chromosome, which has been implicated in the development of chronic myelogenous leukemia (CML. Further testing confirmed a diagnosis of chronic phase CML. After a two-month course of imatinib and close monitoring by a hematological oncologist, her vision has improved and the retinal vascularization has significantly resolved.Conclusions: Eye care professionals are in a unique position to identify this devastating disease early on. A delay in diagnosis of the disease may lead to conversion into the acute phase, which has a poor prognosis for survival. A prompt referral to internal medicine and oncology for co-management is crucial.Keywords: chronic myelogenous leukemia, retinal hemorrhages, Roth spot, imatinib (Gleevec® Philadelphia chromosome, vision loss

  10. Color vision abnormality as an initial presentation of the complete type of congenital stationary night blindness

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    Tan X

    2013-08-01

    Full Text Available Xue Tan, Aya Aoki, Yasuo YanagiDepartment of Ophthalmology, University of Tokyo School of Medicine, Hongo, Bunkyo-ku, Tokyo, JapanAbstract: Patients with the complete form of congenital stationary night blindness (CSNB often have reduced visual acuity, myopia, impaired night vision, and sometimes nystagmus and strabismus, however, they seldom complain of color vision abnormality. A 17-year-old male who was at technical school showed abnormalities in the color perception test for employment, and was referred to our hospital for a detailed examination. He had no family history of color vision deficiency and no other symptoms. During the initial examination, his best-corrected visual acuity was 1.2 in both eyes. His fundus showed no abnormalities except for somewhat yellowish reflex in the fovea of both eyes. Electroretinogram (ERG showed a good response in cone ERG and 30 Hz flicker ERG, however, the bright flash, mixed rod and cone ERG showed a negative type with a reduced b-wave (positive deflection. There was no response in the rod ERG, either. From the findings of the typical ERG, the patient was diagnosed with complete congenital stationary night blindness. This case underscores the importance of ERG in order to diagnose the cause of a color vision anomaly.Keywords: congenital stationary night blindness, CSNB, electroretinogram, ERG, color vision defect

  11. Olecranon bursitis as initial presentation of gout in asymptomatic normouricemic patients

    NARCIS (Netherlands)

    Emad, Yasser; Ragab, Yasser; El-Shaarawy, Nashwa; Rasker, J.J.

    2014-01-01

    Background Acute bursitis is a less frequent presentation of gout, especially in normouricemic subjects compared to the typical pattern of acute gouty arthritis. Aim of the work The aim of the current case reports is to describe the clinical and the magnetic resonance imaging features of acute gout

  12. Initial presentation with dilated cardiomyopathy in a patient of tuberous sclerosis: A rare case report

    OpenAIRE

    Jain, Dharmendra; Kumar, Vikas; Kar, Deba P.; Prasad, Shashi R.

    2013-01-01

    A 35-year-old man presented with dilated cardiomyopathy, an unusual association with tuberous sclerosis. Clinical history and examination were consistent with tuberous sclerosis including major features of tuberous sclerosis complex (TSC) like facial angiofibroma, shagreen patch, subependymal nodules, and angiomyolipoma of kidney. The clinical manifestations, pathogenesis and evaluation of tuberous sclerosis are discussed.

  13. The Influence of Anxiety on the Initial Selection of Emotional Faces Presented in Binocular Rivalry

    Science.gov (United States)

    Gray, Katie L. H.; Adams, Wendy J.; Garner, Matthew

    2009-01-01

    Neurocognitive theories of anxiety predict that threat-related information can be evaluated before attentional selection, and can influence behaviour differentially in high anxious compared to low anxious individuals. We investigate this further by presenting emotional and neutral faces in an adapted binocular rivalry paradigm. We show that the…

  14. Acute visual loss as the initial presentation in a child with systemic Burkitt lymphoma

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    Maria Kourti

    2013-01-01

    Full Text Available Non-Hodgkin lymphoma (NHL accounts for 10% of pediatric malignancies and is the third most common malignancy in childhood. We report a previous healthy 3-year-old boy with stage IV Burkitt lymphoma presenting with acute visual loss. In funduscopy his pupils were fixed at 6 mm in diameter without light perception. He started therapy according to the UKCCSG 9003 protocol. The boy didn′t show any visual improvement but some slight light perception despite his partial remission after CYVE II. He died of neutropenic septicemia before his scheduled radiotherapy. In conclusion, loss of vision is a rare presenting sign in NHL. Differential diagnosis is crucial as early diagnosis and effective treatment are important for survival as well as for visual restoration.

  15. Obstructive Uropathy as an Initial Presentation of Primary Myelofibrosis: Case Report and Review of Literature.

    Science.gov (United States)

    Ganguli, Anirban; Chalokia, Ramandeep Singh; Kaur, Brahm Jyot

    2016-06-01

    Primary myelofibrosis (PMF) is a rare hematological disorder associated with progressive cytopenia and extra-medullary hematopoiesis. Acute kidney injury in this disease has been reported from diverse etiologies such as renal and peri-renal extramedullary hematopoiesis and tumor lysis syndrome. We report a patient who presented with obstructive uropathy from uric acid stones who was incidentally diagnosed with PMF during workup for persistent thrombocytosis and leukocytosis. Marrow histopathology was unique in presenting features of early PMF despite clinical picture mimicking essential thrombocythemia. Despite a common background of hyperuricemia in myeloproliferative neoplasms, AKI resulting from urate nephrolithiasis has seldom been reported in PMF. Published data on this association and clinical management is reviewed briefly. PMID:27408371

  16. Intraperitoneally Placed Foley Catheter via Verumontanum Initially Presenting as a Bladder Rupture

    OpenAIRE

    Omer A Raheem; Jeong, Young Beom

    2011-01-01

    Since urethral Foley catheterization is usually easy and safe, serious complications related to this procedure have been rarely reported. Herein, we describe a case of intraperitoneally placed urethral catheter via verumontanum presenting as intraperitoneal bladder perforation in a chronically debilitated elderly patient. A 82-yr-old male patient was admitted with symptoms of hematuria, lower abdominal pain after traumatic Foley catheterization. The retrograde cystography showed findings of i...

  17. Clinical presentation of intracranial epidermoids: a surgical series of 20 initial and four recurred cases

    OpenAIRE

    Kato, Koichi; Ujiie, Hiroshi; Higa, Takashi; Hayashi, Masataka; Kubo, Osami; Okada, Yoshikazu; HORI, TOMOKATSU

    2010-01-01

    Epidermoids are generally recognized as benign tumors; however, total resection is often difficult. The recurrence from the residual capsule, dissemination of the tumor, and aseptic meningitis are common problems. The aim of the present study was to analyze and report on the clinical characteristics of intracranial epidermoids, particularly complications and cases with a poor clinical outcome. 24 patients with intracranial epidermoids who were treated surgically at Tokyo Women's Medical Unive...

  18. Febrile cholestatic disease as an initial presentation of nodular lymphocyte-predominant Hodgkin lymphoma

    Institute of Scientific and Technical Information of China (English)

    Anna; Mrzljak; Slavko; Gasparov; Ika; Kardum-Skelin; Vesna; Colic-Cvrlje; Slobodanka; Ostojic; Kolonic

    2010-01-01

    Febrile cholestatic liver disease is an extremely unusual presentation of Hodgkin lymphoma(HL).The liver biopsy of a 40-year-old man with febrile episodes and cholestatic laboratory pattern disclosed an uncommon subtype of HL,a nodular lymphocyte-predominant HL(NLPHL).Liver involvement in the early stage of the usually indolent NLPHL's clinical course suggests an aggressiveness and unfavorable outcome.Emphasizing a liver biopsy early in the diagnostic algorithm enables accurate diagnosis and appropriate tre...

  19. Atrophic-appearing Pancreas on Magnetic Resonance Cholangiopancreatography as Initial Presentation of Cystic Fibrosis

    OpenAIRE

    Stratton, Amy; Murphy, Thomas; Laczek, Jeffrey

    2012-01-01

    Cystic fibrosis is an autosomal recessive disease typically diagnosed in early childhood secondary to pulmonary manifestations. We present the unusual case of a 20-year-old man being diagnosed with cystic fibrosis after he was incidentally noted to have an atrophic pancreas on magnetic resonance cholangiopancreatography. He had no sign of chronic pancreatitis or symptoms of exocrine pancreatic insufficiency. As pancreatic atrophy is rare in young adults, the patient was evaluated for cystic f...

  20. Haematuria as an uncommon initial presenting symptom of metastatic squamous cell carcinoma (SCC) to kidney

    OpenAIRE

    Kawsar, Hameem I.; Spiro, Timothy P; Daw, Hamed A

    2011-01-01

    A 47-year-old female presented with a 2-week history of painless haematuria. Urine dipstick showed moderate leucocytes. Blood and urine cultures were negative and cytology was negative for malignant cells. Flexible cystoscopy was negative for any bladder pathology. An ultrasonogram of the abdomen showed a mass in the left kidney. CT showed a mass-like lesion within the left kidney suspicious for renal carcinoma, and cavitary lesions in both lungs. Biopsy of the lung showed clusters of atypica...

  1. Initial Presentation of HIV Infection With Two Successive Acute Arterial Thromboses: A Case Report

    OpenAIRE

    Ziaian, Bizhan; Moslemi, Sam; Tahamtan, Maryam

    2014-01-01

    Introduction: One of the complications of HIV infection is greater risk of thromboembolic events. A variety of mechanisms has been found to be responsible for prothrombotic tendency in patients with HIV infection. Case Presentation: A 27-year-old heterosexual smoker man was referred to our center due to a sudden-onset severe left lower extremity pain and claudication since three days prior to admission. In physical examination, end extremity coldness and discoloration as well as left lower ex...

  2. An Unusual Initial Presentation of Lupus Nephritis as a Renal Mass

    OpenAIRE

    Remi Goupil; Annie-Claire Nadeau-Fredette; Virginie Royal; Alexandre Dugas; Jean-Philippe Lafrance

    2015-01-01

    Lupus nephritis is a frequent manifestation of systemic lupus erythematous. Lupus nephritis usually presents with abnormal urinalysis, proteinuria, and/or renal insufficiency. We report a case of a 48-year-old woman who underwent partial nephrectomy for a fortuitously discovered solid enhancing left kidney mass. No neoplastic cells were found in the biopsy specimen; however, the pathology findings were compatible with immune complex glomerulonephritis with a predominantly membranous distribut...

  3. Bone metastases from initially unknown origin as unusual presentation of thyroid cancer

    International Nuclear Information System (INIS)

    The insular carcinoma of thyroid gland is a poorly frequent neoplasm, slightly differentiated and of clinical aggressive course. The bone metastasis unique as a form of presentation in absence of regional ganglions compromise or another metastasis localization is very unusual. The local invasion, regional ganglions and metastases at a distance (lung and bone) are the usual conduct. It is of interesting to highlight the importance of the immunoreactivity for Tg (thyroglobulin) to tackle the diagnosis, like also the considerable absorption with Tc99m-MDP, I131 and Tc99m-MIBI by the tissue of the metastasis

  4. Acute exacerbation of idiopathic pulmonary fibrosis as the initial presentation of the disease

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    K. Sakamoto

    2009-06-01

    Full Text Available The clinical course of patients with idiopathic pulmonary fibrosis (IPF is generally marked by a decline in pulmonary function over time, although recently there is increasing recognition that fatal deterioration from acute exacerbation can occur at any stage. The patient described in the present case study was a 65-yr-old male who presented with exertional dyspnoea and fever of 2 weeks' duration. He had no history of chronic lung disease or physiological or radiological hallmarks of pre-existing disease. He underwent surgical lung biopsy and the histological examination showed a background pattern of usual interstitial pneumonia (UIP with a pattern of focal acute diffuse alveolar damage (DAD in the area where normal lung architecture was preserved. It is notable that the pathological diagnosis of this rapidly progressive interstitial pneumonia was DAD on UIP, which is typically seen in acute exacerbations of IPF. Unusual findings on high-resolution computed tomography scan were also noted. We presume that in this case acute exacerbation developed in the very early course of IPF. Given the possibility that similar cases may have arisen among patients diagnosed with acute interstitial pneumonia or acute respiratory distress syndrome, the histopathology of rapidly progressive interstitial pneumonia may need to be revisited.

  5. Intraperitoneally placed Foley catheter via verumontanum initially presenting as a bladder rupture.

    Science.gov (United States)

    Raheem, Omer A; Jeong, Young Beom

    2011-09-01

    Since urethral Foley catheterization is usually easy and safe, serious complications related to this procedure have been rarely reported. Herein, we describe a case of intraperitoneally placed urethral catheter via verumontanum presenting as intraperitoneal bladder perforation in a chronically debilitated elderly patient. A 82-yr-old male patient was admitted with symptoms of hematuria, lower abdominal pain after traumatic Foley catheterization. The retrograde cystography showed findings of intraperitoneal bladder perforation, but emergency laparotomy with intraoperative urethrocystoscopy revealed a tunnel-like false passage extending from the verumontanum into the rectovesical pouch between the posterior wall of the bladder and the anterior wall of the rectum with no bladder injury. The patient was treated with simple closure of the perforated rectovesical pouch and a placement of suprapubic cystostomy tube. PMID:21935283

  6. Femoral diaphyseal stress fracture as the initial presentation of acute leukaemia in an adolescent.

    Science.gov (United States)

    Chase, Helen Emily; Pang, Joe Hwong; Sanghrajka, Anish Pradip

    2016-01-01

    A 14-year-old boy was referred to the orthopaedic clinic by his general practitioner, reporting of a 6-week history of left thigh pain. Clinical examination was unremarkable. Radiographs demonstrated a periosteal reaction at the proximal femur. MRI scans demonstrated a stress fracture of the femur, with no associated sinister features and no evidence of a pathological lesion. As the fracture healed and symptoms improved, the patient became unwell with weight loss, lethargy, chest and jaw pain and fevers. After multiple blood tests over a 25-day period, including five full blood counts and two normal blood films, a third blood film finally demonstrated blasts in keeping with acute leukaemia. We discuss a literature review of musculoskeletal manifestations of leukaemia and the often atypical presentations found. PMID:27353177

  7. Fibrodysplasia ossificans progressiva: initial presentation with a preosseous lesion of the scalp and its MRI appearance.

    Science.gov (United States)

    Lin, Fu-Yu; Lin, Chien-Hung; Shu, Ginger; Chen, Clement Kuen-Huang

    2016-07-01

    This case subject is a 1-year-old girl presenting with recurrent diffuse soft-tissue swelling of the scalp and periorbital region. Her family denied any known history of trauma. There was no obvious discoloration or local heat at the lesion. Magnetic resonance imaging (MRI) revealed diffuse soft tissue swelling of the scalp manifesting as high signal intensity on T2-weighted images and low signal intensity on T1-weighted images with diffuse enhancement after gadolinium-contrast administration. Biopsy yielded inconclusive pathological results. Fibrodysplasia ossificans progressiva (FOP) was not suspected until malformation of the patient's toes was noticed. The scalp lesion underwent spontaneous regression, and subsequent radiographs of the chest and cervical spine revealed heterotopic ossifications of the neck and thorax. Early diagnosis of FOP is vital because trauma, unnecessary biopsy and intramuscular injection are known to cause acceleration of heterotopic ossifications. Previous studies reported diffuse soft tissue swelling at the posterior neck, thoracic wall or paraspinal region as preosseous lesions of FOP (Shiva Kumar et al. Neurology. 2010;74(6):e20, Merchant et al. Pediatr Radiol. 2006;36(10):1108-11, Hagiwara et al. AJR Am J Roentgenol. 2003;181(4):1145-7). To our knowledge, diffuse soft tissue swelling of the scalp as a preosseous lesion of FOP and associated MRI findings have not yet been reported. We believe that awareness of preosseous lesions presenting as diffuse soft tissue swelling, in addition to shortening and valgus deformity of the great toes, is an important diagnostic clue for establishing FOP. PMID:27003387

  8. [A case of Creutzfeldt-Jakob disease presenting with arm levitation as an initial symptom].

    Science.gov (United States)

    Kamogawa, Kenji; Ninomiya, Satoko; Okuda, Shinya; Matsumoto, Yushi; Tomita, Hitomi; Okamoto, Kensho; Okuda, Bungo

    2014-01-01

    A 74-year-old, right handed man, developed insidiously with levitation and clumsiness of the right upper limb. His right arm tended to levitate spontaneously, when he was examined. He could put the elevated arm down on command, while the arm resumed to antigravity posture when his attention was diverted. His right arm also exhibited unwilled elevation when performing complex finger movements on the right side. He had a feeling of strangeness of the elevated limb, especially with the eyes closed. In addition to asymmetric limb-kinetic apraxia, combined sensations such as stereognosis were disturbed on the right side. Brain MRI showed high signal lesions predominantly in the left cerebral cortices and basal ganglia. SPECT with (123)I-IMP revealed asymmetric hypoperfusion, predominantly in the left medial frontal and parietal regions. Two months after the onset, levitation of the arm gradually disappeared, with the development of rapidly progressive dementia, frontal signs, dystonia and generalized myoclonus. The diagnosis of Creutzfeldt-Jakob disease (CJD) was made based on the clinical features and cerebrospinal fluid biomarkers. The early manifestation of the patient mimicked corticobasal degeneration which presents with arm levitation or alien hand syndrome. It is suggested that CJD can represent involuntary movements with higher brain dysfunction resembling corticobasal degeneration at the early stage of the illness. Although the underlying mechanism of arm levitation is still unknown, frontal disinhibition and parietal cortical sensory disturbance may contribute to the development of involuntary arm levitation in our patient. PMID:25342014

  9. Hypertrophic pachymeningitis associated with cerebral spinal fluid hypovolemia as initial presentation of systemic lupus erythematous.

    Science.gov (United States)

    Sanchez-Garcia, Me; Gomez-Delgado, F; Gomez-Garduño, A; Blanco-Molina, A; Puebla, Ra Fernandez de la

    2014-02-01

    We report a case of a 61-year-old man with thickening of the dura mater associated with the presence of subdural collections as a consequence of cerebral spinal fluid hypovolemia (CSFH) and hypertrophic pachymeningitis (HP) as presentation of systemic lupus erythematous (SLE). The patient complained about fatigue, musculoskeletal pain, headache and skin lesions. In the laboratory tests minimal normocytic anemia, mild leukopenia, polyclonal hypergammaglobulinemia and antinuclear antibodies (ANA), anti-double-stranded DNA antibodies (dsDNA), antibodies against extractable nuclear antigens (ENA) type SSA-Ro, anti-Smith antigen antibodies (anti-Sm) and anti-ribonucleoprotein antibodies (anti-RNP) were detected. Cranial magnetic resonance imaging (MRI), with and without gadolinium enhancement, revealed generalized thickening of the dura mater more severe at the right parieto-occipital lobes with the presence of subdural collections. The patient was diagnosed with SLE associated both with CSFH and HP. A conservative treatment with prednisone 60 mg daily, mycophenolate mofetil (MMF) 1 g daily and hydroxychloroquine 200 mg twice a day was started with significant clinical and radiological improvement (almost complete resolution of the subdural collections and clear decrease of meningeal thickness). The authors emphasize that HP associated with CSFH in the context of SLE is a rare entity, which makes this case unique. PMID:24351279

  10. HIV-1 Drug Resistance Mutations Are Present in Six Percent of Persons Initiating Antiretroviral Therapy in Lusaka, Zambia

    NARCIS (Netherlands)

    R.L. Hamers; M. Siwale; C.L. Wallis; M. Labib; R. van Hasselt; W.S. Stevens; R. Schuurman; A.M.J. Wensing; M. van Vugt; T.F. Rinke de Wit

    2010-01-01

    Objective: To assess the mutational patterns and factors associated with baseline drug-resistant HIV-1 present at initiation of first-line antiretroviral therapy (ART) at 3 sites in Lusaka, Zambia, in 2007-2008. Methods: Population sequencing of the HIV-1 pol gene was performed in the PharmAccess Af

  11. Pneumatosis Intestinalis as the Initial Presentation of Systemic Sclerosis: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Farshid Ejtehadi

    2012-01-01

    Full Text Available Introduction. Pneumatosis intestinalis (PI is an uncommon pathology characterised by the presence of gas within the intestinal wall. It has been associated with various conditions, including connective tissue diseases. This is the first report of PI being the initial presentation of systemic sclerosis. Case Presentation. The patient, a 75-year-old female, presented with an 8-month history of worsening dysphagia and epigastric pain, as well as other nonspecific symptoms. Initial investigations with an oesophagogastroduodenoscopy diagnosed Candida oesophagitis and also identified an extrinsic compression of the gastric antrum. Subsequently a CT scan of the abdomen and pelvis showed moderately dilated small bowel loops and PI. Due to the patient’s stability, non-critical clinical condition, conservative management was instituted. More detailed investigations confirmed the diagnosis of systemic sclerosis with positive anticentromeric and antinuclear antibodies. The patient improved on methotrexate and was discharged with appropriate outpatient follow-up. Discussion. PI is a rare but well-documented pathology associated with connective tissue diseases, such as systemic sclerosis. In most cases, conservative management is preferable to surgical intervention, depending on the patient’s clinical presentation and progress. This is the first report of PI being the initial presentation of a patient with systemic sclerosis responsive to conservative management.

  12. Primary testicular non-Hodgkin's lymphoma with atrial mass as an initial presentation of acquired immunodeficiency syndrome

    International Nuclear Information System (INIS)

    The association between human immunodeficiency virus (HIV) infection and the increased incidence of testicular tumors is a recent well-organized phenomenon. Testicular tumors in the setting of HIV infection are most frequently of germ cell origin, less commonly lymphomas. We are presenting a unique case of testicular non-Hodgkin's B-cell lymphoma with associated atrial mass and mediastinal lymphadenopathy. The patient was not known to be HIV positive at the time of presentation. The initial clinical, radiological and gross pathologic impression was that of seminoma. Discussion of the differential diagnosis and appropriate work up is presented. (author)

  13. Imaging features of bilateral breast plasmacytoma as unusual initial presentation of multiple myeloma: case report and literature review

    International Nuclear Information System (INIS)

    Breast plasmacytoma (BP) is an extremely rare extramedullary manifestation of multiple myeloma (MM). We report the imaging findings of an unusual case in which BP was the initial presentation of MM. A 53-year-old woman with no contributory medical history underwent chest computed tomography to evaluate intermittent nocturnal anterior chest pain, and bilateral multiple breast masses were found. Following an ultrasound-guided core needle biopsy, these lesions were confirmed to be BP

  14. Symptoms, disability and handicap in unilateral peripheral vestibular disorders. Effects of early presentation and initiation of balance exercises.

    Science.gov (United States)

    Bamiou, D E; Davies, R A; McKee, M; Luxon, L M

    2000-01-01

    The aim of this study was to obtain a profile of disability and handicap in patients with unilateral peripheral vestibular disorders presenting to a specialist tertiary care unit. Two validated questionnaires were sent to patients who had a unilateral peripheral vestibular disorder as defined by strict criteria. Some patients still suffered moderate handicap and disability 5 years after the initial symptoms related to a unilateral vestibular disorder, although the duration of symptoms (onset to questionnaire completion) did not correlate with severity of disability and handicap, as judged by questionnaire scores. However, patients presenting to the unit within 6 months of onset of vertigo commenced balance exercises significantly earlier and had significantly lower disability scores than patients presenting later. A high proportion of non-compliance with, and delay in initiation of, vestibular rehabilitation exercises was noted in the total patient sample, while compliance with, and early initiation of, Cooksey Cawthorne exercises were significantly correlated with low disability and questionnaire scores. These findings suggest that early referral to a specialist balance unit for patients with persistent dizziness is associated with better outcome. PMID:11195943

  15. Initial Presentation of Renal Cell Carcinoma as a Metastatic Mass within the Masseter Muscle: A Case Report and Literature Review

    Energy Technology Data Exchange (ETDEWEB)

    Bae, Kyung Eun; Lee, Han Bee; Cho, Woo Ho; Kim, Jae Hyung; Lee, Ji Hae; Kang, Min Jin [Dept. of Radiology, Sanggye Paik Hospital, Inje University College of Medicine, Seoul (Korea, Republic of); Kim, Hyun Jung [Dept. of Pathology, Sanggye Paik Hospital, Inje University College of Medicine, Seoul (Korea, Republic of)

    2012-02-15

    Renal cell carcinoma (RCC) is often concomitant with distant metastasis, and these metastases are the first sign of an otherwise occult primary. Whereas metastasis of RCC to the head and neck has been reported, metastasis to the masseter muscle, which is composed of skeletal muscle, is quite rare. We now report the case of a 66-year-old man who had a past history of pulmonary tuberculosis, with RCC metastasis of a well-defined intensely enhancing hypervascular mass in the masseter muscle as the initial presentation. We present the imaging findings of this case and a literature review about radiologic differential diagnosis of intramasseteric masses.

  16. Mucosa-associated lymphoid tissue lymphoma with initial supradiaphragmatic presentation: natural history and patterns of disease progression

    International Nuclear Information System (INIS)

    Purpose: Mucosa-associated lymphoid tissue (MALT) lymphoma commonly presents in the gastrointestinal (GI) tract. Supradiaphragmatic MALT lymphoma is less common and its natural history is not well defined. This study was conducted to understand the natural history, to determine the frequency of synchronous disease in the GI tract, and to understand the patterns of disease progression after treatment for supradiaphragmatic MALT lymphoma. Patients and Methods: We retrospectively reviewed the medical records of 39 patients who presented with supradiaphragmatic MALT lymphoma between 1991 and 1997. Results: The median age of patients was 58 years (range, 25-90 years) with 16 male and 23 female patients. The most common primary site was salivary gland followed by ocular adnexa, lung, oral cavity, and others. Sixteen patients underwent esophagogastroduodenoscopy and biopsy (EGD + Bx) and 4 were found to have gastric involvement. Ann Arbor stages were the following: IEA, 17; IIEA, 5, IIEB, 1; and IVA, 16. The initial treatments were: involved field radiation therapy (n = 10), chemotherapy (n = 14), combination of radiation therapy and chemotherapy (n = 9), observation after biopsy (n = 4), antibiotics only (n = 1), and patient refusal of further intervention (n = 1). Seven patients received antibiotics as a part of the initial treatment. Every patient except for 1 was alive at a median follow-up of 39.5 months (range, 3-83 months). Thirty-six patients achieved complete response (CR) to the initial treatment. The actuarial 5-year progression-free survival rate was 83%. Progression of the disease occurred in 4 patients, with 2 in the stomach. Salvage attempts were made to 4 and were successful in 3. Of the 2 patients who relapsed in the stomach, 1 had negative EGD + Bx at the time of initial diagnosis. An EGD + Bx was not done in the second patient. Conclusion: Supradiaphragmatic MALT lymphoma appears to have a favorable prognosis. However, routine evaluation of the stomach

  17. Fibrosing mediastinitis with superior vena cava obstruction as the initial presentation of Langerhans' cell histiocytosis in a young child

    International Nuclear Information System (INIS)

    We present a 2-year-old girl with an unusual presentation of Langerhans' cell histiocytosis (LCH). Five months prior to admission to our hospital, she received IV steroids for bronchial obstruction. On admission, clinical signs of SVC obstruction were evident and a mediastinal mass was evident on the chest radiograph and MRI. Biopsy revealed fibrosing mediastinitis. Five months later, osteolysis was present on a skull radiograph. Surgical biopsy of the skull lesion revealed LCH. This case is unique because it demonstrates a rare initial manifestation of LCH that has not been previously reported. Furthermore, the primary, solitary mediastinal manifestation without calcifications was histologically interpreted as fibrosing mediastinitis, and the final diagnosis of LCH was only made after identifying the skull lesion. (orig.)

  18. Preoperative angiotensin converting enzyme inhibitor usage in patients with chronic subdural hematoma: Associations with initial presentation and clinical outcome.

    Science.gov (United States)

    Neidert, Marian C; Schmidt, Tobias; Mitova, Tatyana; Fierstra, Jorn; Bellut, David; Regli, Luca; Burkhardt, Jan-Karl; Bozinov, Oliver

    2016-06-01

    The aim of this study is to analyze the association of preoperative usage of angiotensin converting enzyme (ACE) inhibitors with the initial presentation and clinical outcome of patients with chronic subdural hematoma (cSDH). Patients treated for cSDH between 2009 and 2013 at our institution were included in this retrospective case-control study. Medical charts were reviewed retrospectively and data were analyzed using descriptive and inferential statistics. Out of 203 patients (58 females, mean age 73.2years), 53 (26%) patients were on ACE inhibitors before their presentation with cSDH. Median initial hematoma volume in individuals with ACE inhibitors (179.2±standard error of the mean [SEM] 13.0ml) was significantly higher compared to patients without ACE inhibitors (140.4±SEM 6.2ml; p=0.007). There was an increased probability of surgical reintervention in the ACE inhibitor group (12/53, 23% versus 19/153, 12%; p=0.079), especially in patients older than 80years (6/23, 26% versus 3/45, 7%; p=0.026). ACE inhibitors are associated with higher hematoma volume in patients with cSDH and with a higher frequency of recurrences requiring surgery (especially in the very old). We hypothesize that these effects are due to ACE inhibitor induced bradykinin elevation causing increased vascular permeability of the highly vascularized neomembranes in cSDH. PMID:26898577

  19. Epidural spinal cord compression as initial clinical presentation of an acute myeloid leukaemia: case report and literature review

    Institute of Scientific and Technical Information of China (English)

    Dominique N'Dri Oka; Alpha Boubacar Bah; André Valentin Tokpa; Louis Derou

    2016-01-01

    Epidural localization of myeloid leukaemia is rarely reported.Spinal cord compression as an initial presentation of acute myeloid leukaemia is extremely rare.This is a report of a 17-year-old black boy who presented to emergency department with neurological symptoms of spinal cord compression.Imaging modalities showed multiple soft tissue masses in the epidural space.After surgical treatment,histopathological examination of the epidural mass showed myeloid leukaemia cells infiltration.Literature review on Medline and "scholar Google" database was done.The characteristics and management of extra-medullary leukaemia are discussed.Granulocytic sarcoma,myeloid sarcoma or chloroma with acute myeloid leukaemia should be considered as part of epidural spinal cord compression.Therefore surgery is indicated on an emergent basis.

  20. Paraneoplastic Recurrent Hypoglycaemic Seizures: An Initial Presentation of Hepatoblastoma in an Adolescent Male—A Rare Entity

    Directory of Open Access Journals (Sweden)

    Irappa Madabhavi

    2014-01-01

    Full Text Available Hepatoblastoma (HB is a rare malignant tumour of the liver and usually occurs in the first three years of life. Hepatoblastoma in adolescents and young adults is extremely rare; nevertheless the prognosis is much worse than in childhood, because these kinds of tumours are usually diagnosed late. Characteristic imaging and histopathological and AFP levels help in the diagnosis of hepatoblastoma. Paraneoplastic features of hepatoblastoma are not uncommon at presentation and include erythrocytosis, thrombocytosis, hypocalcaemia, isosexual precocious puberty, and rarely hypoglycaemia. Even though hypoglycaemia is commonly seen in hepatocellular carcinoma, its association with hepatoblastoma is very rare. We present a case of 15-year-old male patient presenting with complaints of recurrent hypoglycaemic seizures ultimately leading to diagnosis of hepatoblastoma. Managed successfully with neoadjuvant chemotherapy, surgery and adjuvant chemotherapy with adriamycin and cisplatin based regimens. An extensive review of literature in the PubMed and MEDLINE did not reveal much data on paraneoplastic recurrent hypoglycaemic seizures as an initial presentation of hepatoblastomas in adolescents and young adults.

  1. Sepsis associated delirium mimicking postoperative delirium as the initial presenting symptom of urosepsis in a patient who underwent nephrolithotomy

    Science.gov (United States)

    Nag, Deb Sanjay; Chatterjee, Abhishek; Samaddar, Devi Prasad; Singh, Harprit

    2016-01-01

    We report a case of 70 years old male who underwent percutaneous nephrolithotomy for renal calculi. After an uneventful recovery from anaesthesia, the patient developed delirium which manifested as restlessness, agitation, irritability and combative behavior. All other clinical parameters including arterial blood gas, chest X-ray and core temperature were normal and the patient remained haemodynamically stable. But 45 min later the patient developed florid manifestations of septic shock. He was aggressively managed in a protocolized manner as per the Surviving Sepsis Guidelines in the Critical Care Unit and recovered completely. There are no case reports showing postoperative delirium as the only initial presentation of severe sepsis, with other clinical parameters remaining normal. Both urosepsis and sepsis associated delirium have very high mortality. High index of suspicion and a protocolized approach in the management of sepsis can save lives. PMID:27182528

  2. Rapid progression of primary cutaneous gamma-delta T-cell lymphoma with an initial indolent clinical presentation.

    Science.gov (United States)

    Alexander, Riley E; Webb, Alden R; Abuel-Haija, Mohammad; Czader, Magdalena

    2014-10-01

    Primary cutaneous gamma-delta T-cell lymphoma (CGD-TCL) is a rare cutaneous T-cell lymphoma characterized by a rapidly progressive clinical course and a poor prognosis. We report a case of a 52-year-old man with a 10-year history of erythematous nodules and a rapid terminal progression diagnosed as CGD-TCL. Biopsies taken at the time of progression showed a dense lymphocytic infiltrate involving the subcutaneous adipose tissue and deep dermis. One of the biopsies displayed much more limited involvement by CGD-TCL that was nearly identical to the biopsies of the erythematous lesions 10 years before. In conclusion, this case demonstrates a case of CGD-TCL presenting as a longstanding indolent disease with a rapid terminal progression. The indolent clinical course and histological heterogeneity make diagnosing this entity during the initial stage extremely challenging. This case underscores a diverse clinical presentations and a need to consider CGD-TCL in patients showing subcutaneous lesions with an indolent clinical course. PMID:25247673

  3. Uterine and ovarian carcinosarcomas overexpressing Trop-2 are sensitive to hRS7, a humanized anti-Trop-2 antibody

    Directory of Open Access Journals (Sweden)

    Raji Rhoda

    2011-11-01

    Full Text Available Abstract Background We evaluated the expression of human trophoblastic cell-surface marker (Trop-2 and the potential of hRS7 - a humanized monoclonal anti-Trop-2 antibody - as a therapeutic strategy against treatment-refractory human uterine (UMMT and ovarian (OMMT carcinosarcoma cell lines. Materials and methods Trop-2 expression was evaluated by immunohistochemistry (IHC in paraffin-embedded tumor tissues, by real-time polymerase-chain-reaction (RT-PCR and flow-cytometry in cell lines. Sensitivity to hRS7 antibody-dependent cellular cytotoxicity (ADCC and complement-dependent cytotoxicity was tested using 5-hour chromium-release assays against UMMT and OMMT cells. Results Trop-2 expression was elevated in 9 of 26 (35% UMMT and 8 of 14 (57% OMMT tissues tested by IHC. Positivity for Trop-2 mRNA by RT-PCR and surface expression by flow cytometry were detected in 2 of 4 cell lines, with high positivity noted in OMMT-ARK-2. OMMT-ARK-2 was highly sensitive to hRS7 ADCC (range: 34.7-41.0%; P Conclusion Trop-2 is overexpressed in a proportion of UMMT and OMMT, and hRS7 may represent a novel, potentially highly effective treatment option for patients with treatment-refractory carcinosarcomas overexpressing Trop-2.

  4. Rheumatoid Arthritis and Incidence of Twelve Initial Presentations of Cardiovascular Disease: A Population Record-Linkage Cohort Study in England.

    Directory of Open Access Journals (Sweden)

    Mar Pujades-Rodriguez

    Full Text Available While rheumatoid arthritis is an established risk factor for cardiovascular disease (CVD, our knowledge of how the pattern of risk varies for different cardiovascular phenotypes is incomplete. The association between rheumatoid arthritis and the initial presentation of 12 types of CVDs were examined in a contemporary population of men and women of a wide age range.CALIBER data, which links primary care, hospital and mortality data in England, was analysed. A cohort of people aged ≥18 years and without history of CVD was assembled and included all patients with prospectively recorded rheumatoid arthritis from January 1997, until March 2010, matched with up to ten people without rheumatoid arthritis by age, sex and general practice. The associations between rheumatoid arthritis and the initial presentation of 12 types of CVDs were estimated using multivariable random effects Poisson regression models.The analysis included 12,120 individuals with rheumatoid arthritis and 121,191 comparators. Of these, 2,525 patients with and 18,146 without rheumatoid arthritis developed CVDs during a median of 4.2 years of follow-up. Patients with rheumatoid arthritis had higher rates of myocardial infarction (adjusted incidence ratio [IRR] = 1.43, 95%CI 1.21-1.70, unheralded coronary death (IRR = 1.60, 95%CI 1.18-2.18, heart failure (IRR = 1.61, 95%CI 1.43-1.83, cardiac arrest (HR = 2.26, 95%CI 1.69-3.02 and peripheral arterial disease (HR = 1.36, 95%CI 1.14-1.62; and lower rates of stable angina (HR = 0.83, 95%CI 0.73-0.95. There was no evidence of association with cerebrovascular diseases, abdominal aortic aneurysm or unstable angina, or of interactions with sex or age.The observed associations with some but not all types of CVDs inform both clinical practice and the selection of cardiovascular endpoints for trials and for the development of prognostic models for patients with rheumatoid arthritis.

  5. Hemorrhagic small intestine cancer with solitary pulmonary metastasis initially presented as suspected primary lung cancer: an autopsy report.

    Science.gov (United States)

    Iwata, Takashi; Inoue, Kiyotoshi; Kiriike, Sachiko; Izumi, Nobuhiro; Mizuguchi, Shinjiro; Tsukioka, Takuma; Morita, Ryuhei; Nishiyama, Noritoshi; Takemura, Masashi; Osugi, Harusi; Wakasa, Kenichi; Suehiro, Shigefumi

    2007-12-01

    Cancer of the small intestine presenting with a solitary pulmonary metastasis is rare. Diagnosis and treatment of hemorrhagic small intestinal disease is clinically problematic due to its anatomic aspect, especially after multiple laparotomies. The case that we present here was a 79-year-old man who was initially diagnosed with suspected T2N2M0 lung cancer. After non-diagnostic results on two bronchoscopic biopsies and computed tomography-guided needle biopsy, he was admitted for thoracoscopic biopsy and possible curative operation. The patient had a history of multiple laparotomies for gastric ulcer and had no abdominal symptoms. A fecal occult blood test was positive; this was thought to be because of persistent bloody sputum. During the preoperative evaluation period, massive intestinal hemorrhage occurred. Intestinal tumor was identified by double-balloon enteroscopy and emergency laparotomy was performed to control the bleeding. The histopathological diagnosis was metastatic adenocarcinoma. However, intestinal bleeding started again. His systemic status deteriorated progressively, resulting in death. Autopsy revealed a large polypoid tumor with hemorrhagic necrosis in the jejunum that was histologically and immunohistochemically diagnosed as primary poorly differentiated adenocarcinoma in the small intestine. Multiple small submucosal tumors with central ulceration were confirmed as intramural metastases. A lung mass in the right lower lobe was diagnosed as a metastatic lesion. In the diagnosis and treatment of the disease, we faced several clinically difficult problems. We here describe in detail the clinical course and the diagnostic and therapeutic difficulties of this rare case, with some references to the literature. PMID:18432067

  6. A diagnosis challenge-L4 nerve root compression as the initial presentation of chronic inflammatory demyelinating polyneuropathy.

    Science.gov (United States)

    Cojocaru, Inimioara Mihaela; Alexianu, Marilena; Bastian, Alexandra; Sapira, Violeta; Herţea, Cristina; Cojocaru, M

    2012-01-01

    The authors present the case of a 65-year-old woman who was admitted for paraparesis and paresthesias in the inferior limbs. The neurological examination revealed the difficulty in extension of the right foot and of the right toe, accompanied by paresthesias located in the anterolateral area of the right leg, dorsum and plantar area of the foot, the reduction of the right knee jerk, and of the ankle tendon jerk both sides. The vertebro-spinal MRI showed lumbar canal stenosis with L4 intraforaminal compression on the right, and L2-L3 on the left. CSF examination revealed mild increase in protein concentration. The morphological picture of the sural nerve biopsy was compatible with a chronic inflammatory neuropathy and severe muscular lesions of neurogenic origin were observed on right gastrocnemius muscle biopsy. The diagnosis of chronic inflammatory demyelinating polyneuropathy (CIDP) was established. Solu-medrol (0.5 g/d)-5 days, then medrol (prednisolone) was done, followed by improving of the symptomatology. For the relapse of the disease intravenous immunoglobulins (IVIG)-0.4 g/kg/d-5 days was the elective treatment. Six months later she presented a new relapse. IVIG were administered with the remission of the sensitive symptoms. A chronic treatment with medrol was recommended. The diagnosis of L4 disc herniation was obvious in the studied case, but the electroneurographic examination brought extra data for the associated diagnosis of CIDP whose onset was asymmetrical and initially paucisymptomatic. Neither the electroneurographic examination nor the CSF examination were total relevant for CIDP, imposing the sural nerve biopsy. The diagnosis of CIDP involves a team-work composed of neurologist, electroneurophysiologist and neuropathologist. PMID:23610977

  7. Intercomparison of statistical and dynamical downscaling models under the EURO- and MED-CORDEX initiative framework: present climate evaluations

    Science.gov (United States)

    Vaittinada Ayar, Pradeebane; Vrac, Mathieu; Bastin, Sophie; Carreau, Julie; Déqué, Michel; Gallardo, Clemente

    2016-02-01

    Given the coarse spatial resolution of General Circulation Models, finer scale projections of variables affected by local-scale processes such as precipitation are often needed to drive impacts models, for example in hydrology or ecology among other fields. This need for high-resolution data leads to apply projection techniques called downscaling. Downscaling can be performed according to two approaches: dynamical and statistical models. The latter approach is constituted by various statistical families conceptually different. If several studies have made some intercomparisons of existing downscaling models, none of them included all those families and approaches in a manner that all the models are equally considered. To this end, the present study conducts an intercomparison exercise under the EURO- and MED-CORDEX initiative hindcast framework. Six Statistical Downscaling Models (SDMs) and five Regional Climate Models (RCMs) are compared in terms of precipitation outputs. The downscaled simulations are driven by the ERAinterim reanalyses over the 1989-2008 period over a common area at 0.44° of resolution. The 11 models are evaluated according to four aspects of the precipitation: occurrence, intensity, as well as spatial and temporal properties. For each aspect, one or several indicators are computed to discriminate the models. The results indicate that marginal properties of rain occurrence and intensity are better modelled by stochastic and resampling-based SDMs, while spatial and temporal variability are better modelled by RCMs and resampling-based SDM. These general conclusions have to be considered with caution because they rely on the chosen indicators and could change when considering other specific criteria. The indicators suit specific purpose and therefore the model evaluation results depend on the end-users point of view and how they intend to use with model outputs. Nevertheless, building on previous intercomparison exercises, this study provides a

  8. Condrosarcoma Mesenquimal Sinonasal Grado Tres y Carcinosarcoma de Glándula Mamaria de un Canino: Estudios Clínico e Histopatológico Sinunasal Mesenchymal Chondrosarcoma Grade 3 and Mammary Gland Carcinosarcoma of Canine: Clinical and Histopathology Study

    Directory of Open Access Journals (Sweden)

    Anita Roque Rodríguez

    2008-12-01

    , come a 9 years oíd Chow Chow female canine, whose consultation reason was a bilateral epistaxis occurred 4 months ago, sudden loss of the visión and a mass in the nasal región of 2cm of diameter approximately, according to the report of the owner, the mass showed up 1 month the day of the consultation. To the clinical exam they were the following abnormal discoveries. Hirsute hair, opaque, presented a subdermic mass approximately in the nasal región superior of 2 cm. diameter that grew to 5 cm. diameter after 1 month of the consultation, located in the nasal región superior and zigomatic región, of hard consistency, the animal had dysnea, bilateral mydriasis, the bilateral corneal reflection was negative, increase of the infraocular pressure of the right eye, the realized test of obstacles in the clinic was negative, that which showed us a blindness. Besides a complete clinical exploration and taking of the advantages of the cytology, she was carried out an aspired with fine needle of different áreas of the masses so much neoplastic of the nose and of the región of the mammary gland, being obtained two types of samples. The cytology was evaluated to define origin of the tumors of the process. She was carried out biopsy for incisión of the sinunosal región being diagnosed wicked tumor mesenchymal Chondrosarcoma sinunasal that commits bone. After having carried out the autopsy they took samples for histopathology. Being diagnosed mesenchymal chondrosarcoma sinunasal grade 3, with metástasis to lung, and a carcinosarcoma of mammary gland.

  9. Carcinosarcoma of the Pancreas: How a Common Blood Disorder Can Hide an Extremely Rare Tumour

    Directory of Open Access Journals (Sweden)

    Anastasios Katsourakis

    2015-05-01

    Full Text Available Context Sarcomas represent a relatively rare malignancy. Primary sarcomas of the pancreas represent an extremely rare pathology. Case report We report a case of primary pancreatic carcinoma that presented with anaemia. The patient underwent a Kausch-Whipple operation, and, 16 months after the operation, the patient is disease free. Conclusion This unique case describes an extremely rare gastrointestinal tumour that was found during the patient's anaemia assessment.

  10. Delays before Diagnosis and Initiation of Treatment in Patients Presenting to Mental Health Services with Bipolar Disorder

    OpenAIRE

    Patel, Rashmi; Shetty, Hitesh; Jackson, Richard; Broadbent, Matthew; Stewart, Robert; Boydell, Jane; McGuire, Philip; Taylor, Matthew

    2015-01-01

    Background: Bipolar disorder is a significant cause of morbidity and mortality. Although existing treatments are effective, there is often a substantial delay before diagnosis and treatment initiation. We sought to investigate factors associated with the delay before diagnosis of bipolar disorder and the onset of treatment in secondary mental healthcare. Method: Retrospective cohort study using anonymised electronic mental health record data from the South London and Maudsley NHS Foundation T...

  11. Carcinosarcoma with choriocarcinomatous and osteosarcomatous differentiation in a patient with juvenile polyposis syndrome

    Directory of Open Access Journals (Sweden)

    Rafael Parra-Medina

    2015-09-01

    Full Text Available Juvenile polyposis syndrome (JPS is an infrequent autosomal dominant hereditary predisposition to the occurrence of hamartomatous polyps in the colon and rectum. We describe the case of a 12-year-old boy with JPS associated with an abdominal tumor. Histological sections of the abdominal tumor showed components of adenocarcinoma, osteosarcoma, and choriocarcinoma. Immunohistochemistry was AE1/AE3, CK7, HCG and SALL4 positive. Juvenile polyposis syndrome patients are at increased risk of colorectal adenocarcinoma. However, we present a case of an adenocarcinoma associated with other unusual components. This association has not been reported before.

  12. An Unusual Initial Presentation of Sjögren’s Syndrome: Severe Hypokalemic Paralysis Secondary to Distal Renal Tubular Acidosis

    OpenAIRE

    Sengul, Erkan; Bunul, Fatih; Yazici, Ayten; Sengul, Aysun; Dindar, Sevim; Halhalli, Gökçen Selma Kilic; Binnetoglu, Emine

    2013-01-01

    Sjögren’s syndrome is mainly affects the exocrine glands. Patients usually complain of persistent dryness of the mouth and eyes. However, nonexocrine organs such as the kidneys are often affected in these patients. Distal renal tubular acidosis (dRTA) and interstitiel nephritis are common in Sjögren’s syndrome. Nonetheless, severe hypokalemia and paralysis secondary to dRTA are unusual initial manifestation of Sjögren’s syndrome. Here, we describe a case of a 48 year old women admitted to the...

  13. Supply guarantee initiatives for nuclear fuel materials and services and their compatibility with the market. Present discussions and future prospects

    International Nuclear Information System (INIS)

    Under the weakening NPT (Non-Proliferation Treaty) regime, a number of proposals and initiatives for nuclear fuel supply assurance and guarantee mechanisms have been brought on the agenda of international discussions and negotiations. This report first discusses where and why those ideas came out, and then turn to the current situations of markets of nuclear fuel materials and services in terms of degree of market concentration to specific suppliers. Based on those observations, the author attempts to draw a comparison among the proposed schemes in order to examine possible steps for forward that pose least possible influences adverse to the individual markets and thereby could better attract possible recipient states' interests. The report suggests that those initiatives are classified in three types; a) physical assurance, i.e. specific nation(s) and/or entit(-y/-ies) prepare dedicated reserve of materials and/or service capacities for the purpose of supply assurance; b) collective assurance, i.e. a group of nations and/or entities collectively submit their excess materials and service capacities when assurance is activated; and c) financial measures. In view of their feasibility, a two-step approach might be found practical to implement and promote; i.e. 1) in a short-run, a 'soft' scheme which never interferes NPT signatories' right of peaceful development and use of nuclear power could be set and implemented, and 2) in a long-run, R and D efforts should be undertaken to create such a sufficient economic margin that potential recipient states may lose justification of self-development of nuclear fuel cycle technologies and businesses when compared with those services provided by foreign sources attached with a sufficient degree of supply assurances. (author)

  14. Orofacial granulomatosis in children can be the initial manifestation of systemic disease: a presentation of two cases

    DEFF Research Database (Denmark)

    Simonsen, Anne Birgitte; Deleuran, Mette

    2014-01-01

    Orofacial granulomatosis is a chronic granulomatous condition characterized by relapsing and remitting lip swelling and oral involvement that may include deep ulcers, tags and cobblestone formation. It occurs as an independent entity but also in conjunction with systemic diseases such as...... tuberculosis, sarcoidosis and Crohn's disease. The clinical presentation is not indicative of concomitant systemic disease. To highlight the importance of thorough examination to rule out systemic disease, we present two childhood cases of orofacial granulomatosis, one of which was associated to Crohn......'s disease....

  15. Intracranial Extra-Axial Ependymoma in the Ambient Cistern That Initially Presented as Calcification: A Report of Case

    Energy Technology Data Exchange (ETDEWEB)

    Seo, Gi Young; Byun, Jun Soo; Kim, Jae Kyun; Kwon, Jung Taek; Park, Eon Sub; Jung, Yoon Yang [Chung Ang University Hospital, Chung Ang University College of Medicine, Seoul (Korea, Republic of)

    2013-01-15

    Ependymomas usually occur in intraventricular or intraspinal locations. Intracranial extraaxial ependymomas (IEAEs) are very rare. Here, we present an unusual case of an IEAE in 25-year-old man. The patient experienced head trauma two and half years prior to presentation, at which time brain computed tomography (CT) showed only a dense calcification in the left ambient cistern. After two and a half years, follow up brain CT and magnetic resonance imaging depicted interval growth of a calcified mass with cystic change. The tumor was successfully treated surgically, and the pathologic examination confirmed ependymoma.

  16. It is presented initially: linear dislocation & inter-language strategies in Brazilian Academic abstracts in english and portuguese It is presented initially: linear dislocation & inter-language strategies in Brazilian Academic abstracts in english and portuguese

    Directory of Open Access Journals (Sweden)

    Tim Johns

    2008-04-01

    Full Text Available In Brazil, as in the rest of the world, the academic community is under pressure to publish in English so that research findings can enter the mainstream of international debate as rapidly and effectively as possible. For the same reason, it is the editorial policy of most Brazilian academic journals that all papers, whether published in Portuguese or English, should be accompanied by abstracts in both languages. If the inclusion of English abstracts is not to become a meaningless ritual, it is a matter of some importance to evaluate how well the writers of such abstracts succeed in communicating the substance of their work to their peers outside Brazil, and also to examine the linguistic features that may facilitate or interfere with that communication. Although preliminary work has been undertaken by the author on both these questions, the present paper addresses the second only, with special reference to a problem at the intersection of syntax and discourse. In Brazil, as in the rest of the world, the academic community is under pressure to publish in English so that research findings can enter the mainstream of international debate as rapidly and effectively as possible. For the same reason, it is the editorial policy of most Brazilian academic journals that all papers, whether published in Portuguese or English, should be accompanied by abstracts in both languages. If the inclusion of English abstracts is not to become a meaningless ritual, it is a matter of some importance to evaluate how well the writers of such abstracts succeed in communicating the substance of their work to their peers outside Brazil, and also to examine the linguistic features that may facilitate or interfere with that communication. Although preliminary work has been undertaken by the author on both these questions, the present paper addresses the second only, with special reference to a problem at the intersection of syntax and discourse.

  17. Initial comments on the aero geophysical information present at the B and C areas of the Itatira (Brazil) project

    International Nuclear Information System (INIS)

    The aero geophysical project called Itatira,, accomplished by LASA Engenharia e Prospeccoes S.A., Between September and November/1977 through contract with NUCLEBRAS, corresponds to one of the first project of this gender accomplished in national territory. In this project were flight more than 80 000 km of linear lines, which covered approximately 38 000 km2 on the precambrian terrains of the Ceara State, NE Brazil. For several reasons, the total area of the project was subdivided in three sub-areas (A, B and C), each one covered by a different airship (LAS, 1977). This paper presents the geophysical information and preliminary interpretations of the areas B and C that were obtained through the integrated use of the soft wares AUTOCAD r. 14, OASIS MONTAJ r.4.2 and ERMAPPER r.5.5. (author)

  18. Acute small bowel obstruction: a rare initial presentation for the metastasis of the large-cell carcinoma of the lung

    Directory of Open Access Journals (Sweden)

    Song Yongmao

    2012-01-01

    Full Text Available Abstract We present one case with symptom of paroxysmal abdominal pain for over 20 days. Abdominal computerized tomography (CT scan revealed intestinal obstruction and a mass of 6.0 cm × 6.0 cm in size located at the left adrenal. Chest CT scan showed a lobulated mass of 2.7 cm × 2.7 cm in size at the upper left lung. Core needle biopsy of the lung mass confirmed the diagnosis of large cell carcinoma. The patient underwent an emergency abdominal laparotomy and received a chemotherapy regimen that consisted of pemetrexed and cisplatin postoperatively. In addition, we made a review of the literature of the occurrence, diagnosis and outcome of this manifestation.

  19. Accelerated Phase of Chediak-Higashi Syndrome at Initial Presentation: A Case Report of an Uncommon Occurrence in a Rare Disorder.

    Science.gov (United States)

    Jaiswal, Pooja; Yadav, Yogesh Kumar; Bhasker, Nilam; Kushwaha, Rashmi

    2015-12-01

    Chediak-Higashi syndrome (CHS) is an uncommon and fatal congenital disorder. The characteristic features of CHS are partial oculocutaneous albinism, increased vulnerability to infections, presence of abnormal large granules in leukocytes and an accelerated lymphohistiocytic phase. Accelerated phase at initial presentation is rarely seen as it is usually preceded by repeated episodes of infections. Hence this interesting case of a four-month-old Indian child born to consanguineous parents in accelerated phase at initial presentation is described. The boy presented with fever, hepatosplenomegaly, and cleft lip. Clinical diagnosis was leukemia or a lysosomal storage disorder. Cytopaenias, lymphohistiocytic infiltration in bone marrow, and the characteristic large granules in leucocytes helped in the diagnosis, emphasizing the importance of bone marrow in diagnosis of unusual presentation of this rare disorder. PMID:26816903

  20. Clinicopathological correlates in HIV seropositive tuberculosis cases presenting with jaundice after initiating antiretroviral therapy with a structured review of the literature

    Directory of Open Access Journals (Sweden)

    Barr David A

    2012-10-01

    Full Text Available Abstract Background The development of jaundice after initiation of HAART in HIV-TB co-infected patients is a challenging presentation in resource constrained settings, and is often attributed to drug induced liver injury (DILI.Some investigators have described hepatic tuberculosis Immune Reconstitution Inflammatory Syndrome (TB-IRIS as a cause of liver disease in patients initiating HAART, which could also cause jaundice. Case presentations We report the clinical and histopathological features of five HIV-TB co-infected patients presenting with a syndrome of jaundice, tender hepatomegaly, bile canalicular enzyme rise and return of constitutional symptoms within 8 weeks of initiation of highly active antiretroviral therapy (HAART for advanced HIV infection at a rural clinic in KwaZulu Natal, South Africa. All five patients had been diagnosed with tuberculosis infection prior to HAART initiation and were on antituberculous medication at time of developing jaundice. There was evidence of multiple aetiologies of liver injury in all patients. However, based on clinical course and pathological findings, predominant hepatic injury was thought to be drug induced in one case and hepatic tuberculosis associated immune reconstitution inflammatory syndrome (TB-IRIS in the other four. In these later 4 patients, liver biopsy findings included necrotising and non-necrotising granulomatous inflammation in the lobules and portal tracts. The granulomas demonstrated – in addition to epithelioid histiocytes and Langhans giant cells – neutrophils, plasma cells and large numbers of lymphocytes, which are not features of a conventional untreated tuberculous response. Conclusion In this high TB prevalent, low resource setting, TB-IRIS may be an important cause of jaundice post-HAART initiation. Clinicopathological correlation is essential for optimal diagnosis. Further multi-organ based histopathological studies in the context of immune reconstitution would be

  1. Contrast-enhanced [18F] fluorodeoxyglucose-positron emission tomography-computed tomography as an initial imaging modality in patients presenting with metastatic malignancy of undefined primary origin

    OpenAIRE

    Jain, Avani; Srivastava, Madhur Kumar; Pawaskar, Alok Suresh; Shelley, Simon; Elangovan, Indirani; Jain, Hasmukh; Pandey, Somnath; Kalal, Shilpa; Amalachandran, Jaykanth

    2015-01-01

    Background: To evaluate the advantages of contrast enhanced F-18-fluorodeoxyglucose (FDG) positron emission tomography-computed tomography (PET-contrast enhanced CT [CECT]) when used as an initial imaging modality in patients presenting with metastatic malignancy of undefined primary origin (MUO). Materials and Methods: A total of 243 patients with fine needle aspiration cytology/biopsy proven MUO were included in this prospective study. Patients who were thoroughly evaluated for primary or p...

  2. Fibrosing mediastinitis with superior vena cava obstruction as the initial presentation of Langerhans' cell histiocytosis in a young child

    Energy Technology Data Exchange (ETDEWEB)

    Trusen, Andreas; Beissert, Matthias; Darge, Kassa [Department of Paediatric Radiology, Institute of Radiodiagnostics, University of Wuerzburg, Josef-Schneider-Strasse 2, 97080 Wuerzburg (Germany); Hebestreit, Helge [University Children' s Hospital, University of Wuerzburg, Wuerzburg (Germany); Marx, Alexander [Institute of Pathology, University of Wuerzburg, Wuerzburg (Germany)

    2003-07-01

    We present a 2-year-old girl with an unusual presentation of Langerhans' cell histiocytosis (LCH). Five months prior to admission to our hospital, she received IV steroids for bronchial obstruction. On admission, clinical signs of SVC obstruction were evident and a mediastinal mass was evident on the chest radiograph and MRI. Biopsy revealed fibrosing mediastinitis. Five months later, osteolysis was present on a skull radiograph. Surgical biopsy of the skull lesion revealed LCH. This case is unique because it demonstrates a rare initial manifestation of LCH that has not been previously reported. Furthermore, the primary, solitary mediastinal manifestation without calcifications was histologically interpreted as fibrosing mediastinitis, and the final diagnosis of LCH was only made after identifying the skull lesion. (orig.)

  3. Extramedullary blast crisis as initial presentation in chronic myeloid leukemia with the e1a2 BCR-ABL1 transcript: A case report

    Science.gov (United States)

    AI, DI; LIU, WEI; LU, GARY; PATEL, KEYUR PRAVINCHANDRA; CHEN, ZI

    2015-01-01

    A 23-year-old woman presented with enlarged right inguinal lymph nodes. The pathological examination of the nodes revealed infiltration by myeloid sarcoma. A bone marrow smear and biopsy revealed cytogenetic abnormalities, with 46,XX,t(9;22) and chronic myeloid leukemia (CML) was diagnosed. The e1a2 BCR-ABL1 fusion transcript was detected. The patient received imatinib-based combined chemotherapy, allogeneic hematopoietic stem cell transplantation, donor lymphocyte infusions and dasatinib treatment. The patient achieved complete response and has remained leukemia-free for >48 months. To the best of our knowledge, this is the first case report of CML with the e1a2 BCR-ABL1 transcript, with extramedullary blast crisis as the initial presentation. The aim of the present study was to discuss this special case with reference to the literature. PMID:26807241

  4. Low-pressure cardiac tamponade masquerading as severe sepsis diagnosed with a bedside ultrasound and as the initial presentation of malignancy

    Directory of Open Access Journals (Sweden)

    Ricardo Augusto Slaibi Conti

    2014-07-01

    Full Text Available Objective: We report a patient with low-pressure cardiac tamponade masquerading as sepsis and as the initial presentation of malignancy. A quick diagnosis was done by the intensivist performing a bedside ultrasound. Background: The diagnosis of low-pressure cardiac tamponade is a challenge because the classic physical signs of cardiac tamponade can be absent. It is made even more challenging when the vital sign changes and physical examination findings mimic severe sepsis. One of the benefits of a bedside ultrasound in the assessment of a patient with an initial diagnosis of severe sepsis or septic shock is the rapid diagnosis of cardiac tamponade if it is present. Data Source and Synthesis: A 55-year-old male presented to the emergency department with weakness, cough, and syncope. His examination was notable only for dusky mottling of his cheeks, chest, and neck. Specifically, there was no jugular venous distension or pulsus paradoxus. A chest radiograph showed a right upper lobe infiltrate, whereas his electrocardiogram showed only sinus tachycardia. His white blood cell count and lactic acid were elevated. The sepsis protocol was started and a bedside ultrasound revealed signs of cardiac tamponade. The patient immediately improved after a pericardiocentesis. Analysis of the pericardial biopsy revealed adenocarcinoma, later determined to be from a pulmonary primary source. Conclusions: Because low-pressure cardiac tamponade is life-threatening and difficult to diagnose, evaluation of the pericardium with a bedside ultrasound should be considered in patients with syncope, severe sepsis, or shock.

  5. T-DM1, a novel antibody-drug conjugate, is highly effective against uterine and ovarian carcinosarcomas overexpressing HER2.

    Science.gov (United States)

    Nicoletti, Roberta; Lopez, Salvatore; Bellone, Stefania; Cocco, Emiliano; Schwab, Carlton L; Black, Jonathan D; Centritto, Floriana; Zhu, Liancheng; Bonazzoli, Elena; Buza, Natalia; Hui, Pei; Mezzanzanica, Delia; Canevari, Silvana; Schwartz, Peter E; Rutherford, Thomas J; Santin, Alessandro D

    2015-01-01

    Ovarian and uterine carcinosarcoma (CS) are characterized by their aggressive clinical behavior and poor prognosis. We evaluated the efficacy of trastuzumab-emtansine (T-DM1), against primary HER2 positive and HER2 negative CS cell lines in vitro and in vivo. Eight primary CS cell lines were evaluated for HER2 amplification and protein expression by fluorescence in situ hybridization, immunohistochemistry, flow cytometry and qRT-PCR. Sensitivity to T-DM1-induced antibody-dependent-cell-mediated-cytotoxicity (ADCC) was evaluated in 4-h-chromium-release-assays. T-DM1 cytostatic and apoptotic activities were evaluated using flow cytometry based proliferation assays. In vivo activity of T-DM1 was also evaluated. HER2 protein overexpression and gene amplification were detected in 25 % (2/8) of the primary CS cell lines. T-DM1 and T were similarly effective in inducing strong ADCC against CS overexpressing HER2 at 3+ levels. In contrast, T-DM1 was dramatically more effective than T in inhibiting cell proliferation (P < 0.0001) and in inducing G2/M phase cell cycle arrest in the HER2 expressing cell lines (shift of G2/M: mean ± SEM from 14.87 ± 1.23 to 66.57 ± 4.56 %, P < 0.0001). Importantly, T-DM1 was highly active at reducing tumor formation in vivo in CS xenografts overexpressing HER2 (P = 0.0001 and P < 0.0001 compared to T and vehicle respectively) with a significantly longer survival when compared to T and vehicle mice (P = 0.008 and P = 0.0001 respectively). T-DM1 may represent a novel treatment option for the subset of HER2 positive CS patients with disease refractory to chemotherapy. PMID:25398397

  6. Contrast-enhanced [18F] fluorodeoxyglucose-positron emission tomography-computed tomography as an initial imaging modality in patients presenting with metastatic malignancy of undefined primary origin

    International Nuclear Information System (INIS)

    To evaluate the advantages of contrast enhanced F-18-fluorodeoxyglucose (FDG) positron emission tomography-computed tomography (PET-contrast enhanced CT [CECT]) when used as an initial imaging modality in patients presenting with metastatic malignancy of undefined primary origin (MUO). A total of 243 patients with fine needle aspiration cytology/biopsy proven MUO were included in this prospective study. Patients who were thoroughly evaluated for primary or primary tumor was detected by any other investigation were excluded from the analysis. Totally, 163 patients with pathological diagnosis of malignancy but no apparent sites of the primary tumor were finally selected for analysis. The site of probable primary malignancy suggested by PET-CECT was confirmed by biopsy/follow-up. PET-CECT suggested probable site of primary in 128/163 (78.52%) patients. In 30/35 remaining patients, primary tumor was not detected even after extensive work-up. In 5 patients, where PET-CECT was negative, primary was found on further extensive investigations or follow-up. The sensitivity, specificity, positive predictive value and negative predictive value of the study were 95.76%, 66.67%, 88.28% and 85.71% respectively. F-18 FDG PET-CECT aptly serves the purpose of initial imaging modality owing to high sensitivity, negative and positive predictive value. PET-CECT not only surveys the whole body for the primary malignancy but also stages the disease accurately. Use of contrast improves the diagnostic utility of modality as well as help in staging of the primary tumor. Although benefits of using PET-CECT as initial diagnostic modality are obvious from this study, there is a need for a larger study comparing conventional methods for diagnosing primary in patients with MUO versus PET-CECT

  7. Tibial bone metastasis as an initial presentation of endometrial carcinoma diagnosed by fine-needle aspiration cytology: A case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Sarag Aboujafar Boukhar

    2015-01-01

    Full Text Available Endometrial cancer is the most common gynecologic malignancy in the United States. However, bony metastasis is infrequent and exceptionally rare as the initial presentation. We report a case of a 77-year-old female with a clinically silent endometrial carcinoma who presented with a left tibial metastasis as the first manifestation of her disease. Ours is only the third case diagnosed by fine-needle aspiration (FNA cytology, and the first to detail the cytomorphologic features of metastatic endometrial cancer to bone. These microscopic findings, including three-dimensional cohesive clusters with cellular overlapping and cuboidal to columnar cells exhibiting low nuclear: cytoplasmic ratios and partially vacuolated cytoplasm, differ significantly from those of endometrial carcinoma on a Papanicolaou test. The tumor bore similarity to the more commonly encountered metastatic colon cancer, but immunohistochemical staining enabled reliable distinction between these entities. A review of osseous metastases of endometrial cancer demonstrates a predilection for bones of the lower extremity and pelvis with a predominance of the endometrioid histologic subtype. In about a quarter of the cases, the bony metastasis was the first manifestation of the cancer. FNA was an effective diagnostic modality for this unusual presentation of a common malignancy. Awareness of this entity and its differential diagnosis is essential for accurate and timely diagnosis.

  8. Kidney failure as an unusual initial presentation of biclonal gammopathy (IgD multiple myeloma associated with light chain disease: A case report

    Directory of Open Access Journals (Sweden)

    Rabrenović Violeta

    2015-01-01

    Full Text Available Introduction. Immunoglobulin D (IgD myeloma is a rare disease, about 2% of all myelomas, even rarer when accompanied with another multiple myeloma in biclonal gammopathy. We presented a case of biclonal gammopathy - associated manifestation of IgD myeloma and light chain disease in a patient who initially had renal failure. Case report. 37-year-old male approximately one month before hospitalization began to feel malaise and fatigue along with decreased urination. Laboratory analysis revealed azotemia. A dialysis catheter was placed and hemodialysis started. The patient was then admitted to our hospital for further tests and during admission, objective examination revealed pronounced paleness with hepatosplenomegaly and hypertension (170/95 mmHg. Laboratory analysis showed erythrocyte sedimentation rate 122 mm/h, expressed anemic syndrome (Hb 71 g/L and renal failure dialysis rank: creatinine 1,408 μmol/L, urea31.7 mmol/L. There was two M components in serum protein electrophoresis: IgD lambda and free light chain lambda. Proteinuria was nephrotic rank (5.4 g/24 h, whose electrophoresis revealed 2 M components - massive in α 2 fraction of 71%; 7% in the discrete β fraction, beta 2M /serum 110 mg/L, in urine 1.8 mg/L - extremely high; IgL kappa / lambda index 1 : 13 (reference value ratio 2 : 1. The findings pointed to double myeloma disease: IgD myeloma and Bence Jones lambda myeloma. Bone biopsy confirmed IgD myeloma lambda 100% infiltration medulla predominantly plasmablasts. The treatment continued with hemodialysis 3 times per week with chemotherapy protocol bortezomib, doxorubicin, dexamethasone. After 4 cycles of chemotherapy, there was a decrease of IgD, λ - light chains, reduction in proteinuria (1.03 g/24 h, so hemodialysis was reduced to once per week. Six months after treatment initiation the patient underwent autologous bone marrow transplantation. In a 2-year follow-up period double myeloma disease showed complete remission

  9. SUBMIT: Systemic therapy with or without up front surgery of the primary tumor in breast cancer patients with distant metastases at initial presentation

    Directory of Open Access Journals (Sweden)

    Ruiterkamp Jetske

    2012-04-01

    Full Text Available Abstract Background Five percent of all patients with breast cancer have distant metastatic disease at initial presentation. Because metastatic breast cancer is considered to be an incurable disease, it is generally treated with a palliative intent. Recent non-randomized studies have demonstrated that (complete resection of the primary tumor is associated with a significant improvement of the survival of patients with primary metastatic breast cancer. However, other studies have suggested that the claimed survival benefit by surgery may be caused by selection bias. Therefore, a randomized controlled trial will be performed to assess whether breast surgery in patients with primary distant metastatic breast cancer will improve the prognosis. Design Randomization will take place after the diagnosis of primary distant metastatic breast cancer. Patients will either be randomized to up front surgery of the breast tumor followed by systemic therapy or to systemic therapy, followed by delayed local treatment of the breast tumor if clinically indicated. Patients with primary distant metastatic breast cancer, with no prior treatment of the breast cancer, who are 18 years or older and fit enough to undergo surgery and systemic therapy are eligible. Important exclusion criteria are: prior invasive breast cancer, surgical treatment or radiotherapy of this breast tumor before randomization, irresectable T4 tumor and synchronous bilateral breast cancer. The primary endpoint is 2-year survival. Quality of life and local tumor control are among the secondary endpoints. Based on the results of prior research it was calculated that 258 patients are needed in each treatment arm, assuming a power of 80%. Total accrual time is expected to take 60 months. An interim analysis will be performed to assess any clinically significant safety concerns and to determine whether there is evidence that up front surgery is clinically or statistically inferior to systemic therapy

  10. Modelo de tumor de pulmão em rato com o carcinossarcoma de Walker Lung tumor model in rats with Walker’s carcinosarcoma

    Directory of Open Access Journals (Sweden)

    Antero Gomes Neto

    2002-02-01

    Full Text Available OBJETIVO: Desenvolver um modelo de tumor pulmonar em ratos com o carcinossarcoma de Walker e verificar in vivo a presença de tumor por meio de tomografia computadorizada (TC. MÉTODOS: Ratos Wistar fêmeas (n=47 foram anestesiados com pentobarbital, intubados por traqueostomia e submetidos a toracotomia para injeção no parênquima pulmonar de células do tumor de Walker ou do veículo das mesmas. O estudo consistiu de duas etapas: na primeira desenvolveu-se a técnica de implante do tumor e estabeleceu-se o número de células necessário para um bom índice de pega tumoral. Na segunda etapa, determinou-se o volume do tumor em cm³ (Dxd²/2 através de TC e necropsia (6° dia do implante, e analizou-se a sobrevida dos animais. RESULTADOS: O índice de pega do tumor foi 93,3%, sendo 81,8% na primeira etapa e 100% na segunda. A mortalidade cirúrgica foi 17,0%. As medidas dos tumores foram semelhantes (0,099 vs. 0,111 cm³ na tomografia e na necropsia, respectivamente (r=0,993; pOBJECTIVE: To develop a lung tumor model in rats using Walker’s carcinosarcoma and to verify the presence in vivo of tumors using computerized tomography (CT. METHODS: Female Wistar rats (n=47 were anesthetized with pentobarbital, intubated through tracheostomy and submitted to thoracotomy; subsequently a 50-70 mu L volume containing Walker’s tumor cells, or the suspension of these same cells, was injected into the lung parenchyma. The study consisted of two phases: in the first a tumor implantation technique was developed and the number of cells required to attain a satisfactory tumor development rate was established. In the second phase, the tumor volume in cm³ (Dxd²/2 was determined through CT scan and necropsis, and the survival rates were analyzed. RESULTS: The overall tumor development rate was 93.3%, or rather, 81.1% in the first phase and 100% in the second. The surgical mortality rate was 17.0%. The average tumor volume was similar (0.099 vs. 0.111 cm

  11. A review of initiatives to reduce energy-related CO2 emissions from the city of Oxford: past, present and future

    International Nuclear Information System (INIS)

    This paper reviews three key initiatives undertaken in the historical city of Oxford to bring about reductions in energy-related CO2 emissions on a city-wide scale. The author has been part of all the three initiatives. In 2002, a collaborative partnership between academia, industry and city council started the Oxford Solar Initiative (OSI) which uses a community-based approach to help households and organisations in Oxford, financially and technically, to install solar energy systems and energy efficiency measures in buildings. So far OSI has facilitated the installation of 80 active solar systems, over 450 energy efficiency measures and 3,000 low energy bulbs. The scientific basis of OSI is a GIS-based DECoRuM model which estimates and maps baseline energy use and CO2 emissions on a house-by house level, identifies 'pollution' hotspots, predicts the potential for reductions in CO2 emissions and monitors reductions achieved as a result of deploying energy efficiency measures and renewable energy systems. The application of DECoRuM model to a case study in Oxford shows that CO2 emission reductions above 60 % are possible, at a cost of between GBP 6 to GBP 77 per tonne of CO2 emissions saved, depending upon the package of measures used, and the scenario of capital costs (low or high) employed. The OSI and DECoRuM projects have led to the development of an action-oriented Oxford Climate Change Action Plan (OCCAP) which constructs an accurate CO2 emissions inventory for Oxford city for a baseline year, establishes CO2 reduction targets and proposes action for each of the energy-related sectors to meet those targets. The OCCAP will be implemented by Oxford City Council and provides a useful example for other cities in their endeavour for emission reductions

  12. The CAD/CAM product data standards, IGES/PDES (Initial Graphics Exchange Specification/Product Data Exchange Standards): The present and the future

    Energy Technology Data Exchange (ETDEWEB)

    1990-01-01

    The Initial Graphics Exchange Specification (IGES) has more capability than most people infer from the name. It can already provide some product data for manufacturing and test of products and, in particular, products having electrical and electronic aspects. The Product Data Exchange Specification (PDES) promises to do even better. Both of these efforts address the demonstrated need to move product descriptions from one computer-aided system to another in a way that maximizes the utility of the data received. Receiving systems can use these product descriptions (usually after some augmentation) to perform simulations, numerically controlled fabrication operations, process planning and variety of inspections and tests. PDES is expected to support Computer Integrated Manufacturing with the emphasis on Integrated.''

  13. Cardiac tamponade mimicking tuberculous pericarditis as the initial presentation of chronic lymphocytic leukemia in a 58-year-old woman: a case report

    Directory of Open Access Journals (Sweden)

    Nathan Sandeep

    2010-08-01

    Full Text Available Abstract Introduction Chronic lymphocytic leukemia is an indolent disease that often presents with complaints of lymphadenopathy or is detected as an incidental laboratory finding. It is rarely considered in the differential diagnosis of patients presenting with tamponade or a large, bloody pericardial effusion. In patients without known cancer, a large, bloody pericardial effusion raises the possibility of tuberculosis, particularly in patients from endemic areas. However, the signs, symptoms and laboratory findings of pericarditis related to chronic lymphocytic leukemia can mimic tuberculosis. Case Presentation We report the case of a 58-year-old African American-Nigerian woman with a history of travel to Nigeria and a positive tuberculin skin test who presented with cardiac tamponade. She had a mild fever, lymphocytosis and a bloody pericardial effusion, but cultures and stains were negative for acid-fast bacteria. Assessment of blood by flow cytometry and pericardial biopsy by immunohistochemistry revealed CD5 (+ and CD20 (+ lymphocytes in both tissues, demonstrating this to be an unusual manifestation of early stage chronic lymphocytic leukemia. Conclusion Although most malignancies that involve the pericardium clinically manifest elsewhere before presenting with tamponade, this case illustrates the potential for early stage chronic lymphocytic leukemia to present as a large pericardial effusion with tamponade. Moreover, the presentation mimicked tuberculosis. This case also demonstrates that it is possible to treat chronic lymphocytic leukemia-related pericardial tamponade by removal of the fluid without chemotherapy.

  14. A Rare Occurrence of Simultaneous Venous and Arterial Thromboembolic Events – Lower Limb Deep Venous Thrombosis and Pulmonary Thromboembolism as Initial Presentation in Acute Promyelocytic Leukemia

    Science.gov (United States)

    Kutiyal, Aditya S.; Dharmshaktu, Pramila; Kataria, Babita; Garg, Abhilasha

    2016-01-01

    The development of acute myeloid leukemia has been attributed to various factors, including hereditary, radiation, drugs, and certain occupational exposures. The association between malignancy and venous thromboembolism events is well established. Here, we present a case of a 70-year-old Indian man who had presented with arterial and venous thrombosis, and the patient was later diagnosed with acute promyelocytic leukemia (APL). In our case, the patient presented with right lower limb deep venous thrombosis and pulmonary thromboembolism four months prior to the diagnosis of APL. Although thromboembolic event subsequent to the diagnosis of malignancy, and especially during the chemotherapy has been widely reported, this prior presentation with simultaneous occurrence of both venous and arterial thromboembolism has rarely been reported. We take this opportunity to state the significance of a complete medical evaluation in cases of recurrent or unusual thrombotic events. PMID:26949347

  15. Pseudotumor pulmonar como apresentação inicial de granulomatose de Wegener Lung pseudotumor as the initial presentation of Wegener's granulomatosis

    Directory of Open Access Journals (Sweden)

    Marcelo Fouad Rabahi

    2009-04-01

    Full Text Available A granulomatose de Wegener é uma doença inflamatória multissistêmica de etiologia desconhecida, que se caracteriza por vasculite de pequeno e médio calibre. As manifestações clínicas mais comuns envolvem o trato respiratório superior, pulmões e rins e as alterações encontradas nos exames de imagem são geralmente opacidades pulmonares ou nódulos múltiplos, bilaterais e, em 50% dos casos, cavitações. O tratamento é feito com corticoides e imunossupressores. Descreve-se um caso atípico de um homem de 61 anos cuja investigação inicial de um tumor pulmonar unilateral evidenciou, na verdade, Granulomatose de Wegener.Wegener's granulomatosis is a multisystemic inflammatory illness of unknown etiology, characterized by vasculitis of small and medium caliber vessels. The most common clinical manifestations involve the upper respiratory tract, lungs and kidneys. Common alterations in imaging studies include pulmonary opacities and bilateral multiple nodules, cavitations occurring in 50% of the cases. Treatment includes corticosteroids and immunosuppressants. We describe an atypical case of a 61-year-old man initially investigated due to suspicion of a unilateral lung tumor, which proved to be, in fact, a case of Wegener's granulomatosis.

  16. Anti-Aquaporin-4 Antibody-Positive Neuromyelitis Optica Presenting with Syndrome of Inappropriate Antidiuretic Hormone Secretion as an Initial Manifestation

    Directory of Open Access Journals (Sweden)

    H. Nakajima

    2011-10-01

    Full Text Available The distribution of neuromyelitis optica (NMO-characteristic brain lesions corresponds to sites of high aquaporin-4 (AQP4 expression, and the brainstem and hypothalamus lesions that express high levels of AQP4 protein are relatively characteristic of NMO. The syndrome of inappropriate antidiuretic hormone secretion (SIADH is one of the important causes of hyponatremia and results from an abnormal production or sustained secretion of antidiuretic hormone (ADH. SIADH has been associated with many clinical states or syndromes, and the hypothalamic-neurohypophyseal system regulates the feedback control system for ADH secretion. We report the case of a 63-year-old man with NMO, whose initial manifestation was hyponatremia caused by SIADH. Retrospective analysis revealed that the serum anti-AQP4 antibody was positive, and an MRI scan showed a unilateral lesion in the hypothalamus. SIADH recovered completely with regression of the hypothalamic lesion. As such, NMO should even be considered in patients who develop SIADH and have no optic nerve or spinal cord lesions but have MRI-documented hypothalamic lesions.

  17. The initial management of stable angina in Europe, from the Euro Heart Survey: a description of pharmacological management and revascularization strategies initiated within the first month of presentation to a cardiologist in the Euro Heart Survey of Stable Angina.

    NARCIS (Netherlands)

    Daly, C.A.; Clemens, F.; Lopez-Sendon, J.; Tavazzi, L.; Boersma, E.; Danchin, N.; Delahaye, F.; Gitt, A.; Julian, D.; Mulcahy, D.; Ruzyllo, W.; Thygesen, K.; Verheugt, F.W.A.; Fox, K.M.

    2005-01-01

    AIMS: In order to assess adherence to guidelines and international variability in management, the Euro Heart Survey of Newly Presenting Angina prospectively studied medical therapy, percutaneous coronary intervention (PCI), and surgery in patients with new-onset stable angina in Europe. METHODS AND

  18. Initial comments on the aero geophysical information present at the B and C areas of the Itatira (Brazil) project; Comentarios iniciais sobre as informacoes aerogeofisicas presentes nas areas B e C do Projeto Itatira

    Energy Technology Data Exchange (ETDEWEB)

    Castro, Neivaldo Araujo de; Castelo Branco, Raimundo Mariano Gomes [Ceara Univ., Fortaleza, CE (Brazil). Dept. de Geologia. Lab. de Geofisica de Prospeccao e Sensoriamento Remoto

    1999-07-01

    The aero geophysical project called Itatira,, accomplished by LASA Engenharia e Prospeccoes S.A., Between September and November/1977 through contract with NUCLEBRAS, corresponds to one of the first project of this gender accomplished in national territory. In this project were flight more than 80 000 km of linear lines, which covered approximately 38 000 km{sup 2} on the precambrian terrains of the Ceara State, NE Brazil. For several reasons, the total area of the project was subdivided in three sub-areas (A, B and C), each one covered by a different airship (LAS, 1977). This paper presents the geophysical information and preliminary interpretations of the areas B and C that were obtained through the integrated use of the soft wares AUTOCAD r. 14, OASIS MONTAJ r.4.2 and ERMAPPER r.5.5. (author)

  19. Influence of preceding length of anticoagulant treatment and initial presentation of venous thromboembolism on risk of recurrence after stopping treatment: analysis of individual participants’ data from seven trials

    OpenAIRE

    Boutitie, Florent; Pinede, Laurent; Schulman, Sam; Agnelli, Giancarlo; Raskob, Gary; Julian, Jim; Hirsh, Jack; Kearon, Clive

    2011-01-01

    Objective To determine how length of anticoagulation and clinical presentation of venous thromboembolism influence the risk of recurrence after anticoagulant treatment is stopped and to identify the shortest length of anticoagulation that reduces the risk of recurrence to its lowest level. Design Pooled analysis of individual participants’ data from seven randomised trials. Setting Outpatient anticoagulant clinics in academic centres. Population 2925 men or women with a first venous thromboem...

  20. Subacute herpes simplex virus type 1 encephalitis as an initial presentation of chronic lymphocytic leukemia and multiple sclerosis: a case report

    Directory of Open Access Journals (Sweden)

    Corman Lourdes C

    2011-02-01

    Full Text Available Abstract Introduction Herpes simplex virus type 1 encephalitis presents acutely in patients who are immunocompetent. We report what we believe to be the first published case of a subacute course of herpes simplex virus type 1 encephalitis in a patient with asymptomatic chronic lymphocytic leukemia who subsequently developed multiple sclerosis. Case presentation A 49-year-old Caucasian woman with a history of fever blisters presented to the emergency department with a history of left temporal headache for four weeks, and numbness of the left face and leg for two weeks. A complete blood count revealed white blood cell count of 11,820 cells/mL, with an absolute lymphocyte count of 7304 cells/mL. The cerebrospinal fluid contained 6 white blood cells/μL, 63 red blood cells/μL, 54 mg glucose/dL, and 49 mg total protein/dL. Magnetic resonance imaging of the brain revealed meningoencephalitis and bilateral ventriculitis. Cerebrospinal fluid polymerase chain reaction for herpes simplex virus type 1 was positive, and the patient's symptoms resolved after ten days of treatment with parenteral aciclovir. Incidental findings on peripheral blood smear and flow cytometry testing confirmed chronic lymphocytic leukemia. One month later, she developed bilateral numbness of the hands and feet; a repeat cerebrospinal fluid polymerase chain reaction for herpes simplex virus type 1 at this time was negative. A repeat magnetic resonance imaging scan showed an expansion of the peri-ventricular lesions, and the cerebrospinal fluid contained elevated oligoclonal bands and myelin basic protein. A brain biopsy revealed gliosis consistent with multiple sclerosis, and the patient responded to treatment with high-dose parenteral steroids. Conclusion Herpes simplex virus type 1 encephalitis is a rare presentation of chronic lymphocytic leukemia. Our patient had an atypical, subacute course, presumably due to immunosuppression from chronic lymphocytic leukemia. This unusual

  1. Influence of preceding length of anticoagulant treatment and initial presentation of venous thromboembolism on risk of recurrence after stopping treatment: analysis of individual participants’ data from seven trials

    Science.gov (United States)

    Boutitie, Florent; Pinede, Laurent; Schulman, Sam; Agnelli, Giancarlo; Raskob, Gary; Julian, Jim; Hirsh, Jack

    2011-01-01

    Objective To determine how length of anticoagulation and clinical presentation of venous thromboembolism influence the risk of recurrence after anticoagulant treatment is stopped and to identify the shortest length of anticoagulation that reduces the risk of recurrence to its lowest level. Design Pooled analysis of individual participants’ data from seven randomised trials. Setting Outpatient anticoagulant clinics in academic centres. Population 2925 men or women with a first venous thromboembolism who did not have cancer and received different durations of anticoagulant treatment. Main outcome measure First recurrent venous thromboembolism after stopping anticoagulant treatment during up to 24 months of follow-up. Results Recurrence was lower after isolated distal deep vein thrombosis than after proximal deep vein thrombosis (hazard ratio 0.49, 95% confidence interval 0.34 to 0.71), similar after pulmonary embolism and proximal deep vein thrombosis (1.19, 0.87 to 1.63), and lower after thrombosis provoked by a temporary risk factor than after unprovoked thrombosis (0.55, 0.41 to 0.74). Recurrence was higher if anticoagulation was stopped at 1.0 or 1.5 months compared with at 3 months or later (hazard ratio 1.52, 1.14 to 2.02) and similar if treatment was stopped at 3 months compared with at 6 months or later (1.19, 0.86 to 1.65). High rates of recurrence associated with shorter durations of anticoagulation were confined to the first 6 months after stopping treatment. Conclusion Three months of treatment achieves a similar risk of recurrent venous thromboembolism after stopping anticoagulation to a longer course of treatment. Unprovoked proximal deep vein thrombosis and pulmonary embolism have a high risk of recurrence whenever treatment is stopped. PMID:21610040

  2. Seizure is a rare presentation for acute hemolysis due to G6PD deficiency. We report a previously healthy boy who presented initially with seizure and cyanosis and subsequently acute hemolysis, due to glucose-6-phosphate dehydrogenase deficiency (G6PD) an

    OpenAIRE

    FAYYAZI, Afshin; Ali KHAJEH; Hosein ESFAHANI

    2012-01-01

    Seizure is a rare presentation for acute hemolysis due to G6PD deficiency. We report a previously healthy boy who presented initially with seizure and cyanosis and subsequently acute hemolysis, due to glucose-6-phosphate dehydrogenase deficiency (G6PD) and probably secondary methemoglobinemia, following the ingestion of fava beans.

  3. Seizure is a rare presentation for acute hemolysis due to G6PD deficiency. We report a previously healthy boy who presented initially with seizure and cyanosis and subsequently acute hemolysis, due to glucose-6-phosphate dehydrogenase deficiency (G6PD an

    Directory of Open Access Journals (Sweden)

    Afshin FAYYAZI

    2012-06-01

    Full Text Available Seizure is a rare presentation for acute hemolysis due to G6PD deficiency. We report a previously healthy boy who presented initially with seizure and cyanosis and subsequently acute hemolysis, due to glucose-6-phosphate dehydrogenase deficiency (G6PD and probably secondary methemoglobinemia, following the ingestion of fava beans.

  4. Initial Study

    DEFF Research Database (Denmark)

    Torp, Kristian

    2009-01-01

    increased. In the initial study presented here, the time it takes to pass an intersection is studied in details. Two major signal-controlled four-way intersections in the center of the city Aalborg are studied in details to estimate the congestion levels in these intersections, based on the time it takes to...

  5. Clinical and radiological features of pandemic H1N1 2009 influenza virus infection manifesting as acute febrile respiratory illness at their initial presentations: comparison with contemporaneous non-H1N1 patients

    International Nuclear Information System (INIS)

    Background Since the first outbreak caused by the pandemic H1N1 2009 influenza in Mexico, the virus has spread widely across the world with meaningful morbidity and mortality. However, there are few data on the comparative investigations to assess the clinical and radiological features between the H1N1 patient and non-H1N1 patients. Purpose To assess the clinical and radiological features of patients infected by the pandemic H1N1 2009 flu virus at their initial presentation and to compare them with contemporaneous non-H1N1 patients with acute febrile respiratory illness. Material and Methods This retrospective study was approved by the ethics committee of the Armed Forces Medical Command, South Korea. From August to September 2009, 337 consecutive patients presented with an acute febrile respiratory illness in a tertiary military hospital. Reverse-transcriptase polymerase-chain-reaction tests were performed in 62 of these patients under the impression of H1N1 infection. Clinical and radiological features at their initial presentation were described for the H1N1 group (n = 35) and non-H1N1 group (n = 27) and compared between the two groups. Results Increased C-reactive protein level (97%) without leukocytosis (9%) or increased erythrocyte sedimentation rate (0%) was common in the H1N1 group at their initial presentation. On chest radiographs, 12 of 35 (34%) H1N1 patients had abnormal findings; nodules in 10 patients (83%) and consolidations in two (17%). Of the 28 H1N1 patients who underwent thin-section CT 16 patients (57%) showed abnormal findings; ground-glass opacities (GGOs) in 15 (94%), and nodules in 13 (81%). However, there were no significant differences between the H1N1 group and non-H1N1 group in terms of symptoms, laboratory results, or radiological findings (P > 0.05). Conclusion Patients with H1N1 infection show consistent clinical and radiological features at their initial presentation, however, clinical and radiological features of the H1N1 group are

  6. Clinical and radiological features of pandemic H1N1 2009 influenza virus infection manifesting as acute febrile respiratory illness at their initial presentations: comparison with contemporaneous non-H1N1 patients

    Energy Technology Data Exchange (ETDEWEB)

    Yun, Tae Jin (Dept. of Radiology, Armed Force Byukjae Hospital, Gyeonggi-do (Korea, Republic of); Dept. of Radiology, Seoul National Univ. Hospital, Seoul (Korea, Republic of)); Park, Chang Min; Choi, Seung Hong; Lee, Hyun Ju; Goo, Jin Mo (Dept. of Radiology, Seoul National Univ. Hospital, Seoul (Korea, Republic of)), email: cmpark@radiol.snu.ac.kr; Kwon, Gu Jin (Dept. of Family Medicine, Armed Force Byukjae Hospital, Gyeonggi-do (Korea, Republic of); Dept. of Family Medicine, Gangneung Asan Hospital, Gangneung (Korea, Republic of)); Woo, Sung Koo (Dept. of Radiology, Armed Force Byukjae Hospital, Gyeonggi-do (Korea, Republic of)); Park, Seung Hoon (Dept. of Internal Medicine, Armed Force Byukjae Hospital, Gyeonggi-do (Korea, Republic of))

    2011-05-15

    Background Since the first outbreak caused by the pandemic H1N1 2009 influenza in Mexico, the virus has spread widely across the world with meaningful morbidity and mortality. However, there are few data on the comparative investigations to assess the clinical and radiological features between the H1N1 patient and non-H1N1 patients. Purpose To assess the clinical and radiological features of patients infected by the pandemic H1N1 2009 flu virus at their initial presentation and to compare them with contemporaneous non-H1N1 patients with acute febrile respiratory illness. Material and Methods This retrospective study was approved by the ethics committee of the Armed Forces Medical Command, South Korea. From August to September 2009, 337 consecutive patients presented with an acute febrile respiratory illness in a tertiary military hospital. Reverse-transcriptase polymerase-chain-reaction tests were performed in 62 of these patients under the impression of H1N1 infection. Clinical and radiological features at their initial presentation were described for the H1N1 group (n = 35) and non-H1N1 group (n = 27) and compared between the two groups. Results Increased C-reactive protein level (97%) without leukocytosis (9%) or increased erythrocyte sedimentation rate (0%) was common in the H1N1 group at their initial presentation. On chest radiographs, 12 of 35 (34%) H1N1 patients had abnormal findings; nodules in 10 patients (83%) and consolidations in two (17%). Of the 28 H1N1 patients who underwent thin-section CT 16 patients (57%) showed abnormal findings; ground-glass opacities (GGOs) in 15 (94%), and nodules in 13 (81%). However, there were no significant differences between the H1N1 group and non-H1N1 group in terms of symptoms, laboratory results, or radiological findings (P > 0.05). Conclusion Patients with H1N1 infection show consistent clinical and radiological features at their initial presentation, however, clinical and radiological features of the H1N1 group are

  7. Action of tacrolimus on Wistar rat kidneys implanted with Walker 256 carcinosarcoma Estudo da ação do tacrolimus em rins de ratos Wistar implantados com carcinossarcoma de Walker

    Directory of Open Access Journals (Sweden)

    Cristiano Machado Inácio

    2010-02-01

    Full Text Available PURPOSE: To evaluate the development of Walker 256 tumor in male Wistar rats treated with tacrolimus using an experimental kidney tumor model. METHODS: 40 male Wistar rats were divided into four groups: Tumor group (TU (n=10, Tacrolimus-Tumor group (TT (n=10, Tacrolimus group (TC (n=10 and Control group (C (n=10. Treatment with tacrolimus was performed in groups TT and TC. Under anesthesia, the right kidney of each animal of TU and TT was accessed through a supraumbilical incision and inoculated with a 0.1mL solution containing 2x10(6 tumor cells (Walker 256 carcinosarcoma tumor cells. Group TC was treated with a saline solution. All the animals of groups TC and TT were treated with tacrolimus (5mg/kg/day by gavage for 15 days. TU group animals received saline by gavage for 15 days. On the 15th postoperative day, all animals were submitted to euthanasia and blood sampling for analysis of serum creatinine (Cr and blood urea nitrogen (BUN. Abdominal gross examination was performed, the right kidney removed and prepared for histological analysis by hematoxylin-eosin staining. The resulting data were submitted to statistical analysis by ANOVA. RESULTS: Statistical significance was found when comparing creatinine level between groups TU, TT and TC -TT group culminated with a marked increased in creatinine levels (Cr=1.013 ± 0.3028 mg/mL, TU group (Cr=0.5670 ± 0.03536 mg/dL P=0.00256, TC group (Cr =0.711 ± 0.1653 mg/mL P= 0.02832. Statistical significance was found when comparing BUN levels in TT group (71.32 ± 17.14 mg/mL, compared with TU group (45.83 ± 5.046 mg/dL, P=0.000318. There were no statistically significant differences between groups TT and TC (61.23 ± 9.503 mg/mL P=0.7242. Histological analysis showed a poor evolution in TT group with multiple foci of hemorrhage and cortical invasion by the Walker tumor. CONCLUSION: The Tacrolimus-treated group developed a more aggressive tumor and a drug-related nephrotoxic effect.OBJETIVO: Avaliar

  8. Penile Cancer Initially Presented with Enlarged Inguinal Lymph Nodes(Report of 6 Cases)%以腹股沟肿大淋巴结为首发表现的阴茎癌6例报告

    Institute of Scientific and Technical Information of China (English)

    朱耀; 叶定伟; 姚旭东; 张世林; 戴波; 张海梁; 沈益君

    2011-01-01

    目的:探讨以腹股沟肿大淋巴结为首发表现的阴茎痛的I临床特点及诊治方法.方法:本组患者6例,均因为肿大的腹股沟淋巴结初诊于外院,在我院经细胞穿刺学证实为鳞癌转移.全部患者均有包茎或包皮过长病史,在成年后接受过包皮环切手术.4例患者在阴茎包皮环切瘢痕处有小灶肿块或溃疡,广切后病理显示为阴茎鳞癌,2例患者既往环切术标本经病理复片后诊断为阴茎鳞癌.结果:阴茎癌原发灶病理分析显示4例为T1期病变,2例为T2期病变,临床病灶均较小,直径为5~10 mm.腹股沟肿大淋巴结直径最小4 cm.最大达9 cm且伴破溃.6例患者中4例先接受了手术治疗,2例接受了新辅助化疗后再次手术.术后淋巴结病理送检证实腹股沟淋巴结鳞癌累及,且均有淋巴结外癌侵犯.6例患者中有5例复发,仅1例无病存活26个月.结论:以腹股沟肿大淋巴结为首发表现的阴茎癌并不多见,但是初诊时往往被误诊为其他疾病而延误了及时治疗.提高此类患者治疗效果的关键在于早期准确诊断,需要进行腹股沟淋巴结的穿刺病理检查,细致的寻找原发病灶.%Objective:To evaluate the characteristics and outcome of penile cancer initially presented with enlarged inguinal lymph nodes. Methods:A total of 6 patients who were initially referred to other hospital with enlarged inguinal nodes were confirmed to have squamous cell carcinoma metastases in our center. All of them had a history of phimosis and underwent circumcision in adult. Four patients had small lesions in the scar of previous circumcision. Wide local excision showed squamous cell carcinoma in these patients. Two patients were diagnosed as penile cancer after pathological review of circumcision specimens. Results: The penile lesions were staged as T1 in 4 cases and T2 in 2 patient. The diameter of the primary tumor ranged from 5 to 10 mm, and the size of enlarged inguinal mass ranged

  9. Openness initiative

    Energy Technology Data Exchange (ETDEWEB)

    Duncan, S.S. [Los Alamos National Lab., NM (United States)

    1995-12-31

    Although antinuclear campaigns seem to be effective, public communication and education efforts on low-level radioactive waste have mixed results. Attempts at public information programs on low-level radioactive waste still focus on influencing public opinion. A question then is: {open_quotes}Is it preferable to have a program focus on public education that will empower individuals to make informed decisions rather than trying to influence them in their decisions?{close_quotes} To address this question, a case study with both quantitative and qualitative data will be used. The Ohio Low-Level Radioactive Waste Education Program has a goal to provide people with information they want/need to make their own decisions. The program initiated its efforts by conducting a statewide survey to determine information needed by people and where they turned for that information. This presentation reports data from the survey and then explores the program development process in which programs were designed and presented using the information. Pre and post data from the programs reveal attitude and knowledge shifts.

  10. Dor óssea e sua relação na apresentação inicial da leucemia linfóide aguda Bone pain and its relation to the initial presentation of acute lymphoblastic leukemia

    Directory of Open Access Journals (Sweden)

    Patrícia S. Ikeuti

    2006-03-01

    Full Text Available A leucemia linfóide aguda é uma neoplasia maligna do sistema hematopoiético caracterizada pela alteração do crescimento e da proliferação das células linfóides na medula óssea, com conseqüente acúmulo de células jovens indiferenciadas, denominadas blastos. É a neoplasia maligna mais freqüente (70% entre as crianças menores de 15 anos de idade. As manifestações clínicas mais comuns incluem febre, equimose e palidez, porém a dor óssea pode ser encontrada como sintoma inicial em 25% dos casos. Assim, com o objetivo de determinar a freqüência da dor óssea e sua relação com dados clínico-laboratoriais em crianças portadoras de leucemia linfóide aguda atendidas na unidade de Oncologia Pediátrica do Hospital de Base de São José do Rio Preto-SP, foram avaliadas cinqüenta crianças portadoras de leucemia linfóide aguda com idade até 15 anos, no período de dezembro de 1991 a dezembro de 2001. Entre as crianças estudadas, 18 apresentaram dor óssea como queixa principal e, destas, 14 apresentaram tempo de evolução (período entre primeiro sintoma e o diagnóstico superior a 15 dias (p=0.018. Além disso, 13 crianças com dor óssea e tempo de evolução superior a 15 dias apresentaram níveis de hemoglobina inferiores a 8g/dl (p=0,008.Acute lymphoblastic leukemia is a hematopoietic malignancy characterized by alterations in the growth and proliferation of lymphoblastic cells in bone marrow, with consequent accumulation of immature white blood cells called blasts. It is the most common malignant neoplasm seen in under fifteen-year-olds. Acute lymphoblastic leukemia frequently presents with fever, ecchymosis and paleness, however bone pain is the initial symptom found in 25% of the cases. The objective of this work is to determine the frequency of bone pain and its relation with clinical and laboratory data in children with acute lymphoblastic leukemia admitted in the Pediatric Oncology Unit of Hospital de Base de S

  11. Present time

    OpenAIRE

    Romero, Gustavo E.

    2014-01-01

    The idea of a moving present or `now' seems to form part of our most basic beliefs about reality. Such a present, however, is not reflected in any of our theories of the physical world. I show in this article that presentism, the doctrine that only what is present exists, is in conflict with modern relativistic cosmology and recent advances in neurosciences. I argue for a tenseless view of time, where what we call `the present' is just an emergent secondary quality arising from the interactio...

  12. Present time

    CERN Document Server

    Romero, Gustavo E

    2014-01-01

    The idea of a moving present or `now' seems to form part of our most basic beliefs about reality. Such a present, however, is not reflected in any of our theories of the physical world. I show in this article that presentism, the doctrine that only what is present exists, is in conflict with modern relativistic cosmology and recent advances in neurosciences. I argue for a tenseless view of time, where what we call `the present' is just an emergent secondary quality arising from the interaction of perceiving self-conscious individuals with their environment. I maintain that there is no flow of time, but just an ordered system of events.

  13. CATCHY PRESENTATIONS

    DEFF Research Database (Denmark)

    Eriksen, Kaare; Tollestrup, Christian; Ovesen, Nis

    2011-01-01

    and ideas in many areas and avoiding “Death by Powerpoint”. This paper discusses the need and tools for making short presentations and describes the result from a business development project where engineering graduate students in architecture and design used the Pecha Kucha format to present their...

  14. OAST Space Theme Workshop. Volume 2: Theme summary. 2: Space industrialization (no. 8). A. Theme statement. B. 26 April 1976 presentation. C. Summary statement. D. Initiative action (form 5)

    Science.gov (United States)

    1976-01-01

    Enabling technology needs and other requirements to support space industrialization include: large space structures; fabrication and joining processes; single stage to orbit and heavy lift launch vehicles; nuclear and solar space power systems; robotics, manipulators, and teleoperators; biotechnology in space; artificial gravity; the utilization of lunar materials for construction; and the extraction of oxygen and metals from lunar resources. New initiatives (FY 1978) directly supportive or partly related to space industrialization are listed.

  15. Lecture Presentations

    International Nuclear Information System (INIS)

    The Symposium on Physics of Elementary Interactions in the LHC Era held in Warsaw from 21 to 22 April 2008. The main subject of the workshop was to present the progress in CERN LHC collider project. Additionally some satellite activities in field of education, knowledge and technology transfer in the frame of CERN - Poland cooperation were shown

  16. 儿童Wernicke's脑病1例并35例文献复习%Severe sepsis as an initial presentation in children with Wernicke's encephalopathy: report of a case and literature review

    Institute of Scientific and Technical Information of China (English)

    辛毅; 万代红; 初清; 李爱敏; 高兴娟

    2011-01-01

    conducted in 20/36 cases and 16/20 cases showed abnormal hypodensity in bilateral basal ganglia, one case revealed diffuse cortical atrophy. The brain MR scan was conducted in 13/36 cases and all the 13 cases revealed symmetrical abnormal signal in bilateral mamillary body and basal ganglia, and 7/13 cases showed abnormal signals in the tegmentum of midbrain, cerebral aqueduct and white matter around the third and fourth ventricles. The diagnosis of WE was confirmed by MR in 12 cases, triad combined with MR in 3 cases, autopsy in 1 case among the 13 cases who underwent MR scan. The diagnosis of WE was confirmed by the TPPE and/or lactate levels in 9/11 cases. The initial thiamine was given by intravenous or intramuscular infusion in 33/36 cases, unknown method in 1 case, orally in 1 case and no thiamine was used in 1 case. The dosage of thiamine was 100 mg daily in 29/35 cases, unknown in 3/35 cases, 50 mg daily in 2/35 cases, 600 mg daily in 1/35 case. 34/35 patients' clinical symptoms improved during 24 hours to 1 week after initial treatment, and 1 case died due to no response to thiamine. Nineteen patients were followed up for 2-2. 5 months and 17 cases recovered completely. Conclusion Wernicke' s encephalopathy can be difficult to diagnose because of a relatively non-specific clinical presentation. The characteristic MRI findings and the dramatic response of neurological signs to parenteral thiamine will assist early clinical diagnosis.Early and timely thiamine supplementation could reverse the clinical features and improve the prognosis in most cases.%目的 探讨儿童Wernicke's脑病临床特点以及诊断与治疗,提高对该病的认识.方法 总结1例以严重脓毒症为首发表现的儿童Wernicke's脑病的临床表现、诊断及治疗特点,并对国内外近10年报道的35例儿童病例进行文献复习.结果 包括本例患儿共36例,男22/36例,年龄2个月~16岁.除本例外均有基础疾病:喂养不当25/35例、长期呕吐5/35

  17. Radiographic and histological evaluation of bisphosphonate alendronate and metotrexate effects on rat mandibles inoculated with Walker 256 carcinosarcoma Avaliação radiográfica e histológica do efeito do bisfosfonato alendronato e do metotrexato na mandíbula de ratos inoculados com carcinossarcoma 256 de Walker

    Directory of Open Access Journals (Sweden)

    Ana Paula Negreiros Nunes Alves

    2007-12-01

    Full Text Available PURPOSE: To investigate the effects of bisphosphosnate alendronate (ALD and metotrexate (MTX on an experimental model of Walker 256 carcinosarcoma developed in the oral cavity of rats. METHODS Walker 256 carcinosarcoma cell suspension (0,1 mL containing 10(6 cell/mL was implanted in the alveoli of the first and second molars. The animals were divided and treated with saline, MTX, ALD, and MTX plus ALD. Later, the animals were sacrificed, the tumors were measured and the mandibles were removed for radiographic and histological analysis. RESULTS: In the control group, the radiographic images demonstrated radioluscency with poorly defined borders, and the microscopic examination revealed tumor infiltration into the peripheral and central regions of the bone. Areas of necrosis were commonly seen. In the treated groups with ALD, associated or not with MTX, the radiographic analysis revealed circumscribed tumor-induced osteolysis and various degrees of radiotransparence; while, histologically, preserved bone trabeculae with osteoid formation was observed among malignant cells. CONCLUSION: The bisphosphonate alendronate exherted an osteoprotective effect and induced bone neoformation on the Walker 256 carcinosarcoma inoculated in rat mandibles. The combination of metotrexate with bisphosphonate alendronate is more successful than treatment with the agents alone in controlling the growth of neoplastic cells and in stimulating reactive new bone. Therefore, this may be an alternative treatment to malignant lesions of maxillaries with osteolysis.OBJETIVO: Avaliar o efeito do bisfosfonato alendronato (ALD e do metotrexato (MTX em modelo do carcinossarcoma 256 de Walker na mandíbula de ratos. MÉTODOS: Uma suspensão de células tumorais do carcinossarcoma 256 de Walker (0,1mL, na concentração de 10(6 células/mL, foi implantada nos alvéolos de ratos previamente abertos por exodontia. Os animais foram divididos em grupos e tratados com salina, MTX, ALD e

  18. Technical presentation

    CERN Multimedia

    FI Department

    2008-01-01

    RADIOSPARES, the leading catalogue distributor of components (electronic, electrical, automation, etc.) and industrial supplies will be at CERN on Friday 3 October 2008 (Main Building, Room B, from 9.00 a.m. to 3.00 p.m.) to introduce its new 2008/2009 catalogue. This will be the opportunity for us to present our complete range of products in more detail: 400 000 part numbers available on our web site (Radiospares France, RS International, extended range of components from other manufacturers); our new services: quotations, search for products not included in the catalogue, SBP products (Small Batch Production: packaging in quantities adapted to customers’ requirements); partnership with our focus manufacturers; demonstration of the on-line purchasing tool implemented on our web site in conjunction with CERN. RADIOSPARES will be accompanied by representatives of FLUKE and TYCO ELECTRONICS, who will make presentations, demonstrate materials and answer any technical questio...

  19. Initial external events: floods

    International Nuclear Information System (INIS)

    The initial external event, specifically flood in a Nuclear power plant, and the calculation necessary to determine the contribution of this type of event in a Probabilistic Safety Analysis, are presented. (M.I.)

  20. Technical presentation

    CERN Document Server

    FP Department

    2009-01-01

    07 April 2009 Technical presentation by Leuze Electronics: 14.00 – 15.00, Main Building, Room 61-1-017 (Room A) Photoelectric sensors, data identification and transmission systems, image processing systems. We at Leuze Electronics are "the sensor people": we have been specialising in optoelectronic sensors and safety technology for accident prevention for over 40 years. Our dedicated staff are all highly customer oriented. Customers of Leuze Electronics can always rely on one thing – on us! •\tFounded in 1963 •\t740 employees •\t115 MEUR turnover •\t20 subsidiaries •\t3 production facilities in southern Germany Product groups: •\tPhotoelectric sensors •\tIdentification and measurements •\tSafety devices

  1. Open Archives Initiative

    OpenAIRE

    McMillan, Gail

    2004-01-01

    This presentation, which was given at the annual meeting of the Society of Scholarly Publishing on June 1, 2000, describes the Open Archives Initiative (OAI), a protocol for exchanging content between digital repositories. The presentation outlines OAI's history, core components, key stakeholders, and ongoing developments. Presented at the Society for Scholarly Publishing: June 1, 2000

  2. The Value of 18F-FDG PET/CT in Diagnostic Procedure of Intravascular Large B-Cell Lymphoma Presenting Fever of Unknown Origin and Pulmonary Hypertension as an Initial Manifestation.

    Science.gov (United States)

    Wu, Fengyu; Wang, Zhenguang; Xing, Xiaoming; Yu, Mingming; Shi, Bin

    2016-06-01

    A 57-year-old man presented with fever of unknown origin and pulmonary hypertension. An F-FDG PET/CT scan was performed to evaluate the source of fever, which showed diffuse, homogeneously increased FDG uptake in both lungs, which prompted the transbronchial lung biopsy. The pathological examination from biopsy specimen demonstrated intravascular large B-cell lymphoma. PMID:26914573

  3. Rill Initiation

    OpenAIRE

    Ottosen, Thor-Bjørn

    2008-01-01

    This project is about rill erosion. The aim is to test whether rill initiation can be predicted from the shear strength of the soil as measured with a torvane on saturated soil. This approach was set forward by Rauws and Govers 1988. Rainfall simulation experiments are conducted at a plot size 2x1m, performed in May on the Marbjerg experimental field. The results are evaluated using a chain set to measure alterations of the surface roughness as a result of the erosion, visual evaluation of ph...

  4. Supply Chain Initiatives Database

    Energy Technology Data Exchange (ETDEWEB)

    None

    2012-11-01

    The Supply Chain Initiatives Database (SCID) presents innovative approaches to engaging industrial suppliers in efforts to save energy, increase productivity and improve environmental performance. This comprehensive and freely-accessible database was developed by the Institute for Industrial Productivity (IIP). IIP acknowledges Ecofys for their valuable contributions. The database contains case studies searchable according to the types of activities buyers are undertaking to motivate suppliers, target sector, organization leading the initiative, and program or partnership linkages.

  5. Thyroid metastasis as initial presentation of clear cell renal carcinoma

    Directory of Open Access Journals (Sweden)

    César Pablo Ramírez-Plaza

    2015-01-01

    Conclusion: The possibility of finding of an incidental metastatic tumor in the thyroid gland from a previous unknown and non-diganosed primary (as CCRC in our case was is rare and account only for less than 1% of malignancies. Nonetheless, the thyroid gland is a frequent site of metastasis and the presence of “de novo” thyroid nodules in oncologic patients must be always considered and studied.

  6. Obsessive compulsive symptoms at initial presentation of adolescent eating disorders.

    Science.gov (United States)

    Cassidy, E; Allsopp, M; Williams, T

    1999-09-01

    An association between obsessive compulsive disorder and eating disorders has often been reported in the literature. It has been suggested that the association may be accounted for by depression, starvation or family factors but the literature remains inconclusive. In this study self-report scales were used to measure eating attitudes, obsessional symptoms, depressive symptoms and family functioning in an eating disordered group, a psychiatric control group and in the parents of both groups. The eating disordered group scored significantly higher than controls on the Maudsley Obsessive Compulsive Inventory and the Leyton Obsessional Inventory but not on the Childhood Depression Inventory. The differences were not correlated with Quetelet's Body Mass Index. Both groups of parents scored within the normal range for all scales. The high obsessional scores in the anorexic group seem to be due to high scoring on items relating to perfectionism. The role of perfectionism as a risk factor for the development of eating disorders and OCD is discussed. PMID:10550701

  7. Citizen participation and citizen initiatives

    International Nuclear Information System (INIS)

    Contents: Social conditions for citizen initiatives - technical change and employment - crisis behaviour - socio-psychological analysis of political planning; legitimation - presentation and criticism - conditions for citizen initiatives coming into being within the field of tension citizen : administration - legal problems of citizen initiatives - environmental protection in the energy discussion; participation; models. (HP)

  8. Retinoblastoma presenting as metastasis

    International Nuclear Information System (INIS)

    Objective: The purpose of this study was to evaluate the frequency of metastatic retinoblastoma on initial presentation. Design: Prospective study. Place and duration of study: Supra Regional Centre for Retinoblastoma, Department of Ophthalmology, Khyber Teaching Hospital Peshawar Pakistan from July 1, 1999 to January 31, 2003. Methods: Data was collected from 80 registered Retinoblastoma patients admitted and examined under anaesthesia for tumours assessment. Diagnosis was supported with the help of CT scan and confirmed by histopathology of the enucleated specimen for evidence of optic nerve invasion by the tumour. Results: Twenty (25%) patients were presenting as Metastasis on initial presentation. Mean age was 3.5 years, range was 7 months to 12 years. Out of these 20 patients with metastasis, 10 were male and 10 were female. Eighteen (90%) of them were from lower socio-economic group. Conclusion: Failure in early diagnosis of retinoblastoma, advance age and unilateral disease are associated with extraocular spread; this tragic scenario can be prevented best be early detection and prompt treatment plan implementation. (author)

  9. Stellar Presentations (Abstract)

    Science.gov (United States)

    Young, D.

    2015-12-01

    (Abstract only) The AAVSO is in the process of expanding its education, outreach and speakers bureau program. powerpoint presentations prepared for specific target audiences such as AAVSO members, educators, students, the general public, and Science Olympiad teams, coaches, event supervisors, and state directors will be available online for members to use. The presentations range from specific and general content relating to stellar evolution and variable stars to specific activities for a workshop environment. A presentation—even with a general topic—that works for high school students will not work for educators, Science Olympiad teams, or the general public. Each audience is unique and requires a different approach. The current environment necessitates presentations that are captivating for a younger generation that is embedded in a highly visual and sound-bite world of social media, twitter and U-Tube, and mobile devices. For educators, presentations and workshops for themselves and their students must support the Next Generation Science Standards (NGSS), the Common Core Content Standards, and the Science Technology, Engineering and Mathematics (STEM) initiative. Current best practices for developing relevant and engaging powerpoint presentations to deliver information to a variety of targeted audiences will be presented along with several examples.

  10. Gravity wave initiated convection

    Science.gov (United States)

    Hung, R. J.

    1990-01-01

    The vertical velocity of convection initiated by gravity waves was investigated. In one particular case, the convective motion-initiated and supported by the gravity wave-induced activity (excluding contributions made by other mechanisms) reached its maximum value about one hour before the production of the funnel clouds. In another case, both rawinsonde and geosynchronous satellite imagery were used to study the life cycles of severe convective storms. Cloud modelling with input sounding data and rapid-scan imagery from GOES were used to investigate storm cloud formation, development and dissipation in terms of growth and collapse of cloud tops, as well as, the life cycles of the penetration of overshooting turrets above the tropopause. The results based on these two approaches are presented and discussed.

  11. INITIAL TRAINING OF RESEARCHERS

    Directory of Open Access Journals (Sweden)

    Karina Alejandra Cruz-Pallares

    2015-07-01

    Full Text Available The document presents results of a research that used as strategy a complementary training project with thirty-three students of a Bachelors Degree in Primary School 1997(DPS,1997 of an Education Faculty for the initial training of investigators, applied by four teachers members of the academic research group in Mexico; that develops through process of action research methodology. Highlighted in results is the strengthening of the competition of reading, understanding and writing scientific texts, which is analogous to the first feature of the graduate profile called intellectual skills. Among the conclusions it is emphasized that the initial training of teachers in a task that is quite interesting, challenging and complex, as is the educational complex phenomenon.

  12. The Yekaterinburg headache initiative

    DEFF Research Database (Denmark)

    Lebedeva, Elena R; Olesen, Jes; Osipova, Vera V;

    2013-01-01

    disability are well in excess of the global and European averages, is no exception, while arcane diagnoses and treatment preferences are an aggravating factor. Urgent remedial action, with political support, is called for. METHODS: Yekaterinburg, in Sverdlovsk Oblast, is the chosen centre for a...... demonstrational interventional project in Russia, undertaken within the Global Campaign against Headache. The initiative proposes three actions: 1) raise awareness of need for improvement; 2) design and implement a three-tier model (from primary care to a single highly specialized centre with academic affiliation...... context of a health-care needs assessment, and as a model for all Russia. We present and discuss early progress of the initiative, justify the investment of resources required for implementation and call for the political support that full implementation requires. The more that the Yekaterinburg headache...

  13. Unusual presentation of phaeochromocytoma.

    Science.gov (United States)

    Hope, D C D; Palan, J M

    2016-01-01

    A 44-year-old woman, with a background of heart, lung and renal transplantation secondary to cystic fibrosis and type 1 diabetes, presented with tachycardia, hyperglycaemia, nausea and vomiting. She was initially managed for diabetic ketoacidosis with severe dehydration. However, persistent episodic hypertension and tachycardia led the investigating team to identify significantly raised urinary metanephrines and a left-sided adrenal mass; Iodine-123-meta-iodobenzylguanidine single photon emission computer tomography scan (MIBG SPECT/CT) showed avid uptake of tracer, confirming a left-sided phaeochromocytoma. She was started on medical management and is awaiting an elective laparoscopic procedure. This case describes the presentation of a unilateral phaeochromocytoma as ketoacidosis in a patient with type 1 diabetes with no other apparent precipitant. This highlights the metabolic counter-regulatory effect of excess catecholamines in addition to the inotropic/chronotropic effects that are associated with this adrenal tumour. Recognition of atypical signs and symptoms may point towards an atypical precipitant of diabetic ketoacidosis-a medical emergency presenting to front-line clinicians. PMID:27166010

  14. Initialized Fractional Calculus

    Science.gov (United States)

    Lorenzo, Carl F.; Hartley, Tom T.

    2000-01-01

    This paper demonstrates the need for a nonconstant initialization for the fractional calculus and establishes a basic definition set for the initialized fractional differintegral. This definition set allows the formalization of an initialized fractional calculus. Two basis calculi are considered; the Riemann-Liouville and the Grunwald fractional calculi. Two forms of initialization, terminal and side are developed.

  15. Virtual Presenters: Towards Interactive Virtual Presentations

    NARCIS (Netherlands)

    Nijholt, A.; Cappellini, V.; Hemsley, J.

    2005-01-01

    We discuss having virtual presenters in virtual environments that present information to visitors of these environments. Some current research is surveyed and we will look in particular to our research in the context of a virtual meeting room where a virtual presenter uses speech, gestures, pointing

  16. Stirling to Flight Initiative

    Science.gov (United States)

    Hibbard, Kenneth E.; Mason, Lee S.; Ndu, Obi; Smith, Clayton; Withrow, James P.

    2016-01-01

    NASA has a consistent need for radioisotope power systems (RPS) to enable robotic scientific missions for planetary exploration that has been present for over four decades and will continue into the foreseeable future, as documented in the most recent Planetary Science Decadal Study Report. As RPS have evolved throughout the years, there has also grown a desire for more efficient power systems, allowing NASA to serve as good stewards of the limited plutonium-238 (238Pu), while also supporting the ever-present need to minimize mass and potential impacts to the desired science measurements. In fact, the recent Nuclear Power Assessment Study (NPAS) released in April 2015 resulted in several key conclusion regarding RPS, including affirmation that RPS will be necessary well into the 2030s (at least) and that 238Pu is indeed a precious resource requiring efficient utilization and preservation. Stirling Radioisotope Generators (SRGs) combine a Stirling cycle engine powered by a radioisotope heater unit into a single generator system. Stirling engine technology has been under development at NASA Glenn Research Center (GRC) in partnership with the Department of Energy (DOE) since the 1970's. The most recent design, the 238Pu-fueled Advanced Stirling Radioisotope Generator (ASRG), was offered as part of the NASA Discovery 2010 Announcement of Opportunity (AO). The Step-2 selections for this AO included two ASRG-enabled concepts, the Titan Mare Explorer (TiME) and the Comet Hopper (CHopper), although the only non-nuclear concept, InSight, was ultimately chosen. The DOE's ASRG contract was terminated in 2013. Given that SRGs utilize significantly less 238Pu than traditional Radioisotope Thermoelectric Generators (RTGs) - approximately one quarter of the nuclear fuel, to produce similar electrical power output - they provide a technology worthy of consideration for meeting the aforementioned NASA objectives. NASA's RPS Program Office has recently investigated a new Stirling to

  17. Initiation of protein synthesis in bacteria

    DEFF Research Database (Denmark)

    Laursen, Brian Søgaard; Sørensen, Hans Peter; Mortensen, Kim Kusk;

    2005-01-01

    Valuable information on translation initiation is available from biochemical data and recently solved structures. We present a detailed description of current knowledge about the structure, function, and interactions of the individual components involved in bacterial translation initiation. The f...

  18. Customs Modernization Initiatives : Case Studies

    OpenAIRE

    De Wulf, Luc; José B. Sokol

    2004-01-01

    This volume presents case studies of customs modernization initiatives in eight developing countries: Bolivia, Ghana, Morocco, Mozambique, Peru, the Philippines, Turkey, and Uganda. The purpose of these case studies was to obtain a firsthand view of how these countries undertook customs reforms and to assess their success. The overall lessons learned from these studies are presented in cha...

  19. Making your presentation fun: creative presentation techniques

    Energy Technology Data Exchange (ETDEWEB)

    KEENEN,MARTHA JANE

    2000-05-18

    What possesses someone to volunteer and go through hoops and red tape to make a presentation at a conference? For that matter, why does anyone ever present anything to anyone? Actually, presentations are a fact of life and there are many reasons for doing a presentation and doing it well. New and existing staff need training and orientation to the way things are done here. Handing all of them a manual and hoping they read it is pretty much a waste of paper. On the other hand, an effective, entertaining and upbeat presentation on the relevant topics is more likely to stick with those people. They will even have a name and face to remember and seek out when they have an issue on or with that topic. This can be a very effective beginning for networking with new peers. The presenter is seen as knowledgeable, as a source of information on company topics and possibly evaluated as a potential mentor or future manager. Project staff and/or peers benefit from clear, concise, presentations of topical knowledge. This is one way that a group working on various aspects of the same project or program can stay in touch and in step with each other. Most importantly, presentations may be the best or only door into the minds (and budgets) of management and customers. These presentations are a wonderful opportunity to address legal and compliance issues, budget, staffing, and services. Here is a chance, maybe the only one, to demonstrate and explain the wonderfulness of a program and the benefit they get by using the services offered most effectively. An interactive presentation on legal and compliance issues can be an effective tool in helping customers and/or management make good risk management decisions.

  20. Chorea as the presentating feature of neurosyphilis

    Directory of Open Access Journals (Sweden)

    Ozben Serkan

    2009-01-01

    Full Text Available Syphilis is still a significant public health problem in developing countries. Although chorea is a very rare manifestation of neurosyphilis, it might be on occasions the initial symptom. This report presents a patients with neurosyphilis who had chorea as the initial presenting symptom.

  1. An Early Presenting Esophageal Schwannoma

    OpenAIRE

    Choo, Shelly S.; Maurice Smith; Ashley Cimino-Mathews; Yang, Stephen C.

    2011-01-01

    Esophageal schwannoma is a rare diagnosis and historically has been a tumor of middle-aged females. We report a case of a 22-year-old male presenting initially with dyspnea secondary to tracheal compression from an 8 × 6 × 3.0 cm esophageal schwannoma. The tumor was surgically resected, and diagnosis was confirmed with immunohistochemical and pathological studies. We report the youngest case of esophageal schwannoma in an otherwise healthy individual.

  2. Texts of presentation

    Energy Technology Data Exchange (ETDEWEB)

    Magnin, G.; Vidolov, K.; Dufour-Fallot, B.; Dewarrat, Th.; Rose, T.; Favatier, A.; Gazeley, D.; Pujol, T.; Worner, D.; Van de Wel, E.; Revaz, J.M.; Clerfayt, G.; Creedy, A.; Moisan, F.; Geissler, M.; Isbell, P.; Macaluso, M.; Litzka, V.; Gillis, W.; Jarvis, I.; Gorg, M.; Bebie, B.

    2004-07-01

    Implementing a sustainable local energy policy involves a long term reflection on the general interest, energy efficiency, distributed generation and environmental protection. Providing services on a market involves looking for activities that are profitable, if possible in the 'short-term'. The aim of this conference is to analyse the possibility of reconciling these apparently contradictory requirements and how this can be achieved. This conference brings together the best specialists from European municipalities as well as important partners for local authorities (energy agencies, service companies, institutions, etc.) in order to discuss the public-private partnerships concerning the various functions that municipalities may perform in the energy field as consumers and customers, planners and organizers of urban space and rousers as regards inhabitants and economic players of their areas. This document contains the summaries of the following presentations: 1 - Performance contracting: Bulgarian municipalities use private capital for energy efficiency improvement (K. VIDOLOV, Varna (BG)), Contracting experiences in Swiss municipalities: consistent energy policy thanks to the Energy-city label (B. DUFOUR-FALLOT and T. DEWARRAT (CH)), Experience of contracting in the domestic sector (T. ROSE (GB)); 2 - Public procurement: Multicolor electricity (A. FAVATIER (CH)), Tendering for new green electricity capacity (D. GAZELEY (GB)), The Barcelona solar thermal ordinance (T. PUJOL (ES)); 3 - Urban planning and schemes: Influencing energy issues through urban planning (D. WOERNER (DE)), Tendering for the supply of energy infrastructure (E. VAN DE WEL (NL)), Concessions and public utility warranty (J.M. REVAZ (CH)); 4 - Certificate schemes: the market of green certificates in Wallonia region in a liberalized power market (G. CLERFAYT (BE)), The Carbon Neutral{sup R} project: a voluntary certification scheme with opportunity for implementation in other European

  3. North American radioactive beam initiatives

    International Nuclear Information System (INIS)

    After a brief review of existing radioactive beam facilities in North America, two new initiative (the Oak Ridge Radioactive Ion Beam Facility and the IsoSpin Laboratory) are described in some detail. An evaluation of which nuclei these facilities will be able to study, that cannot be studied with stable targets and beams, also is presented

  4. Teaching Presentation Skills

    Science.gov (United States)

    Baker, William H.; Thompson, Michael P.

    2004-01-01

    Effective teaching of presentation skills focuses on the most important element of the presentation--the message itself. Some instructors place the heaviest emphasis on the messenger (the presenter) and focus their presentation feedback on all the presenter is doing wrong--saying "um," gesturing awkwardly, and so forth. When students receive this…

  5. Subacute sclerosing panencephalitis presenting as mania

    Directory of Open Access Journals (Sweden)

    Aggarwal Ashish

    2011-01-01

    Full Text Available Subacute sclerosing panencephalitis (SSPE is a rare, invariably fatal degenerative disease of the central nervous system developing after measles infection. Besides neurological symptoms as initial presenting symptoms, rare reports of its presentation with pure psychiatric symptoms have been reported. We here report a case of 14 year old male who initially presented with manic symptoms and then subsequently diagnosed to be suffering from SSPE. Improtance of ruling our organic conditions is emphasized.

  6. Sustainable Agricultural Marketing Initiatives

    OpenAIRE

    Hakan Adanacıoğlu

    2015-01-01

    Sustainable marketing is a holistic approach that puts equal emphasis on environmental, social equity, and economic concerns in the development of marketing strategies. The purpose of the study is to examine and discuss the sustainable agricultural marketing initiatives practiced throughout the World and Turkey, and to put forth suggestions to further improve the performance of agricultural marketing initiatives in Turkey. Some of the sustainable agricultural marketing initiatives practiced a...

  7. Emerging Pathogens Initiative (EPI)

    Data.gov (United States)

    Department of Veterans Affairs — The Emerging Pathogens Initiative (EPI) database contains emerging pathogens information from the local Veterans Affairs Medical Centers (VAMCs). The EPI software...

  8. Initiatives of Ecological Responsibility

    Directory of Open Access Journals (Sweden)

    Roman Sergeevich Volodin

    2015-12-01

    Full Text Available Preservation of environment is one of the global problems for the mankind. The concept of sustainable development presented at the governmental level in 1987 urged to fix at the interstate level the basic principles of development of humanity in harmony with the nature. The Charter signed in 1991 “Business and sustainable development” proclaimed a new stage of development of world entrepreneurship – business had to become ecologicallyoriented and to form the ecologically-oriented demand. In recent years it is possible to state the huge growth of technologies of effective environmental management, energy saving and energy efficiency. The leading world corporations include reduction of the ecological aspects in priority strategic objectives, as much as possible promoting transition to the use of green technologies. “Green” experience of the Western companies showed that reduction of influence on environment is not only the task of the state, but also the effective instrument to increase competitiveness of the organization. Besides the growth of favorable perception of the company by consumers, it receives considerable decrease in prime cost of the made production or the rendered services due to effective and economical use of natural resources. Russia is among the first countries who accepted the concept of sustainable development at the legislative level, nevertheless, only recently we can note that technologies of rational environmental management, energy saving and energy efficiency became one of priority problems of its development. In the present article the advanced methods of the state and private initiatives in the field of ecological responsibility are considered, and the methods of overcoming the new challenges are offered.

  9. Shock Initiation of Energetic Materials at Different Initial Temperatures

    Energy Technology Data Exchange (ETDEWEB)

    Urtiew, P A; Tarver, C M

    2005-01-14

    Shock initiation is one of the most important properties of energetic materials, which must transition to detonation exactly as intended when intentionally shocked and not detonate when accidentally shocked. The development of manganin pressure gauges that are placed inside the explosive charge and record the buildup of pressure upon shock impact has greatly increased the knowledge of these reactive flows. This experimental data, together with similar data from electromagnetic particle velocity gauges, has allowed us to formulate the Ignition and Growth model of shock initiation and detonation in hydrodynamic computer codes for predictions of shock initiation scenarios that cannot be tested experimentally. An important problem in shock initiation of solid explosives is the change in sensitivity that occurs upon heating (or cooling). Experimental manganin pressure gauge records and the corresponding Ignition and Growth model calculations are presented for two solid explosives, LX-17 (92.5 % triaminotrinitrobenzene (TATB) with 7.5 % Kel-F binder) and LX-04 (85 % octahydro-1,3,5,7-tetranitro-1,3,5,7-tetrazine (HMX) with 15 % Viton binder) at several initial temperatures.

  10. Presentation of findings

    International Nuclear Information System (INIS)

    the Safety of Radioactive Waste Management. The overall decommissioning strategy to be adopted should be identified as early as possible in the planning process. The presentations and discussions at this conference indicated a distinct shift towards immediate dismantling as a preferred strategy. Turning to social issues, the participation of the public, including community leaders, work forces and interest groups, in the decision making processes should be initiated as early as possible and should continue throughout the process. The aim is to minimize the negative social and economic effects of decommissioning. In the discussion on waste management issues, it was noted that there was progress on the provision of national repositories for radioactive waste would be of great benefit to decommissioning. The long term retention of knowledge is of great importance in two respects: people and records. Funding is clearly vital to decommissioning. Provision needs to be made to ensure that sufficient funds will be available, with a high degree of confidence, when they are needed. An appropriate mechanism should be in place before a new facility is licensed to operate. With regard to the removal of regulatory controls, it was noted that the recycling or reuse of materials from decommissioning can greatly reduce the amount of waste that needs to be disposed of in a repository.This can preserve resources and repository capacity. Criteria for the international trade in such materials are needed, and therefore should be internationally agreed. A great deal of work has been done aimed at establishing criteria for the removal of materials from regulatory control.Work aimed at reaching international consensus on an acceptable methodology, including codes and scenarios, for establishing clearance levels should continue. Questions remain as to whether the criteria for the release of sites should be the same as those for materials, whether natural and artificial radionuclides can be

  11. Sustainable Agricultural Marketing Initiatives

    Directory of Open Access Journals (Sweden)

    Hakan Adanacıoğlu

    2015-07-01

    Full Text Available Sustainable marketing is a holistic approach that puts equal emphasis on environmental, social equity, and economic concerns in the development of marketing strategies. The purpose of the study is to examine and discuss the sustainable agricultural marketing initiatives practiced throughout the World and Turkey, and to put forth suggestions to further improve the performance of agricultural marketing initiatives in Turkey. Some of the sustainable agricultural marketing initiatives practiced around the world are carried out through civil organizations. Furthermore; some of these initiatives have also launched by farmers, consumers, food processors and retailers. The long-term strategies to increase these initiatives should be determined due to the fact that examples of successful sustainable agricultural marketing initiatives are inadequate and cannot be spread in Turkey. In this context, first of all, the supports provided by the government to improve agricultural marketing systems, such as EU funds for rural development should be compatible with the goals of sustainable marketing. For this purpose, it should be examined whether all proposed projects related to agricultural marketing meet the social, economic, and environmental principles of sustainable marketing. It is important that supporting organizations, especially civil society organisations, should take an active role for faster dissemination and adoption of sustainable agricultural marketing practices in Turkey. These organizations may provide technical assistance in preparing successful project proposals and training to farm groups. In addition, the other organizations, such as local administrations, producers' associations, cooperatives, can contribute to the success of sustainable agricultural marketing initiatives. The use of direct marketing strategies and vertical integration attempts in sustainable agricultural marketing initiatives that will likely be implemented in Turkey is

  12. Initial physics measurements on FFTF

    International Nuclear Information System (INIS)

    Initial criticality of the Fast Flux Test Facility (FFTF) was achieved on February 9, 1980 at 3:45 p.m. During the period November 27, 1979 to March 8, 1980, fuel was loaded into the FFTF core, initial criticality was achieved, and several subcritical physics measurements were performed. The data obtained from initial FFTF nuclear operation are presented. Specifically, the absolute and relative neutron count rates were predicted for the bulk of the seventy-three fuel loadings of FFTF. Agreement between predicted and observed values is illustrated. Severe variations of fission chamber detection efficiency in the reactor shield is contrasted with that near the core center. Control rod worths, measured by the rod drop inverse kinetics method, are compared with predictions based upon Engineering Mockup Critical (EMC) evaluations. Control rod reactivity worth curves measured by rod run-in inverse kinetics are given

  13. Thick Presentism and Newtonian Mechanics

    CERN Document Server

    Lubashevsky, Ihor

    2016-01-01

    In the present paper I argue that the formalism of Newtonian mechanics stems directly from the general principle to be called the principle of microlevel reducibility which physical systems obey in the realm of classical physics. This principle assumes, first, that all the properties of physical systems must be determined by their states at the current moment of time, in a slogan form it is "only the present matters to physics." Second, it postulates that any physical system is nothing but an ensemble of structureless particles arranged in some whose interaction obeys the superposition principle. I substantiate this statement and demonstrate directly how the formalism of differential equations, the notion of forces in Newtonian mechanics, the concept of phase space and initial conditions, the principle of least actions, etc. result from the principle of microlevel reducibility. The philosophical concept of thick presentism and the introduction of two dimensional time---physical time and meta-time that are mut...

  14. Workshop Presentations: Overviews

    Data.gov (United States)

    National Aeronautics and Space Administration — These slides were presented at the AePW, April 21-22, 2012. Additional presentations can be found on each of the associated analysis webpages. Separate pages...

  15. The Art of Presenting.

    Science.gov (United States)

    Lukey-Coutsocostas, Kathryn; Tanner-Bogia, Julia

    1998-01-01

    Provides suggestions for helping nonnative English speakers in planning and delivering an effective presentation. Topics covered include the following: fears, choosing a topic, planning, title/summary/abstract, equipment, delivery, and evaluation of the present. (Author/VWL)

  16. Anorexia Nervosa or Not? A Case Presentation

    OpenAIRE

    Swanson, Richard W.; Haight, Kenneth R.

    1989-01-01

    The authors of this article present a case of diabetic gastroparesis, initially diagnosed as anorexia nervosa. They compare the symptoms and signs of diabetic gastroparesis with the diagnostic criteria for anorexia nervosa and discuss treatment with domperidone.

  17. Renewable Electricity Futures (Presentation)

    Energy Technology Data Exchange (ETDEWEB)

    Mai, T.

    2012-08-01

    This presentation summarizes findings of NREL's Renewable Electricity Futures study, published in June 2012. RE Futures investigated the challenges and impacts of achieving very high renewable electricity generation levels in the contiguous United States by 2050. This presentation was presented in a Wind Powering America webinar on August 15, 2012 and is now available through the Wind Powering America website.

  18. Presenting Food Science Effectively

    Science.gov (United States)

    Winter, Carl K.

    2016-01-01

    While the need to present food science information effectively is viewed as a critical competency for food scientists by the Institute of Food Technologists, most food scientists may not receive adequate training in this area. Effective presentations combine both scientific content and delivery mechanisms that demonstrate presenter enthusiasm for…

  19. The MEGAPIE Initiative

    International Nuclear Information System (INIS)

    MEGAPIE (Megawatt Pilot Experiment) is a joint initiative by Commissariat a l'Energie Atomique (CEA), France, Forschungszentrum Karlsruhe (FZK), Germany, and Paul Scherrer Institut (PSI), Switzerland, to design, build, operate and explore a liquid lead-bismuth spallation target for 1MW of beam power, taking advantage of the existing spallation neutron facility SINQ at PSI. Such a target based on an eutectic mixture with a melting point as low as 125 oC and a boiling point as high as 1670 oC is the preferred concept in several studies aiming at utilising accelerators to drive subcritical assemblies in order to transmute long lived nuclear waste into shorter lived isotopes in an effort to ease problems of long term storage and final disposal. MEGAPIE will be an essential step towards demonstrating the feasibility of the coupling of a high power accelerator, a spallation target and a subcritical assembly. It will specifically address one of the most critical issues, namely the behaviour of a liquid metal target under realistic operating conditions. As an intensely instrumented pilot experiment it will provide valuable data for benchmarking of frequently used computer codes and will allow to gain important experience in the safe handling of components that have been irradiated with PbBi. It will be installed at the ring cyclotron at PSI with 590 MeV proton energy and a continuous current of 1.8 mA. The basic concept of the MEGAPIE target as well as the definition of the project phases and of the supporting research and development activities at the participating laboratories are described in the present report

  20. Initial Radionuclide Inventories

    International Nuclear Information System (INIS)

    The purpose of this analysis is to provide an initial radionuclide inventory (in grams per waste package) and associated uncertainty distributions for use in the Total System Performance Assessment for the License Application (TSPA-LA) in support of the license application for the repository at Yucca Mountain, Nevada. This document is intended for use in postclosure analysis only. Bounding waste stream information and data were collected that capture probable limits. For commercially generated waste, this analysis considers alternative waste stream projections to bound the characteristics of wastes likely to be encountered using arrival scenarios that potentially impact the commercial spent nuclear fuel (CSNF) waste stream. For TSPA-LA, this radionuclide inventory analysis considers U.S. Department of Energy (DOE) high-level radioactive waste (DHLW) glass and two types of spent nuclear fuel (SNF): CSNF and DOE-owned (DSNF). These wastes are placed in two groups of waste packages: the CSNF waste package and the codisposal waste package (CDSP), which are designated to contain DHLW glass and DSNF, or DHLW glass only. The radionuclide inventory for naval SNF is provided separately in the classified ''Naval Nuclear Propulsion Program Technical Support Document'' for the License Application. As noted previously, the radionuclide inventory data presented here is intended only for TSPA-LA postclosure calculations. It is not applicable to preclosure safety calculations. Safe storage, transportation, and ultimate disposal of these wastes require safety analyses to support the design and licensing of repository equipment and facilities. These analyses will require radionuclide inventories to represent the radioactive source term that must be accommodated during handling, storage and disposition of these wastes. This analysis uses the best available information to identify the radionuclide inventory that is expected at the last year of last emplacement, currently identified as

  1. Gauging without initial symmetry

    Science.gov (United States)

    Kotov, Alexei; Strobl, Thomas

    2016-01-01

    The gauge principle is at the heart of a good part of fundamental physics: Starting with a group G of so-called rigid symmetries of a functional defined over space-time Σ, the original functional is extended appropriately by additional Lie(G) -valued 1-form gauge fields so as to lift the symmetry to Maps(Σ , G) . Physically relevant quantities are then to be obtained as the quotient of the solutions to the Euler-Lagrange equations by these gauge symmetries. In this article we show that one can construct a gauge theory for a standard sigma model in arbitrary space-time dimensions where the target metric is not invariant with respect to any rigid symmetry group, but satisfies a much weaker condition: It is sufficient to find a collection of vector fields va on the target M satisfying the extended Killing equationv a(i ; j) = 0 for some connection acting on the index a. For regular foliations this is equivalent to requiring the conormal bundle to the leaves with its induced metric to be invariant under leaf-preserving diffeomorphisms of M, which in turn generalizes Riemannian submersions to which the notion reduces for smooth leaf spaces M / ∼. The resulting gauge theory has the usual quotient effect with respect to the original ungauged theory: in this way, much more general orbits can be factored out than usually considered. In some cases these are orbits that do not correspond to an initial symmetry, but still can be generated by a finite-dimensional Lie group G. Then the presented gauging procedure leads to an ordinary gauge theory with Lie algebra valued 1-form gauge fields, but showing an unconventional transformation law. In general, however, one finds that the notion of an ordinary structural Lie group is too restrictive and should be replaced by the much more general notion of a structural Lie groupoid.

  2. Innovative presentations for dummies

    CERN Document Server

    Anthony, Ray

    2014-01-01

    Be the speaker they follow with breakthrough innovative presentations Innovative Presentations For Dummies is a practical guide to engaging your audience with superior, creative, and ultra-compelling presentations. Using clear language and a concise style, this book goes way beyond PowerPoint to enable you to reimagine, reinvent, and remake your presentations. Learn how to stimulate, capture, and hold your audience in the palm of your hand with sound, sight, and touch, and get up to speed on the latest presentation design methods that make you a speaker who gets audiences committed and acting

  3. Laser Actuated Presentation System

    OpenAIRE

    Chowdhary, Atul; Agrawal, Vivek; Karmakar, Subhajit; Sarkar, Sandip

    2009-01-01

    We present here a pattern sensitive PowerPoint presentation scheme. The presentation is actuated by simple patterns drawn on the presentation screen by a laser pointer. A specific pattern corresponds to a particular command required to operate the presentation. Laser spot on the screen is captured by a RGB webcam with a red filter mounted, and its location is identified at the blue layer of each captured frame by estimating the mean position of the pixels whose intensity is above a given thre...

  4. Laser Actuated Presentation System

    CERN Document Server

    Chowdhary, Atul; Karmakar, Subhajit; Sarkar, Sandip

    2009-01-01

    We present here a pattern sensitive PowerPoint presentation scheme. The presentation is actuated by simple patterns drawn on the presentation screen by a laser pointer. A specific pattern corresponds to a particular command required to operate the presentation. Laser spot on the screen is captured by a RGB webcam with a red filter mounted, and its location is identified at the blue layer of each captured frame by estimating the mean position of the pixels whose intensity is above a given threshold value. Measured Reliability, Accuracy and Latency of our system are 90%, 10 pixels (in the worst case) and 38 ms respectively.

  5. Alarm filtering and presentation

    International Nuclear Information System (INIS)

    This paper discusses alarm filtering and presentation in the control room of nuclear and other process control plants. Alarm generation and presentation is widely recognized as a general process control problem. Alarm systems often fail to provide meaningful alarms to operators. Alarm generation and presentation is an area in which computer aiding is feasible and provides clear benefits. Therefore, researchers have developed several computerized alarm filtering and presentation approaches. This paper discusses problems associated with alarm generation and presentation. Approaches to improving the alarm situation and installation issues of alarm system improvements are discussed. The impact of artificial intelligence (AI) technology on alarm system improvements is assessed. (orig.)

  6. How does depression present in general practice?

    OpenAIRE

    Lam, CLK

    1998-01-01

    This was a retrospective study of the records of Chinese patients diagnosed as having depression in a general practice clinic in Hong Kong. The records of 66 newly diagnosed patients during the period September 1, 1992 to April 30, 1994 were reviewed for their initial presenting symptoms and depressive symptoms. Ninety-four per cent of the patients with depression initially presented with somatic symptoms. The spectrum of complaints was broad with symptoms referred to various organ systems. T...

  7. Prairie Reconstruction Initiative

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — The purpose of the Prairie Reconstruction Initiative Advisory Team (PRIAT) is to identify and take steps to resolve uncertainties in the process of prairie...

  8. Nursing Home Quality Initiative

    Data.gov (United States)

    U.S. Department of Health & Human Services — This Nursing Home Quality Initiative (NHQI) website provides consumer and provider information regarding the quality of care in nursing homes. NHQI discusses...

  9. Surgical Critical Care Initiative

    Data.gov (United States)

    Federal Laboratory Consortium — The Surgical Critical Care Initiative (SC2i) is a USU research program established in October 2013 to develop, translate, and validate biology-driven critical care....

  10. Quality Initiatives - General Information

    Data.gov (United States)

    U.S. Department of Health & Human Services — CMS has developed a standardized approach for the development of quality measures that it uses in its quality initiatives. Known as the Measures Management System...

  11. The RAS Initiative

    Science.gov (United States)

    NCI established the RAS Initiative to explore innovative approaches for attacking the proteins encoded by mutant forms of RAS genes and to ultimately create effective, new therapies for RAS-related cancers.

  12. Initial Symptoms of ALS

    Science.gov (United States)

    ... Chapters Certified Centers and Clinics Support Groups About ALS About Us Our Research In Your Community Advocate ... Diagnosis En español Symptoms The initial symptoms of ALS can be quite varied in different people. One ...

  13. Piezoelectrically Initiated Pyrotechnic Igniter

    Science.gov (United States)

    Quince, Asia; Dutton, Maureen; Hicks, Robert; Burnham, Karen

    2013-01-01

    This innovation consists of a pyrotechnic initiator and piezoelectric initiation system. The device will be capable of being initiated mechanically; resisting initiation by EMF, RF, and EMI (electromagnetic field, radio frequency, and electromagnetic interference, respectively); and initiating in water environments and space environments. Current devices of this nature are initiated by the mechanical action of a firing pin against a primer. Primers historically are prone to failure. These failures are commonly known as misfires or hang-fires. In many cases, the primer shows the dent where the firing pin struck the primer, but the primer failed to fire. In devices such as "T" handles, which are commonly used to initiate the blowout of canopies, loss of function of the device may result in loss of crew. In devices such as flares or smoke generators, failure can result in failure to spot a downed pilot. The piezoelectrically initiated ignition system consists of a pyrotechnic device that plugs into a mechanical system (activator), which on activation, generates a high-voltage spark. The activator, when released, will strike a stack of electrically linked piezo crystals, generating a high-voltage, low-amperage current that is then conducted to the pyro-initiator. Within the initiator, an electrode releases a spark that passes through a pyrotechnic first-fire mixture, causing it to combust. The combustion of the first-fire initiates a primary pyrotechnic or explosive powder. If used in a "T" handle, the primary would ramp the speed of burn up to the speed of sound, generating a shock wave that would cause a high explosive to go "high order." In a flare or smoke generator, the secondary would produce the heat necessary to ignite the pyrotechnic mixture. The piezo activator subsystem is redundant in that a second stack of crystals would be struck at the same time with the same activation force, doubling the probability of a first strike spark generation. If the first

  14. Implementing Development Initiatives

    OpenAIRE

    Jamal Khan

    1999-01-01

    Implementation is at the core of all development initiatives and strategies and experience has shown that there exists a gap between formulation and implementation. This paper focuses on the attempts for implementing initiatives for promoting decentralised management and increased participation in developing countries arid identifies the obstacles in the process. It is generally seen that problems of implementation cannot be entirely anticipated and planned for in advance. Also decentralisati...

  15. Choice of initial therapy

    Directory of Open Access Journals (Sweden)

    Manuel Battegay

    2014-11-01

    Full Text Available Current international and national treatment guidelines such as EACS, BHIVA, DHHS or IAS update regularly recommendations on the choice of initial combination antiretroviral treatment (cART regimens. Preferred cART regimens include a backbone with two nucleoside (nucleotide reverse transcriptase inhibitors combined either with one non-nucleoside reverse transcriptase inhibitor or one ritonavir boosted protease inhibitor or more recently one integrase inhibitor. Response rates according to viral load measurements increased in recent years, in particular due to better tolerability. The choice of initial therapy is flexible and influenced by several factors such as height of viral load, genotypic resistance testing, CD4 cell count, co-morbidities, interactions, potential adverse events, (potential for pregnancy, convenience, adherence, costs as well as physician's and patient's preferences. Diverse highly potent initial cART regimens exist. Following the many possibilities, the choice of a regimen is based on a mixture of evidence-informed data and individualized concepts, some of the latter only partly supported by strong evidence. For example, different perceptions and personal experiences exist about boosted protease inhibitors compared to non-nucleoside reverse transcriptase inhibitors or integrase inhibitors and vice versa which may influence the initial choice. This lecture will discuss choices of initial cART in view of international guidelines and the evidence for individualization of initial HIV therapy.

  16. Leprosy neuropathy: clinical presentations.

    Science.gov (United States)

    Nascimento, Osvaldo J M

    2013-09-01

    Leprosy is a chronic infectious peripheral neuropathy caused by Mycobacterium leprae. The different clinical presentations of the disease are determined by the quality of the host immune response. Early detection of leprosy and treatment by multidrug therapy are the most important steps in preventing deformity and disability. Thus the early recognition of the clinical leprosy presentation is essential. Mononeuritis, mononeuritis multiplex (MM), polyneuritis (MM summation) are the most frequent. The frequent anesthetic skin lesions are absent in the pure neuritic leprosy presentation form. Isolated peripheral nerve involvement is common, including the cranial ones. Arthritic presentation is occasionally seen, usually misdiagnosed as rheumatoid arthritis. Attention should be given to autonomic dysfunctions in leprosy. There are clinical presentations with severe neuropathic pain - painful small-fiber neuropathy. Leprous late-onset neuropathy (LLON) clinical presentation should be considered facing a patient who develop an inflammatory neuropathy many years after a previous skin leprosy treatment. PMID:24141500

  17. CERN Electronics Pool presentations

    CERN Multimedia

    2011-01-01

    The CERN Electronics Pool has organised a series of presentations in collaboration with oscilloscope manufacturers. The last one will take place according to the schedule below.   Time will be available at the end of the presentation to discuss your personal needs. The Agilent presentation had to be postponed and will be organised later. -     Lecroy: Thursday, 24 November 2011, in 530-R-030, 14:00 to 16:30.

  18. Product presentation on DVD

    OpenAIRE

    Willsund, John

    2008-01-01

    The purpose of this thesis is to seek answers to the questions how the sales in a photo shop can be affected by animated commercial presentations and what the costs of producing such presentations would be. The costs are calculated from three different scenarios. The presentations produced has been for one single camera model and for selected products within three product groups; binoculars, digital cameras and printed matters. The task has included image processing of self-shot and existing ...

  19. Conns' syndrome - atypical presentations

    International Nuclear Information System (INIS)

    Primary hyperaldosteronism (Conns' syndrome) commonly presents with a combination of clinical features of hypokalemia and hypertension. Atypical presentations like normotension, normokalemia and neurological ailments are described in few cases. We encountered two such cases, the first presenting with acute neurological complaint and second case having insignificant hypertension. Both the patients had a characteristic biochemical and imaging profile consistent with primary hyperaldosteronism and responded to surgical resection of adrenal adenoma. (author)

  20. Presentation skills for nurses.

    Science.gov (United States)

    Foulkes, Mark

    2015-02-20

    This article emphasises the importance of effective presentation skills. Such skills allow nurses to share knowledge and expertise and to communicate clearly in a range of workplace scenarios. Nurses are increasingly being asked to present in formal and informal situations, such as conferences, poster presentations, job interviews, case reports and ward-based teaching. This article explores the principles underpinning the development of these skills, discusses the situations in which they could be applied and demonstrates how nurses might improve and develop as presenters. PMID:25690236

  1. Renewable Electricity Futures (Presentation)

    Energy Technology Data Exchange (ETDEWEB)

    Mai, T.

    2012-08-01

    This presentation summarizes findings of NREL's Renewable Electricity Futures study, published in June 2012. RE Futures investigated the challenges and impacts of achieving very high renewable electricity generation levels in the contiguous United States by 2050. It was presented in a Power Systems Engineering Research Center webinar on September 4, 2012.

  2. Renewable Electricity Futures (Presentation)

    Energy Technology Data Exchange (ETDEWEB)

    Hand, M.; Mai, T.

    2012-08-01

    This presentation library summarizes findings of NREL's Renewable Electricity Futures study, published in June 2012. RE Futures investigated the challenges and impacts of achieving very high renewable electricity generation levels in the contiguous United States by 2050. It was presented in an Union of Concerned Scientists webinar on June 12, 2012.

  3. Data Mining SIAM Presentation

    Science.gov (United States)

    Srivastava, Ashok; McIntosh, Dawn; Castle, Pat; Pontikakis, Manos; Diev, Vesselin; Zane-Ulman, Brett; Turkov, Eugene; Akella, Ram; Xu, Zuobing; Kumaresan, Sakthi Preethi

    2006-01-01

    This viewgraph document describes the data mining system developed at NASA Ames. Many NASA programs have large numbers (and types) of problem reports.These free text reports are written by a number of different people, thus the emphasis and wording vary considerably With so much data to sift through, analysts (subject experts) need help identifying any possible safety issues or concerns and help them confirm that they haven't missed important problems. Unsupervised clustering is the initial step to accomplish this; We think we can go much farther, specifically, identify possible recurring anomalies. Recurring anomalies may be indicators of larger systemic problems. The requirement to identify these anomalies has led to the development of Recurring Anomaly Discovery System (ReADS).

  4. Initial state propagators

    CERN Document Server

    Collins, Hael

    2013-01-01

    It is possible to define a general initial state for a quantum field by introducing a contribution to the action defined at an initial-time boundary. The propagator for this theory is composed of two parts, one associated with the free propagation of fields and another produced by the operators of this initial action. The derivation of this propagator is shown for the case of a translationally and rotationally invariant initial state. In addition to being able to treat more general states, these techniques can also be applied to effective field theories that start from an initial time. The eigenstates of a theory with interacting heavy and light fields are different from the eigenstates of the theory in the limit where the interactions vanish. Therefore, a product of states of the noninteracting heavy and light theories will usually contain excitations of the heavier state once the interactions are included. Such excitations appear as nonlocal effects in the effective theory, which are suppressed by powers of...

  5. Pseudoxanthoma elasticum. Case presentation

    Directory of Open Access Journals (Sweden)

    Graciela Caridad Cabrera Acea

    2009-05-01

    Full Text Available The case of a female patient of 23 years of age is presented. The patient attended to the dermatology consultation in her health area for skin lesions in the neck area, of 10 years of evolution with new lesions after three years in different parts of her body (armpits, periumbilical, vaginal and rectal regions. These lesions present an aspect similar to orange skin, surrounded by yellow papules. the diagnosis was pseudoxanthoma elasticum after the clinical and histopathological analysis, and the perimetry. We present this case since this is an infrequent disease and for the importance of an early diagnosis of skin lesions in a systemic disease.

  6. Heterotrophic Pregnancy- Rare Presentation

    Directory of Open Access Journals (Sweden)

    AB Chattopadhyay

    2013-06-01

    Full Text Available Heterotopic pregnancy, a potentially dangerous and life-threatening clinical associated with intrauterine (IU and extra uterine pregnancies at the same time. Incidence of such cases are rare but very often missed as the diagnosis being overlooked during examination of the pregnant women with risk factors for an ectopic pregnancy such as free fluid with or without an adnexal mass or acute abdominal pain and shock presentation. Hence a high degree of clinical evaluation is warranted examining the pregnant women. In Present paper we report a case with rare presentation as heterotopic pregnancy from emergency hospital of teaching hospital.

  7. Initiating events frequency determination

    International Nuclear Information System (INIS)

    The paper describes work performed for the Nuclear Power Station (NPS). Work is related to the periodic initiating events frequency update for the Probabilistic Safety Assessment (PSA). Data for all relevant NPS initiating events (IE) were reviewed. The main focus was on events occurring during most recent operating history (i.e., last four years). The final IE frequencies were estimated by incorporating both NPS experience and nuclear industry experience. Each event was categorized according to NPS individual plant examination (IPE) initiating events grouping approach. For the majority of the IE groups, few, or no events have occurred at the NPS. For those IE groups with few or no NPS events, the final estimate was made by means of a Bayesian update with general nuclear industry values. Exceptions are rare loss-of-coolant-accidents (LOCA) events, where evaluation of engineering aspects is used in order to determine frequency.(author)

  8. International EUREKA: Initialization Segment

    International Nuclear Information System (INIS)

    The Initialization Segment creates the starting description of the uranium market. The starting description includes the international boundaries of trade, the geologic provinces, resources, reserves, production, uranium demand forecasts, and existing market transactions. The Initialization Segment is designed to accept information of various degrees of detail, depending on what is known about each region. It must transform this information into a specific data structure required by the Market Segment of the model, filling in gaps in the information through a predetermined sequence of defaults and built in assumptions. A principal function of the Initialization Segment is to create diagnostic messages indicating any inconsistencies in data and explaining which assumptions were used to organize the data base. This permits the user to manipulate the data base until such time the user is satisfied that all the assumptions used are reasonable and that any inconsistencies are resolved in a satisfactory manner

  9. Practically Perfect Presentations.

    Science.gov (United States)

    Harris, Richard M.

    1994-01-01

    Offers nine practical suggestions for instructional presentations: build a sense of partnership, ask rhetorical questions, be spontaneous, use a conversational tone, control tone of voice, involve listener through gesture, be creative, be relevant, and achieve clarity. (JOW)

  10. Doctoral Research Presentations

    OpenAIRE

    Thomson, Alison; Plummer-Fernandez, Matthew; Yurman, Paulina; Migliore, Enza; Gray, Nicola; Yang, Ya-huei; Hogan, Nicola; Kerridge, Tobie

    2015-01-01

    The Department of Design has a thriving community of scholars and practitioners engaged in doctoral research. In this session students,graduates and visiting researchers will present their research covering a broad range of topics and research interests.

  11. Ovarian Cysts. Case Presentation

    International Nuclear Information System (INIS)

    We present the clinical case of a 50 days old girl, born with cystic ovaries, secondary to hormonal stimulation. The clinical diagnosis and management is described and a revision of the literature is made.

  12. Workshop Presentations: BSCW Analysts

    Data.gov (United States)

    National Aeronautics and Space Administration — These slides were presented at the AePW, April 21-22, 2012. They detail the analytical results generated by each of the participating analysis teams for the...

  13. Workshop Presentations: RSW Analysts

    Data.gov (United States)

    National Aeronautics and Space Administration — These slides were presented at the AePW, April 21-22, 2012. They detail the analytical results generated by each of the participating analysis teams for the...

  14. Workshop Presentations: HIRENASD Analysts

    Data.gov (United States)

    National Aeronautics and Space Administration — These slides were presented at the AePW, April 21-22, 2012. They detail the analytical results generated by each of the participating analysis teams for the HIRENASD.

  15. Renewable Electricity Futures (Presentation)

    Energy Technology Data Exchange (ETDEWEB)

    Mai, T.

    2012-10-01

    This presentation library summarizes findings of NREL's Renewable Electricity Futures study, published in June 2012. RE Futures investigated the challenges and impacts of achieving very high renewable electricity generation levels in the contiguous United States by 2050.

  16. ARE YOU PRESENT?

    OpenAIRE

    Juul, Henrik; Gilmartin, Thomas; Thomas, Thomas Tom

    2007-01-01

    Master of Computer Mediated Comunication thesis: ARE YOU PRESENT? FROM SPECTATOR TO PARTICIPANT IN COMPUTER MEDIATED CONFERENCES This thesis analyzes the application of Social Presence theory on a conference with participants attending online in UNDP and the consequences hereof.

  17. Presenting New Grammar

    Institute of Scientific and Technical Information of China (English)

    WU Cai-ling; WANG Xi

    2015-01-01

    More and more researchers have now agreed upon the necessity of teaching grammar, but it still remains controversial as how to teach the forms, with the central consideration of not to harm the meaning-focused communicative teaching method. In this essay, one of the issues in grammar teaching will be discussed as how to present new grammar to learners, through evaluating and modifying a particular presentation activity in a grammar-teaching textbook.

  18. Tritium monitoring : present status

    International Nuclear Information System (INIS)

    The report summarizes the present status of techniques employed for the monitoring of tritium in water, air and other samples. A brief mention of the work done by numerous workers in the field, critical comments about the work and a fairly exhaustive list of references about the work done during the last 4 decades has been presented. On-line monitoring on real time basis in nuclear reactors is also discussed. (author). 83 refs., 10 refs., 2 tabs

  19. SIRENOMELIA A RARE PRESENTATION

    OpenAIRE

    K. Ramesh Reddy; Srinivas, S; Shiva Kumar; Surweshwar Reddy; Hariprasad; G M Irfan

    2012-01-01

    We are presenting two cases of Sirenomelia (Mermaid Syndrome), which is an extreme example of the caudal regression syndrome. It invariably presents with lower limb fusion, sacral and pelvic bony anomalies, absent external genitalia, imperforate anus, and renal agenesis or dysgenesis. There are approximately 300 cases reported in the literature, 15% of which are associated with twinning, most often monozygotic. The syndrome of caudal regression is thought to be the result of injury to the cau...

  20. Present status of dibaryons

    International Nuclear Information System (INIS)

    In the present notes the author tries to assess the situation regarding dibaryons in the various channels with baryon number two, emphasizing the problems and discussing in greater detail the most recent developments since the Versailles Conference. One of the motivations for the present search of B=2 states is the possibility of colored subclusters for systems with six quarks which cannot occur for ordinary baryons or mesons. (Auth.)

  1. The colonial present

    OpenAIRE

    Bunnell, Tim

    2006-01-01

    cultural geographies 2006 13: 305-312 reviews in brief The colonial present. By Derek Gregory. Malden, MA: Blackwell. 2004. 367 pp. £16.99 paper. ISBN 1577180909. The colonial present extends and deepens our understanding of contemporary geopolitics in ways that speak to the key concerns of this journal. For Derek Gregory as for Edward Said, to whom the book is dedicated, and whose intellectual legacy runs through its pages - issues of cu...

  2. Blade Testing Trends (Presentation)

    Energy Technology Data Exchange (ETDEWEB)

    Desmond, M.

    2014-08-01

    As an invited guest speaker, Michael Desmond presented on NREL's NWTC structural testing methods and capabilities at the 2014 Sandia Blade Workshop held on August 26-28, 2014 in Albuquerque, NM. Although dynamometer and field testing capabilities were mentioned, the presentation focused primarily on wind turbine blade testing, including descriptions and capabilities for accredited certification testing, historical methodology and technology deployment, and current research and development activities.

  3. Leprosy: An unusual presentation

    Directory of Open Access Journals (Sweden)

    Geeta Kiran Arakkal

    2015-01-01

    Full Text Available Leprosy is a chronic infectious disease caused by Mycobacterium leprae, commonly manifesting as hypopigmented anesthetic patches with thickened nerves. Primary hyperpigmentation in leprosy is a rare manifestation. Literature search showed only few case reports of Hansen's disease with single hyperpigmented patch and involvement of relatively immune zones like palms and soles. We report a case of leprosy presenting primarily as hyperpigmented patches over the trunk and extremities with involvement of palms and soles which is a rare presentation.

  4. Communication and presentation skills

    OpenAIRE

    Lorencová, Ivana

    2014-01-01

    This bachelor thesis deals with individual factors of communication and basic presentations skills. The theoretical part specifies the basic elements of verbal and non-verbal communication and basic factors connected with preparation and realisation of a presentation. The practical part of the thesis comprises an analysis of impacts of speaker's visual and other communication influences over an audience. The results are applied to a Multimedia Display exhibition taking place during the bachel...

  5. Dermatofibroma: Atypical presentations

    Directory of Open Access Journals (Sweden)

    Mousumi Roy Bandyopadhyay

    2016-01-01

    Full Text Available Dermatofibroma is a common benign fibrohistiocytic tumor and its diagnosis is easy when it presents classical clinicopathological features. However, a dermatofibroma may show a wide variety of clinicopathological variants and, therefore, the diagnosis may be difficult. The typical dermatofibroma generally occurs as a single or multiple firm reddish-brown nodules. We report here two atypical presentations of dermatofibroma - Atrophic dermatofibroma and keloidal presentation of dermatofibroma. Clinical dermal atrophy is a common phenomenon in dermatofibromas as demonstrated by the dimpling on lateral pressure. However, this feature is exaggerated in the atrophic variant of dermatofibroma. Atrophic dermatofibroma is defined by dermal atrophy of more than 50% of the lesion apart from the usual features of common dermatofibroma. The keloidal variant of dermatofibroma should not be overlooked as a simple keloid. The findings of keloidal change in dermatofibromas may support that trauma is a possible cause of dermatofibroma.

  6. Dermatofibroma: Atypical Presentations.

    Science.gov (United States)

    Bandyopadhyay, Mousumi Roy; Besra, Mrinal; Dutta, Somasree; Sarkar, Somnath

    2016-01-01

    Dermatofibroma is a common benign fibrohistiocytic tumor and its diagnosis is easy when it presents classical clinicopathological features. However, a dermatofibroma may show a wide variety of clinicopathological variants and, therefore, the diagnosis may be difficult. The typical dermatofibroma generally occurs as a single or multiple firm reddish-brown nodules. We report here two atypical presentations of dermatofibroma - Atrophic dermatofibroma and keloidal presentation of dermatofibroma. Clinical dermal atrophy is a common phenomenon in dermatofibromas as demonstrated by the dimpling on lateral pressure. However, this feature is exaggerated in the atrophic variant of dermatofibroma. Atrophic dermatofibroma is defined by dermal atrophy of more than 50% of the lesion apart from the usual features of common dermatofibroma. The keloidal variant of dermatofibroma should not be overlooked as a simple keloid. The findings of keloidal change in dermatofibromas may support that trauma is a possible cause of dermatofibroma. PMID:26955137

  7. Mixed-Initiative Clustering

    Science.gov (United States)

    Huang, Yifen

    2010-01-01

    Mixed-initiative clustering is a task where a user and a machine work collaboratively to analyze a large set of documents. We hypothesize that a user and a machine can both learn better clustering models through enriched communication and interactive learning from each other. The first contribution or this thesis is providing a framework of…

  8. The SEED Initiative

    Science.gov (United States)

    Teich, Carolyn R.

    2011-01-01

    Committed to fulfilling the promise of the green economy, the American Association of Community Colleges (AACC) launched the Sustainability Education and Economic Development (SEED) initiative (www.theseedcenter.org) in October 2010. The project advances sustainability and clean energy workforce development practices at community colleges by…

  9. Clean Energy Manufacturing Initiative

    Energy Technology Data Exchange (ETDEWEB)

    None

    2013-04-01

    The initiative will strategically focus and rally EERE’s clean energy technology offices and Advanced Manufacturing Office around the urgent competitive opportunity for the United States to be the leader in the clean energy manufacturing industries and jobs of today and tomorrow.

  10. Sustaining Participatory Design Initiatives

    DEFF Research Database (Denmark)

    Iversen, Ole Sejer; Dindler, Christian

    2014-01-01

    While many participatory design (PD) projects succeed in establishing new organisational initiatives or creating technology that is attuned to the people affected, the issue of how such results are sustained after the project ends remains an important challenge. We explore the challenge...

  11. Initial Market Assessment

    OpenAIRE

    World Bank, (WB)

    2013-01-01

    Responding appropriately to the country’s high exposure and vulnerability to natural disasters, and capitalizing on a well-functioning insurance industry, Vietnam has embraced insurance mechanisms in disaster risk management and agriculture more vigorously than most developing countries. But some initiatives like the disaster risk reduction (DRR) strategy’s mandate to implement disaster ri...

  12. Initial operation of PDX

    International Nuclear Information System (INIS)

    Initial operation of PDX with a circular cross-section plasma is described. The machine parameters are given and the glow discharge cleaning is discussed. Plasma parameters for a circular deuterium plasma discharge are given for both moderate and low q experiments

  13. Analyzing in the Present

    DEFF Research Database (Denmark)

    Revsbæk, Line; Pedersen, Lene Tanggaard

    2015-01-01

    The article presents a notion of “analyzing in the present” as a source of inspiration in analyzing qualitative research materials. The term emerged from extensive listening to interview recordings during everyday commuting to university campus. Paying attention to the way different parts of...... various interviews conveyed diverse significance to the listening researcher at different times became a method of continuously opening up the empirical material in a reflexive, breakdown-oriented process of analysis. We argue that situating analysis in the present of analyzing emphasizes and acknowledges...... contributes to an ongoing methodological conversation problematizing the notion of “data” and the use of “data-reliant” methods of analysis....

  14. Book Presentation | 27 February

    CERN Multimedia

    The CERN Library

    2013-01-01

    "A caccia del bosone di Higgs. Magneti, governi, scienziati e particelle nell'impresa scientifica del secolo" by Luciano Maiani and Romeo Bassoli, published by Mondadori. On Wednesday 27 February Luciano Maiani will present the book "A caccia del bosone di Higgs. Magneti, governi, scienziati e particelle nell'impresa scientifica del secolo". More information here. The presentation will take place in the Council Chamber at 16.00 and will be followed by a debate and book signing. The book will be on sale. You are cordially invited.

  15. Renewable Electricity Futures (Presentation)

    Energy Technology Data Exchange (ETDEWEB)

    Mai, T.

    2012-08-01

    This presentation library summarizes findings of NREL's Renewable Electricity Futures study, published in June 2012. RE Futures investigated the challenges and impacts of achieving very high renewable electricity generation levels in the contiguous United States by 2050. It was presented at the 2012 RE AMP Annual Meeting. RE-AMP is an active network of 144 nonprofits and foundations across eight Midwestern states working on climate change and energy policy with the goal of reducing global warming pollution economy-wide 80% by 2050.

  16. Round table presentation

    International Nuclear Information System (INIS)

    Considerations on radiological protection always start off with discussions on concepts, principles and other basic assumptions. We are all aware of the fact that the International Commission on Radiological Protection (ICRP) is currently holding such discussions. They are useful for corporate radiological protection if they lead to rules and regulations which meet practical everyday requirements. In the topical sessions, papers have been presented on the implementation of 'basic safety standards' and corporate radiological protection in medical institutions, research institutions, technical plants and nuclear power stations. Some of these contributions were followed by discussions. In this presentation I would like to come back to some of the items raised in these discussions

  17. The Depressive Psychopathology Scale: presentation and initial validation in a sample of Peruvian psychiatric patients La Escala de Psicopatología Depresiva: presentación y validación inicial en una muestra de pacientes psiquiátricos peruanos

    Directory of Open Access Journals (Sweden)

    Johann M Vega-Dienstmaier

    2011-10-01

    Full Text Available OBJECTIVE: Presentation and validation of the Depressive Psychopathology Scale (DPS, a new, Spanish-language psychometric inventory, in a sample of Peruvian psychiatric patients. METHODS: From 1999 to 2001, the DPS, Zung Self-rating Depression Scale (ZSDS, and Major Depressive Disorder (MDD module of the Structured Clinical Interview for DSM-IV Disorders (SCID were administered to 226 nonpsychotic outpatients referred to the National Institute of Mental Health in Lima, Peru, for their initial clinical evaluation. In the evaluation, attending psychiatrists 1 corroborated the general diagnosis and presence or absence of MDD and 2 rated depression severity based on clinical opinion and on Clinical Global Im-pression-Severity scale criteria. RESULTS: Mean time to complete the DPS was 7.22 minutes (standard deviation, 3.99. Cronbach's alpha value was 0.86. For diagnosis of MDD, based on the SCID, area under receiver operating characteristic curve (AUROC was 0.872 and the selected cutoff score (26/27 had 81.32% sensitivity and 80% specificity; based on the attending psychiatrists' evaluation, AUROC was 0.832 and the selected cutoff score (25/26 had 77.67% sensitivity and 72.32% specificity. The DPS was significantly correlated with the ZSDS (rho = 0.8, P OBJETIVO: Presentación y validación de la Escala de Psicopatología Depresiva (EPD, un nuevo inventario psicométrico en lengua española, en una muestra de pacientes psiquiátricos peruanos. MÉTODOS: De 1999 al 2001, se administraron la EPD, la Escala de Autoevaluación de la Depresión de Zung (ZSDS y el módulo correspondiente al Trastorno Depresivo Mayor (TDM de la Entrevista Clínica Estructurada para trastornos del DSM-IV (SCID a 226 pacientes ambulatorios no psicóticos derivados al Instituto Nacional de Salud Mental de Lima para su evaluación clínica inicial. En la evaluación, los psiquiatras responsables 1 corroboraron el diagnóstico general y la presencia o ausencia de TDM, y 2

  18. Presentation of 2004 earnings

    International Nuclear Information System (INIS)

    This presentation offers financial information on the AREVA Group earnings for the year 2004. With manufacturing facilities in over 40 countries and a sales network in over 100, Areva offers customers technological solutions for nuclear power generation and electricity transmission and distribution. The Group also provides interconnect systems to the telecommunications, computer and automotive markets. (A.L.B.)

  19. Agriculture Oral Presentations

    International Nuclear Information System (INIS)

    This publication contains 23 papers related to the use of nuclear techniques in plant breeding in Turkey, effect of gamma irradiations on growing various plants, mutations and soil chemistry, etc., presented at 4. International Congress of Nuclear Agriculture and Animal Science in Bursa, Turkey, 25-27 Sep 1996. A separate abstract was prepared for each paper

  20. Presentation of 2004 earnings

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2005-03-01

    This presentation offers financial information on the AREVA Group earnings for the year 2004. With manufacturing facilities in over 40 countries and a sales network in over 100, Areva offers customers technological solutions for nuclear power generation and electricity transmission and distribution. The Group also provides interconnect systems to the telecommunications, computer and automotive markets. (A.L.B.)

  1. Keynote presentation : SAR systems

    NARCIS (Netherlands)

    Halsema, D. van; Otten, M.P.G.; Maas, A.P.M.; Bolt, R.J.; Anitori, L.

    2011-01-01

    Synthetic Aperture Radar (SAR) systems are becoming increasingly important sensors in as well the military environment as in the civilian market. In this keynote presentation an overview will be given over more than 2 decades of SAR system∼ and SAR application development at TNO in the Netherlands.

  2. Managing Presentation Anxiety

    Science.gov (United States)

    Hartman, Jackie L.; LeMay, Elaine

    2004-01-01

    All business communication professors struggle with anxiety-ridden students when discussing public speaking. To alleviate students' fears of speaking in public a process was designed to allow business communication students to acknowledge, address, and annul their presentation fears. A six-year comparative study using qualitative methods and…

  3. Intraductal Papilloma: Atypical Presentation

    OpenAIRE

    P Ramaswamy; Tanya Khaitan; Anuradha, A.; B Praveen Kumar; Sudhakar, S.

    2013-01-01

    Ductal papillomas have unique papillary features arising from the salivary gland duct system. They comprise three rare benign adenomas, namely, inverted ductal papilloma, sialadenoma papilliferum, and intraductal papilloma. Intraductal papilloma is an extremely rare benign salivary gland tumor that occurs most commonly in the minor salivary glands. Here, we are presenting a case report of intraductal papilloma in an 18-year-old patient.

  4. Neurosyphilis: Various Presentations

    Directory of Open Access Journals (Sweden)

    Kezban Aslan

    2012-12-01

    Full Text Available Neurosphylisis develops in about 5 % of untreated patients infected with Treponema pallidum. Spirocet, disseminates systemically hours to days after inoculation. Early invasion to central nervous system can be seen in infected patients without symptomatic. In these lecture we presented three patients with different complain. The patients have had; diplopia, headache and blurred vision, numness and slimming of legs.

  5. WWNPQFT-2010 - Slides of the presentations

    International Nuclear Information System (INIS)

    This document is made up of the slides of the presentations. The object of this workshop is to consolidate and publicize new efforts in non-perturbative field theories. The main topics are quantum chromodynamics, Yang-Mills theory, effective locality, the Gribov-Zwanziger Lagrangian, and renormalization. A presentation is dedicated to the initial stages of high energy nucleus-nucleus collisions

  6. Adult onset xanthogranuloma presenting as laryngeal mass.

    Science.gov (United States)

    Li, Shawn; Weidenbecher, Mark

    2016-01-01

    Histiocytic disorders can be classified according to the distribution pattern of the lesions and the organs involved. Non-Langerhans-cell histiocytosis is a rare group of diseases that have varied clinical presentations ranging from isolated masses to diffuse systemic eruptions. We discuss a patient who initially presented with a vocal cord lesion and was ultimately diagnosed with adult onset xanthogranuloma. PMID:26954863

  7. Tuberculosis Endometritis Presenting as A Leiomyoma

    Directory of Open Access Journals (Sweden)

    Mahboobeh Shirazi

    2015-02-01

    Full Text Available Genitourinary tuberculosis is a common extrapulmonary manifestation of tuberculosis. Taking into consideration that genitourinary tuberculosis may be associated with a diversity of presentations, its diagnoses may be difficult. A young woman with an initial presumptive diagnosis of a uterine leiomyoma presented with abdominal pain and a pelvic mass that after further investigations, she was diagnosed with genital tuberculosis.

  8. Tuberculosis Endometritis Presenting as A Leiomyoma

    OpenAIRE

    Mahboobeh Shirazi; Fatemeh Shahbaz; Leila Pirzadeh; Seyed Rahim Mohammadi; Parisa Ghaffari; Tahereh Eftekhar

    2015-01-01

    Genitourinary tuberculosis is a common extrapulmonary manifestation of tuberculosis. Taking into consideration that genitourinary tuberculosis may be associated with a diversity of presentations, its diagnoses may be difficult. A young woman with an initial presumptive diagnosis of a uterine leiomyoma presented with abdominal pain and a pelvic mass that after further investigations, she was diagnosed with genital tuberculosis.

  9. [Premature newborn: a case presentation].

    Science.gov (United States)

    Pastor Rodríguez, Jesús David; Pastor Bravo, María Del Mar; López García, Visitación; Cotes Teruel, María Isabel; Mellado, Jesús Eulogio; Cárceles, José Jara

    2010-01-01

    A case is presented of a premature newborn of 27 weeks gestation and weighing 420 grams who was delivered as a result of a maternal pre-eclampsia and retarded intra-uterine growth. During the 125 days of hospitalisation, an individual care plan based on the Virginia Henderson model was devised and applied to both the child and her parents using NANDA diagnostics, interventions according to the NIC classification, and the expected results according to the NOC classification. The Marjory Gordon functional patterns were used for the initial assessment. By applying the pre-term newborn (PTNB) plan, all their needs were provided and were modified throughout the hospital stay, with new needs that were added to the established ones. These required a continuous assessment with the subsequent adapting of the care plan. Likewise, the care required by the parents varied from the initial grief due to the possible loss of their child to learning the alarm signs and the home care that their child would need. The child was finally discharged weighing 2900 grams and with normal neurological and psychomotor development, although with a lower weight appropriate to her age. Currently, at 2 years old, the child has a normal neurological and psychomotor development, but with weight and size lower than the P(3) percentile. She requires speech therapy treatment due to paralysis of the right vocal cord. PMID:20605104

  10. Summary of the presentations

    International Nuclear Information System (INIS)

    This part summarizes the content of the six following presentations: 1. IAEA requirements/guidance for the decommissioning safety case (Mike Bell, IAEA); 2. Safety case in an EIA context (Patrick O'SULLIVAN, The Netherlands); 3. Plant configuration and the D and D licensing process (Eugenio GIL LOPEZ and Pedro CARBONERAS, Spain); 4. Accident assessment (Ivo TRIPPUTI, Italy; Ingmar LUND, Sweden); 5. Balancing radiological and industrial risk in the safety case (Pascal DEBOODT, Belgium); 6. The safety case for safe store and dormancy periods (Paul WOOLLAM, UK). Following the six presentations, the WPDD members discussed the safety case in an open discussion led by the Topical Session Chair, Frances Taylor. The discussion was wide-ranging, and topics varied from the standards that apply to releases to the environment during safe store, to decommissioning parallels with other major processing industries and facilities (such as oil rigs). Frances Taylor steered the discussion toward addressing the questions that the WPDD Core Group had proposed for the topical session. The Chair, the Rapporteur, and some members of the group sensed that the presentations had covered such an wide variety of issues, and that the content of the presentations themselves differed so greatly, that it would be difficult to distill a position paper from the information gathered, as had been the mandate from the Core Group. In addition, the meaning of the term 'Safety Case' differed greatly among participants in the topical session. Some took the term to mean the analysis and document that the implementor provides to the regulator, describing how operations will be performed safely. Others considered the term to mean the overall safety and risk conditions inherent in a nuclear facility during operations or decommissioning. With the differences in presentations and with the meaning of the terminology remaining unclear, the WPDD participants did not reach consensus conclusions on December 5, 2001

  11. Initial conditions and sampling for multifield inflation

    CERN Document Server

    Easther, Richard

    2013-01-01

    We investigate the initial conditions problem for multifield inflation. In these scenarios the pre-inflationary dynamics can be chaotic, increasing the sensitivity of the onset of inflation to the initial data even in the homogeneous limit. To analyze physically equivalent scenarios we compare initial conditions at fixed energy. This ensures that each trajectory is counted once and only once, since the energy density decreases monotonically. We present a full analysis of hybrid inflation that reveals a greater degree of long range order in the set of "successful" initial conditions than was previously apparent. We explore the effective smoothing scale for the fractal set of successful initial conditions induced by the finite duration of the pre-inflationary phase. The role of the prior information used to specify the initial data is discussed in terms of Bayesian sampling.

  12. SIRENOMELIA A RARE PRESENTATION

    Directory of Open Access Journals (Sweden)

    K Ramesh Reddy

    2012-01-01

    Full Text Available We are presenting two cases of Sirenomelia (Mermaid Syndrome, which is an extreme example of the caudal regression syndrome. It invariably presents with lower limb fusion, sacral and pelvic bony anomalies, absent external genitalia, imperforate anus, and renal agenesis or dysgenesis. There are approximately 300 cases reported in the literature, 15% of which are associated with twinning, most often monozygotic. The syndrome of caudal regression is thought to be the result of injury to the caudal mesoderm early in gestation. One of our cases survived for 12 days after birth. This new born had an unusually high anorectal anomaly in which the colon was ending at the level of mid transverse colon, fused lower limbs and genital anomalies. Ultrasound of the abdomen revealed horseshoe kidney. Colostomy was performed on day 2 of life. The second case encountered was a stillborn baby on whom an autopsy was performed.

  13. El escenario del presente

    Directory of Open Access Journals (Sweden)

    Cruz, Manuel

    2008-12-01

    Full Text Available The disappearance of the idea of progress in post-Enlightenment thought constitutes one of the central tenets of the network of topics that make up contemporary social imagery. However, that tenet, which in a sense has been present from the origins of the Enlightment tradition, produces discursive effects of significant relevance, a particular kind of perverse effects related to thought, not always legitimized enough to certify that disappearance.

    La desaparición de la idea de progreso en el pensamiento postilustrado constituye uno de los convencimientos centrales del entramado de tópicos que forman el imaginario social contemporáneo. Pero dicho convencimiento, en cierto modo presente desde los orígenes de la propia tradición ilustrada, da lugar a efectos discursivos de considerable importancia, a una particular modalidad de efectos perversos en materia de pensamiento, no siempre suficientemente aquilatados al certificar dicha desaparición.

  14. Conversation VS Presentation

    Institute of Scientific and Technical Information of China (English)

    侯克为

    2015-01-01

    <正>It is always said that a good teacher should be a good lecturer.He or she should at least master all the different methods of presenting a good presentation to students.We expect our teachers to give a wonderful lecture in class and that’s everything a successful teacher should do.However,is this truly right?Does it really make sense that a teacher should be a lecturer and treat our students as audiences in class?No,I don’t think so.Especially after all these years of teaching primary and middle school students,I think a successful teacher should be a good talker.They should always know how

  15. Heterotrophic Pregnancy- Rare Presentation

    OpenAIRE

    AB Chattopadhyay; Somshekhar Sharma; Kushagra Garg

    2013-01-01

    Heterotopic pregnancy, a potentially dangerous and life-threatening clinical associated with intrauterine (IU) and extra uterine pregnancies at the same time. Incidence of such cases are rare but very often missed as the diagnosis being overlooked during examination of the pregnant women with risk factors for an ectopic pregnancy such as free fluid with or without an adnexal mass or acute abdominal pain and shock presentation. Hence a high degree of clinical evaluation is warranted examining ...

  16. Choriocarcinoma presenting with thyrotoxicosis

    OpenAIRE

    Sotello, David; Rivas, Ana Marcella; Test, Victor J.; Lado-Abeal, Joaquin

    2016-01-01

    We describe a 26-year-old man with metastatic choriocarcinoma who presented with hyperthyroidism associated with elevated β-human chorionic gonadotropin (B-HCG) and respiratory failure secondary to diffuse lung metastasis. After the first cycle of chemotherapy, the concentration of B-HCG dramatically decreased and the patient became euthyroid, allowing us to discontinue antithyroid medications. The patient's hyperthyroidism was caused by stimulation of the thyroid gland by high B-HCG levels, ...

  17. Practical modes of presentation

    OpenAIRE

    Glick, E.

    2015-01-01

    The Intellectualist thesis that know-how is a kind of propositional knowledge faces a simple problem: For any proposition p, it seems that one could know p without knowing how to do the activity in question. For example, it seems that one could know that w is a way to swim even if one didn't know how to swim oneself. In this paper I argue that this "sufficiency problem" cannot be adequately addressed by appealing to practical modes of presentation.

  18. Presentation = Speech + Slides

    Directory of Open Access Journals (Sweden)

    Derik Badman

    2008-12-01

    Full Text Available Back in October, Aaron Schmidt posted “HOWTO give a good presentation” to his blog walking paper. His second bullet point of “thoughts” on good presentations is: Please don’t fill your slides with words. Find some relevant and pretty pictures to support what you’re saying. You can use the pictures to remind yourself what you’re going [...

  19. INTERVIEWS : PRESENTING YOU

    OpenAIRE

    ブリトン, ジョセフ; Britton, Joseph

    2005-01-01

    The conclusions drawn in this paper are based upon more than 30 years of personal research along with the findings of communication firms and media consultants whose business is to influence our opinions. To quantify the success rate of implementing particular methods of interviewee presentations is a most difficult challenge often wrought with the bias of the researcher. This author has instead drawn conclusions about successful interviews based upon the fundamental questions asked by leadin...

  20. Presentation of the journal.

    OpenAIRE

    Hernández, Esteban

    2004-01-01

    The recent upsurge in the volume and quality of the accounting history research in Spain has positioned it as one of the top nations in the field. However, only two Spanish journals are now dedicated entirely to accounting, and, while some Spanish accounting history researchers do publish part of their work in English language journals, publication continues to be a difficult proposition for most. Thus, many researchers can hope only to present their work as papers at Conferences and Congress...

  1. Speaker's presentations. Energy supply security

    International Nuclear Information System (INIS)

    This document is a collection of most of the papers used by the speakers of the European Seminar on Energy Supply Security organised in Paris (at the French Ministry of Economy, Finance and Industry) on 24 November 2000 by the General Direction of Energy and Raw Materials, in co-operation with the European Commission and the French Planning Office. About 250 attendees were present, including a lot of high level Civil Servants from the 15 European State members, and their questions have allowed to create a rich debate. It took place five days before the publication, on 29 November 2000, by the European Commission, of the Green Paper 'Towards a European Strategy for the Security of Energy Supply'. This French initiative, which took place within the framework of the European Presidency of the European Union, during the second half-year 2000. will bring a first impetus to the brainstorming launched by the Commission. (author)

  2. Multiple Presentations of Brain TB

    Directory of Open Access Journals (Sweden)

    H. Kharazi

    2008-01-01

    Full Text Available Tuberculosis of the central nervous system is an im-portant cause of mortality and morbidity."nPrompt diagnosis and early treatment are extremely important to reduce its morbidity and mortality. The main forms of central nervous system tuberculosis are represented by tuberculosis meningitis, meningeal or parenchymal tuberculomas, and tuberculosis abscess formation. Sequels consist of hydrocephalus, calcifi-cations, and areas of encephalomalacia."nCT is the diagnostic imaging modality in many clini-cal settings to demonstrate the various aspects of cra-nial tuberculosis on initial presentation and to moni-tor the evolution of the disease and response to ther-apy. In this review we illustrate CT scan findings of intracranial lesions of tuberculosis in our patients.

  3. Tuberous Sclerosis: Multiple Presentations

    Directory of Open Access Journals (Sweden)

    M. Sanei Taheri

    2008-01-01

    Full Text Available Introduction: Tuberous sclerosis is an autosomal do-minant genetic disorder that involves multiple or-gans. The predominant lesions are the hamartomas. Classically tuberous sclerosis has been characterized by a classic clinical triad of facial angiofibromas in 90%,retardation in 50-80%,seizure 80-90% and all three in 30%."nThe disease occurs in 1:100,000 persons in all races with nearly equal distribution between the sexes. "nCase Presentation: We had six patients who admitted with different presentations of tuberous sclerosis with a past history of convulsion from childhood, skin le-sions and mental retardation, also with new onset headache and changed pattern of convulsion. In physical examination facial angiofibromas and sub-ungual fibromas apparently detected. Brain CT scan study with contrast showed multiple calcified nod-ules associated with tubers and ventriculomegaly, also an enhancing enlarged nodule at foramen of mo-nro, which was suggestive of subependymal giant cell astrocytoma (SGCA. In abdominal and pelvic CT scan and ultrasonography, massive bilateral angio-myolipomatosis diagnosed. Also Focal hypodense le-sions in liver which were hyperechoic in ultrasono-graphy were diagnosed. With MRI study tubers, white matter lesions and subependymal nodules asso-ciated with SGCA were detected better. After surgery SGCA was proved."nDiscussion: Our patients had different presentations and various findings of this spectrum discussed in this lecture.

  4. Self-initiated expatriates

    DEFF Research Database (Denmark)

    Selmer, Jan; Lauring, Jakob

    2014-01-01

    Purpose – As it has been suggested that adult third-culture kids may be more culturally adaptable than others, they have been labelled “the ideal” expatriates. In this article, we explore the adjustment of self-initiated expatriate academics in Hong Kong, comparing adult third-culture kids with...... adult mono-culture kids. Design/methodology/approach – We use survey results from 267 self-initiated expatriate academics in Hong Kong. Findings – Exploratory results show that adult third-culture kids had a higher extent of general adjustment. No significant results were found in relation to...... interaction adjustment and job adjustment. We also found that recent expatriate experiences generally had a positive association with the adjustment of adult mono-culture kids, but this association only existed in terms of general adjustment for adult third-culture kids. Originality/value – Once corroborated...

  5. Laser Initiated Actuator study

    Energy Technology Data Exchange (ETDEWEB)

    Watson, B.

    1991-06-27

    The program task was to design and study a laser initiated actuator. The design of the actuator is described, it being comprised of the fiber and body subassemblies. The energy source for all experiments was a Spectra Diode 2200-H2 laser diode. The diode is directly coupled to a 100 micron core, 0.3 numerical aperture fiber optic terminated with an SMA connector. The successful testing results are described and recommendations are made.

  6. Innovative Rural Development Initiatives

    OpenAIRE

    Wickenhagen, A.; Pontieri, A.; Heilig, G.K.

    2002-01-01

    This Interim Report provides first results from case studies of innovative rural development initiatives in Europe. They were conducted by IIASA's European Rural Development (ERD) project during 2001 -- primarily to test the feasibility of the research concept and to get a first realistic impression of rural development problems and possibilities at the IDeal level. These reports are only the first round of a much larger sample of some 40 to 50 case studies, which are planned for the nex...

  7. Initiation Train Experiments

    Science.gov (United States)

    Francois, Elizabeth; Johnson, Carl; Liechty, Gary; Whitley, Von

    2015-06-01

    In an effort to evaluate and qualify a new detonator diagnostic, booster selection and main charge configuration, a variety of small-scale tests have been conducted. This paper will describe the needs, testing approach and model validation. Because of the limited size available some novel approaches were made to understand the observed phenomenon. Function time and time of arrival at various locations in the initiation train are desirable data points. Knowing when each segment initiates the next segment and the time to run up to detonation is critical. Results of our experiments were modeled for timing accuracy, wave shape and pressure. Agreement between the experiments and models will be discussed. The testing that will be discussed is time of arrival wires, PDV, and fiber optic arrays. The time of arrival wire measures the detonator cup breakout time. When correlated to bridge burst, an absolute time is collected. This data point also gives time zero for the booster initiation. Many models actually start at the booster, rather than the detonator, so the inclusion of this data point will improve modeling efforts.

  8. Alopecia as the Presenting Symptom of Syphilis.

    Science.gov (United States)

    Ornelas, Jennifer; Agbai, Oma N; Kiuru, Maija; Sivamani, Raja K

    2015-07-01

    Alopecia can be one of the many symptoms of secondary syphilis and the clinical presentations include essential syphilitic alopecia or symptomatic syphilitic alopecia. In this report, we present a case of a patient with essential syphilitic alopecia whose sole presenting symptom of syphilis was alopecia. Despite an initial negative rapid plasma reagin (RPR) test, he was ultimately found to have syphilis on scalp biopsy. His alopecia improved following treatment with benzathine penicillin. This presentation serves as a reminder to clinicians to be cognizant of alopecia as a presenting sign of syphilis. A review of the specificity and sensitivity of the typical tests used for the diagnosis is presented. PMID:26436969

  9. Xeroderma pigmentosum. Case presentation.

    Directory of Open Access Journals (Sweden)

    Damaris Díaz Leonard

    2008-08-01

    Full Text Available Twelve years old patient (YGS, female, white, of rural origin; with history of facial and truncal bullae since the age of eight months when exposed to the sun light. It was first diagnosed as solar dermatitis. At the age of 6 it was assessed as xeroderma pigmentosum. This diagnosis was confirmed at the age of 10 by the histopathology department and reassessed by the National Reference Centre. For the infrequency of this disease, a bibliographic revision was carried out to make a report for this case presentation.

  10. Presentation of the Dossier

    Directory of Open Access Journals (Sweden)

    Tércio Machado Siqueira

    2011-06-01

    Full Text Available The Week of Theological Studies (SETET in 2010 had the theme "Bible and daily life: the Word of God in the everyday life of communities of faith." The lectures where guided by the proposal to establish a link between the Bible and the common pastoral practice of local churches. It was a week where one could observe the importance of re-reading the Bible as a critical academic reflection of study allied to the practice of faith.In this sense, as proposed by the Editor of the Revista Caminhando, this edition contains a dossier, whose guiding principle is the theme of the SETET. The articles presented here are the result of the conferences held in the Week. A major highlight is the fact that the lectures were given in order to maintain a dialogue between the Bible, Theology and Ministry.In this journal, the reader will find reflections about worship in a biblical and pastoral perspective. The biblical reflection we ha a number of significant articles for the discussion of the proposed topic: Samuel F. Salgado, biblical scholar, highlights the importance of worship as a meetingplace, and Luiz Carlos Ramos, pastoralist, discusses the origins of preaching as an essential element of worship.The subject of re-reading biblical texts count with texts by Rui de Souza Josgrilberg, systematic theologian, Suely Xavier dos Santos, biblical scholar, and Jonas Machado, biblical scholar, who deal with reading the Bible in the daily life. Josgrilberg highlights the value of the hermeneutical process and daily life to approximate the world of the Bible to our world. Santos explores the biblical perspective of everyday life and the practical implications for today. Machado, in turn, presents the characteristics of Bible reading in a popular perspective and makes some suggestions to avoid dangerous interpretations.The biblical scholars, Tercio Machado Siqueira and Marcelo Carneiro,as Josué Lazier, educator, present the reading of the Bible related to education

  11. Present on Site

    DEFF Research Database (Denmark)

    Ingemann, Bruno

    Why are exhibitions and museums so important? What can they be used for? Who determines relevance in a transformative process? Transforming exhibitions is not just something you do, it is something that gets better the more you do it. This book looks at the intersection of the visitor or user, wh...... • Invisibles – The exhibition design processes • Openings – Category, objects and communication Present on site is relevant not only for students and researchers in the field of museum communication, media and design studies, but also for exhibition and museum practitioners....

  12. Exit Presentation -- Maintaining Balance

    Science.gov (United States)

    Heap, Erin

    2010-01-01

    This slide presentation reviews the projects which the author engaged in during an internship at Johnson Space Center. Project 1 was involved with Stochastic Resonance (SR). Stochastic resonance is a phenomenon in which the response of a non-linear system to a weak input signal is optimized by the presence of a particular non-zero level of noise. The goal of this project was to develop a countermeasure for sensorimotor disturbances that are experienced after long duration space flight. The second project was a pilot study that was to examine how adaptation to a novel functional task was affected by postural disturbance.

  13. Craniosynostoses. A case presentation.

    Directory of Open Access Journals (Sweden)

    Barbara Aleida García Hernández

    2008-12-01

    Full Text Available A case of a three-month female infant who was born in an ectopic and institutional delivery is described. His parents are healthy and came to the consultation office due to an enlargement in the posterior part of the head. Precocious Hyperostosis due to synostoses of the sagittal and diastasis suture of the lambdoidal suture was confirmed in the radiography. It was decide to put the patient under surgical treatment after assessing the case with a neurosurgeon. An early diagnosis and treatment of this non frequent disease are of great importance because it does not permit a presentation of neurological sequelae.

  14. Choriocarcinoma presenting with thyrotoxicosis.

    Science.gov (United States)

    Sotello, David; Rivas, Ana Marcella; Test, Victor J; Lado-Abeal, Joaquin

    2016-01-01

    We describe a 26-year-old man with metastatic choriocarcinoma who presented with hyperthyroidism associated with elevated β-human chorionic gonadotropin (B-HCG) and respiratory failure secondary to diffuse lung metastasis. After the first cycle of chemotherapy, the concentration of B-HCG dramatically decreased and the patient became euthyroid, allowing us to discontinue antithyroid medications. The patient's hyperthyroidism was caused by stimulation of the thyroid gland by high B-HCG levels, as shown by the marked improvement of the patient's thyroid function panel after chemotherapy. PMID:26722165

  15. Radwaste - Multimedia presentation

    International Nuclear Information System (INIS)

    Radioactivity is a part of the Nature since the creation of the Earth. We have learned how to use radioactivity in medicine, power industry, and in other areas of life. Similarly as in other activities, waste is generated. We offer you basic information about radioactivity and radioactive waste (radwaste) in four films: Radioactivity, Source of radwaste, Management of radwaste. In the glossary are video presentations: Container (Castor) for radioactive waste; Deep underground repository; Transport vehicle; WWER type reactor. Encyclopedic part of the program contains detailed theoretical and practical information about use of radioactivity and radioactive waste. You will find the explanation in the part Glossary. (authors)

  16. Toxocariasis Presenting as Encephalomyelitis

    Directory of Open Access Journals (Sweden)

    Gregory Helsen

    2011-01-01

    Full Text Available We describe a farmer who presented with a clinical picture of a transverse thoracic myelitis. MRI showed inflammatory lesions in brain and thoracic spinal cord. Toxocariasis was suspected because of eosinophilia in blood and cerebrospinal fluid, and this diagnosis was confirmed immunologically. He was successfully treated with antihelminthics in combination with corticosteroids. Neurotoxocariasis is rare and diagnosis can be difficult because of the different and atypical clinical manifestations. It should be considered in every case of central neurological syndrome associated with eosinophilia.

  17. Leaching of initial and burnt danburite by sulfuric acid

    International Nuclear Information System (INIS)

    Sulfuric acid decomposition of initial and burnt danburite was studied in this work. The interaction between initial and pre baked danburite by sulfuric acid was studied as well. The influence of temperature, process duration and concentration of sulfuric acid on the rate of component extraction from initial and burnt danburite was defined. The chemical composition of initial danburite is presented.

  18. Qualification process initiative in Spain

    International Nuclear Information System (INIS)

    As it is expected to harmonize the Spanish qualification requirements in accordance with the European methodology, different initiatives have been implemented to demonstrate ISI (in-service inspection) procedures and equipment capabilities for its nuclear power plants. This presentation describes some examples in NDT qualification and validation, such as eddy current inspection of steam generator tubing, inspection of control rod drive housing (CRDH) welds, ultrasonic inspection of BWR RPV nozzle, ultrasonic inspection of stainless steel and dissimilar welds of NPP (PICI project), inspection of RPV head penetration (Petava project), bottom nuclear instrumentation penetrations of RPV (PIV project), BWR shroud inspection, inspection of burned fuel elements (Sicom project)

  19. Radiological presentation of neurosarcoidosis

    Directory of Open Access Journals (Sweden)

    Stjepanović Mihailo I.

    2014-01-01

    Full Text Available Introduction. In diagnostics of neurosarcoidosis, radiological diagnostic procedures are available, non-invasive and they contribute significantly to the diagnosis of this disease. The aim of this paper is to present a brief overview of the radiological diagnostic methods, their application, and their importance in daily clinical work with these patients. Radiological Presentation of Neurosarcoidosis. Magnetic resonance is the method of choice in diagnostics of this disease. Computed tomography can also be helpful in patients with contraindications for magnetic resonance, although it is less precise in assessing the involvement of the periventricular white matter, hypothalamus, and cranial nerves. The number of lesions and the degree of involvement of the parenchyma and leptomeninges are better seen by magnetic resonance than by computed tomography scan. It is important to note that the magnetic resonance imaging may be normal in patients with neurosarcoidosis, especially in patients with cranial neuropathy, or in patients treated with corticosteroids. There is a number of variability in the occurrence of neurosarcoidosis on radiological images. Conclusion. Radiological procedures are on the very top of diagnostic pyramid of this disease due to their availability, non-invasiveness, and precision.

  20. Bad (Re)Presentations

    CERN Multimedia

    Computer Security Team

    2013-01-01

    This time, we would like to address copyright violations (again) - but with a twist. While previous articles focussed on “Music, videos and the risk for CERN” or on software licences, the focus is now on using photos, music and images “found” on the Web for presentations, publications and web pages…   Just recently, a video produced for CERN and published on YouTube and Facebook used background music from a contemporary popular artist. However, the people responsible failed to obtain the appropriate permission to actually use that music. They thought that having bought it on iTunes was sufficient. But it was not: “buying” means you have the right to listen, but not the right for further distribution or re-publication. As a result, the videos were pulled from YouTube and Facebook. Similarly, how many of us integrate graphics and images “found” on the Web into our presentations?  How many of us...

  1. DOE financial assurance presentation

    International Nuclear Information System (INIS)

    The presentation topic is California's approach to license application review in meeting financial assurances for the proposed Ward Valley site. The purpose of the presentation is to provide information on specific financial assurance provisions contained in 10 CFR Part 61 and how California intends to satisfy those requirements. Also, as rate setter, California intends to demonstrate how it will assure allowable costs to the rate base though a financial prudency review. The key provisions of financial assurance are: 10 CFR Section 61.61 - This provision requires an applicant to demonstrate its ability to finance licensed activities; 10 CFR Section 61.62 - This provision requires an applicant to provide assurance that sufficient funds will be available for site closure and stabilization; and 10 CFR Section 61.63 - This provision requires an applicant to provide 'a copy of a binding arrangement, such as a lease, between the applicant and the disposal site owner, so that sufficient funds will be available to cover the costs of the institutional control period.' To assist California in its determination of financial assurance compliance to be demonstrated by the applicant for Part 61 requirements, is NUREG guidance document 1199 'Standard Format and Content of a License Application for a Low-Level Radioactive Waste (LLRW) Disposal Facility.' The detailed financial assurance provisions of NUREG 1199 are then embodied in NUREG 1200, 'Standard Review Plant for the Review of a License Application for a LLRW Disposal Facility.'

  2. EDITORIAL: Presentation of Manuscripts

    Science.gov (United States)

    Hudson, R. P.

    1984-01-01

    We wish to draw the attention of authors to two points concerning the presentation of manuscripts. First, some changes have been made recently in our Instructions to Authors. We have reduced from two to one the number of duplicate copies of the manuscript required, asked for corrected proofs to be returned to the Editor rather than directly to the publishers, clarified that a single set of illustration-photographs will suffice, removed a specific suggestion for a style manual that we had offered for general guidance only, and added an instruction on conventions in spelling and hyphenation. Secondly, authors are required, of course, to present a thorough analysis of their experimental data and to include an estimate of their uncertainty. For this purpose, however, we strongly encourage the authors to follow the recommendations put forward by an international working group [1] to the Comité International des Poids et Mesures (CIPM) and endorsed by that body in its Recommandation 1 (CI-1981). This recommendation has been published by the CIPM [2] and was also summarized recently in this journal [3]. [1] 1981 Metrologia 17 69-74, in particular, see pp 73-74 [2] 1981 ProcA~¨s-Verbaux CIPM 10th Session 49, A1 A12. An English language version is available on application to the Director of the Bureau International des Poids et Mesures. [3] 1982 Metrologia 18 41-44, in particular, see p 44.

  3. Tests and present status of gauge theories

    International Nuclear Information System (INIS)

    The author discusses the predictions of the standard model for strong, weak and electromagnetic interactions. The Abelian Model is presented to represent gauge theories at work. Hadronic structure functions are explained which describe the distribution of quarks and gluons within the initial state hadrons. Hadronic fragmentation functions are defined and illustrated. A set of exercises is presented which may be helpful toward understanding the material presented

  4. Alopecia as the Presenting Symptom of Syphilis

    OpenAIRE

    Ornelas, Jennifer; Agbai, Oma N; Kiuru, Maija; Sivamani, Raja K.

    2015-01-01

    Alopecia can be one of the many symptoms of secondary syphilis and the clinical presentations include essential syphilitic alopecia or symptomatic syphilitic alopecia. In this report, we present a case of a patient with essential syphilitic alopecia whose sole presenting symptom of syphilis was alopecia. Despite an initial negative rapid plasma reagin (RPR) test, he was ultimately found to have syphilis on scalp biopsy. His alopecia improved following treatment with benzathine penicillin. Thi...

  5. Severe neuropsychiatric presentation of Wilson's disease

    OpenAIRE

    Chakor, Rahul T.; Santhosh, N. S.

    2011-01-01

    Wilson's disease (WD) is a relatively rare disease of copper metabolism. The diagnosis is often missed initially. The presentation is usually neurologic or hepatic, seen in 40% of patients. Psychiatric presentation of WD is reported in only 15% of patients. We present a 32-year-old patient with severe psychiatric manifestations. On examination, he had mild rest and postural tremors and a KF ring was seen. Serum ceruloplasmin was low and 24-hour urinary copper was elevated. The patient respond...

  6. Presenting numerical risk estimates

    International Nuclear Information System (INIS)

    The Environment Agency for England and Wales has, together with the other Environment Agencies, published guidance on the requirements for authorisation for the disposal of low-level and intermediate-level radioactive waste. The guidance specifies an individual risk target for the post-closure period, and requires developers to consider collective radiological impacts. Information on how risks and impacts should be calculated or assessed has not been published. The objectives of this report are to provide background information on the calculation of risk, to review how regulatory regimes for other activities and in other countries use risk criteria, including both individual and societal risk criteria. Conclusions and recommendations are presented on how the Environment Agency might develop additional guidance to ensure that safety cases meet the Agency's requirements

  7. ANDRAD - Present and future

    International Nuclear Information System (INIS)

    Full text: Binding responsibility for the radioactive waste, until it has decayed - that is the aim for which the Romanian Government has created ANDRAD, the National Agency for Radioactive Waste. By the establishment of this organization, Romania meets the requirements of the 'Joint Convention on Safety of Spent Nuclear Fuel Management and Safety of Radioactive Waste Management' and of the 'European Council Conclusions on Nuclear Safety'. The main objective of ANDRAD is the safe management of spent nuclear fuel and radioactive waste, including disposal, under conditions that ensure the nuclear security and the protection against ionizing radiations of the staff professionally exposed, of the population, environment and property, at present and in the future, without compromising the needs of the next generations. (authors)

  8. Film Presentation: Die Urknallmaschine

    CERN Multimedia

    Carolyn Lee

    2010-01-01

    Die Urknallmaschine, an Austrian film by Gerd Baldauf, narrated by Norbert Frischauf (Alpha Österreich - ORF, 2009).  In CERN’s gigantic complex particles are accelerated to almost the speed of light, brought to collision and made to divide into even smaller particles. Public opinion of CERN’s research is also divided. Sceptics fear that black holes may be created. Might the goal to study the origin of the world lead to its destruction? The Austrian researcher Norbert Frischauf worked at CERN for many years. With his guidance it is possible to explore the world’s largest research centre, get a glimpse of the fascinating work the scientists do there and take a crash course in particle physics. Die Urknallmaschine will be presented on Friday, 25 June from 13:00 to 14:00 in the Main Auditorium. Language: German

  9. RESRAD model presentation

    Energy Technology Data Exchange (ETDEWEB)

    Yu, C.; Faillace, E.; Chen, S.Y. [Argonne National Lab., IL (United States); Wallo, A. III; Williams, W.A.; Peterson, H.; Domotor, S. [Dept. of Energy, Washington, DC (United States)

    1998-05-01

    RESRAD was one of the multimedia models selected by the US Nuclear Regulatory Commission (NRC) to include in its workshop on radiation dose modeling and demonstration of compliance with the radiological criteria for license termination. This paper is a summary of the presentation made at the workshop and focuses on the 10 questions the NRC distributed to all participants prior to the workshop. The code selection criteria, which were solicited by the NRC, for demonstrating compliance with the license termination rule are also included. Among the RESRAD family of codes, RESRAD and RESRAD-BUILD are designed for evaluating radiological contamination in soils and in buildings. Many documents have been published to support the use of these codes. This paper focuses on these two codes. The pathways considered, the databases and parameters used, quality control and quality assurance, benchmarking, verification and validation of these codes, and capabilities as well as limitations of these codes are discussed in detail.

  10. Through bulkhead initiator studies

    Energy Technology Data Exchange (ETDEWEB)

    Begeal, D.R. [Sandia National Labs., Albuquerque, NM (United States). Explosive Subsystems and Materials Dept.

    1997-03-01

    This report describes recent work done to demonstrate feasibility of a fail-safe Through Bulkhead Initiator with minimum dimensions and suitable for use in cyclical thermal environments. Much of the ground work for a fail-safe TBI was previously done by A.C. Schwartz. This study is an expansion of Schwartz`s work to evaluate devices with bulkheads of 304 stainless steel and Inconel 718; explosive donors of PETN, BNCP, and a 0.005 inch thick steel flying plate donor traveling at 2.6 mm/{micro}s; and explosive acceptors of PETN and BNCP. Bulkhead thickness were evaluated in the range of 0.040 to 0.180 inch. The explosive acceptors initiated a small HMX pellet to drive a 0.005 inch thick steel flying plate, and VISAR histories of the HMX-driven flying plates were the measure of acceptable performance. A companion set of samples used a PMMA acceptor to measure the particle velocities at the bulkhead/PMMA interface with VISAR. These data were used to compute the input pressure to the acceptor explosives in an attempt to measure initiation threshold. Unfortunately, the range of bulkhead thicknesses tested did not give any failures, thus the threshold was not determined. It was found that either explosive or the flying plate would perform as a TBI in the bulkhead thickness range tested. The optimum TBI is about 0.060 inches thick, and steel bulkheads seem to be more structurally sound than those made of Inconel. That is, cross section views of the Inconel bulkheads showed it to be more prone to stress cracking than was the 304 stainless steel. Both PETN and BNCP showed good performance when tested at {minus}65 F following thermal cycling of {minus}65 F to +165 F. Analysis of the TBI function times showed that BNCP acceptor explosives were undergoing the classical deflagration to detonation process. The PETN acceptors were undergoing prompt detonation.

  11. Water Past and Present

    Science.gov (United States)

    2008-01-01

    This image of sulfate and water ice deposits in the Olympia Undae region of Mars was taken by the Compact Reconnaissance Imaging Spectrometer for Mars (CRISM) at 2213 UTC on October 2, 2006 (6:13 p.m. EDT) near 81.6 degrees north latitude, 188.9 degrees east longitude. CRISM's image was taken in 544 colors covering 0.36-3.92 micrometers, and shows features as small as 20 meters (66 feet) across. Olympia Undae is a large dune field that stretches some 1,100 kilometers (684 miles) across the northern polar region of Mars, just south of the ice cap. The region holds a vast expanse of complex, shifting dunes and is best described as a sand sea or erg similar to the Sahara. The two images above provide interesting clues into Mars' history by revealing the planet's wet past and frozen present. The left image is an infrared, false-color image that reveals dark-colored dunes overlying a lighter substrate. Spectral data from CRISM and its sister instrument OMEGA suggest similar compositions of these dunes and the dark basal, or lowermost, unit of the north polar layered deposits. HIRISE images revealed cross-bedding (crossed layers that are oriented at a different angle to the main layer) in this dark unit. On Earth, cross-bedded sediments can form in both windy and watery environments. The dark polar basal unit on Mars is interpreted as a sand sheet underlying and pre-dating the ice, and now being eroded to dunes by the Martian winds. The mineralogy of the Olympia Undae region holds a record of past water. CRISM spectral data (right image) shows that the darker dunes are rich in polyhydrated sulfate (sulfates with more than one water molecule incorporated into each molecule of the mineral). The mineral gypsum is a polyhydrated sulfate, and the most likely constituent in these dunes. The gypsum probably formed by evaporation of ancient, saline water or by aqueous alteration of the silicate portion of the dune material. Areas shaded in red are cover by dust. Blue areas in

  12. Initial Cooling Experiment (ICE)

    CERN Multimedia

    Photographic Service

    1978-01-01

    In 1977, in a record-time of 9 months, the magnets of the g-2 experiment were modified and used to build a proton/antiproton storage ring: the "Initial Cooling Experiment" (ICE). It served for the verification of the cooling methods to be used for the "Antiproton Project". Stochastic cooling was proven the same year, electron cooling followed later. Also, with ICE the experimental lower limit for the antiproton lifetime was raised by 9 orders of magnitude: from 2 microseconds to 32 hours. For its previous life as g-2 storage ring, see 7405430. More on ICE: 7711282, 7809081, 7908242.

  13. Hanford tanks initiative plan

    International Nuclear Information System (INIS)

    Abstract: The Hanford Tanks Initiative (HTI) is a five-year project resulting from the technical and financial partnership of the U.S. Department of Energy's Office of Waste Management (EM-30) and Office of Science and Technology Development (EM-50). The HTI project accelerates activities to gain key technical, cost performance, and regulatory information on two high-level waste tanks. The HTI will provide a basis for design and regulatory decisions affecting the remainder of the Tank Waste Remediation System's tank waste retrieval Program

  14. Hanford tanks initiative plan

    Energy Technology Data Exchange (ETDEWEB)

    McKinney, K.E.

    1997-07-01

    Abstract: The Hanford Tanks Initiative (HTI) is a five-year project resulting from the technical and financial partnership of the U.S. Department of Energy`s Office of Waste Management (EM-30) and Office of Science and Technology Development (EM-50). The HTI project accelerates activities to gain key technical, cost performance, and regulatory information on two high-level waste tanks. The HTI will provide a basis for design and regulatory decisions affecting the remainder of the Tank Waste Remediation System`s tank waste retrieval Program.

  15. EFFECTIVE DIVERSITY MANAGEMENT INITIATIVES

    Directory of Open Access Journals (Sweden)

    Suat Begec

    2013-01-01

    Full Text Available Diversity characteristics defines into four areas; personality, internal and external characteristics, and organizational characteristics. Today it is hard to find individuals, organizational and management styles all similar to each other. Twenty-first century leaders face diversity challenges in many arenas and it is a fact that leaders have to live with these diversities. Values affects on the management and organization systems. The global values gain importance and remove the sources of diversities. The leaders believe that the values should be mostly protected. This article focuses on effective diversity management initiatives.

  16. IAEA knowledge management initiatives

    International Nuclear Information System (INIS)

    Since its inception the IAEA has always been a knowledge based organization, requested to serve and promote the cause of peaceful use of nuclear science and technology. For nearly five decades the IAEA has been providing nuclear information and knowledge to Member States. A substantial part of the IAEA's activities under the regular budget and technical cooperation programme are aimed at developing and sustaining adequate nuclear competence in the Member States, including helping to build capacity in different aspects of the peaceful uses of nuclear energy. The paper describes some knowledge management initiatives that are being implemented within the framework of the IAEA programme on nuclear knowledge management. (author)

  17. Feedback stabilization initiative

    International Nuclear Information System (INIS)

    Much progress has been made in attaining high confinement regimes in magnetic confinement devices. These operating modes tend to be transient, however, due to the onset of MHD instabilities, and their stabilization is critical for improved performance at steady state. This report describes the Feedback Stabilization Initiative (FSI), a broad-based, multi-institutional effort to develop and implement methods for raising the achievable plasma betas through active MHD feedback stabilization. A key element in this proposed effort is the Feedback Stabilization Experiment (FSX), a medium-sized, national facility that would be specifically dedicated to demonstrating beta improvement in reactor relevant plasmas by using a variety of MHD feedback stabilization schemes

  18. Initiation of slug flow

    Energy Technology Data Exchange (ETDEWEB)

    Hanratty, T.J.; Woods, B.D. [Univ. of Illinois, Urbana, IL (United States)

    1995-12-31

    The initiation of slug flow in a horizontal pipe can be predicted either by considering the stability of a slug or by considering the stability of a stratified flow. Measurements of the shedding rate of slugs are used to define necessary conditions for the existence of a slug. Recent results show that slugs develop from an unstable stratified flow through the evolution of small wavelength waves into large wavelength waves that have the possibility of growing to form a slug. The mechanism appears to be quite different for fluids with viscosities close to water than for fluids with large viscosities (20 centipoise).

  19. Presentation of Pydio

    CERN Document Server

    CERN. Geneva

    2014-01-01

    **Pydio is an open-source platform for file sharing and synchronisation.** It is wildly used by enterprises and organizations worldwide, including major universities. Pydio comes with a rich web-based interface, native clients for both iOS and Android mobile devices, and lately a new sync client for desktop platforms. Pydio v6 is of great useability and introduces many new features that makes it the ultimate sharing machine. Its architecture makes it a perfect fit for either easily deploying an on-premise dropbox solution, or building more complicated solutions where the box feature is integrated as OEM. Storage-agnostic, Pydio is a simple layer that can be deployed on top of any storage backend, thus providing scalability and high-availability out-of-the-box. Charles du Jeu is the lead developer of the solution and will briefly present its feature and how it can fit for research and engineering purpose. See https://pyd.io/ for more information.

  20. Brazilian Nanotechnology Initiative

    Science.gov (United States)

    Fazzio, Adalberto

    2015-03-01

    In Brazil there is intense research activity in nanotechnology, most of these developed in universities and research institutes. The Brazilian Nanotechnology Initiative (BNI) aims to integrate government actions to promote the competitiveness of the Brazilian industry. This initiative is founded on support for research and development in the laboratories of the National Laboratories for Nanotechnology (SisNANO), starting from an improvement in infrastructure and opening of laboratories for users of academia and business, promoting interaction and transfer knowledge between academia and business. Country currently has 26 thematic networks of nanotechnology, 16 -Virtual-National Institutes of Technology, seven National- Laboratories and 18 Associate Laboratories, which comprise the SisNANO. Seeking to expand and share governance with other government actors, the Interministries Committee for Nanotechnology was set up, composed of 10 ministries, and has the task of coordinating the entire program of the Federal Government Nanotechnology.Cooperation activities are an important part of BNI. Currently Brazil has cooperation programs with U.S., China, Canada and European Union among others. Recently, Brazil decided to join the European NanoReg program where 60 research groups are joining efforts to provide protocols and standards that can help regulatory agencies and governments.

  1. Initiatives for proliferation prevention

    International Nuclear Information System (INIS)

    Preventing the proliferation of weapons of mass destruction is a central part of US national security policy. A principal instrument of the Department of Energy's (DOE's) program for securing weapons of mass destruction technology and expertise and removing incentives for scientists, engineers and technicians in the newly independent states (NIS) of the former Soviet Union to go to rogue countries or assist terrorist groups is the Initiatives for Proliferation Prevention (IPP). IPP was initiated pursuant to the 1994 Foreign Operations Appropriations Act. IPP is a nonproliferation program with a commercialization strategy. IPP seeks to enhance US national security and to achieve nonproliferation objectives by engaging scientists, engineers and technicians from former NIS weapons institutes; redirecting their activities in cooperatively-developed, commercially viable non-weapons related projects. These projects lead to commercial and economic benefits for both the NIS and the US IPP projects are funded in Russian, Ukraine, Kazakhstan and Belarus. This booklet offers an overview of the IPP program as well as a sampling of some of the projects which are currently underway

  2. Initiatives for proliferation prevention

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-04-01

    Preventing the proliferation of weapons of mass destruction is a central part of US national security policy. A principal instrument of the Department of Energy`s (DOE`s) program for securing weapons of mass destruction technology and expertise and removing incentives for scientists, engineers and technicians in the newly independent states (NIS) of the former Soviet Union to go to rogue countries or assist terrorist groups is the Initiatives for Proliferation Prevention (IPP). IPP was initiated pursuant to the 1994 Foreign Operations Appropriations Act. IPP is a nonproliferation program with a commercialization strategy. IPP seeks to enhance US national security and to achieve nonproliferation objectives by engaging scientists, engineers and technicians from former NIS weapons institutes; redirecting their activities in cooperatively-developed, commercially viable non-weapons related projects. These projects lead to commercial and economic benefits for both the NIS and the US IPP projects are funded in Russian, Ukraine, Kazakhstan and Belarus. This booklet offers an overview of the IPP program as well as a sampling of some of the projects which are currently underway.

  3. TACE Case Presentations

    Directory of Open Access Journals (Sweden)

    Mahyar Mohammadifard

    2010-05-01

    Full Text Available Gold standard treatment of hepatocellular carci-noma is surgical resection but more than 80% of patients with HCC are unresectable at the time of diagnosis, and due to poor local circumstances or the patient's general condition, the prognosis is poor. "nBecause HCC tumors are fed exclusively by the he-patic artery, successful TACE leads to tumor necrosis. The liver parenchyma is rarely damaged because it is fed by the portal vein. Injection of an emulsion of iodized oil and cytostatic agents into the hepatic artery leads to selective deposition of the emulsion in the tumor. Compared with intravenous administration of cytostatic material, TACE reduces the maximum plasma concentration and increases the average concentration of cytostatic agents in the tumor, especially when the cytostatic material is combined with gelatin powder particles. "nFor example, concentration of an emulsion of cisplatin in iodized oil 4-9 weeks after intraarterial administration is 42 times greater in the tumor than in the parenchyma."nTwo cases of HCC are presented which were treated successfully with TACE 20 months ago."nIn the first patient after one session of TACE, tumor markers fell down into normal range and MDCT showed complete necrosis and cystic changes in the mass without residual or recurrent tumor until this time. "nIn the next case tumor markers showed no significant decrease after the first session of TACE and MDCT showed residual tumor which was fed by an accessory arterial branch from SMA. This branch was treated in another session. Two months later, tumor markers fell down and MDCT showed no tumor activity. "nThese patients have been symptom free after the mentioned interventions.

  4. BOUVERET'S SYNDROME (CASE PRESENTATION

    Directory of Open Access Journals (Sweden)

    Dipak

    2014-01-01

    Full Text Available Bouveret's syndrome is defined as gastric outlet obstruction caused by duodenal impaction of a large gallstone which passes into the duodenal bulb through a cholecystogastric or cholecystoduodenal fistula. We describe a case of Bouv eret's Syndrome in an middle aged patient that was successfully treated with resection of distal part of stomach and 1 st part of duodenum by laparotomy. We will also review the literature on this uncommon condition. Biliary enteric fistula is as such a rar e complication and comparatively rare cause of intestinal obstruction. And even if becomes so; generally it lodges in the terminal ileum and rarely in duodenum. Obstructing proximal part of duodenum or distal part of stomach is a curiosity and i.e. Bouvere t’s syndrome. Generally patient presents with nausea, vomiting, haematemesis, abdominal distention or epigastric pain. G.I. bleeding, obstructive jaundice, pancreatitis or duodenal or gastric perforation are rare complications. The treatment is purely surg ical – either enterolithotomy or gastrotomy with associated cholecystectomy with repair of fistula or enterolithotomy with or without second stage cholecystectomy. It is worth to mention here that so far histological findings of Bouveret’s syndrome are no t described in the literature. Even though findings are not that much specific; but presence of foci of abscesses, dense mixed inflammatory exudates in all the coats of distal part of stomach, 1 st part of duodenum and gall bladder along with formation of l ymphoid follicles with prominent germinal centers in muscle coat are definitely mentionable and we feel these may give clue. On gross examination the thickness of stomach wall and duodenal wall are increased and there is narrowing of lumen. If there is sto ne in gall bladder; it may also show thickened out wall due to presence of chronic cholelithiasis with cholecystitis.

  5. Round table presentation

    International Nuclear Information System (INIS)

    Full text: This Round Table deals with the main problems in the operational implementation of radiation safety standards. I will not reiterate previous comments that were made in the other sessions and round tables but I will make a very wide and open presentation in this regard. Since we are discussing problems, I will present this from a general perspective and not just from a national one. So, in my experience problems result from two main causes: problems at the organization level and those due to unsolved or pending technical aspects. The first group concerns organizational problems. In my view, according to my experience, and not only in Argentina, the basic problems are usually related to ineffectual regulatory performance. Second, non-appropriate technical competence in radiation protection and safety matters at all levels; that means at worker, employer and regulatory levels. However, legal competence is a necessary condition but not a sufficient one. The basic point here is knowledge - knowledge and experience - and we can have a very formal and appropriate background of real competence, real instruments, but if we don't have real technical competence the results will not be very satisfactory. Another topic concerns the inadequate discharge of managerial responsibilities at the operational level and following on from this, a weak safety culture and a lack of an effective quality system. The operational implementation of radiation protection standards is often more formalistic than realistic. So in this type of case, for any given country, a commitment at a very high political level is a necessity. The second set of factors associated with such problems are unsolved or pending technical factors and in my view the issue with the complex system of exemption, clearance and action levels, particularly in the case of commodities, is to establish an adequate set of activity concentration levels for specific radionuclides, either natural or artificial, for

  6. ANDRAD - Present and Prospects

    International Nuclear Information System (INIS)

    ANDRAD is the national authority charged with nation wide coordination of safe management of spent fuel and radioactive waste including their final disposal. The ANDRAD activities aim at protection of population health and environment against the hazard of ionizing radiations both at present and for the future. Hence, the authority has the following competencies: coordinates the process of safe management of spent fuel and radioactive wastes; establishes and ensures administration and physical protection of the national repositories for final disposal of spent fuel and radioactive wastes. To achieve these objectives the authority makes use of processes and methods of managing the spent fuel and radioactive wastes that can guarantee the permissible level of protection of population and environment against ionizing radiations. Thus, by making use of the best available techniques the management will protect the future generation from paying unjustified prices for minimizing radioactive activity, to reduce the amount of spent fuel and associated radioactive wastes. The authority monitors the implementation by the licensees of their commitments for: financing their own activities of collecting, sorting, treating, conditioning, intermediate storing and transportation up to final disposal of the spent fuel; decommissioning of nuclear and radiological units; reporting annually to ANDRAD the amounts of radioactive wastes resulting from their activities; establishing strategies and annual planning (for intermediate and long terms) of the activities preceding the final disposal; financing ANDRAD activities by annual contribution, etc. ANDRAD has the following obligations: establishes the national strategy for safe management of the radioactive wastes in Romania; establishes the annual plans of activity; maintains and updates the national database concerning the amounts and types of wastes and spent fuels produced within nuclear units and facilities; establishes technical

  7. Clinical syndromes of nervous distemper in dogs initially presented without conventional evidences of CDV infection
    Síndromes clínicas da apresentação neurológica da cinomose em cães admitidos inicialmente sem as evidencias convencionais da infecção pelo CDV

    OpenAIRE

    Alexandre Mendes Amude; Amauri Alcindo Alfieri; Mônica Vicky Bahr Arias; Alice Fernandes Alfieri

    2012-01-01

    Despite large vaccination practice, canine distemper virus (CDV) is yet an important infectious agent that leads to nervous disease in canine populations worldwide. Unfortunately, the clinical diagnosis of distemper encephalomyelitis is often difficult in cases presented without conventional evidences of CDV infection such as systemic signs and myoclonus. Therefore, the aim of this study was to evaluate the neurological deficits and the clinical syndromes of nervous distemper in dogs sufferin...

  8. Mature cystic Theratome. Presentation of a case

    International Nuclear Information System (INIS)

    The case of a patient of five months of age is presented, to which was diagnosed cystic theratome, initially was assisted in another institution to present consistent square of four days in dry cough and sialorrea. It was managed initially with pneumonia diagnosis and spill paraneumonic. The x-ray of initial thorax demonstrated an opacity committing the two inferior thirds of the left hemithorax, with obliteration of the costofrenic angle and contralateral deviation of the cardio mediastinum, later on another thorax x-ray to the entrance with diagnostic impression of sepsis of lung origin and pneumonia suspicion with spill associate pleural, was practiced closed thoracotomy, obtaining 60 cc of sallow liquid. For the persistence of the opacity basal left in the control x-ray, he was practiced thorax tomography. For the presence of multiple densities and the localization of the lesion it outlines the possibility of cystic theratome

  9. Breckinridge Project, initial effort

    Energy Technology Data Exchange (ETDEWEB)

    None, None

    1982-09-01

    Report III, Volume 1 contains those specifications numbered A through J, as follows: General Specifications (A); Specifications for Pressure Vessels (C); Specifications for Tanks (D); Specifications for Exchangers (E); Specifications for Fired Heaters (F); Specifications for Pumps and Drivers (G); and Specifications for Instrumentation (J). The standard specifications of Bechtel Petroleum Incorporated have been amended as necessary to reflect the specific requirements of the Breckinridge Project, and the more stringent specifications of Ashland Synthetic Fuels, Inc. These standard specifications are available to the Initial Effort (Phase Zero) work performed by all contractors and subcontractors. Report III, Volume 1 also contains the unique specifications prepared for Plants 8, 15, and 27. These specifications will be substantially reviewed during Phase I of the project, and modified as necessary for use during the engineering, procurement, and construction of this project.

  10. Instrumented Pipeline Initiative

    Energy Technology Data Exchange (ETDEWEB)

    Thomas Piro; Michael Ream

    2010-07-31

    This report summarizes technical progress achieved during the cooperative agreement between Concurrent Technologies Corporation (CTC) and U.S. Department of Energy to address the need for a for low-cost monitoring and inspection sensor system as identified in the Department of Energy (DOE) National Gas Infrastructure Research & Development (R&D) Delivery Reliability Program Roadmap.. The Instrumented Pipeline Initiative (IPI) achieved the objective by researching technologies for the monitoring of pipeline delivery integrity, through a ubiquitous network of sensors and controllers to detect and diagnose incipient defects, leaks, and failures. This report is organized by tasks as detailed in the Statement of Project Objectives (SOPO). The sections all state the objective and approach before detailing results of work.

  11. The Ombudperson Initiative Group

    CERN Multimedia

    Laura Stewart

    Following many discussions that took place at some of the ATLAS Women's Network lunch gatherings, a few ATLAS women joined forces with similarly concerned CERN staff women to form a small group last Fall to discuss the need for a CERN-wide Ombudsperson. This has since evolved into the Ombudsperson Initiative Group (OIG) currently composed of the following members: Barbro Asman, Stockholm University; Pierre Charrue, CERN AB; Anna Cook, CERN IT; Catherine Delamare, CERN and IT Ombudsperson; Paula Eerola, Lund University; Pauline Gagnon, Indiana University; Eugenia Hatziangeli, CERN AB; Doreen Klem, CERN IT; Bertrand Nicquevert, CERN TS and Laura Stewart, CERN AT. On June 12, members of the OIG met with representatives of Human Resources (HR) and the Equal Opportunity Advisory Panel (EOAP) to discuss the proposal drafted by the OIG. The meeting was very positive. Everybody agreed that the current procedures at CERN applicable in the event of conflict required a thorough review, and that a professionnally trai...

  12. The Advanced Energy Initiative

    Science.gov (United States)

    Milliken, JoAnn; Joseck, Fred; Wang, Michael; Yuzugullu, Elvin

    The President's Advanced Energy Initiative (AEI), launched in 2006, addresses the challenges of energy supply and demand facing our Nation by supporting research and development of advanced technologies for transportation and stationary power generation. The AEI portfolio includes clean coal, nuclear and renewable energy technologies (solar and wind) for stationary power generation and advanced battery technologies, cellulosic ethanol as a fuel and hydrogen fuel cells for transportation. These research and development programs are underpinned by comprehensive life-cycle analysis efforts using models such as Hydrogen Analysis (H2A) and Greenhouse Gases, Regulated Emissions and Energy Use in Transportation (GREET) to enable a better understanding of the characteristics and trade-offs associated with advanced energy options and to help decision makers choose viable pathways for clean, reliable and affordable energy.

  13. Follicular Lymphoma Presenting with Leptomeningeal Disease

    OpenAIRE

    Rubens Costa; Ricardo Costa; Renata Costa

    2014-01-01

    Follicular lymphoma is generally an indolent B cell lymphoproliferative disorder of transformed follicular center B cells. Central nervous system metastasis is a very rare complication portending a very poor prognosis. We report a rare case of follicular lymphoma presenting with leptomeningeal involvement achieving a complete remission after initial therapy.

  14. PREGO (presentation of Graves' orbitopathy) study

    DEFF Research Database (Denmark)

    Perros, Petros; Žarković, Miloš; Azzolini, Claudio;

    2015-01-01

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

  15. Higher-dimensional puncture initial data

    CERN Document Server

    Zilhão, Miguel; Cardoso, Vitor; Gualtieri, Leonardo; Herdeiro, Carlos; Sperhake, Ulrich; Witek, Helvi

    2011-01-01

    We calculate puncture initial data, corresponding to single and binary black holes with linear momenta, which solve the constraint equations of D dimensional vacuum gravity. The data are generated by a modification of the pseudo-spectral code presented in arXiv:gr-qc/0404056 and made available as the TwoPunctures thorn inside the Cactus computational toolkit. As examples, we exhibit convergence plots, the violation of the Hamiltonian constraint as well as the initial data for D=4,5,6,7. These initial data are the starting point to perform high energy collisions of black holes in D dimensions.

  16. Sustainable Forestry Business Initiatives at IDB

    OpenAIRE

    José Rente Nascimento

    2006-01-01

    This presentation discusses some of IDB's initiatives and instruments available to support the development of sustainable forest businesses in LAC. These include initiatives for improving business climate for sustainable forest investments, such as the Forest Investment Attractiveness Index (IAIF) and the Process to Improve the Business Climate for Forest Investment (PROMECIF). They also include those for improving governments' supporting role, such as regulations, policies, institutions, pub...

  17. Inhomogeneous inflation: The initial-value problem

    Energy Technology Data Exchange (ETDEWEB)

    Laguna, P. (Theoretical Division, Los Alamos National Laboratory, Los Alamos, New Mexico (USA)); Kurki-Suonio, H. (Lawrence Livermore National Laboratory, University of California, Livermore, California (USA)); Matzner, R.A. (Center for Relativity, The University of Texas at Austin, Austin, Texas (USA))

    1991-11-15

    We present a spatially three-dimensional study for solving the initial-value problem in general relativity for inhomogeneous cosmologies. We use York's conformal approach to solve the constraint equations of Einstein's field equations for scalar field sources and find the initial data which will be used in the evolution. This work constitutes the first stage in the development of a code to analyze the effects of matter and spacetime inhomogeneities on inflation.

  18. Parental involvement in children's initial literacy education

    OpenAIRE

    Malnar, Evelin

    2015-01-01

    This Master's degree work presents research of parenting role in their children's initial literacy education development. The study was focused on systematic initial literacy in second grade elementary school. Theoretical knowledge and study results of various (domestic and foreign) authors were included in the research, in which parents and their children of two different second grade classes participated in two groups: Experimental Group (EG) and Control Group (CG). Children of both groups ...

  19. Uterine cancer presenting as obstructive jaundice

    OpenAIRE

    Manuel, Valdano

    2016-01-01

    Valdano Manuel, Eserval Rocha, Giovana Fortini, Zeida Pascoal, Renata Netto, Lenira Rengel, Claudio Birolini, Edivaldo Massazo Utiyama Department of General and Trauma Surgery, Hospital das Clínicas, School of Medicine, University of São Paulo, São Paulo, Brazil Abstract: Obstructive jaundice as an initial manifestation of uterine cancer is extremely rare. We present a case of a 72-year-old female who presented with obstructive jaundice, supposedly for pancr...

  20. Uterine cancer presenting as obstructive jaundice

    OpenAIRE

    Manuel V; Rocha E; Fortini G; Pascoal Z; Netto R; Rengel L; Birolini C; Utiyama EM

    2016-01-01

    Valdano Manuel, Eserval Rocha, Giovana Fortini, Zeida Pascoal, Renata Netto, Lenira Rengel, Claudio Birolini, Edivaldo Massazo Utiyama Department of General and Trauma Surgery, Hospital das Clínicas, School of Medicine, University of São Paulo, São Paulo, Brazil Abstract: Obstructive jaundice as an initial manifestation of uterine cancer is extremely rare. We present a case of a 72-year-old female who presented with obstructive jaundice, supposedly for pancreatic cancer...

  1. MONTANA PALLADIUM RESEARCH INITIATIVE

    Energy Technology Data Exchange (ETDEWEB)

    Peters, John; McCloskey, Jay; Douglas, Trevor; Young, Mark; Snyder, Stuart; Gurney, Brian

    2012-05-09

    Project Objective: The overarching objective of the Montana Palladium Research Initiative is to perform scientific research on the properties and uses of palladium in the context of the U.S. Department of Energy's Hydrogen, Fuel Cells and Infrastructure Technologies Program. The purpose of the research will be to explore possible palladium as an alternative to platinum in hydrogen-economy applications. To achieve this objective, the Initiatives activities will focus on several cutting-edge research approaches across a range of disciplines, including metallurgy, biomimetics, instrumentation development, and systems analysis. Background: Platinum-group elements (PGEs) play significant roles in processing hydrogen, an element that shows high potential to address this need in the U.S. and the world for inexpensive, reliable, clean energy. Platinum, however, is a very expensive component of current and planned systems, so less-expensive alternatives that have similar physical properties are being sought. To this end, several tasks have been defined under the rubric of the Montana Palladium Research Iniative. This broad swath of activities will allow progress on several fronts. The membrane-related activities of Task 1 employs state-of-the-art and leading-edge technologies to develop new, ceramic-substrate metallic membranes for the production of high-purity hydrogen, and develop techniques for the production of thin, defect-free platinum group element catalytic membranes for energy production and pollution control. The biomimetic work in Task 2 explores the use of substrate-attached hydrogen-producing enzymes and the encapsulation of palladium in virion-based protein coats to determine their utility for distributed hydrogen production. Task 3 work involves developing laser-induced breakdown spectroscopy (LIBS) as a real-time, in situ diagnostic technique to characterize PGEs nanoparticles for process monitoring and control. The systems engineering work in task 4

  2. The Saudi Initiative for asthma

    Directory of Open Access Journals (Sweden)

    Al-Moamary Mohamed

    2009-01-01

    Full Text Available The Saudi Initiative for Asthma (SINA provides up-to-date guidelines for healthcare workers managing patients with asthma. SINA was developed by a panel of Saudi experts with respectable academic backgrounds and long-standing experience in the field. SINA is founded on the latest available evidence, local literature, and knowledge of the current setting in Saudi Arabia. Emphasis is placed on understanding the epidemiology, pathophysiology, medications, and clinical presentation. SINA elaborates on the development of patient-doctor partnership, self-management, and control of precipitating factors. Approaches to asthma treatment in SINA are based on disease control by the utilization of Asthma Control Test for the initiation and adjustment of asthma treatment. This guideline is established for the treatment of asthma in both children and adults, with special attention to children 5 years and younger. It is expected that the implementation of these guidelines for treating asthma will lead to better asthma control and decrease patient utilization of the health care system.

  3. Through-bulkhead-initiator development

    Energy Technology Data Exchange (ETDEWEB)

    Heckes, A.A.

    1978-01-01

    A reliable pyrotechnic to pyrotechnic Through-Bulkhead-Initiator (TBI) has been developed. Significant design problems which were solved in the development of the TBI were: (1) reliable ignition of the Pd/Al donor charge across a gap through the use of the intermetallic pyrotechnic Ti/B and an expulsion charge of TiH/sub x//KClO/sub 4/; (2) control of the temperature of the donor charge by limiting the percentage of Al in a Pd/Al or Pd/Al Stainless Steel mixture to a range of 4 to 6.3 wt%; (3) control of slumping of the donor charge by the addition of up to 30 wt% SS particles to the Pd/Al reactive mixture. This provided reliable heat transfer because thermal contact was maintained; and (4) improvement of the temperature-time profile by changing the L/D ratio from 2.0 to 1.0, elimination of insulators and doubling the mass of the donor charge to about 6 g. Experimental and theoretical results are presented to illustrate the initiator development.

  4. Presentation

    OpenAIRE

    Nicanor Lopes

    2010-01-01

    The Journal Caminhando debuts with a new editorial format: eachmagazine will have a Dossier.In 2010 Christianity celebrated the centenary of Edinburgh. TheWorld Missionary Conference in Edinburgh in 1910 is regarded by manyas missiological watershed in the missionary and ecumenical movement.So the Faculty of Theology of the Methodist Church (FATEO) decidedto organize a Wesleyan Week discussing the issue of mission. For anevent of this magnitude FATEO invited the Rev. Dr. Wesley Ariarajah,Meth...

  5. Presentation

    Directory of Open Access Journals (Sweden)

    Tercio Machado Siqueira

    1986-08-01

    Full Text Available This issue of Caminhando contains an article written by Methodist theologian, Dr. John B. Cobb, Jr., of The Claremont School of Theology, California, USA. The publication of this work has many purposes, but the main one is to provide the basic text of the "Meeting of the Process Theology and Liberation Theology" to be held in Sao Paulo, under the coordination of the Faculty of Theology. The attempt to bring together theologians of the "periphery" and the "center" of the world is no longer a pioneer one. In 1977, E. Dussel and J. Pixley organized a meeting that pointed to the need to build more bridges and continue dialogue. Others came, each one revealing truths so far only recognized by the people of the "periphery" of the world.It is very healthy to know that Dr. Cobb recognizes this, and we understand his decision to be involved in this meeting as a sign of "repentance” of process theologians. I met and lived with Dr. Cobb for a little over two years in Claremont. What impresses about him is his commitment to the mission of the Church. When reading his work, we can see in it the result of someone who is serious about the local church. His active participation in his faith community makes me sure that the reader will come into dialogue with someone who is very serious and has an exaggerated love for the church and its mission.Tercio Machado Siqueira EditorThe journal was reedited in 2009.Helmut RendersEditor of the online-edition.

  6. ALOS-2 initial results

    Science.gov (United States)

    Kankaku, Yukihiro; Suzuki, Shinichi; Shimada, Masanobu

    2015-10-01

    The Advanced Land Observing Satellite-2 (ALOS-2) was launched from Tanegashima Space Center by H-IIA rocket successfully on 24th May 2014. ALOS-2 carries the Phased Array type L-band Synthetic Aperture Radar-2 (PALSAR-2) as the state-of-the-art L-band SAR system which succeeds to PALSAR onboard ALOS. PALSAR-2 uses almost whole bandwidth allocated for L-band active sensor of Earth Exploration Satellites Service specified by the Radio Regulation in order to realize the high resolution observation, and also, it transmits more than 6 kW power for lower Noise Equivalent Sigma Zero using 180 TRMs driven by Gallium Nitride (GaN) amplifier which is the first use in space. Furthermore, because ALOS-2 carries the SAR system only, PALSAR-2 antenna can be mounted under the satellite body. It enables to observe right-/left-looking observation by satellite maneuvering. And the high accuracy orbit control to maintain the satellite within 500 m radius tube against the reference orbit enables high coherence for the InSAR processing. Using these new technologies, ALOS-2 has been operating to fulfill the mission requirements such as disaster monitoring and so on. This document introduces the initial result of ALOS-2 from the first year operation.

  7. Scientific Component Technology Initiative

    Energy Technology Data Exchange (ETDEWEB)

    Kohn, S; Bosl, B; Dahlgren, T; Kumfert, G; Smith, S

    2003-02-07

    The laboratory has invested a significant amount of resources towards the development of high-performance scientific simulation software, including numerical libraries, visualization, steering, software frameworks, and physics packages. Unfortunately, because this software was not designed for interoperability and re-use, it is often difficult to share these sophisticated software packages among applications due to differences in implementation language, programming style, or calling interfaces. This LDRD Strategic Initiative investigated and developed software component technology for high-performance parallel scientific computing to address problems of complexity, re-use, and interoperability for laboratory software. Component technology is an extension of scripting and object-oriented software development techniques that specifically focuses on the needs of software interoperability. Component approaches based on CORBA, COM, and Java technologies are widely used in industry; however, they do not support massively parallel applications in science and engineering. Our research focused on the unique requirements of scientific computing on ASCI-class machines, such as fast in-process connections among components, language interoperability for scientific languages, and data distribution support for massively parallel SPMD components.

  8. The new childcare initiative

    CERN Multimedia

    Cigdem Issever

    The ATLAS Women's Network recently sent out a general mailing to all ATLAS and CMS members to announce a new initiative aimed at improving childcare facilities for Users coming to CERN. Several people have expressed the need that CERN should provide or facilitate affordable day care for children of temporary visitors at CERN. The ATLAS Women's Network is now forming a child care task force from concerned people and invites all those interested to join this effort. You can do so by either adding your name to the mailing list cern-users-childcare@cern.ch in Simba or by contacting Cigdem.Issever@cern.NOSPAM.ch and Pauline.Gagnon@cern.NOSPAM.ch. More than 50 people have already joined this effort. Those who have joined the mailing list will soon receive all the details about the next conference call meeting which has been scheduled for Thursday October 25th from 16:30 to 18:00 CERN time. The preliminary agenda is the following: Summary of our first contact of ATLAS and CMS (5 min) Discussion about the co-conv...

  9. TFTR initial operations

    International Nuclear Information System (INIS)

    The Tokamak Fusion Test Reactor (TFTR) has operated since December 1982 with ohmically heated plasmas. Routine operation with feedback control of plasma current, position, and density has been obtained for plasmas with I/sub p/ approx. = 800 kA, a = 68 cm, R = 250 cm, and B/sub t/ = 27 kG. A maximum plasma current of 1 MA was achieved with q approx. = 2.5. Energy confinement times of approx. 150 msec were measured for hydrogen and deuterium plasmas with anti n/sub e/ approx. = 2 x 1013 cm-3, T/sub e/ (0) approx. = 1.5 keV, T/sub i/ (0) approx. = 1.5 keV, and Z/sub eff/ approx. = 3. The preliminary results suggest a size-cubed scaling from PLT and are consistent with Alcator C scaling where tau approx. nR2a. Initial measurements of plasma disruption characteristics indicate current decay rates of approx. 800 kA in 8 ms which is within the TFTR design requirement of 3 MA in 3 ms

  10. Initial treatment of Parkinson's disease.

    Science.gov (United States)

    Tarsy, Daniel

    2006-05-01

    Initial treatment of early idiopathic Parkinson's disease (PD) begins with diagnosis based on clinical evaluation supplemented by laboratory studies and brain imaging to exclude causes of secondary parkinsonism. In most cases, testing is normal and the diagnosis of PD rests on clinical criteria. In patients with mild symptoms and signs, the diagnosis of PD may not initially be apparent, and follow-up evaluation is needed to arrive at a diagnosis. Once the diagnosis is made, pharmacologic treatment may not be the first step. First, patient education is essential, especially because PD is a high-profile disease for which information and misinformation are readily available to patients and families. Counseling concerning prognosis, future symptoms, future disability, and treatment must be provided. Questions from patients concerning diet, lifestyle, and exercise are especially common at this point. The decision of when to initiate treatment is the next major consideration. Much controversy but relatively little light has been brought to bear on this issue. L-dopa was the first major antiparkinson medication to be introduced and remains the "gold standard" of treatment. Next in efficacy are the dopamine agonists (DAs). A debate has raged concerning whether initial dopaminergic treatment should be with L-dopa or DAs. Physicians have been concerned about forestalling the appearance of dyskinesias and motor fluctuations, whereas patients have incorrectly understood that L-dopa and possibly other antiparkinson drugs have a finite duration of usefulness, making it important to defer treatment for as long as possible. This has created "L-dopa phobia," which may stand in the way of useful treatment. In spite of this controversy, there is uniform agreement that the appropriate time to treat is when the patient is beginning to be disabled. This varies from patient to patient and depends on age, employment status, nature of job, level of physical activity, concern about

  11. Clinical syndromes of nervous distemper in dogs initially presented without conventional evidences of CDV infectionSíndromes clínicas da apresentação neurológica da cinomose em cães admitidos inicialmente sem as evidencias convencionais da infecção pelo CDV

    Directory of Open Access Journals (Sweden)

    Alexandre Mendes Amude

    2012-12-01

    Full Text Available Despite large vaccination practice, canine distemper virus (CDV is yet an important infectious agent that leads to nervous disease in canine populations worldwide. Unfortunately, the clinical diagnosis of distemper encephalomyelitis is often difficult in cases presented without conventional evidences of CDV infection such as systemic signs and myoclonus. Therefore, the aim of this study was to evaluate the neurological deficits and the clinical syndromes of nervous distemper in dogs suffering from neurological disease admitted in the absence of the conventional evidences of CDV infection. Dogs presented with central nervous disease in which toxic/traumatic or a CDV-free etiology could be excluded ante mortem were prospectively followed up and which that died (natural death or euthanasia, despite medical treatment and necropsy was carried out were included in this study. Ten out of 35 evaluated dogs were post mortem diagnosed with CDV encephalomyelitis by both CDV RNA detection through RT-PCR assay in nervous tissue and observation of distemper-compatible neuroparenchymal lesions. According to the nervous signs, clinical history, and the age of presentation, the distemper dogs were grouped in three clinical syndromes of CDV encephalomyelitis: i canine distemper encephalitis in immature dogs (CDEID (n=3; ii multifocal distemper encephalomyelitis in mature dogs (MDEMD (n=6; and iii old dog encephalitis (ODE-like syndrome (n=1. The respective nervous deficits expected from each one of the syndromes herein presented were discussed.Apesar da prática de vacinação, o vírus da cinomose canina (CDV ainda é um importante agente infeccioso que leva à doença neurológica na população canina em todo o mundo. Infelizmente, o diagnóstico clínico da encefalomielite pela cinomose é difícil nos casos apresentados sem evidências clínicas convencionais de infecção pelo CDV, tais como sinais sistêmicos e mioclonia. Portanto, o objetivo deste estudo

  12. Epithelial predominant synovial sarcoma presenting as chronic non-healing ulcer of foot: A rare presentation

    Directory of Open Access Journals (Sweden)

    Gauri Salgaonkar

    2015-04-01

    Full Text Available Synovial sarcoma is a morphologically and cytogenetically distinct aggressive neoplasm which presents as a deep seated painful mass in the lower extremities of young adult males. We report a rare case of synovial sarcoma presenting as a non-healing ulcer over the foot in a 29 year old male, which was misdiagnosed initially as a malignant skin adnexal tumour.

  13. Epithelial predominant synovial sarcoma presenting as chronic non-healing ulcer of foot: A rare presentation

    OpenAIRE

    Gauri Salgaonkar; Kanthilatha Pai; Padmapriya Jaiprakash; Sathish Pai; Anurag Ayachit

    2015-01-01

    Synovial sarcoma is a morphologically and cytogenetically distinct aggressive neoplasm which presents as a deep seated painful mass in the lower extremities of young adult males. We report a rare case of synovial sarcoma presenting as a non-healing ulcer over the foot in a 29 year old male, which was misdiagnosed initially as a malignant skin adnexal tumour.

  14. An unusual presentation of primary sclerosing cholangitis

    Institute of Scientific and Technical Information of China (English)

    Franklin Whitney Goldwire; William E Norris; Jonathan M Koff; Zachary D Goodman; Milton T Smith

    2008-01-01

    This case report describes the unusual presentation of a patient who had findings which were initially suggestive of a type IV choledochal cyst.Her liver biopsy demonstrated biliary cirrhosis.She was treated with endoscopic retrograde cholangiopancreatography and biliary stent exchanges over one year.Her cholangiogram one year later demonstrated resolution of the biliary cystic dilation which led to her initial diagnosis,with beading and stricturing of the hepatic ducts consistent with primary sclerosing cholangitis.Liver-associated enzymes and physical findings also improved.A liver biopsy one year later demonstrated a marked improvement in hepatic fibrosis with no evidence of cirrhosis.

  15. The Gaia Initial Quasar Catalog

    Science.gov (United States)

    Andrei, H.; Antón, S.; Taris, F.; Bourda, G.; Souchay, J.; Bouquillon, J.; Barache, C.; Pereira Osorio, J. J.; Charlot, P.; Vieira Martins, R.; Lambert, S.; Camargo, J. I.; da Silva Neto, D. N.; Assan, M.; le Campion, J.-F.

    2014-12-01

    We present the latest, updated, and fully corrected version of the Gaia Initial QSO Catalog (GIQC), produced by the CU3 GWP-S-335-13000. It contains 1 248 372 objects, of which 191 802 are considered and marked as Defining ones, because of their observational history and existence of spectroscopic redshift. Also objects with strong, calibrator-like radio emission are included in this category. The Defining objects represent a clean sample of quasars. The remaining objects aim to bring completeness to the GIQC at the time of its compilation. For the whole GIQC the average density is 30.3 sources per sq.deg., practically all sources have an indication of magnitude and of morphological indexes, and 90% of the sources have an indication of redshift and of variability indexes.

  16. Initial Formation of Trust

    DEFF Research Database (Denmark)

    Schärfe, Henrik; Dougerthery, Elizabeth Ann

    2011-01-01

    In this paper we present a study of how touch may be used as a way of inducing trust in the meeting with a teloperated android, the Geminoid-DK. The use of hapics with Gestalt-based 'Balance Theory' is used as a persuasive desing of the interaction between human and robot. Balance theory includes...

  17. European nuclear education initiatives

    International Nuclear Information System (INIS)

    Whatever option regarding their future nuclear energy development is chosen by European Union Member States, the availability of a sufficient number of well trained and experienced staff is key for the responsible use of nuclear energy. This is true in all areas including design, construction, operation, decommissioning, fuel cycle and waste management as well as radiation protection. Given the high average age of existing experts leading to a significant retirement induce a real risk of the loss of nuclear competencies in the coming years. Therefore the demand of hiring skilled employees is rising. The challenge of ensuring a sufficient number of qualified staff in the nuclear sector has been acknowledged widely among the different stakeholders, in particular the nuclear industry, national regulatory authorities and Technical Support Organisations (TSOs). Already the EURATOM Treaty refers explicitly to the obligation for the Commission to carry out training actions. Recently initiatives have been launched at EU level to facilitate and strengthen the efforts of national stakeholders. The European Nuclear Education Network (ENEN) Association aims at preservation and further development of expertise in the nuclear field by higher education and training. The goal of the European Nuclear Energy Leadership Academy (ENELA) is to educate future leaders in the nuclear field to ensure the further development of sustainable European nuclear energy solutions The European Nuclear Energy Forum (ENEF) is a platform operated by the European Commission for a broad discussion on the opportunities and risks of nuclear energy. The nuclear programs under investigation in the Joint Research Center (JRC) are increasingly contributing to Education and Training (E and T) initiatives, promoting a better cooperation between key players and universities as well as operators and regulatory bodies in order to mutually optimise their training programmes. Another objective is to increase

  18. Initial Cladding Condition

    International Nuclear Information System (INIS)

    The purpose of this analysis is to describe the condition of commercial Zircaloy clad fuel as it is received at the Yucca Mountain Project (YMP) site. Most commercial nuclear fuel is encased in Zircaloy cladding. This analysis is developed to describe cladding degradation from the expected failure modes. This includes reactor operation impacts including incipient failures, potential degradation after reactor operation during spent fuel storage in pool and dry storage and impacts due to transportation. Degradation modes include cladding creep, and delayed hydride cracking during dry storage and transportation. Mechanical stresses from fuel handling and transportation vibrations are also included. This Analysis and Model Report (AMR) does not address any potential damage to assemblies that might occur at the YMP surface facilities. Ranges and uncertainties have been defined. This analysis will be the initial boundary condition for the analysis of cladding degradation inside the repository. In accordance with AP-2.13Q, ''Technical Product Development Planning'', a work plan (CRWMS M andO 2000c) was developed, issued, and utilized in the preparation of this document. There are constraints, caveats and limitations to this analysis. This cladding degradation analysis is based on commercial Pressurized Water Reactor (PWR) fuel with Zircaloy cladding but is applicable to Boiling Water Reactor (BWR) fuel. Reactor operating experience for both PWRs and BWRs is used to establish fuel reliability from reactor operation. It is limited to fuel exposed to normal operation and anticipated operational occurrences (i.e. events which are anticipated to occur within a reactor lifetime), and not to fuel that has been exposed to severe accidents. Fuel burnup projections have been limited to the current commercial reactor licensing environment with restrictions on fuel enrichment, oxide coating thickness and rod plenum pressures. The information provided in this analysis will be used in

  19. Initial Cladding Condition

    Energy Technology Data Exchange (ETDEWEB)

    E. Siegmann

    2000-08-22

    The purpose of this analysis is to describe the condition of commercial Zircaloy clad fuel as it is received at the Yucca Mountain Project (YMP) site. Most commercial nuclear fuel is encased in Zircaloy cladding. This analysis is developed to describe cladding degradation from the expected failure modes. This includes reactor operation impacts including incipient failures, potential degradation after reactor operation during spent fuel storage in pool and dry storage and impacts due to transportation. Degradation modes include cladding creep, and delayed hydride cracking during dry storage and transportation. Mechanical stresses from fuel handling and transportation vibrations are also included. This Analysis and Model Report (AMR) does not address any potential damage to assemblies that might occur at the YMP surface facilities. Ranges and uncertainties have been defined. This analysis will be the initial boundary condition for the analysis of cladding degradation inside the repository. In accordance with AP-2.13Q, ''Technical Product Development Planning'', a work plan (CRWMS M&O 2000c) was developed, issued, and utilized in the preparation of this document. There are constraints, caveats and limitations to this analysis. This cladding degradation analysis is based on commercial Pressurized Water Reactor (PWR) fuel with Zircaloy cladding but is applicable to Boiling Water Reactor (BWR) fuel. Reactor operating experience for both PWRs and BWRs is used to establish fuel reliability from reactor operation. It is limited to fuel exposed to normal operation and anticipated operational occurrences (i.e. events which are anticipated to occur within a reactor lifetime), and not to fuel that has been exposed to severe accidents. Fuel burnup projections have been limited to the current commercial reactor licensing environment with restrictions on fuel enrichment, oxide coating thickness and rod plenum pressures. The information provided in this analysis

  20. Sustainable Forest Bioenergy Initiative

    Energy Technology Data Exchange (ETDEWEB)

    Breger, Dwayne; Rizzo, Rob

    2011-09-20

    In the state’s Electricity Restructuring Act of 1998, the Commonwealth of Massachusetts recognized the opportunity and strategic benefits to diversifying its electric generation capacity with renewable energy. Through this legislation, the Commonwealth established one of the nation’s first Renewable Energy Portfolio Standard (RPS) programs, mandating the increasing use of renewable resources in its energy mix. Bioenergy, meeting low emissions and advanced technology standards, was recognized as an eligible renewable energy technology. Stimulated by the state’s RPS program, several project development groups have been looking seriously at building large woody biomass generation units in western Massachusetts to utilize the woody biomass resource. As a direct result of this development, numerous stakeholders have raised concerns and have prompted the state to take a leadership position in pursuing a science based analysis of biomass impacts on forest and carbon emissions, and proceed through a rulemaking process to establish prudent policy to support biomass development which can contribute to the state’s carbon reduction commitments and maintain safeguards for forest sustainability. The Massachusetts Sustainable Forest Bioenergy Initiative (SFBI) was funded by the Department of Energy and started by the Department of Energy Resources before these contentious biomass issues were fully raised in the state, and continued throughout the substantive periods of this policy development. Thereby, while SFBI maintained its focus on the initially proposed Scope of Work, some aspects of this scope were expanded or realigned to meet the needs for groundbreaking research and policy development being advanced by DOER. SFBI provided DOER and the Commonwealth with a foundation of state specific information on biomass technology and the biomass industry and markets, the most comprehensive biomass fuel supply assessment for the region, the economic development impact

  1. Nursing Facility Initiative Annual Report

    Data.gov (United States)

    U.S. Department of Health & Human Services — This annual report summarizes impacts from the Initiative to Reduce Avoidable Hospitalizations among Nursing Facility Residents in 2014. This initiative is designed...

  2. National Take-Back Initiative

    Science.gov (United States)

    ... Physicians Drug Disposal Information Drug and Chemical Information E-commerce Initiatives Federal Agencies & Related Links Federal Register Notices ... Physicians Drug Disposal Information Drug and Chemical Information E-commerce Initiatives Federal Agencies & Related Links Federal Register Notices ...

  3. Justification: The IAEA Initiative

    International Nuclear Information System (INIS)

    A substantial percentage of medical procedures using ionizing radiation are lacking in justification and optimization, rendering unnecessary a substantial fraction of the effective dose per capita from medical exposures, and thereby causing an unnecessary radiation burden to the global population. The paper presents data published by the United Nations Scientific Committee on the Effects of Atomic Radiation, and information about relevant actions being taken by the IAEA through its International Action Plan for the Radiation Protection of Patients. (author)

  4. Initial Design principles

    OpenAIRE

    Jensen, Thomas; Vatrapu, Ravi

    2015-01-01

    This paper presents a design science approach to solving persistent problems in the international shipping eco system by creating the missing common information infrastructures. Specifically, this paper reports on an ongoing dialogue between stakeholders in the shipping industry and information systems researchers engaged in the design and development of a prototype for an innovative IT-artifact called Shipping Information Pipeline which is a kind of “an internet” for shipping information. Th...

  5. Initial Data for Numerical Relativity

    OpenAIRE

    Cook Greg

    2000-01-01

    Initial data are the starting point for any numerical simulation. In the case of numerical relativity, Einstein's equations constrain our choices of these initial data. We will examine several of the formalisms used for specifying Cauchy initial data in the 3+1 decomposition of Einstein's equations. We will then explore how these formalisms have been used in constructing initial data for spacetimes containing black holes and neutron stars. In the topics discussed, emphasis is placed on those ...

  6. Rain initiation time in turbulent warm clouds

    CERN Document Server

    Falkovich, G; Vucelja, M

    2004-01-01

    We present a mean-field model that describes droplet growth due to condensation and collisions and droplet loss due to fallout. The model allows for an effective numerical simulation. We study how the rain initiation time depends on different parameters. We also present a simple model that allows one to estimate the rain initiation time for turbulent clouds with an inhomogeneous concentration of cloud condensation nuclei. In particular, we show that over-seeding even a part of a cloud by small hygroscopic nuclei one can substantially delay the onset of precipitation.

  7. Modelling Lightning Initiation and Attachment to Aircraft

    International Nuclear Information System (INIS)

    We present initial calculations of the formation of streamers on an aircraft. A two-dimensional model has been used to determine electric field strengths and charge densities around solids of various geometries and electrical conductivities. The calculations take into account the distortion of the background electric fields by the solid material and the production and motion of charged species. Detailed time-dependent visualizations of the streamer initiation and propagation are presented. The effects of size and aspect ratio of the gross features of the aircraft on the development of the streamers is discussed

  8. Graduates and initial employment.

    Science.gov (United States)

    Rydon, Sharon Elizabeth; Rolleston, Anna; Mackie, Joan

    2008-07-01

    This research project was undertaken to inform nurse educators in the Department of Nursing and Health Studies of Manukau Institute of Technology of the employment opportunities for new graduate nurses emerging from the three year degree and registration programme. The research study aimed to contribute evidence for informed discussion when issues around curriculum development arose, particularly those issues that affect employment success of graduates. A literature review was undertaken of local and international studies and this highlighted a number of studies that examined the experience of new graduates in employment. There was however little evidence that studies had focused on the experiences of graduates as they initially sought employment or their perceptions of how their ability to successfully gain employment was linked to the nursing programme they were exiting from. The data collection tool was a survey consisting of a number of closed questions which required respondents to indicate the option most closely fitting their experience. Analysis of these results was undertaken using SPSS. The last section of the survey invited respondents to comment on any aspect of the focus of the study and qualitative analysis was undertaken of these comments. Graduates from the programme for the previous three years were targeted and names and addresses were available from departmental and institute databases. The research was submitted to the MIT Research and Ethics Committee who stated that the project did not require ethical approval as a retrospective, anonymous survey. 89.8% of graduates across the three years were successful in gaining employment in the first three months post registration. The number of graduates employed within a District Health Board (DHB) declined across the three years but there were no significant differences between cohorts. Overall, 73% of graduates were employed into new graduate positions. The majority of graduates felt that their

  9. Uterine cancer presenting as obstructive jaundice.

    Science.gov (United States)

    Manuel, Valdano; Rocha, Eserval; Fortini, Giovana; Pascoal, Zeida; Netto, Renata; Rengel, Lenira; Birolini, Claudio; Utiyama, Edivaldo Massazo

    2016-01-01

    Obstructive jaundice as an initial manifestation of uterine cancer is extremely rare. We present a case of a 72-year-old female who presented with obstructive jaundice, supposedly for pancreatic cancer. After detailed diagnostic investigation, the cause of the jaundice was attributed to a metastatic compression of the common bile duct, from the primary neoplasm of the uterus. This case highlights the importance of including uterine cancer in the differential diagnosis of woman presenting with obstructive jaundice, even though it is very rare. PMID:27462179

  10. Initiation of Meiotic Recombination in Mammals

    Directory of Open Access Journals (Sweden)

    Rajeev Kumar

    2010-12-01

    Full Text Available Meiotic recombination is initiated by the induction of programmed DNA double strand breaks (DSBs. DSB repair promotes homologous interactions and pairing and leads to the formation of crossovers (COs, which are required for the proper reductional segregation at the first meiotic division. In mammals, several hundred DSBs are generated at the beginning of meiotic prophase by the catalytic activity of SPO11. Currently it is not well understood how the frequency and timing of DSB formation and their localization are regulated. Several approaches in humans and mice have provided an extensive description of the localization of initiation events based on CO mapping, leading to the identification and characterization of preferred sites (hotspots of initiation. This review presents the current knowledge about the proteins known to be involved in this process, the sites where initiation takes place, and the factors that control hotspot localization.

  11. Towards Coherent Control of Energetic Material Initiation

    Science.gov (United States)

    Greenfield, M. T.; McGrane, S. D.; Scharff, R. J.; Moore, D. S.

    2009-12-01

    We present direct optical initiation (DOI) of energetic materials using coherent control of localized energy deposition. DOI requires depositing energy into the material to produce a critical size hot spot, which allows propagation of the reaction and thereby initiation. The hot spot characteristics needed for growth to initiation can be studied using quantum controlled initiation (QCI). Achieving QCI in condensed phase energetic materials requires optimally shaped ultrafast laser pulses to coherently guide the energy flow along desired paths. As a test of our quantum control capabilities we have successfully demonstrated our ability to control the reaction pathway of the chemical system stilbene. An acousto-optical modulator based pulse shaper was used at 266 nm, in a shaped pump/supercontinuum probe technique, to enhance and suppress the relative yields of the cis- to trans-stilbene isomerization. The quantum control techniques tested in the stilbene experiments are currently being used to investigate QCI of the explosive hexanitroazobenzene (HNAB).

  12. The importance of cytology in diagnosing rare breast carcinoma: Two case reports

    OpenAIRE

    Ćuk Mirjana; Gajanin Radoslav; Mališ Miloš; Erić Dražan; Lalović Nenad; Marić Helena

    2013-01-01

    Introduction. This paper presents two cases of very rare tumors of breast: breast sebaceos carcinoma, which has rarely been described in medical literature, and breast carcinosarcoma. Morphological characteristics and biological behavior of sebaceos carcinoma are still rather vague. Carcinosarcoma of the breast is a rare malignancy with distinct cell lines described as a breast carcinoma of ductal type with a sarcoma-like component. Case report. The first presented case is a 73-year-old...

  13. EXPERIENCES WITH IDEA PROMOTING INITIATIVES

    DEFF Research Database (Denmark)

    Gish, Liv

    In new product development a central activity is to provide new ideas. Over the last decades experiences with stimulating employee creativity and establishing idea promoting initiatives have been made in industrial practice. Such initiatives are often labeled Idea Management – a research field with...... a growing interest. In this paper I examine three different idea promoting initiatives carried out in Grundfos, a leading pump manufacturer. In the analysis I address what understandings of idea work are inscribed in the initiatives and what role these initiatives play in the organization with...

  14. EXPERIENCES WITH IDEA PROMOTING INITIATIVES

    DEFF Research Database (Denmark)

    Gish, Liv

    2011-01-01

    In new product development a central activity is to provide new ideas. Over the last decades experiences with stimulating employee creativity and establishing idea promoting initiatives have been made in industrial practice. Such initiatives are often labeled Idea Management – a research field with...... a growing interest. In this paper I examine three different idea promoting initiatives carried out in Grundfos, a leading pump manufacturer. In the analysis I address what understandings of idea work are inscribed in the initiatives and what role these initiatives play in the organization with...

  15. Throat clicking as the initial symptom of Parkinson's disease.

    Science.gov (United States)

    Iyer, Sanjay S; Morgan, John C; Glover, Andrea L; Sethi, Kapil D

    2005-10-01

    The presenting manifestations of Parkinson's disease (PD) are variable, but a majority of patients note tremor as the initial symptom. Others complain of slowing of movements, loss of dexterity, fatigue, or changes in handwriting as initial symptoms. We describe a patient who developed an unusual clicking sound emanating from his throat as the initial manifestation of PD. PMID:16001408

  16. The ENERGY STAR Purchasing Initiative

    Energy Technology Data Exchange (ETDEWEB)

    Dolin, Jennifer, R.; Raynolds, Ned, R.

    1998-08-23

    Federal, state, and local governments could save at least $139 million annually by reducing energy waste through the purchase and use of energy-efficient products. Reducing this waste would reduce annual greenhouse gas emissions by 4.1 million metric tons of carbon (MMTCs) by the year 2010; the equivalent of planting an area of trees the size of Yellowstone National Park. In addition, with $50-70 billion in purchasing power for energy-related products, specifying energy efficiency could significantly shift the market for these products. The Federal government recently launched the ENERGY STAR® Purchasing Initiative to channel the purchasing power of state and local governments -and its environmental impact- in the direction of energy-efficient products to capture significant environmental benefits and increase the demand in the marketplace. Part of this effort studied why governments don’t currently procure the most efficient products, and attempted to identify the changes that would be necessary to allow many governments to do so. Some of the initial barriers to energy-efficient procurement that were found are: • Lack of information about the availability of energy-efficient products; • Split incentives, where the agency purchasing the products do not pay for the utility bills directly and, therefore, have little interest, or incentive, to save energy; • Misinformation about the benefits of energy efficiency; • Energy efficiency not seen as a value-added aspect of procurement; • Budget constraints; and • Lowest first-cost bias. This paper will present the results of this study and describe the mechanisms that will be put into place to address each of these barriers.

  17. Orbital Pseudotumor: Uncommon Initial Presentation of IgG4-Related Disease

    OpenAIRE

    Teresa Carbone; Ricardo Azêdo Montes; Beatriz Andrade; Pedro Lanzieri; Luis Mocarzel

    2015-01-01

    IgG4-related disease (IgG4-RD) encompasses a group of fibroinflammatory conditions recognized in recent times. The main clinical features include variable degrees of tissue fibrosis, tumorlike expansions, perivascular lymphocytic infiltration rich in IgG4-positive plasma cells, and elevated serum IgG4. A case has been reported of an elderly patient with an unexplained unilateral exophthalmia; biopsy was performed and revealed lymphocytic infiltration, suggesting IgG4-RD. High serum levels of ...

  18. Presentation of the research project: gender dimension in initial physical education teacher education in Portugal

    OpenAIRE

    Queirós, Telma Maria Gonçalves; Botelho-Gomes, Paula; Silva, Paula

    2011-01-01

    Gender dimension exists across societies and therefore education. Hence certain learning areas in particular (e.g. Physical Education (PE)) are embedded with powerful gendered practices. Recent international research has shown that physical activities within the school curriculum contribute to reinforce and development of “gender-appropriate” behaviour often considered socially and culturally legitimate. In Portugal, this is also particularly visible in some studies which argued that teachers...

  19. Voters’ Initiatives to Repeal or Prevent Laws Prohibiting Employment Discrimination Against LGBT People, 1974-Present

    OpenAIRE

    Sears, Brad; Mallory, Christy; Hunter, Nan D.

    2009-01-01

    One marker of the hostility and animus directed towards LGBT Americans is the proliferation of attempts to use state and local ballot measures to repeal or preclude protection against employment discrimination based on sexual orientation or gender identity. The pattern of outcomes has slowly shifted in the last 30 years from a majority of these attempts succeeding to a majority failing. Nonetheless, proponents of workplace equality for the LGBT minority have had to respond – more frequently t...

  20. Risk Factors in the Initial Presentation of Specific Cardiovascular Disease Syndromes

    Science.gov (United States)

    2013-03-03

    Heart Diseases; Cardiovascular Diseases; Acute Myocardial Infarction; Unstable Angina; Chronic Stable Angina; Ischemic Stroke; Cerebrovascular Accident; Subarachnoid Hemorrhage; Transient Ischemic Attack; Abdominal Aortic Aneurysm; Peripheral Arterial Disease; Sudden Coronary Death; Ventricular Arrhythmia; Sudden Death; Cardiac Arrest; Heart Failure

  1. Novel Scanning Lens Instrument for Evaluating Fresnel Lens Performance: Equipment Development and Initial Results (Presentation)

    Energy Technology Data Exchange (ETDEWEB)

    Herrero, R.; Miller, D. C.; Kurtz, S. R.; Anton, I.; Sala, G.

    2013-07-01

    A system dedicated to the optical transmittance characterization of Fresnel lenses has been developed at NREL, in collaboration with the UPM. The system quantifies the optical efficiency of the lens by generating a performance map. The shape of the focused spot may also be analyzed to understand change in the lens performance. The primary instrument components (lasers and CCD detector) have been characterized to confirm their capability for performing optical transmittance measurements. Measurements performed on SoG and PMMA lenses subject to a variety of indoor conditions (e.g., UV and damp heat) identified differences in the optical efficiency of the evaluated lenses, demonstrating the ability of the Scanning Lens Instrument (SLI) to distinguish between the aged lenses.

  2. Obstructive jaundice at the initial presentation in small-cell lung cancer

    OpenAIRE

    Takigawa, Nagio

    2010-01-01

    Nobuaki Ochi1, Nagio Takigawa1, Masayuki Yasugi1, Etsuji Ishida2, Hirofumi Kawamoto2, Akihiko Taniguchi1, Daijiro Harada1, Eiko Hayashi3, Hiroko Toda3, Hiroyuki Yanai3, Mitsune Tanimoto1, Katsuyuki Kiura11Department of Hematology, Oncology and Respiratory Medicine, 2Department of Gastroenterology and Hepatology, 3Department of Pathology and Oncology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, JapanAbstract: Obstructive jaundice sometimes ma...

  3. Understanding the Role of Autoimmune Disorders on the Initial Presentation of Cardiovascular Disease

    Science.gov (United States)

    2015-04-20

    Myocardial Infarction; Ischemic Stroke; Stroke; Subarachnoid Haemorrhage; Venous Thrombosis; Transient Ischemic Attack; Stable Angina Pectoris; Unstable Angina; Heart Failure; Peripheral Arterial Disease; Abdominal Aortic Aneurysm

  4. Florida Hydrogen Initiative

    Energy Technology Data Exchange (ETDEWEB)

    Block, David L

    2013-06-30

    The Florida Hydrogen Initiative (FHI) was a research, development and demonstration hydrogen and fuel cell program. The FHI program objectives were to develop Florida?s hydrogen and fuel cell infrastructure and to assist DOE in its hydrogen and fuel cell activities The FHI program funded 12 RD&D projects as follows: Hydrogen Refueling Infrastructure and Rental Car Strategies -- L. Lines, Rollins College This project analyzes strategies for Florida's early stage adaptation of hydrogen-powered public transportation. In particular, the report investigates urban and statewide network of refueling stations and the feasibility of establishing a hydrogen rental-car fleet based in Orlando. Methanol Fuel Cell Vehicle Charging Station at Florida Atlantic University ? M. Fuchs, EnerFuel, Inc. The project objectives were to design, and demonstrate a 10 kWnet proton exchange membrane fuel cell stationary power plant operating on methanol, to achieve an electrical energy efficiency of 32% and to demonstrate transient response time of less than 3 milliseconds. Assessment of Public Understanding of the Hydrogen Economy Through Science Center Exhibits, J. Newman, Orlando Science Center The project objective was to design and build an interactive Science Center exhibit called: ?H2Now: the Great Hydrogen Xchange?. On-site Reformation of Diesel Fuel for Hydrogen Fueling Station Applications ? A. Raissi, Florida Solar Energy Center This project developed an on-demand forecourt hydrogen production technology by catalytically converting high-sulfur hydrocarbon fuels to an essentially sulfur-free gas. The removal of sulfur from reformate is critical since most catalysts used for the steam reformation have limited sulfur tolerance. Chemochromic Hydrogen Leak Detectors for Safety Monitoring ? N. Mohajeri and N. Muradov, Florida Solar Energy Center This project developed and demonstrated a cost-effective and highly selective chemochromic (visual) hydrogen leak detector for safety

  5. Diagnostic performance on briefly presented mammographic images

    Science.gov (United States)

    Mugglestone, Mark D.; Gale, Alastair G.; Cowley, Helen C.; Wilson, A. R. M.

    1995-04-01

    Previously an outline model of the radiological diagnostic process has been proposed which posits the importance of the initial glance at a medical image in helping to establish an appropriate diagnosis. As part of a long tern study of knowledge elicitation in mammography we examine the amount of information available to breast screening radiologists within the initial 'glance' at a mammogram. These data are compared to those from examining the same images normally. Overall, performance in a brief presentation was poorer than in normal viewing, as expected, but was also worse than found in comparable brief presentation studies using the chest radiograph. These results are discussed with regard to the inferences which can be made about the nature of mammographic knowledge which is utilized in the diagnostic process and how it is organized within the framework of a conceptual model.

  6. ATP and Presentation Service for Mizar Formalizations

    CERN Document Server

    Urban, Josef; Sitcliffe, Geoff

    2011-01-01

    This paper describes the Automated Reasoning for Mizar (MizAR) service, which integrates several automated reasoning, artificial intelligence, and presentation tools with Mizar and its authoring environment. The service provides ATP assistance to Mizar authors in finding and explaining proofs, and offers generation of Mizar problems as challenges to ATP systems. The service is based on a sound translation from the Mizar language to that of first-order ATP systems, and relies on the recent progress in application of ATP systems in large theories containing tens of thousands of available facts. We present the main features of MizAR services, followed by an account of initial experiments in finding proofs with the ATP assistance. Our initial experience indicates that the tool offers substantial help in exploring the Mizar library and in preparing new Mizar articles.

  7. Initial evaluation of vertigo

    Directory of Open Access Journals (Sweden)

    Lemajić-Komazec Slobodanka

    2006-01-01

    Full Text Available Dizziness is one of the most common reasons patients visit their physicians. Balance control depends on receiving afferent sensory information from several sensory systems: vestibular, optical and proprioceptive. Bioelectric signals, generated by body movements in the semicircular canals and in the otolithic apparatus, are transported via the vestibular nerve to the vestibular nucleus. All four vestibular nuclei, located bilaterally in medial longitudinal fasciculus, are linked with central nervous system structures. These central nervous system structures are involved in maintaining visual stability, spatial orientation and balance control. Nystagmus is a result of afferent signals balance disorders. Nystagmus due to peripheral lesions is conjugate nystagmus, because there is a bilateral central connection. Lesions above the vestibular nuclei induce deficits in synchronization and conjugation of eye movements, thus the nystagmus is dissociated. This paper shows that in peripheral vestibular disorders spontaneous nystagmus is rhythmic, associated, horizontal-rotatory or horizontal, with subjective sensation of dizziness which decreases with time and harmonic signs whose direction coincides with the slow phase of nystagmus and it is associated with mild disorders during pendular stimulation with statistically significant vestibular hypofunction. Spontaneous nystagmus in central vestibular lesions is severe, dissociated, horizontal, rotatory or vertical, without changes related to optical suppression; if vestibular symptoms are present, they are non-harmonic. In central disorders, findings after thermal stimulation are either normal or pathological, with dysrhythmias and inhibition in pendular stimulation. This paper deals with differential diagnosis of vertigo based on anamnesis and clinical examination, as well as objective diagnostic tests. .

  8. Breckinridge Project, initial effort

    Energy Technology Data Exchange (ETDEWEB)

    None

    1982-01-01

    Report IV, Volume 6 provides descriptions, data, and drawings pertaining to Gasification and Purification (Plant 12). Gasification and Purification (Plant 12) produces makeup hydrogen for H-COAL Preheating and Reaction (Plant 3), and produces a medium Btu fuel gas for consumption in fired heaters. The following information is included: a description of the plant's process design, including the utility balance, catalysts and chemicals usage, and a process flow diagram; an equipment list, including item numbers and descriptions; data sheets and sketches for major plant components; and pertinent engineering drawings. An appendix contains: an overall site plan showing the locations of all plants; and the symbols and legend for the piping and instrument diagrams included in this volume. Gasification and Purification (Plant 12) utilizes process technology from three licensors: gasification of vacuum bottoms using the Texaco process, shift conversion using the Haldor Topsoe process, and purification of fuel gas and shifted gas using the Allied Chemical Selexol process. This licensed technology is proprietary in nature. As a result, this volume does not contain full disclosure of these processes although a maximum of information has been presented consistent with the confidentiality requirements. Where data appears incomplete in this volume, it is due to the above described limitations. Full data concerning this plant are available for DOE review at the Houston offices of Bechtel Petroleum, Inc.

  9. Efficient and Fast Initialization Algorithm for K-means Clustering

    OpenAIRE

    Mohammed El Agha; Wesam M. Ashour

    2012-01-01

    The famous K-means clustering algorithm is sensitive to the selection of the initial centroids and may converge to a local minimum of the criterion function value. A new algorithm for initialization of the K-means clustering algorithm is presented. The proposed initial starting centroids procedure allows the K-means algorithm to converge to a “better” local minimum. Our algorithm shows that refined initial starting centroids indeed lead to improved solutions. A framework for implementing and ...

  10. A fascinating presentation of hepatic hydrothorax

    OpenAIRE

    Gaduputi, Vinaya; Tariq, Hassan; Kanneganti, Kalyan

    2013-01-01

    We report this case of a 43-year-old woman with hepatitis-C cirrhosis who presented with a large right sided pleural effusion complicated by hypoxic respiratory failure and altered mentation necessitating dependence on mechanical ventilation. The pleural effusion spontaneously resolved upon initiation of mechanical positive pressure ventilation and recurred almost immediately after weaning the patient off the ventilator. The pre-ventilation, ventilation and post-ventilation chest X-ray films ...

  11. Mesenchymal Cystic Hamartoma Presenting with Spontaneous Pneumothorax

    OpenAIRE

    J Glezos; Toppin, D; Cooney, T

    2003-01-01

    A 53-year-old woman presented with a spontaneous right-sided pneumothorax. Computed tomography chest scan demonstrated a large bulla involving the right middle lobe. Recurrence of the pneumothorax after initial closed chest tube drainage necessitated thoracotomy and wedge resection. Histopathological examination revealed features consistent with a benign mesenchymal cystic hamartoma. Pneumothorax is a recognized complication of mesenchymal cystic hamartoma, a lesion that also has malignant po...

  12. Disseminated tuberculosis presenting as acute lung injury

    OpenAIRE

    Mary Grace; V K Shameer; Renjith Bharathan; Kavitha Chandrikakumari

    2014-01-01

    Tuberculosis presenting as acute lung injury is distinctly uncommon, even in India where tuberculosis an endemic disease. Simultaneously, acute lung injury is a highly fatal complication of tuberculosis. A high index of suspicion is needed to diagnose tuberculosis in such cases. Failure to initiate early treatment can have disastrous consequences as exemplified in this case report. This case attempts to highlight the need to consider tuberculosis as one of the likely causative factors for acu...

  13. Breckinridge Project, initial effort

    Energy Technology Data Exchange (ETDEWEB)

    None

    1982-01-01

    The project cogeneration plant supplies electric power, process steam and treated boiler feedwater for use by the project plants. The plant consists of multiple turbine generators and steam generators connected to a common main steam header. The major plant systems which are required to produce steam, electrical power and treated feedwater are discussed individually. The systems are: steam, steam generator, steam generator fuel, condensate and feedwater deaeration, condensate and blowdown collection, cooling water, boiler feedwater treatment, coal handling, ash handling (fly ash and bottom ash), electrical, and control system. The plant description is based on the Phase Zero design basis established for Plant 31 in July of 1980 and the steam/condensate balance as presented on Drawing 31-E-B-1. Updating of steam requirements as more refined process information becomes available has generated some changes in the steam balance. Boiler operation with these updated requirements is reflected on Drawing 31-D-B-1A. The major impact of updating has been that less 600 psig steam generated within the process units requires more extraction steam from the turbine generators to close the 600 psig steam balance. Since the 900 psig steam generation from the boilers was fixed at 1,200,000 lb/hr, the additional extraction steam required to close the 600 psig steam balance decreased the quantity of electrical power available from the turbine generators. In the next phase of engineering work, the production of 600 psig steam will be augmented by increasing convection bank steam generation in the Plant 3 fired heaters by 140,000 to 150,000 lb/hr. This modification will allow full rated power generation from the turbine generators.

  14. Evaluation and Evaluating the Community Initiative "URBAN"

    DEFF Research Database (Denmark)

    Alves, Sonia

    2013-01-01

    greater focus on a more open and democratic process of evaluation. This paper presents and compares different conceptual and methodological frameworks created for the assessment of the European initiative Urban II, including the one that was used by the author in the context of an academic evaluation in...

  15. Evaluating the Bush Climate Change Initiative

    NARCIS (Netherlands)

    Moor APG de; Berk MM; Elzen MGJ den; Vuuren DP van; MNV

    2002-01-01

    This report evaluates the Climate Change Initiative as presented by President Bush on February 14, 2002. The President's proposal aims to reduce the greenhouse gas intensity of the US economy by 18 per cent between 2002 and 2012. This policy target can be regarded as being very modest, when compared

  16. Initial value formulation of Newtonian gravity

    CERN Document Server

    Natario, J

    2004-01-01

    We show that there exists a remarkable analogy between the initial value formulation of General Relativity and Newton's gravity theory, which can be recast as an evolution problem for a flat metric in R^3. We identify conditions for solutions of both evolution problems to coincide and present examples, including a Newtonian analogue of the warp drive.

  17. 28 CFR 541.15 - Initial hearing.

    Science.gov (United States)

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Initial hearing. 541.15 Section 541.15 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT INMATE DISCIPLINE... was last confined. (d) The inmate is entitled to make a statement and to present documentary...

  18. How Taipower initiated its nuclear power projects

    International Nuclear Information System (INIS)

    Taiwan's experience in initiating its nuclear power projects is briefly presented step by step: personnel training, energy survey to justify the need of a new project, site selection, overall preparation for stability and reliability of the integrated system, reactor-type selection, feasibility study training of staff, and fulfillment of legal requirements

  19. Kennesaw State University Classroom Technology Initiative.

    Science.gov (United States)

    McHaney, Jane; Wallace, Deborah; Taylor, Beverley

    The purpose of the Kennesaw State University (KSU) Coca Cola/Board of Regents Classroom Technology Initiative was to develop preservice and inservice teachers' expertise in educational technology such as computers, presentation software, and multimedia and to teach educators to apply those skills to content instruction. Project goals were to…

  20. Inflation with generalized initial conditions

    Energy Technology Data Exchange (ETDEWEB)

    Albrecht, A.; Brandenberger, R.; Matzner, R.

    1987-01-15

    In many current models of the early Universe a scalar field phi which is only very weakly coupled to other quantum fields is used to generate inflation. In such models there are no forces which could thermalize the scalar field, and previous assumptions about its preinflation ''initial'' conditions must be abandoned. In this paper the onset of inflation is studied classically for more general initial conditions of the scalar field configuration. In particular, initial conditions with a nonvanishing spatial average of phi, with phi chosen at random in each initial horizon volume, and with random initial momenta are considered. We identify and discuss several mechanisms that can drive these more general initial conditions toward an inflationary state. The analysis is done in one spatial dimension.

  1. Researching British university sport initiations

    OpenAIRE

    Wintrup, Glen

    2011-01-01

    This thesis was submitted for the degree of Doctor of Philosophy and awarded by Brunel University. The study of sport initiations is in its infancy. So far, the North American-centric research has focussed on ‘exposing and condemning’ morally unacceptable initiation activities, which are referred to as hazing. Hazing moral panics in North America has resulted in universities utilising sport initiation empirical research to construct anti-hazing policies; policies proven to be ineffective i...

  2. Self-initiated expatriate academics

    DEFF Research Database (Denmark)

    Selmer, Jan; Lauring, Jakob

    2013-01-01

    were collected from 428 self-initiated expatriate academics from 60 countries employed in 35 universities in five northern European countries. Results confirm that there are differences in terms of work outcomes among the different types of self-initiated expatriate academics, especially regarding the......In this chapter we examine self-initiated expatriate academics. Universities are to an increasing extent looking for talent beyond national boundaries. Accordingly, self-initiated expatriate academics represent a fast growing group of highly educated professionals who gain employment abroad...

  3. Distributed Pyro Initiation System Project

    Data.gov (United States)

    National Aeronautics and Space Administration — Evaluate Current State of the Art; Define Critical Performance Requirements; Select Components; Smart Initiator or Smart Connector; Perform Detailed Cost/Benefit...

  4. Investigations of initiation spot size effects

    Energy Technology Data Exchange (ETDEWEB)

    Clarke, Steven A [Los Alamos National Laboratory; Akinci, Adrian A [Los Alamos National Laboratory; Leichty, Gary [Los Alamos National Laboratory; Schaffer, Timothy [Los Alamos National Laboratory; Murphy, Michael J [Los Alamos National Laboratory; Munger, Alan [Los Alamos National Laboratory; Thomas, Keith A [Los Alamos National Laboratory

    2010-01-01

    As explosive components become smaller, a greater understanding of the effect of initiation spot size on detonation becomes increasingly critical. A series of tests of the effect of initiation spot size will be described. A series of DOI (direct optical initiation) detonators with initiation spots sizes from {approx}50 um to 1000um have been tested to determine laser parameters for threshold firing of low density PETN pressings. Results will be compared with theoretical predictions. Outputs of the initiation source (DOI ablation) have been characterized by a suite of diagnostics including PDV and schlieren imaging. Outputs of complete detonators have been characterized using PDV, streak, and/or schlieren imaging. At present, we have not found the expected change in the threshold energy to spot size relationship for DOI type detonators found in similar earlier for projectiles, slappers and EBWs. New detonators designs (Type C) are currently being tested that will allow the determination of the threshold for spot sizes from 250 um to 105um, where we hope to see change in the threshold vs. spot size relationship. Also, one test of an extremely small diameter spot size (50um) has resulted in preliminary NoGo only results even at energy densities as much as 8 times the energy density of the threshold results presented here. This gives preliminary evidence that 50um spot may be beyond the critical initiation diameter. The constant threshold energy to spot size relationship in the data to date does however still give some insight into the initiation mechanism of DOI detonators. If the DOI initiation mechanism were a 1D mechanism similar to a slapper or a flyer impact, the expected inflection point in the graph would have been between 300um and 500um diameter spot size, within the range of the data presented here. The lack of that inflection point indicates that the DOI initiation mechanism is more likely a 2D mechanism similar to a sphere or rod projectile. We expect to

  5. Solar initiative at Oukaimeden Observatory

    Science.gov (United States)

    Benkaldoun, Zouhair; Makela, Jonathan J.; Meriwether, John W.

    2013-07-01

    The solar research program at Oukaimeden Observatory started in 1988 with the helioseimological IRIS network. The Moroccan researchers involved in this research have analyzed solar observations in order to detect and characterize the solar sphere modes of oscillations. In the coming year, the researchers at the Oukaimeden Observatory will add new research capabilities by joining the International Space Weather Initiative (ISWI), installing a suite of optical instruments, comprising a Remote Equatorial Nighttime Observatory of Ionospheric Regions (RENOIR). The scope and objectives to be achieved in this proposed project are to: • deploy a Fabry-Perot interferometer and wide-angle imaging system to the Observatoire Astronomique Universitaire de LOukaimeden; • train students and researchers from Cadi Ayyad University on the operation of the equipment and related analysis techniques; • collect and analyze data from the equipment to study properties of upper-atmospheric winds and temperatures and how they relate to the occurrence of space weather; and • develop an international collaboration network with other researchers using similar instrumentation in Brazil and Peru. We will present here the plan we intend to develop for the Moroccan solar program in connection with ISWI.

  6. NMR imaging of the brain: initial impressions

    International Nuclear Information System (INIS)

    An NMR imaging system designed and built by Thorn-EMI Ltd was installed at Hammersmith Hospital in March 1981. In the first year of operation 180 patients and 40 volunteers have had cranial examinations and initial impressions bases on this experience are presented. Patients with a wide variety of neurological diseases have been studied to provide a basis for diagnostic interpretation, to define distinctive features, and to evaluate different types of scanning sequences. NMR imaging appears to be of considerable value in neurological diagnosis and has a number of advantages over CT. The detailed evaluation of NMR imaging will require much more work but the initial results are very promising

  7. Student initiative: A conceptual analysis

    Directory of Open Access Journals (Sweden)

    Polovina Nada

    2014-01-01

    Full Text Available In the description and scientific consideration of the attitude of children and youth towards their education and development, the concept of student initiative has been gaining ground lately, and it is hence the subject of analysis in this paper. The analysis is important because of the discrepancy between the increased efforts of the key educational policy holders to promote the idea about the importance of the development of student initiative and rare acceptance of this idea among theoreticians, researchers and practitioners dealing with the education and development of children and youth. By concretising the features of initiative student behaviour, our aim was, on the one hand, to observe the structural determinants and scientific status of the very concept of an initiative student, and, on the other, to contribute to the understanding of the initiative behaviour in practice. In the first part of the paper we deal with different notions and concretisations of the features of initiative behaviour of children and youth, which includes the consideration of: basic student initiative, academic student initiative, individual student initiative, the capacity for initiative and personal development initiative. In the second part of the paper, we discuss the relations of the concept of student initiative with the similar general concepts (activity/passivity, proactivity, agency and the concepts immediately related to school environment (student involvement, student participation. The results of our analysis indicate that the concept of student initiative has: particular features that differentiate it from similar concepts; the potential to reach the status of a scientific concept, bearing in mind the initial empirical specifications and general empirical verifiability of the yet unverified determinants of the concept. In the concluding part of the paper, we discuss the implications of the conceptual analysis for further research, as well as for

  8. Gorenstein algebras presented by quadrics

    OpenAIRE

    Migliore, Juan; Nagel, Uwe

    2011-01-01

    We establish restrictions on the Hilbert function of standard graded Gorenstein algebras with only quadratic relations. Furthermore, we pose some intriguing conjectures and provide evidence for them by proving them in some cases using a number of different techniques, including liaison theory and generic initial ideals.

  9. Congenic tuberculosis. Presentation of clinical case

    International Nuclear Information System (INIS)

    We are presenting the case of less than to 2 month old and premature infant, she had hyaline membrane disease and required mechanical ventilation during 6 days, at the first month. She presented a viral rhinopharyngitis symptomatology, perioral cyanosis with apnoea, and respiratory distress, the chest x-ray showed multiple bilateral hyperlucid images, mainly at the right side afterwards the patient presented intermittent fever of long evolution and initially received treatment for cavitary bronchopneumonia and sequel of mechanical ventilation, receiving multiple antimicrobial antibiotics, the mother had intermittent fevers since the sixth month of pregnancy and was hospitalized for suspected endometritis after delivery, she presented clinical impairment which evolved to sepsis and died in the ICU, the endometrial histopathology showed granulomas suggesting tuberculosis, due to long history of fevers in the baby and the genital tuberculosis in the mother a tuberculosis study was performed in the girl which resulted positive

  10. To Boldly Go: First-year exploration of OER Initiatives

    OpenAIRE

    Walz, Anita R.

    2014-01-01

    Presented at the Virginia Libraries Association Annual Conference. Open Educational Resources present opportunities for teaching faculty to save students thousands of dollars in textbook costs. This session describes the basics of what "OER" is and provides an overview of several successful OER initiatives as well as the University Libraries' strategic approach to evaluate and pilot OER initiatives at Virginia Tech.

  11. Initial Distribution Spread: A density forecasting approach

    CERN Document Server

    Machete, Reason L

    2012-01-01

    Ensemble forecasting of nonlinear systems involves the use of a model to run forward a discrete ensemble (or set) of initial states. Data assimilation techniques tend to focus on estimating the true state of the system, even though model error limits the value of such efforts. This paper argues for choosing the initial ensemble in order to optimise forecasting performance rather than estimate the true state of the system. Density forecasting and choosing the initial ensemble are treated as one problem. Forecasting performance can be quantified by some scoring rule. In the case of the logarithmic scoring rule, theoretical arguments and empirical results are presented. It turns out that, if the underlying noise dominates model error, we can diagnose the noise spread.

  12. Microrhythmic characteristics of musical instrument initial transients

    Science.gov (United States)

    Bader, Rolf

    2005-04-01

    A microrhythmic analysis of initial transients of the violin, the guitar, the saxophone, the clarinet, and percussion instruments has been performed. They show characteristic patterns between instrument families, concerning the derivation of microrhythmic intervals within the tonal frequency range compared to psychoacoustic discrimination tasks by listeners. Microrhythm here is defined as the temporal distance between two amplitude peaks. As initial transients are a crucial part of the sound in terms of identification of instruments and the initial is just in the range of the second integration time of the ear, where frequency components can just be identified, these microrhythmic patterns could be a possibility for listeners to identify the instrument families. This is because microrhythmic intervals are instantaneously present and do not need an integration time span.

  13. Mathematical Reasoning in Teachers' Presentations

    Science.gov (United States)

    Bergqvist, Tomas; Lithner, Johan

    2012-01-01

    This paper presents a study of the opportunities presented to students that allow them to learn different types of mathematical reasoning during teachers' ordinary task solving presentations. The characteristics of algorithmic and creative reasoning that are seen in the presentations are analyzed. We find that most task solutions are based on…

  14. METHODS FOR PERFECTING PRESENTATION SKILLS

    OpenAIRE

    Daniela N. Ilieva - Koleva

    2014-01-01

    Presentation skills are crucial for the nowadays managers and business people. This article aims to examine different traditional and unconventional methods for enhancing and perfecting presentation skills. It provides suggestions on how to structure a presentation, what type of verbal language to include, and pays significant attention to body language during presentations, as well as to the relation between the presenter and the audience. The paper highlights a variety of instruments and te...

  15. Put Power into Your Presentations: Using Presentation Software Effectively

    Science.gov (United States)

    Safransky, Robert J.; Burmeister, Marsha L.

    2009-01-01

    Microsoft PowerPoint, Apple Keynote, and OpenOffice Impress are relatively common tools in the classroom and in the boardroom these days. What makes presentation software so popular? As the Chinese proverb declares, a picture is worth a thousand words. People like visual presentations. Presentation software can make even a dull subject come to…

  16. Effect of flow velocity on crack initiation

    International Nuclear Information System (INIS)

    Constant extension rate tensile (CERT) tests are traditionally used to understand the influence of material composition, heat treatment, temperature and environmental variables on stress corrosion crack (SCC) initiation. However, fluid flow rate has not been investigated as a parameter that could affect SCC initiation until recently. These studies have exhibited longer time to failure under high flow conditions indicating delayed crack initiation. Because these experiments have been performed in highly oxygenated water, no correlation has been established between the influence of flow velocity on the electrochemical corrosion potential (ECP) and the time to failure of tensile test specimens. The interrelationship between the fluid flow velocity, ECP and the time to failure is of great interest to the Boiling Water Reactor (BWR) applications primarily because of the previous observations that the ECP of Type 304 stainless steel increases with fluid flow velocity. This paper describes an attempt that has been made to understand the interrelationship between fluid flow velocity, ECP and the time for crack initiation in high temperature high purity water simulating both the BWR chemistry and the component flow velocity conditions. The range of flow velocities employed in the present study was 0.002 to 2 ft/s. The studies indicate that while high flow velocities can increase ECP there is a delayed effect on crack initiation

  17. Crack initiation under generalized plane strain conditions

    International Nuclear Information System (INIS)

    A method for estimating the decrease in crack-initiation toughness, from a reference plane strain value, due to positive straining along the crack front of a circumferential flaw in a reactor pressure vessel is presented in this study. This method relates crack initiation under generalized plane strain conditions with material failure at points within a distance of a few crack-tip-opening displacements ahead of a crack front, and involves the formulation of a micromechanical crack-initiation model. While this study is intended to address concerns regarding the effects of positive out-of- plane straining on ductile crack initiation, the approach adopted in this work can be extended in a straightforward fashion to examine conditions of macroscopic cleavage crack initiation. Provided single- parameter dominance of near-tip fields exists in the flawed structure, results from this study could be used to examine the appropriateness of applying plane strain fracture toughness to the evaluation of circumferential flaws, in particular to those in ring-forged vessels which have no longitudinal welds. In addition, results from this study could also be applied toward the analysis of the effects of thermal streaming on the fracture resistance of circumferentially oriented flaws in a pressure vessel. 37 refs., 8 figs., 1 tab

  18. Painless pulsatile mass as first presentation of renal cell carcinoma

    OpenAIRE

    Kimberley Hoyland; Nikhil Vasdev; Paul Nathan; Damian Hanbury

    2014-01-01

    Renal cell carcinoma rarely presents with typical features of abdominal pain, flank mass and haematuria, and up to 30% of patients present with metastases. We present the case of an 81 year old man who presented with a painless, pulsatile sternal metastasis as an initial presentation of renal cell carcinoma. This case highlights the importance of recognizing even unusual presentations of renal cell carcinoma, and that although sternal metastases are rare, when they do occur there should be a ...

  19. Dementia presenting with visual complaints

    OpenAIRE

    Koutroumanos, Nikolaos; Clarke, Michael P; Mosimann, Urs Peter

    2009-01-01

    A 78-year-old female developed memory problems after a 2-year history of persistent visual complaints. Ocular pathology did not explain the extent of her perceived visual impairment. Cognitive screening tests found prominent visuo-constructive deficits and a comprehensive dementia assessment revealed the diagnosis of Alzheimer’s disease. This case describes visual complaints as the initial symptom of dementia, pre-dating memory impairment by several years. We discuss clinical signs of cerebra...

  20. Stochastic dynamics of cancer initiation

    International Nuclear Information System (INIS)

    Most human cancer types result from the accumulation of multiple genetic and epigenetic alterations in a single cell. Once the first change (or changes) have arisen, tumorigenesis is initiated and the subsequent emergence of additional alterations drives progression to more aggressive and ultimately invasive phenotypes. Elucidation of the dynamics of cancer initiation is of importance for an understanding of tumor evolution and cancer incidence data. In this paper, we develop a novel mathematical framework to study the processes of cancer initiation. Cells at risk of accumulating oncogenic mutations are organized into small compartments of cells and proliferate according to a stochastic process. During each cell division, an (epi)genetic alteration may arise which leads to a random fitness change, drawn from a probability distribution. Cancer is initiated when a cell gains a fitness sufficiently high to escape from the homeostatic mechanisms of the cell compartment. To investigate cancer initiation during a human lifetime, a 'race' between this fitness process and the aging process of the patient is considered; the latter is modeled as a second stochastic Markov process in an aging dimension. This model allows us to investigate the dynamics of cancer initiation and its dependence on the mutational fitness distribution. Our framework also provides a methodology to assess the effects of different life expectancy distributions on lifetime cancer incidence. We apply this methodology to colorectal tumorigenesis while considering life expectancy data of the US population to inform the dynamics of the aging process. We study how the probability of cancer initiation prior to death, the time until cancer initiation, and the mutational profile of the cancer-initiating cell depends on the shape of the mutational fitness distribution and life expectancy of the population

  1. Motility initiation in active gels

    CERN Document Server

    Recho, Pierre; Truskinovsky, Lev

    2015-01-01

    Motility initiation in crawling cells requires a symmetry breaking mechanism which transforms a symmetric state into a polarized state. Experiments on keratocytes suggest that polarization is triggered by increased contractility of motor proteins. In this paper we argue that contraction can be responsible not only for the symmetry breaking transition but also for the incipient translocation of the segment of an active gel mimicking the crawling cell. Our model suggests that when the contractility increases sufficiently far beyond the motility initiation threshold, the cell can stop and re-symmetrizes. The proposed theory reproduces the motility initiation pattern in fish keratocytes and the behavior of keratocytes prior to cell division.

  2. Shock initiation of high explosives

    International Nuclear Information System (INIS)

    We have substantially advanced the experimental and theoretical study of shock initiation in the past five years. The current generation of our stress and particle-velocity gauges allows quantitative input to a predictive initiation model. Fast infrared radiometry has provided insight into the ignition and growth aspect of initiation and provided semiquantitative data on particle-size effects for inclusion into the model. This approach, combining experimental and theoretical studies, has already paid off in the design and modeling of our initation systems, which are important to a weapon's safety and vulnerability as well as to its performance

  3. Presentation-Oriented Visualization Techniques.

    Science.gov (United States)

    Kosara, Robert

    2016-01-01

    Data visualization research focuses on data exploration and analysis, yet the vast majority of visualizations people see were created for a different purpose: presentation. Whether we are talking about charts showing data to help make a presenter's point, data visuals created to accompany a news story, or the ubiquitous infographics, many more people consume charts than make them. Traditional visualization techniques treat presentation as an afterthought, but are there techniques uniquely suited to data presentation but not necessarily ideal for exploration and analysis? This article focuses on presentation-oriented techniques, considering their usefulness for presentation first and any other purposes as secondary. PMID:26780762

  4. Present market for nuclear energy

    International Nuclear Information System (INIS)

    The present market for nuclear energy is present since nuclear production and electric power generation to the utilization of radioisotopes in medicine and biology. Some data about the main world suppliers to this market are shown. (E.G.)

  5. Great Lakes Initiative (GLI) Clearinghouse

    Data.gov (United States)

    U.S. Environmental Protection Agency — The Great Lakes Initiative Toxicity Data Clearinghouse is a central location for information on criteria, toxicity data, exposure parameters and other supporting...

  6. FY 10 Multifamily Initial Endorsements

    Data.gov (United States)

    Department of Housing and Urban Development — In FY 2010, HUD's Multifamily's 18 Hubs initially endorsed 1011 loans totaling $11.3 billion and providing 170,672 units/ beds. FY 10's $11.3 billion is the highest...

  7. Initiative against nuclear power plants

    International Nuclear Information System (INIS)

    This publication of the Initiative of Austrian Nuclear Power Plant Opponents contains articles on radiactive waste dispoasal in Austria and and discusses safety issues of the nuclear power plant 'Zwentendorf'. (kancsar)

  8. Insulinoma presenting as postprandial hypoglycaemia

    OpenAIRE

    Madathil, Asgar; Weaver, Jola

    2011-01-01

    Although insulinoma commonly presents as fasting hypoglycaemia it can rarely present as postprandial hypoglycaemia. We describe a case of insulinoma presenting as postprandial hypoglycaemia and type 2 diabetes mellitus (T2DM). A 60-year-old man presented with a 6 year history of postprandial hypoglycaemic symptoms. A diagnosis of T2DM was made using a standard oral glucose tolerance test to which patient’s postprandial hypoglycaemia was attributed. He was given dietetic advice for postprandia...

  9. Tracheoesophageal fistula as the presenting manifestation of Hodgkin's lymphoma.

    OpenAIRE

    Alba, D.; Lobato, S. D.; Alvarez-Sala, R.; Villasante, C.; Echevarría, C.

    1994-01-01

    We present a patient with tracheoesophageal fistula as the initial manifestation of Hodgkin's disease with oesophageal involvement. To our knowledge, this has not been previously reported. The diagnosis of Hodgkin's lymphoma was made at autopsy.

  10. How to initiate creativity through film making

    DEFF Research Database (Denmark)

    Philipsen, Heidi

    2011-01-01

    creativity. My problem formulation in this paper is: How do conditions initiate creativity in film production? And how can they be used across the education system in initiating creative competences? My aim is to suggest a didactic model for such ‘scaffolded’ creativity in film production. While other media......Creativity is constantly demanded especially in the Western part of the world: Creative competences, environments, educations, classes etc. Despite of that, only few scholars have researched the conditions behind these elements, and even fewer have researched them in relation to film making. I will...... empirical studies I will suggest in this paper a learning design for creative film making. In my presentation at the Nordmedia conference I will present more findings from my research and propose ideas of how to transfer this knowledge to an educational context...

  11. Renal infarction in patients presenting with suspected renal colic *

    OpenAIRE

    Seetho, Ian W.; Bungay, Peter M.; Taal, Maarten W.; Fluck, Richard J.; Leung, Janson C. H.

    2009-01-01

    Acute renal infarction is a serious medical emergency. The diagnosis is often delayed or missed as it is not common. Hence, the exact incidence of acute renal infarction is not known. Failure to consider renal infarction in the initial differential diagnosis results in a delay in diagnosis and treatment, which in turn leads to permanent loss of renal function. We present two cases of acute kidney infarction that were initially treated as renal colic. In addition, we present a third case when ...

  12. Built Environment Energy Analysis Tool Overview (Presentation)

    Energy Technology Data Exchange (ETDEWEB)

    Porter, C.

    2013-04-01

    This presentation provides an overview of the Built Environment Energy Analysis Tool, which is designed to assess impacts of future land use/built environment patterns on transportation-related energy use and greenhouse gas (GHG) emissions. The tool can be used to evaluate a range of population distribution and urban design scenarios for 2030 and 2050. This tool was produced as part of the Transportation Energy Futures (TEF) project, a Department of Energy-sponsored multi-agency project initiated to pinpoint underexplored strategies for abating GHGs and reducing petroleum dependence related to transportation.

  13. Disseminated tuberculosis presenting as acute lung injury

    Directory of Open Access Journals (Sweden)

    Mary Grace

    2014-01-01

    Full Text Available Tuberculosis presenting as acute lung injury is distinctly uncommon, even in India where tuberculosis an endemic disease. Simultaneously, acute lung injury is a highly fatal complication of tuberculosis. A high index of suspicion is needed to diagnose tuberculosis in such cases. Failure to initiate early treatment can have disastrous consequences as exemplified in this case report. This case attempts to highlight the need to consider tuberculosis as one of the likely causative factors for acute lung injury and the importance of starting empirical antituberculous therapy in suspected cases early.

  14. Sputter-initiated resonance ionization spectroscopy

    International Nuclear Information System (INIS)

    A new technique, sputter-initiated resonance ionization spectroscopy (SIRIS), which provides an ultrasensitive analysis of solid samples for all elements except helium and neon is described in this paper. Sensitivities down to 1 part in 1012 should be available in routine SIRIS analysis, and greater sensitivities should be available for special cases. The basic concepts of this technology and early results in the development of the new SIRIS process and apparatus are presented. (Auth.)

  15. Epistaxis as the initial manifestation of brucellosis

    OpenAIRE

    Al Mousa, Abdullah I

    2008-01-01

    Brucellosis is a multisystem disease with a broad spectrum of clinical manifestations. Hematologic complications in the form of mild pancytopenia are occasionally reported in the course of acute brucellosis. Rarely, thrombocytopenia is severe and can be associated with purpura and mucosal bleeding. Epistaxis as the initial manifestation of brucellosis is a rarely reported phenomenon. A case of young adult is being reported who presented with epistaxis due to brucellosis-induced thrombocytopenia.

  16. Collective intelligence for community energy initiatives.

    OpenAIRE

    Cavero, Jose; Kortuem, Gerd; Wolff, Annika

    2015-01-01

    In this paper we present an approach aimed at overcoming barriers to the success of community energy initiatives in urban areas. The proposed methods will support communities in identifying and adopting community energy solutions by connecting citizens with a collection of relevant datasets including satellite, energy and socio-economic data. Citizens will be provided with the ability to explore the data and with advanced urban data analytics methods to identify key aspects and potential area...

  17. Regulatory Initiative to Oversee Licensees' Safety Culture

    International Nuclear Information System (INIS)

    This paper presents the regulatory initiative of regulator's engagement into safety culture and suggests a systematic scheme to implement it for the operation of nuclear power plants in Korea. In recent years, international discussions relating to regulatory oversight of licensees' safety culture have taken place and several attempts have been made to establish practical approaches to the oversight. The event at Kori unit 1 in February 2012 made a new stage of regulator's engaging in licensee's safety culture in Korea

  18. Challenges to the Jordanian Electronic Government Initiative

    OpenAIRE

    Ala M. Abu-Samaha; Yara Abdel Samad

    2014-01-01

    This paper aims to present a number of key challenges to the Jordanian Electronic Government Initiative as a precursor to embracing mobile government (the future electronic governmental service provision). The first wave of electronic governmental services was delivered through the web as the sole communication channel. Despite the limited success of a small number of governmental entities to utilise such a communication channel, the very limited penetration of the Internet in Jordan has damp...

  19. Novel quantum initial conditions for inflation

    CERN Document Server

    Handley, W J; Hobson, M P

    2016-01-01

    We present a novel approach for setting initial conditions on the mode functions of the Mukhanov Sazaki equation. These conditions are motivated by minimisation of the renormalised stress-energy tensor, and are valid for setting a vacuum state even in a context where the spacetime is changing rapidly. Moreover, these alternative conditions are potentially observationally distinguishable. We apply this to the kinetically dominated universe, and compare with the more traditional approach.

  20. Current Initiatives in Cost and Management

    OpenAIRE

    Kirby, William H.

    1984-01-01

    This presentation addresses cost containment initiatives for employers and proposes a management system approach for cost reductions and improved control over the execution of their health care benefit programs. Standard cost management is emphasized as a management tool for more intensive application in hospitals and other large provider organizations. It is a powerful tool for cost reduction and control, prospective costing with reasonable precision, and improving organizational performance...

  1. Introducing the Portuguese web archive initiative

    OpenAIRE

    Gomes, Daniel; Nogueira, André; Miranda, João; Costa, Miguel

    2009-01-01

    This paper introduces the Portuguese Web Archive initiative, presenting its main objectives and work in progress. Term search over web archives collections is a desirable feature that raises new challenges. It is discussed how the terms index size could be reduced without significantly decreasing the quality of search results. The results obtained from the first performed crawl show that the Portuguese web is composed approximately at least by 54 million contents that cor...

  2. Isolated Torticollis May Present as an Atypical Presentation of Meningitis

    Directory of Open Access Journals (Sweden)

    Roger Chirurgi

    2012-01-01

    Full Text Available Background. Bacterial meningitis is a life-threatening medical emergency that requires urgent diagnosis and treatment. Diagnosis is infrequently missed if the patient presents with the classic symptoms of fever, headache, rash, nuchal rigidity, or Kernig or Brudzinski sign. However, it may be less obvious in neonates, elderly, or immunocompromised patients. Meningitis which presents as isolated torticollis, without any other signs or symptoms, is exceedingly rare. Objective. To identify an abnormal presentation of meningitis in an adult immunocompromised patient. Case Report. We present a case of an adult diabetic male who presented multiple times to the ED with complaint of isolated torticollis, who ultimately was diagnosed with bacterial meningitis. Conclusion. We propose that in the absence of sufficient explanation for acute painful torticollis in an immunocompromised adult patient, further evaluation, possibly including a lumbar puncture may be warranted.

  3. Holocene peatland initiation in the Greater Everglades

    Science.gov (United States)

    Dekker, Stefan; de Boer, Hugo; Dermody, Brian; Wagner-Cremer, Friederike; Wassen, Martin; Eppinga, Maarten

    2015-04-01

    The mechanisms involved in the initiation and development of the Greater Everglades peatland ecosystems in South Florida (USA) remain a topic of discussion. In this study, we present an overview of basal ages of peat deposits in South Florida, which shows two major episodes of peatland initiation between 7.0-4.5 kyr and 3.5-2.0 kyr. Our analysis of regional climate proxy datasets led to three alternative hypotheses that may explain the timing and duration of these two peatland initiation episodes: (1) decreased drainage due to relative sea level (RSL) rise during the Holocene (2) gradual increase in precipitation throughout the Holocene, and (3) a combination of increasing precipitation, rising RSL and oscillations in the climate system. We test whether these three hypotheses can explain the pattern of initiation and development of the Greater Everglades peatlands using models that simulate the non-linear processes involved in peat production and decomposition in combination with the local drainage conditions of Southern Florida. The model results suggest that RSL-rise alone cannot predict the onset of peat initiation in the Greater Everglades using our model setup. The model also implies that the climate was wet enough for peat development also during the early Holocene. The first two hypothesized mechanisms in combination with climate oscillations may explain the onset of peat accumulation at 8.2 kyr BP. The two-phased character of peat land initiation may be explained by the spatial distribution of local drainage conditions. As peatland development is highly non-linear, our model uncovers a mechanistic way how peats can suddenly shift from a dry high equilibrium to a wet low equilibrium resulting in lake formation as observed in paleo-ecological studies in the Greater Everglades.

  4. Unusual presentation of Klinefelter syndrome

    Directory of Open Access Journals (Sweden)

    Chanchal Das

    2013-01-01

    Full Text Available Introduction: Klinefelter syndrome usually presents in the puberty and adulthood with its characteristic features. We report a boy who had Klinefelter syndrome with hypospadias and hydrocele. Case Note: Six and half year old boy had complaints of genitourinary problem in the form of hypospadias, small phallus and hydrocele. Karyotyping showed 47,XXY. Conclusion: This case illustrates that Klinefelter syndrome was presented in the infancy with hypospadias and hydrocele which are very uncommon presentation of the disease

  5. Emphysematous pyelonephritis: a rare presentation.

    Directory of Open Access Journals (Sweden)

    Jain S

    2000-01-01

    Full Text Available Emphysematous pyelonephritis is a rare life threatening infection in diabetes characterised by suppurative infection of renal parenchyma and perirenal tissues. It usually presents with fever, nausea, vomiting, abdominal pain, shock, lethargy, and confusion. Diabetic ketoacidosis is an uncommon presentation. In the present case, an elderly female presented with abdominal pain, fever, vomiting, and altered sensorium. She was diagnosed to have diabetic ketoacidosis with metabolic encephalopathy with right emphysematous pyelonephritis. She had an excellent response to medical treatment alone and was later discharged on oral hypoglycaemic agents.

  6. MHC Class Ⅰ Antigen Presentation- Recently Trimmed and Well Presented

    Institute of Scientific and Technical Information of China (English)

    Barry Flutter; Bin Gao

    2004-01-01

    Presentation of antigenic peptide to T cells by major histocompatibility complex (MHC) class Ⅰ molecules is the key to the cellular immune response. Non-self intracellular proteins are processed into short peptides and transported into endoplasmic reticulum (ER) where they are assembled with class Ⅰ molecules assisted by several chaperone proteins to form trimeric complex. MHC class Ⅰ complex loaded with optimised peptides travels to the cell surface of antigen presentation cells to be recognised by T cells. The cells presenting non-self peptides are cleared by CD8 positive T cells. In order to ensure that T cells detect an infection or mutation within the target cells the process of peptide loading and class Ⅰ expression must be carefully regulated. Many of the cellular components involved in antigen processing and class Ⅰ presentation are known and their various functions are now becoming clearer. Cellular & Molecular Immunology. 2004;1(1):22-30.

  7. MHC Class I Antigen Presentation- Recently Trimmed and Well Presented

    Institute of Scientific and Technical Information of China (English)

    BarryFlutter; BinGao

    2004-01-01

    Presentation of antigenic peptide to T cells by major histocompatibility complex (MHC) class I molecules is the key to the cellular immune response. Non-self intracellular proteins are processed into short peptides and transported into endoplasmic reticulum (ER) where they are assembled with class I molecules assisted by several chaperone proteins to form trimeric complex. MHC class I complex loaded with optimised peptides travels to the cell surface of antigen presentation cells to be recognised by T cells. The cells presenting non-self peptides are cleared by CD8 positive T cells. In order to ensure that T cells detect an infection or mutation within the target cells the process of peptide loading and class I expression must be carefully regulated. Many of the cellular components involved in antigen processing and class I presentation are known and their various functions are now becoming clearer. Cellular & Molecular Immunology. 2004;1(1):22-30.

  8. Integrated Initiating Event Performance Indicators

    International Nuclear Information System (INIS)

    The U.S. Nuclear Regulatory Commission Industry Trends Program (ITP) collects and analyses industry-wide data, assesses the safety significance of results, and communicates results to Congress and other stakeholders. This paper outlines potential enhancements in the ITP to comprehensively cover the Initiating Events Cornerstone of Safety. Future work will address other cornerstones of safety. The proposed Tier 1 activity involves collecting data on ten categories of risk-significant initiating events, trending the results, and comparing early performance with prediction limits (allowable numbers of events, above which NRC action may occur). Tier 1 results would be used to monitor industry performance at the level of individual categories of initiating events. The proposed Tier 2 activity involves integrating the information for individual categories of initiating events into a single risk-based indicator, termed the Baseline Risk Index for Initiating Events or BRIIE. The BRIIE would be evaluated yearly and compared against a threshold. BRIIE results would be reported to Congress on a yearly basis

  9. Syndrome of initial reaction to irradiation (review of literature)

    International Nuclear Information System (INIS)

    Last year data, characterizing current ideas of pathophysiological and neurochemical mechanisms of initial reaction and future trends in research of pharmacological means of its cupping prophylaxis are presented. A great quantity of data, related to important role of biogenic amines, prostaglandines and neuropeptides in mechanisms of initial reaction to irradiation is accumulated. All this determines the search of means to fight the initial radiation reaction

  10. Prechamber initiation of detonation in gaseous mixtures

    Science.gov (United States)

    Bivol, G. Yu; Golovastov, S. V.; Golub, V. V.

    2015-11-01

    A process of deflagration-to-detonation transition in propane-butane-oxygen and acetylene-oxygen mixtures, in an open channel with a circular cross section with a diameter of 3 mm, was investigated experimentally. Detonation initiation was carried out by burning the mixture in the prechamber connected to the channel. The prechamber was considered as an extended source for the initiation of the detonation of a finite volume. To measure the velocity of a flame front, photodiodes, installed along the axis of the channel, were used. To determine the boundary conditions at the entrance to the channel, a piezoelectric pressure transducer was used. The influence of the dimensions of the prechamber, equivalence ratio and fuel on the pressure profile, and evolution of the flame front along the axis of the channel are presented. It was shown that, the dynamics of the flame front and shock waves in the channel can occur in different scenarios depending on the geometry of the prechamber and equivalence ratio. Two limit effects of the prechamber detonation initiation in the channel have been analyzed. The pre-detonation distances and the minimal energy of direct initiation of the detonation were determined.

  11. Perirenal hemorrhage as first presentation of Wilms tumor

    Energy Technology Data Exchange (ETDEWEB)

    Byerly, Douglas [The Ohio State University College of Medicine and Public Health, Columbus, Ohio (United States); Coley, Brian [Columbus Children' s Hospital, Department of Radiology, Columbus, OH (United States); Ruymann, Frederick [Columbus Children' s Hospital, Section of Hematology/Oncology, Department of Pediatrics, Columbus, Ohio (United States)

    2006-07-15

    Wilms tumor typically presents as an abdominal mass, though occasionally patients present with other manifestations. We report a case of a child presenting with a perirenal hemorrhage and an initially occult Wilms tumor, found only on subsequent renal arteriography. Symptoms in this patient were caused by the presence of perirenal and subcapsular hemorrhage rather than the tumor itself. Despite an unusual presentation, we need to consider underlying neoplasia in children with renal hemorrhage and the absence of a history of trauma. Follow-up studies might help clarify initial negative imaging results. (orig.)

  12. Sternal Tuberculosis: An Uncommon Presentation

    OpenAIRE

    Manish Narang; Archana Dwivedi; Shiva Narang; Gopesh Mehrotra

    2011-01-01

    Primary tubercular osteomyelitis of sternum presenting as an acute swelling over chest is an extremely rare presentation in pediatric population. We herein report such a case which was diagnosed by CT scan showing lytic lesion and aspiration revealed positive culture for Mycobacterium tuberculosis. Child improved with antitubercular treatment.

  13. Sternal Tuberculosis: An Uncommon Presentation

    Directory of Open Access Journals (Sweden)

    Manish Narang

    2011-12-01

    Full Text Available Primary tubercular osteomyelitis of sternum presenting as an acute swelling over chest is an extremely rare presentation in pediatric population. We herein report such a case which was diagnosed by CT scan showing lytic lesion and aspiration revealed positive culture for Mycobacterium tuberculosis. Child improved with antitubercular treatment.

  14. Present status of processing method

    Energy Technology Data Exchange (ETDEWEB)

    Kosako, Kazuaki [Sumitomo Atomic Energy Industries Ltd., Tokyo (Japan)

    1998-11-01

    Present status of processing method for a high-energy nuclear data file was examined. The NJOY94 code is the only one available to the processing. In Japan, present processing used NJOY94 is orienting toward the production of traditional cross section library, because a high-energy transport code using a high-energy cross section library is indistinct. (author)

  15. Integrating Financial Analysis into Presentations

    Science.gov (United States)

    Saatci, Elizabeth

    2004-01-01

    Assignments that combine case studies with applied research can work for presentations as well as for written reports. One such assignment that has proven to be successful both in the author's classes and later in the students' professional lives is based on (1) incorporating banking concepts and encouraging their use in presentations; (2)…

  16. Neutrino astronomy: Present and future

    Indian Academy of Sciences (India)

    Thomas McCauley

    2006-10-01

    I briefly review the present and future status of the burgeoning field of neutrino astronomy. I outline the astrophysics and particle physics goals, design, and performance of the various current and proposed neutrino telescopes. Also described are present results and future expectations.

  17. Presentations of the SINS Symposium

    International Nuclear Information System (INIS)

    The goal of the symposium was presentation of the scientific researches performed at Soltan Institute for Scientific Research (SINS) as well as their far-reaching directions. Symposium was directed to all scientific workers of the SINS, invited specialist as well as to non-specialists. Presentations were performed mainly by young physicists (postgraduates and post-docs)

  18. Characteristics of patients initiating raloxifene compared to those initiating bisphosphonates

    Directory of Open Access Journals (Sweden)

    Wang Sara

    2008-12-01

    Full Text Available Abstract Background Both raloxifene and bisphosphonates are indicated for the prevention and treatment of postmenopausal osteoporosis, however these medications have different efficacy and safety profiles. It is plausible that physicians would prescribe these agents to optimize the benefit/risk profile for individual patients. The objective of this study was to compare demographic and clinical characteristics of patients initiating raloxifene with those of patients initiating bisphosphonates for the prevention and treatment of osteoporosis. Methods This study was conducted using a retrospective cohort design. Female beneficiaries (45 years and older with at least one claim for raloxifene or a bisphosphonate in 2003 through 2005 and continuous enrollment in the previous 12 months and subsequent 6 months were identified using a collection of large national commercial, Medicare supplemental, and Medicaid administrative claims databases (MarketScan®. Patients were divided into two cohorts, a combined commercial/Medicare cohort and a Medicaid cohort. Within each cohort, characteristics (demographic, clinical, and resource utilization of patients initiating raloxifene were compared to those of patients initiating bisphosphonate therapy. Group comparisons were made using chi-square tests for proportions of categorical measures and Wilcoxon rank-sum tests for continuous variables. Logistic regression was used to simultaneously examine factors independently associated with initiation of raloxifene versus a bisphosphonate. Results Within both the commercial/Medicare and Medicaid cohorts, raloxifene patients were younger, had fewer comorbid conditions, and fewer pre-existing fractures than bisphosphonate patients. Raloxifene patients in both cohorts were less likely to have had a bone mineral density (BMD screening in the previous year than were bisphosphonate patients, and were also more likely to have used estrogen or estrogen/progestin therapy in the

  19. Translation initiation in colorectal cancer.

    Science.gov (United States)

    Parsyan, Armen; Hernández, Greco; Meterissian, Sarkis

    2012-06-01

    Colorectal cancers (CRC) are one of the most common causes of morbidity and mortality in high-income countries. Targeted screening programs have resulted in early treatment and a substantial decrease in mortality. However, treatment strategies for CRC still require improvement. Understanding the etiology and pathogenesis of CRC would provide tools for improving treatment of patients with this disease. It is only recently that deregulation of the protein synthesis apparatus has begun to gain attention as a major player in cancer development and progression. Among the numerous steps of protein synthesis, deregulation of the process of translation initiation appears to play a key role in cancer growth and proliferation. This manuscript discusses a fascinating and rapidly growing field exploring translation initiation as a fundamental component in CRC development and progression and summarizing CRC treatment perspectives based on agents targeting translation initiation. PMID:22418835

  20. Quantum Measurement and Initial Conditions

    Science.gov (United States)

    Stoica, Ovidiu Cristinel

    2016-03-01

    Quantum measurement finds the observed system in a collapsed state, rather than in the state predicted by the Schrödinger equation. Yet there is a relatively spread opinion that the wavefunction collapse can be explained by unitary evolution (for instance in the decoherence approach, if we take into account the environment). In this article it is proven a mathematical result which severely restricts the initial conditions for which measurements have definite outcomes, if pure unitary evolution is assumed. This no-go theorem remains true even if we take the environment into account. The result does not forbid a unitary description of the measurement process, it only shows that such a description is possible only for very restricted initial conditions. The existence of such restrictions of the initial conditions can be understood in the four-dimensional block universe perspective, as a requirement of global self-consistency of the solutions of the Schrödinger equation.