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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. Primary hepatic carcinosarcoma

    Institute of Scientific and Technical Information of China (English)

    Mehmet Çelikbilek; Kemal Deniz; Edip Torun; Tarık Artış; Ersin Özaslan; Ökkeş İbrahim Karahan; Tahir Ercan Patıroğlu; Ömer Özbakır

    2011-01-01

    BACKGROUND: Primary hepatic carcinosarcoma is a rare malignant tumor containing an intimate mixture of carci-nomatous and sarcomatous elements. Reports on risk factors, epidemiology, and pathogenesis of the tumor as well as the experience in its treatment are limited. METHOD: We present a case of primary carcinosarcoma of the liver in a 69-year-old man who complained of right hypochondrial pain and weight loss for two months. RESULTS:  Magnetic resonance imaging revealed a 14×12 cm mass in segments 7-8 and 4 of the liver with vena hepatica invasion. An ultrasonography-guided biopsy showed osteoid tissue without osteoblastic rimming. Vascular structures accompanied the osteoid tissue. The patient underwent surgery after a diagnosis of hemangioma. Intraoperative frozen sections revealed a carcinosarcoma associated with an osteosarcoma and cholangiocellular carcinoma components. CONCLUSIONS: Preoperative diagnosis of this rare primary hepatic malignant tumor may be difficult by biopsy owing to intratumoral heterogeneity. Highly mature areas of the osteosarcomatous component may lead to misdiagnosis of metaplastic bone tissue. Clinicopathologic features of this rare entity are discussed.

  3. [Carcinosarcomas in female genital tracts: general review].

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    Guy, Jean-Baptiste; Trone, Jane-Chloé; Casteillo, François; Forest, Fabien; Pacaut, Cécile; Moncharmont, Coralie; Espenel, Sophie; Vallard, Alexis; Langrand Escure, Julien; Collard, Olivier; Peoc'h, Michel; Magné, Nicolas

    2014-01-01

    Carcinosarcoma, also known as mixed mesodermal tumor or malignant mixed Mullerian tumor (MMMT) is a pathological entity combining a sarcomatous and a carcinomatous component. Found in thoracic, digestive, genitourinary, liver or skin locations, the most common location is the female genital tract. In gynecological tumors, carcinosarcoma accounts for about 2-5% of endometrial cancers, and 1% of ovarian cancers. To date, there is no consensus on the therapeutic strategy. It relies mostly on maximum cytoreductive surgery. Adjuvant therapy remains controversial, and few prospective studies investigating its interest. Retrospective studies show the benefits of adjuvant chemotherapy based on platinum in most cases. Radiation therapy has a place in the adjuvant situations of endometrial and cervical carcinosarcoma. A more detailed pathological knowledge, and the use of targeted therapies may be promising in this histological subtype whose prognosis remains very poor. The objective of this study is to present the main principles of carcinosarcoma management in female genital tracts, describing pathological and prognostic features at the same time.

  4. Carcinosarcoma of the renal pelvis and urinary bladder: a case report

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    Yilmaz, Erkan; Birlik Bilge; Arican, Zumre; Guney, Soner [Dokuz Eylul University School of Medicine, Izmir (Turkmenistan)

    2003-12-15

    Carcinosarcomas are rare biphasic malignant neoplasms with epithelial and a spindle cell component. We present a 62-year-old man with a history of noticeably abdominal distension, proved by surgery to be caused by carcinosarcoma of the renal pelvis and urinary bladder, occupying the entire left abdominal flank. We also illustrate the appearance of this rare entity on sonography and computed tomography.

  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 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.

  8. Evaluation of Six Patients with Pulmonary Carcinosarcoma with a Literature Review

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    Sinem Nedime Sökücü

    2012-01-01

    Full Text Available Background. Carcinosarcoma of the lung is a rare malignant neoplasm. We evaluated the diagnosis and treatment of six carcinosarcoma cases, including a synchronous tumour and a solitary pulmonary tumour, along with the clinical and histological features and survival times. Methods. From a retrospective analysis of 1076 non-small-cell lung cancer resections performed between January 1996 and January 2011, six patients (0.5% with pulmonary carcinosarcoma (all males; mean age 58 years; range 53–66 who underwent surgical treatment were studied. Results. The mean tumour pathological T diameter was 7.2 cm (median 6 cm, range 3–14.5 cm. Only one patient was diagnosed with carcinosarcoma preoperatively. The clinical presentation and tumour localisations differed. The operations performed were a lobectomy (n=4, pneumonectomy (n=1, and bilobectomy (n=1. Histologically, the epithelial characteristics of the tumours were consistent with squamous cell carcinoma in most of the patients. A complete resection was performed in all six patients. No mortality occurred in the early postoperative period. The median survival time was 9 (3–25 months. Conclusion. The preoperative diagnosis of carcinosarcoma of the lung is difficult due to the composition of the different histopathological structures. Complete surgical resection is the treatment of choice for pulmonary carcinosarcoma, although further studies are needed.

  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. 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.

  11. Uterine carcinosarcoma in a patient with didelphys uterus.

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    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

  12. 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...

  13. Clinically aggressive “low-grade” uterine carcinosarcoma: A case report

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    Theresa Clearman; Adela Cimic; Ellenson, Lora H.; Divya Gupta

    2015-01-01

    Highlights • We present a case of uterine carcinoma with low-grade carcinomatous and sarcomatous components. • The tumor is likely a rare biphasic form of carcinosarcoma. • Molecular profiling suggests that it is a Type I endometrial cancer. • The tumor was extremely chemotherapy-resistant.

  14. 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.

  15. 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.

  16. 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

  17. Thyroid carcino-sarcoma in a dog

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    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...

  18. 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.

  19. 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

  20. 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.

  1. 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.

  2. 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.

  3. 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

  4. 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.

  5. 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.

  6. 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.

  7. The Natural History and Outcomes of the Patients with Carcinosarcoma Involving Kidney and Renal Pelvis

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    Jue Wang

    2011-01-01

    Full Text Available Background. The objective of this paper was to examine the epidemiology, natural history, and prognostic factors of carcinosarcoma of the kidney and renal pelvis (CSKP using population-based registry. Patients and Methods. Forty-three patients with CSKP, diagnosed between January 1973 and December 2007, were identified from the national Surveillance, Epidemiology, and End Results (SEER database and reviewed. Results. 79% of all patients with known SEER stage were classified as having regional or distant stage; almost all the patients with known histology grade had poorly or undifferentiated histology. The median cancer specific survival was 6 months (95% CI 4–9. The 1-year cancer-specific survival rate for entire cohort was 30.2%. There were no differences in terms of age at diagnosis, histological grade, tumor stage on presentation, and frequency of nephrectomy between carcinosarcoma of kidney (CSK or renal pelvis (CSP. In multivariate analysis, age at diagnosis, tumor stage, and year of diagnosis were found to be significant predictors for cancer-specific survival. Conclusion. CSKP commonly presented as high-grade, advanced stage disease, and was associated with a poor prognosis regardless of location.

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

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    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.

  9. Clinical Analysis of one Case Youth Primary Ovarian Carcinosarcoma%青年原发性卵巢癌肉瘤1例临床分析

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    刘忠宇; 赵恩锋; 刘春红; 乔江丽; 李晨星

    2012-01-01

    Objective: To improve the understanding of youth primary ovarian carcinosarcoma ,and explore the clinical features , diagnosis and therapy of ovarian carcinosarcoma. Method: A case report of youth primary ovarian carcinosarcoma and review relative literatures. Result: Primary ovarian carcinosarcoma may be associated with elevated CA125, mostly gastrointestinal symptoms onset, poor prognosis and rapid progress , Present mainly treatment is surgery and there is no effective on chemotherapy. Conclusion: Primary o-varian carcinosarcoma is a kind of rare , highly aggressive and highly malignant tumor , it is a variety of the mixed malignant mesodermal tumors. Mainly seen in postmenopausal women, 30 were extremely rare before the age of onset. Poor progress and low survival rate.%目的:提高对青年原发性卵巢癌肉瘤的认识,探讨原发性卵巢癌肉瘤的临床特点、诊断及治疗.方法:报道1例青年原发性卵巢癌肉瘤,并复习相关文献.结果:原发性卵巢癌肉瘤可伴有CA125的升高,多以消化道症状起病,预后差进展迅速,目前主要以手术治疗为主,没有有效的化疗方案.结论:原发性卵巢癌肉瘤为恶性混合性中胚层肿瘤中的一种,临床罕见,高度恶性,特异性临床表现少,病理活检为确诊手段,多见于绝经后妇女,30岁以前发病者罕见,预后差生存率低.

  10. 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

  11. Molecular markers and clinical behavior of uterine carcinosarcomas : focus on the epithelial tumor component

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    de Jonge, Renske A; Nijman, Hans W.; Wijbrandi, Tera F.; Reyners, Anna K. L.; Boezen, H. Marike; Hollema, Harry

    2011-01-01

    Carcinosarcomas (malignant mixed Mullerian tumors) of the uterus are rare and aggressive malignancies consisting of an epithelial (carcinoma) and a mesenchymal (sarcoma) tumor component and are considered as metaplastic endometrial carcinomas. This study evaluated molecular characteristics and clini

  12. 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.

  13. 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...

  14. Cardiac Tamponade as Initial Presentation of Hodgkin Lymphoma

    Directory of Open Access Journals (Sweden)

    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. Acute anterior uveitis as the initial presentation of alkaptonuria

    Directory of Open Access Journals (Sweden)

    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.

  16. Unusual initial presentation of herpes simplex virus as inguinal lymphadenopathy.

    Science.gov (United States)

    Fleming, Sarah A; Strickler, John G

    2015-01-01

    Genital herpes simplex virus (HSV) infections are a common cause of inguinal lymphadenopathy. However, surgical excision of enlarged inguinal nodes is almost never performed to initially diagnose genital herpes simplex virus, due to the distinct external presentation of genital herpetic vesicles that usually occur with the first symptoms of infection. Therefore, the histologic and immunophenotypic features of HSV-associated inguinal lymphadenopathy are unfamiliar to most pathologists. The current report describes the lymph node pathology of two immunocompetent patients, whose initial HSV diagnosis was established through surgical excision of enlarged inguinal lymph nodes. Histologic examination showed features consistent with viral lymphadenopathy, including florid follicular hyperplasia, monocytoid B-cell hyperplasia, and paracortical hyperplasia without extensive necrosis. Immunohistochemical stains for HSV antigens, using polyclonal anti-HSV I and II antibodies, demonstrate strong immunoreactivity for HSV in a small number of cells in the subcapsular sinuses, especially in areas with monocytoid B-cell hyperplasia. Rare scattered HSV-positive cells also are identified in paracortical areas and germinal centers. We conclude that an initial diagnosis of genital HSV infection may be established by inguinal lymph node biopsy.

  17. Unusual Initial Presentation of Herpes Simplex Virus as Inguinal Lymphadenopathy

    Directory of Open Access Journals (Sweden)

    Sarah A. Fleming

    2015-01-01

    Full Text Available Genital herpes simplex virus (HSV infections are a common cause of inguinal lymphadenopathy. However, surgical excision of enlarged inguinal nodes is almost never performed to initially diagnose genital herpes simplex virus, due to the distinct external presentation of genital herpetic vesicles that usually occur with the first symptoms of infection. Therefore, the histologic and immunophenotypic features of HSV-associated inguinal lymphadenopathy are unfamiliar to most pathologists. The current report describes the lymph node pathology of two immunocompetent patients, whose initial HSV diagnosis was established through surgical excision of enlarged inguinal lymph nodes. Histologic examination showed features consistent with viral lymphadenopathy, including florid follicular hyperplasia, monocytoid B-cell hyperplasia, and paracortical hyperplasia without extensive necrosis. Immunohistochemical stains for HSV antigens, using polyclonal anti-HSV I and II antibodies, demonstrate strong immunoreactivity for HSV in a small number of cells in the subcapsular sinuses, especially in areas with monocytoid B-cell hyperplasia. Rare scattered HSV-positive cells also are identified in paracortical areas and germinal centers. We conclude that an initial diagnosis of genital HSV infection may be established by inguinal lymph node biopsy.

  18. 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.

  19. 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

  20. 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

  1. Parotid gland carcinosarcoma with follicular dendritic cell sarcoma as mesenchymal component: a case report

    Institute of Scientific and Technical Information of China (English)

    LIU Qiang; ZHU Jian-shan; XU Yan-ping

    2005-01-01

    @@ The WHO has classified malignant mixed tumours of salivary glands into noninvasive carcinoma in pleomorphic adenoma, invasive carcinoma in pleomorphic adenoma, carcino-sarcoma and metastasizing mixed tumour.1 Carcinosarcoma, or true malignant mixed tumour, is a tumour composed of both carcinomatous and sarcomatous elements. It is an exceedingly rare tumour of the salivary glands and only about 60 cases have been reported.2 In this report we describe a case of carcinosarcoma of a parotid gland that contained an unusual mesenchymal component (follicular dendritic cell sarcoma, FDCS) in a 55-year-old man with cytological, histological and immunohistochemical findings. To our knowledge, this histological pattern has not been reported previously in the English literature.

  2. 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

  3. Carcinosarcoma of the liver with mesenchymal differentiation Shinichi Sumiyoshi, Masataka Kikuyama, Yuji Matsubayashi, Fujito Kageyama, Yoshihiro Ide,

    Institute of Scientific and Technical Information of China (English)

    Shinichi Sumiyoshi; Masataka Kikuyama; Yuji Matsubayashi; Fujito Kageyama; Yoshihiro Ide; Yoshimasa Kobayashi; Hirotoshi Nakamura

    2007-01-01

    We report an extremely rare case where a mesenchymal differentiation, especially embryonal sarcoma, was demonstrated in cholangiocarcinoma. At autopsy, a yellowish-white tumor (15 cm × 12 cm) was found in the right hepatic lobe, and there were several daughter nodules in both hepatic lobes. Histologically, most of the main tumor and all of the daughter nodules examined showed sarcomatous changes (spindle cells, pleomorphic cells and hyalization). Histologic examination of a part of the main tumor disclosed a focus of adenocarcinoma within the tumor. The frequent transitions between the adenocarcinomatous areas and the sarcomatous areas suggested that sarcomatous transformation occurred in the cholangiocarcinoma and then spread rapidly.Immunohistochemically, the adenocarcinomatous elements were positive for cytokeratin, carcinoembryonic antigen (CEA) and epithelial membrane antigen, and negative in the sarcomatous cells. Vimentin was positive only in the sarcomatous elements. The findings of the present case support the view that carcinosarcomas represent carcinomas that develop sarcomatous elements via metaplasia of the epithelial element.

  4. Cardiac arrhythmia as initial presentation of aneurysmal subarachnoid hemorrhage

    NARCIS (Netherlands)

    van der Kleij, FGH; Henselmans, JML; van de Loosdrecht, AA

    1999-01-01

    Cardiac arrhythmia and sudden death are most frequently caused by preexisting heart disease. Rarely, cardiac arrhythmia is a first symptom of an acute neurological event. We describe a patient with asystole and other cardiac arrhythmias, as initial symptoms of acute aneurysmal subarachnoid hemorrhag

  5. Molecular characteristics of two esophageal carcinosarcomas: a hint for theclonality of carcinomatic and sarcomatic tumor components

    Institute of Scientific and Technical Information of China (English)

    MH Sun; G Mechtersheimer; P Moellera; CH Herfarth; MV Knebel Doeberitz; HK Scharkert; T Lehnert; J Gebert

    2000-01-01

    AIM To study the clonality of the esophageal carcinosarcoma by using molecular approaches.METHODS Two esophageal carcinosarcomas were included in the study. Tumor area from dysplasticlesion, squamout cell carcinoma, basaloid cell carcinoma and spindle cell elements were microdissectedseparately. Each element was analyzed with 14 microsatellite markers and direct sequenced for p53 gene andras gene mutation.RESULTS Both tumors displayed a typical histologic feature of carcinosarcoma. Both cases showed thedivergent differentiation by immunohistochemistry study. In case 1 the identical LOH at p53 and hMLH1 lociwas detected. The heterogenous LOH was detected only in carcinosarcoma at RB1 and BRCA1 loci, whilethe LOH at ACTC locus was seen only in sarcoma. The same mutation of the splice site of exon 6-intron 6displayed in the two tumor elements. In case 2, a coordinate LOH at RB locus was demonstrated in threetypes of tumor elements: sqamous carcinoma, basaloid carcinoma and spindle cell element. A heterogenousLOH was seen only in spindle cells at TAP1 locus. No mutation in exon 5-8 of p53 gene has been found incase 2. No mutation of K-ras gene was found.CONCLUSION Although the different differentiation, the two elements of esophageal carcinosarcoma mayhave a single clonality. The p53 gene mutation occurred before the two differentiation directions switched.The distinct molecular genotype can be determined through molecular biological analysis. The microsatelliteprofiling can serve as an approach to find out which genetic alteration occurs before or after thedifferentiation is determines.

  6. 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.

  7. 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

  8. Citrobacter koseri Pneumonia As Initial Presentation of Underlying Pulmonary Adenocarcinoma

    Science.gov (United States)

    Pennington, Kelly; Van Zyl, Martin; Escalante, Patricio

    2016-01-01

    Citrobacter koseri is a motile, gram-negative rod traditionally known to cause infection in individuals with significant comorbidities and immunocompromised status. While most cases represent nosocomial infections, rarely community-acquired infections have been reported. We present a previously healthy man in his 60s with C. koseri pneumonia who was subsequently found to have underlying pulmonary adenocarcinoma, illustrating the need for further investigation for immunodeficiency and/or intrapulmonary pathology.

  9. 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.

  10. 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.

  11. Carcinoma lung presenting with choroidal metastasis as initial presentation: A rarity

    Directory of Open Access Journals (Sweden)

    Tapesh Bhattacharyya

    2013-01-01

    Full Text Available Diminished vision due to choroidal metastasis as the primary symptom of lung cancer is very uncommon. Here, we report such a presentation in a 54-year-old male patient of small cell lung cancer. The outcome is usually dismal with this kind of presentation. The patient received systemic chemotherapy as well as intravitreal bevacizumab but with no improvement in vision. The patient had been given external beam radiotherapy and showed subjective improvement in his ocular symptoms.

  12. p53 is not related to Ki-67 immunostaining in the epithelial and mesenchymal components of female genital tract carcinosarcomas.

    Science.gov (United States)

    Bałon, Beata; Kaznowska, Ewa; Ignatov, Atanas; Steć, Anna; Semczuk-Sikora, Anna; Schneider-Stock, Regine; Jóźwik, Maciej; Sulkowski, Stanisław; Cybulski, Marek; Szumiło, Justyna; Semczuk, Andrzej

    2013-10-01

    Carcinosarcomas (CSs) are composed of two separate histological components and are rare neoplasms of the female genital tract. Therefore, CS pathogenesis has not yet been fully elucidated. In the present study, immunohistochemical techniques were used to determine the role of p53 and Ki-67 overexpression in female genital tract CSs. The study group was comprised of 36 patients with CSs originating from the uterus (n=31), cervix (n=3) and ovary (n=2), as well as 3 metastatic tissues. p53 was overexpressed in the epithelial component of 23 out of 36 (64%) tumors, and in the mesenchymal component of 20 out of 36 (56%) tumors. In both CS components, there was a significant correlation between p53 overexpression and patient age and ovarian metastases. Ki-67 overexpression was detected in the epithelial component in 15 out of 36 (42%) cases, and in the mesenchymal component in 13 out of 36 (36%) neoplasms. There was a significant correlation of p53 overexpression between the carcinomatous and sarcomatous components (R=0.884, Ptumor components. In conclusion, based on immunohistochemical results, p53 was overexpressed in more than half of the female genital tract CSs included in the present study, either at the epithelial or mesenchymal component. The correlation between p53 or Ki-67 overexpression in both tumor components supports the combination theory of histogenesis in the majority of these tumors.

  13. 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.

  14. 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...

  15. 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

  16. Back to the Future: Estimating Initial Globular Cluster Masses from their Present Day Stellar Mass Functions

    CERN Document Server

    Webb, Jeremy J

    2015-01-01

    We use N-body simulations to model the 12 Gyr evolution of a suite of star clusters with identical initial stellar mass functions over a range of initial cluster masses, sizes, and orbits. Our models reproduce the distribution of present-day global stellar mass functions that is observed in the Milky Way globular cluster population. We find that the slope of a star cluster's stellar mass function is strongly correlated with the fraction of mass that the cluster has lost, independent of the cluster's initial mass, and nearly independent of its orbit and initial size. Thus, the mass function - initial mass relation can be used to determine a Galactic cluster's initial total stellar mass, if the initial stellar mass function is known. We apply the mass function - initial mass relation presented here to determine the initial stellar masses of 33 Galactic globular clusters, assuming an universal Kroupa initial mass function. Our study suggests that globular clusters had initial masses that were on average a factor...

  17. A COMPARATIVE PET STUDY USING DIFFERENT C-11 LABELED AMINO-ACIDS IN WALKER 256 CARCINOSARCOMA-BEARING RATS

    NARCIS (Netherlands)

    DAEMEN, BJG; ELSINGA, PH; ISHIWATA, K; PAANS, AMJ; VAALBURG, W

    1991-01-01

    In Walker 256 carcinosarcoma-bearing rats, the dynamic distribution of L-[1-C-11]tyrosine, L-[methyl-C-11]methionine, L-[1-C-11]methionine and D-[1-C-11]methionine has been measured by PET. An equivalent tumor-imaging potential was observed for each of the three L-amino acids. Thirty minutes after i

  18. 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.

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

    Directory of Open Access Journals (Sweden)

    Fuyuki Tateno

    2014-08-01

    Full Text Available 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.

  20. 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, ...

  1. Disseminated intravascular large-cell lymphoma with initial presentation mimicking Guillain-Barré syndrome.

    Science.gov (United States)

    Jiang, Qin Li; Pytel, Peter; Rowin, Julie

    2010-07-01

    We report a patient with intravascular large B-cell lymphoma who initially presented with acute ascending weakness and sensory changes. Electrodiagnostic testing and cerebral spinal fluid (CSF) studies were initially suggestive of a demyelinating polyneuropathy. Further clinical evaluation and testing were consistent with mononeuropathy multiplex. Autopsy revealed disseminated intravascular large-cell lymphoma. Intravascular large-cell lymphoma should be considered in the differential diagnosis of a rapidly evolving neuropathy associated with other organ involvement.

  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. 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.

  4. Renal Cell Carcinoma Initially Presenting as an Arteriovenous Malformation: A Case Presentation and a Review of the Literature

    Directory of Open Access Journals (Sweden)

    Samuel Volin

    2013-01-01

    Full Text Available We describe a case of a patient who presented with hematuria and was diagnosed with a renal arteriovenous malformation (AVM. Transcatheter arterial embolization subsequently was performed on this lesion multiple times. Follow-up imaging demonstrated that the AVM was masking an underlying, rapidly growing renal cell carcinoma (RCC. We describe the pathological and radiographic characteristics of AVMs and RCC. We describe the strengths and weaknesses of computed tomography (CT and magnetic resonance imaging (MRI to detect and characterize RCC and AVM. We recommend initial and follow-up MR imaging in patients with an AVM to establish a baseline, monitor treatment response, and survey lesions for underlying and obscured malignancy.

  5. 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...

  6. 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...

  7. An uncommon initial presentation of snake bite-subarachnoid hemorrhage: A case report with literature review

    OpenAIRE

    Manoj Kumar Roy; Joydip Dutta; Apratim Chatterjee; Anup Sarkar; Koushik Roy; Rakhesh Agarwal; Durjoy Lahiri; Amrito Biswas; Anupam Mondal; Pranab Maity; Jotideb Mukhopadhyay

    2015-01-01

    Snake bites are very common in India, particularly in West Bengal. Snake bite can cause various hematological, neuromyopathical complications. It can be very fatal if not detected and treated early. Timely intervention can save the patient. We are reporting a case of hematotoxic Russell viper snake bite presented with subarachnoid hemorrhage. Patient was successfully treated with antivenom serum (AVS) along with other conservative management. Subarachnoid hemorrhage as an initial presentation...

  8. 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...

  9. Decreased Vision as Initial Presenting Symptom of Acute Lymphoblastic Leukemia: A Case Report

    Directory of Open Access Journals (Sweden)

    Christoph Palme

    2016-07-01

    Full Text Available This case illustrates that hematologic disorders must be considered as a potentially life-threatening cause for vision loss. Proper laboratory workup and timely interdisciplinary approach are essential to ensure the best possible care for ophthalmic patients. Historically, before the use of bone marrow biopsy, the ophthalmologist was often asked to assist in the diagnosis of leukemia. Since ophthalmological symptoms may be the initial presenting signs of leukemia as highlighted in this case, the ophthalmogist is still of crucial importance.

  10. 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 ...

  11. [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 was diagnosed with a spinal cord tumour between Th3 and Th9. We suggest that spinal cord tumour should be considered in patients with increased intracranial pressure or hydrocephalus of unknown origin Udgivelsesdato: 2008/9/15...

  12. 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...

  13. [Neuromyelitis optica spectrum disorders as initial presentation of Sjögren's syndrome: A case report].

    Science.gov (United States)

    Alva Díaz, Carlos; Andamayo Villalba, Luis; Mori, Nicanor; Ventura Chilón, Jésica Janet; Romero, Roberto

    2016-02-29

    Neuromyelitis Optica Spectrum Disorder (NMOSD) is a rare systemic autoimmune disease which is sometimes found in association with other autoimmune disorders including Sjogren's syndrome. Neurological manifestations occur in 20% to 25% of diagnosed cases of Sjögren's syndrome; however, less than 5% of patients with Sjögren's syndrome have neurological manifestations as the initial presenting feature of Sjögren's syndrome. We report the case of an elderly female with longitudinal myelitis as a presenting feature who had positive antibody to aquaporin-4 (NMO-IgG) and Sjögren's syndrome.

  14. An uncommon initial presentation of snake bite-subarachnoid hemorrhage: A case report with literature review.

    Science.gov (United States)

    Roy, Manoj Kumar; Dutta, Joydip; Chatterjee, Apratim; Sarkar, Anup; Roy, Koushik; Agarwal, Rakhesh; Lahiri, Durjoy; Biswas, Amrito; Mondal, Anupam; Maity, Pranab; Mukhopadhyay, Jotideb

    2015-01-01

    Snake bites are very common in India, particularly in West Bengal. Snake bite can cause various hematological, neuromyopathical complications. It can be very fatal if not detected and treated early. Timely intervention can save the patient. We are reporting a case of hematotoxic Russell viper snake bite presented with subarachnoid hemorrhage. Patient was successfully treated with antivenom serum (AVS) along with other conservative management. Subarachnoid hemorrhage as an initial presentation in viper bite is very rare and we discuss the case with proper literature review. PMID:26425018

  15. An uncommon initial presentation of snake bite-subarachnoid hemorrhage: A case report with literature review

    Directory of Open Access Journals (Sweden)

    Manoj Kumar Roy

    2015-01-01

    Full Text Available Snake bites are very common in India, particularly in West Bengal. Snake bite can cause various hematological, neuromyopathical complications. It can be very fatal if not detected and treated early. Timely intervention can save the patient. We are reporting a case of hematotoxic Russell viper snake bite presented with subarachnoid hemorrhage. Patient was successfully treated with antivenom serum (AVS along with other conservative management. Subarachnoid hemorrhage as an initial presentation in viper bite is very rare and we discuss the case with proper literature review.

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

    Science.gov (United States)

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

    2015-06-01

    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 fracture who also underwent plain film or computed tomography (CT) imaging were retrospectively reviewed. The subjects were divided into intoxicated and sober groups. Patient characteristics, injury-to-presentation time, fracture location, and discrepancies between initial clinical and radiological evaluations were compared. Of 1286 subjects, 181 patients were included in the intoxicated group. Only intoxicated patients presented with head/neck fractures more than 24 hours after injury. The intoxicated group showed a higher rate of head/neck fractures (skull 23.2% vs 5.8%, face and orbit 30.4% vs 9.5%; P spinal fractures during this period. Alcohol-related injuries are more often associated with head/neck fractures but less extremity injuries. The rate of fractures missed by emergency physicians but later diagnosed by radiologists was the same in intoxicated and sober patients. PMID:26091471

  19. 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.

  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. 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

  2. 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.

  3. Outcome and Predictive Factors in Uterine Carcinosarcoma Using Postoperative Radiotherapy: A Rare Cancer Network Study.

    Science.gov (United States)

    Zwahlen, Daniel R; Schick, Ulrike; Bolukbasi, Yasemin; Thariat, Juliette; Abdah-Bortnyak, Roxolyana; Kuten, Abraham; Igdem, Sefik; Caglar, Hale; Ozsaran, Zeynep; Loessl, Kristina; Belkaaloul, Kaouthar Khanfir; Villette, Sylviane; Vees, Hansjörg

    2016-06-28

    Uterine carcinosarcomas (UCS) are rare tumors. Consensus regarding therapeutic management in non-metastatic disease is lacking. This study reports on outcome and predictive factors when using postoperative radiotherapy. We analyzed a retrospective analysis in 124 women treated between 1987-2007 in the framework of the Rare-Cancer-Network. Median follow-up was 27 months. Postoperative pelvic EBRT was administered in 105 women (85%) and 92 patients (74%) received exclusive or additional vaginal brachytherapy. Five-year overall survival (OS), disease-free survival (DFS), cancer specific survival (CSS) and locoregional control (LRC) were 51.6% (95% CI 35-73%), 53.7% (39-71%), 58.6% (38-74%) and 48% (38-67%). Multivariate analysis showed that external beam radiation therapy (EBRT) >50Gy was an independent prognostic factor for better OS (P=0.03), CSS (P=0.02) and LRC (P=0.01). Relative risks (RR) for better OS (P=0.02), DFS (P=0.04) and LRC (P=0.01) were significantly associated with younger age (≤60 years). Higher brachytherapy (BT)-dose (>9Gy) improved DFS (P=0.04) and LRC (P=0.008). We concluded that UCS has high systemic failure rate. Local relapse was reduced by a relative risk factor of over three in all stages of diseases when using higher doses for EBRT and brachytherapy. Postoperative RT was most effective in UCS stage I/II-diseases. PMID:27441069

  4. 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\\

  5. Budd-Chiari syndrome as an initial presentation of hepatocellular carcinoma: a case report.

    Science.gov (United States)

    Bălăceanu, Lavinia Alice; Diaconu, Camelia Cristina; Aron, Gheorghiţa

    2014-06-01

    We report the case of a 84-year-old admitted with symptoms of congestive heart failure. Ultrasonography revealed a hyperechoic nodule in the left lobe of the liver, with a peripheral hypoechoic rim, multiple irregular hypoechoic nodules in both hepatic lobes, portal vein, inferior vena cava, and right atrium thrombosis. On ultrasonographic and alpha-fetoprotein criteria the case was interpreted as hepatocellular carcinoma with Budd-Chiari syndrome. The particularity of the case is the initial presentation of the hepatocellular carcinoma as Budd-Chiari syndrome. The inferior vena cava and right atrium thrombosis, as a cause of secondary Budd-Chiari syndrome in a patient with hepatocellular carcinoma, has been rarely reported.

  6. Acrometastasis as the Initial Presentation of aKRAS-Positive Colon Cancer

    Directory of Open Access Journals (Sweden)

    Helen Gharwan

    2012-07-01

    Full Text Available The propensity of colon cancer to metastasize to bones is very low compared to prostate, breast or lung cancer. The reason for this is not yet understood, although an explanation for the osteotropism of certain primaries has been offered by the ‘seed and soil’ concept, suggesting that the bone microenvironment provides a favorable ‘soil’ for metastasis and proliferation of some tumor cells (‘seeds’ [1]. Here, we report an unusual case of colon cancer with metastasis to the finger at initial presentation, and exophytic sclerotic lesions to other bones. The incidence of metastases to fingers/toes (acrometastases is reported to be only 0.1%, even after including involvement of primary sites other than the colon. The etiology and characteristics of acrometastases are reviewed in this case report.

  7. 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

  8. 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

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

    Science.gov (United States)

    Erdem, Ilknur; Elbasan Omar, Senay; Ali, Ridvan Kara; Gunes, Hayati; Topkaya, Aynur Eren

    2016-01-01

    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.

  10. [Carcinosarcoma of the breast a rare entity with fatal prognosis. One case report].

    Science.gov (United States)

    Villalón-López, José Sebastián; Souto-del Bosque, Rosalía; Alonso-Briones, Marco Vinicio; Trujillo-de Anda, Ana Patricia

    2013-01-01

    Antecedentes: los carcinomas metaplásticos de la glándula mamaria son un grupo heterogéneo de neoplasias con pobre pronóstico en comparación con el carcinoma ductal invasor. Corresponden a menos de 1% del total de las neoplasias malignas de la glándula mamaria. Casi siempre se manifiestan como tumores de alto grado con menor índice de metástasis ganglionares y menor expresión de receptores de estrógeno y progesterona, Her2 y mayor expresión de Her1 y Ki-67. Caso clínico: se reporta el caso de una mujer de 52 años de edad con carcinosarcoma mamario que se manifiesta con un tumor mamario izquierdo, fungado, ulcerado, polipoide, de 18 cm de diámetro, con metástasis ganglionares al momento del diagnóstico. Recibió tratamiento multimodal con quimioterapia neoadyuvante seguida de mastectomía y quimioterapia complementaria; evolucionó con metástasis pulmonares y recurrencia local masiva. Falleció por complicaciones derivadas de la enfermedad.Conclusiones: los carcinomas metaplásticos de la glándula mamaria son padecimientos sumamente raros. Debido a la naturaleza de la enfermedad y su forma de presentación el pronóstico es pobre. Existen varios subtipos histológicos basados en estudios de hematoxilina y eosina o tinciones de inmunohistoquímica. El tratamiento debe ser multimodal (cirugía, radioterapia y quimioterapia) para obtener mejores resultados.

  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. Fulminate hepatic failure as an initial presentation of non-hodgkin lymphoma: a case report.

    Science.gov (United States)

    Ahmadi, Bizhan; Shafieipour, Sara; Akhavan Rezayat, Kambiz

    2014-04-01

    Viral hepatitis and toxins comprise most common causes of fulminate hepatic failure that are often diagnosed with standard laboratory tests. Herein we discuss a rare, difficult to diagnosis etiology of acute liver failure (ALF). A 62-year-old man presented with a two-week history of fever and fatigue. At four days before admission he became lethargic. His past medical and drug histories were unremarkable. Physical examination revealed generalized jaundice, fever and loss of consciousness. Laboratory tests showed elevated liver transaminases with direct hyper-bilirubinemia. Abdominal ultrasonography and CT scan showed hepatosplenomegaly and para-aortic abdominal lymphadenopathy. A further work-up included liver biopsy. The histopathology and imunohistochemistry was compatible with diffuse large B-cell lymphoma. He underwent high dose glucocorticoid therapy but his condition deteriorated rapidly and he died eight days after admission. ALF as an initial manifestation of malignant hepatic infiltration is extremely rare yet should be considered in all patients with unknown hepatic failure that are highly suspicious for malignant neoplasm.

  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. 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

  16. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  18. 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.

  19. 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.

  20. 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.

  1. 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

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

    Directory of Open Access Journals (Sweden)

    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

  3. 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

  4. 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

  5. Bilateral sudden sensorineural hearing loss as an initial presentation of myelodysplastic syndrome.

    Science.gov (United States)

    Lee, Eun Jung; Yoon, Yong Joo

    2012-01-01

    This study reports an unusual case in which myelodysplastic syndrome presented bilateral sudden sensorineural hearing loss as the first symptom of the disease. The aural symptoms and signs such as tinnitus, dizziness, and hearing impairment of a hematologic disease are common. However, sudden hearing loss as the first manifestation of a hematologic disease is extremely rare. A 76-year-old woman presented with bilateral sudden hearing loss. The patient was found to have myelodysplastic syndrome during a workup for her hearing loss. Unfortunately, the patient's hearing loss did not improve after the medical treatment.

  6. 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

  7. 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…

  8. Bilateral Acromioclavicular Septic Arthritis as an Initial Presentation of Streptococcus pneumoniae Endocarditis

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    Neda Hashemi-Sadraei

    2014-01-01

    Full Text Available Infective endocarditis (IE is infrequently associated with septic arthritis. Moreover, septic arthritis of the acromioclavicular (AC joint is rarely reported in the literature. We report a case of Streptococcus pneumoniae IE in a patient who presented with bilateral AC joint septic arthritis and we review the literature on the topic.

  9. 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

  10. 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.

  11. 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...

  12. 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...

  13. 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...

  14. 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...

  15. 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...

  16. 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...

  17. Bilateral optic nerve edema presenting as initial manifestation of thyroid eye disease.

    Science.gov (United States)

    Wilson, Michelle E; Kim, Charles; Carrasco, Jacqueline

    2016-10-01

    A 48-year-old smoker with a history of hyperthyroidism treated 10 years prior to presentation with radioactive iodine ablation of the thyroid gland presented to his ophthalmologist with a 2-week history of transient loss of vision in the right eye occurring for 1 to 2 hours each morning. He denied ocular pain, diplopia or change in the prominence of one or both eyes. Examination revealed 2 mm of relative proptosis on the right, bilateral temporal flare and lower lid retraction. There was minimal upper lid retraction and no evidence of lid lag. Ocular motility was full. Dilated fundoscopic examination revealed bilateral optic nerve edema, right more than left. CT of the orbit demonstrated enlargement of the extraocular muscles bilaterally with marked enlargement of the right medial rectus and left inferior rectus muscles resulting in crowding at the orbital apex bilaterally. Laboratory testing revealed the patient to be hyperthyroid. The patient was treated with high dose oral steroids followed by orbital radiation. Hyperthyroidism was managed by the patient's primary care physician. Visual symptoms rapidly improved with oral steroids and orbital radiation. Optic nerve edema completely resolved. Repeat CT imaging demonstrated a reduction in the enlargement of the extraocular muscles with relief of bilateral optic nerve compression.

  18. 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.

  19. Systemic immunoglobulin light-chain amyloidosis presenting hematochezia as the initial symptom.

    Science.gov (United States)

    Kon, Tetsuo; Nakagawa, Naoki; Yoshikawa, Fumitsugu; Haba, Kazunao; Kitagawa, Nagako; Izumi, Michihiro; Kumazaki, Setsuo; Ishida, Satoshi; Aikawa, Ryuichi

    2016-08-01

    Immunoglobulin light-chain (AL) amyloidosis is characterized by the deposition of insoluble fibrils composed of immunoglobulin light chains secreted by monoclonal plasma cells. Given the recent advances in the therapy of AL amyloidosis, it is important to diagnose this disease as early as possible. Herein, we describe the case of a 62-year-old man with hepatitis C virus (HCV)-related cirrhosis presenting with hematochezia. Colonoscopy showed multiple submucosal hematomas within the region ranging from the transverse colon to the sigmoid colon. Kappa immunoglobulin light-chain amyloid deposition was also detected. Bone marrow examination revealed a monoclonal abnormal plasma cell population. Thus, the patient was diagnosed with systemic immunoglobulin light-chain amyloidosis. The hematochezia was conservatively managed. However, because of liver failure caused by liver cirrhosis, the patient developed massive pleural effusion and died of respiratory failure. Postmortem examination revealed amyloid deposition in the esophagus, stomach, duodenum, ileum, descending colon, pancreas, heart, and lung. In these organs, amyloid deposition was limited to the vascular wall. We concluded that AL amyloidosis can present hematochezia arising from submucosal hematoma in the large colon before other systemic symptoms appear.

  20. Systemic immunoglobulin light-chain amyloidosis presenting hematochezia as the initial symptom.

    Science.gov (United States)

    Kon, Tetsuo; Nakagawa, Naoki; Yoshikawa, Fumitsugu; Haba, Kazunao; Kitagawa, Nagako; Izumi, Michihiro; Kumazaki, Setsuo; Ishida, Satoshi; Aikawa, Ryuichi

    2016-08-01

    Immunoglobulin light-chain (AL) amyloidosis is characterized by the deposition of insoluble fibrils composed of immunoglobulin light chains secreted by monoclonal plasma cells. Given the recent advances in the therapy of AL amyloidosis, it is important to diagnose this disease as early as possible. Herein, we describe the case of a 62-year-old man with hepatitis C virus (HCV)-related cirrhosis presenting with hematochezia. Colonoscopy showed multiple submucosal hematomas within the region ranging from the transverse colon to the sigmoid colon. Kappa immunoglobulin light-chain amyloid deposition was also detected. Bone marrow examination revealed a monoclonal abnormal plasma cell population. Thus, the patient was diagnosed with systemic immunoglobulin light-chain amyloidosis. The hematochezia was conservatively managed. However, because of liver failure caused by liver cirrhosis, the patient developed massive pleural effusion and died of respiratory failure. Postmortem examination revealed amyloid deposition in the esophagus, stomach, duodenum, ileum, descending colon, pancreas, heart, and lung. In these organs, amyloid deposition was limited to the vascular wall. We concluded that AL amyloidosis can present hematochezia arising from submucosal hematoma in the large colon before other systemic symptoms appear. PMID:27318996

  1. 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

  2. Incidental Discovery of a Testicular Plasmacytoma at Initial Presentation of Multiple Myeloma

    Directory of Open Access Journals (Sweden)

    Amanda R. Hathaway

    2013-01-01

    Full Text Available Testicular plasmacytomas are a rare phenomenon reported in the literature and they can occur as a solitary plasmacytoma, as a recurrence of multiple myeloma, or concurrently in an active myeloma. We report the case of a 43-year-old man who presented with back pain and was diagnosed with multiple myeloma. A CT scan performed to determine the extent of disease revealed an incidental mass in the testicle. Immunohistochemical staining of the mass revealed monoclonal cytolpasmic IgA in the tumor cells and serum studies showed this same immunoglobulin. Following orchiectomy, radiotherapy to the vertebra, chemotherapy with bortezomib, dexamethasone, and doxorubicin, and an autologous bone marrow transplant, the patient is alive twelve months after diagnosis and is in complete remission.

  3. 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

  4. [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

  5. [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.

  6. Cervical Cord Compression as Initial Presentation of Papillary Thyroid Carcinoma: a Case Report.

    Science.gov (United States)

    Selvakumar, Veda Padma Priya; Goel, Ashish; Kumar, Kapil

    2016-09-01

    Cervical cord compression secondary to extension of a long standing papillary thyroid carcinoma as well as multiple cases of distal cord compression from occult follicular thyroid carcinoma have been reported. But cervical cord compression from Papillary Thyroid Carcinoma has not been reported so far. Forty eight year old lady presented with progressive quadriparesis of 2 months duration. MRI of the cervical spine showed destructive lesion with soft tissue component in vertebral bodies and posterior elements of C4-C6 vertebrae with cord compression along with a large thyroid mass extending to retrosternal region likely malignant. USG guided FNAC & Biopsy of thyroid lesion was inconclusive. She underwent Preoperative Selective angioembolisation for vertebral metastasis followed by total thyroidectomy with cervical cord decompression, bone grafting and plating. HPE reported follicular variant of Papillary Thyroid carcinoma. Four weeks postoperatively she underwent radioiodine ablation by 263 mci of I 131. She then received palliative EBRT to cervical and dorsal spine 30 Gy/10 fractions. She is alive and neurologically stable at 6 months follow up. Papillary thyroid carcinoma has an excellent prognosis. Hence a prompt management of primary disease and aggressive approach to metastatic lesion may prolong survival and allow favorable prognosis. PMID:27651699

  7. Acute Myocardial Infarction with Left Ventricular Failure as an Initial Presentation of Takayasu's Arteritis.

    Science.gov (United States)

    Saxena, Amrish; Sontakke, Tushar R; Mishra, Deepankar; Saxena, Shilpa; Banode, Pankaj

    2016-05-01

    Takayasu's Arteritis (TA) is an uncommon chronic inflammatory and stenotic disease of medium and large-sized arteries characterized by a strong predilection for the aortic arch and its major branches. We report a rare manifestation of TA in a 16-year-old female with no previous history of heart disease who presented with heart failure. She was found to have hypertension and discrepancies of pulses in upper and lower limbs. She developed ST elevated anterior wall myocardial infarction (MI) during hospitalization. Her aortography revealed narrowing of descending thoracic, upper abdominal and infrarenal aorta with significant stenosis of both renal arteries. She was diagnosed as a case of TA on the basis of her clinical profile and arteriography. Her coronary angiography did not reveal any stenosis or occlusion or aneurysm in coronary arteries or at coronary ostia which is in contrast to patients of TA with MI reported in the literature who had focal or diffuse stenosis or aneurysm in the coronaries. PMID:27437287

  8. Acute Myocardial Infarction with Left Ventricular Failure as an Initial Presentation of Takayasu’s Arteritis

    Science.gov (United States)

    Sontakke, Tushar R; Mishra, Deepankar; Saxena, Shilpa; Banode, Pankaj

    2016-01-01

    Takayasu’s Arteritis (TA) is an uncommon chronic inflammatory and stenotic disease of medium and large-sized arteries characterized by a strong predilection for the aortic arch and its major branches. We report a rare manifestation of TA in a 16-year-old female with no previous history of heart disease who presented with heart failure. She was found to have hypertension and discrepancies of pulses in upper and lower limbs. She developed ST elevated anterior wall myocardial infarction (MI) during hospitalization. Her aortography revealed narrowing of descending thoracic, upper abdominal and infrarenal aorta with significant stenosis of both renal arteries. She was diagnosed as a case of TA on the basis of her clinical profile and arteriography. Her coronary angiography did not reveal any stenosis or occlusion or aneurysm in coronary arteries or at coronary ostia which is in contrast to patients of TA with MI reported in the literature who had focal or diffuse stenosis or aneurysm in the coronaries. PMID:27437287

  9. 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

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

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    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.

  11. 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.

  12. 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

  13. Bronchiolitis Obliterans Organizing Pneumonia as an Initial Presentation of Systemic Lupus Erythematosus: A Rare Case Report and Literature Review

    Science.gov (United States)

    Wang, Hung-Ping; Chen, Chun-Ming; Chen, Yih-Yuan; Chen, Wei

    2016-01-01

    The etiology of bronchiolitis obliterans organizing pneumonia (BOOP) remains controversial. While it has been reportedly associated with several connective tissue disorders, there are only rare reports of BOOP associated with systemic lupus erythematosus (SLE). Herein, we report a 56-year-old female patient who presented with dyspnea on exertion, cough, fever, and joint pain of her left wrist and fingers as initial symptoms. Laboratory tests revealed positivity for anti-nuclear antibody, anti-Ro, and anti-double strand DNA antibody. In this case, the patient with SLE had respiratory illness as the initial symptom due to BOOP in the absence of clear etiology. The diagnosis of BOOP was confirmed by thoracic surgery biopsy. Her respiratory symptoms and radiologic findings significantly improved following prednisolone treatment. PMID:27200095

  14. 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.)

  15. Disseminated Cryptococcal Infection Resulting in Acute Respiratory Distress Syndrome (ARDS) as the Initial Clinical Presentation of AIDS.

    Science.gov (United States)

    Orsini, Jose; Blaak, Christa; Tam, Eric; Rajayer, Salil; Morante, Joaquin

    2016-01-01

    Cryptococcosis is a cosmopolitan but rare opportunistic mycosis which is usually caused by Cryptococcus neoformans. Although the most common and worrisome disease manifestation is meningoencephalitis, pulmonary cryptococcosis has the potential to be lethal. The diagnosis of cryptococcal pneumonia is challenging, given its non-specific clinical and radiographic features. Respiratory failure leading to acute respiratory distress syndrome as a consequence of cryptococcal disease has been infrequently addressed in the literature. We herein present a case of disseminated cryptococcal infection leading to acute respiratory distress syndrome, refractory shock, and multiorgan dysfunction as the initial clinical manifestation in a patient who was newly diagnosed with acquired immunodeficiency syndrome. PMID:27086819

  16. Cross-sectional analysis of late HAART initiation in Latin America and the Caribbean: late testers and late presenters.

    Directory of Open Access Journals (Sweden)

    Brenda Crabtree-Ramírez

    Full Text Available BACKGROUND: Starting HAART in a very advanced stage of disease is assumed to be the most prevalent form of initiation in HIV-infected subjects in developing countries. Data from Latin America and the Caribbean is still lacking. Our main objective was to determine the frequency, risk factors and trends in time for being late HAART initiator (LHI in this region. METHODOLOGY: Cross-sectional analysis from 9817 HIV-infected treatment-naïve patients initiating HAART at 6 sites (Argentina, Chile, Haiti, Honduras, Peru and Mexico from October 1999 to July 2010. LHI had CD4(+ count ≤200 cells/mm(3 prior to HAART. Late testers (LT were those LHI who initiated HAART within 6 months of HIV diagnosis. Late presenters (LP initiated after 6 months of diagnosis. Prevalence, risk factors and trends over time were analyzed. PRINCIPAL FINDINGS: Among subjects starting HAART (n = 9817 who had baseline CD4(+ available (n = 8515, 76% were LHI: Argentina (56%[95%CI:52-59], Chile (80%[95%CI:77-82], Haiti (76%[95%CI:74-77], Honduras (91%[95%CI:87-94], Mexico (79%[95%CI:75-83], Peru (86%[95%CI:84-88]. The proportion of LHI statistically changed over time (except in Honduras (p≤0.02; Honduras p = 0.7, with a tendency towards lower rates in recent years. Males had increased risk of LHI in Chile, Haiti, Peru, and in the combined site analyses (CSA. Older patients were more likely LHI in Argentina and Peru (OR 1.21 per +10-year of age, 95%CI:1.02-1.45; OR 1.20, 95%CI:1.02-1.43; respectively, but not in CSA (OR 1.07, 95%CI:0.94-1.21. Higher education was associated with decreased risk for LHI in Chile (OR 0.92 per +1-year of education, 95%CI:0.87-0.98 (similar trends in Mexico, Peru, and CSA. LHI with date of HIV-diagnosis available, 55% were LT and 45% LP. CONCLUSION: LHI was highly prevalent in CCASAnet sites, mostly due to LT; the main risk factors associated were being male and older age. Earlier HIV-diagnosis and earlier treatment initiation are needed

  17. 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.

  18. A case of MCTD overlapped by Takayasu's arteritis, presenting Raynaud's phenomenon as the initial manifestation of both diseases.

    Science.gov (United States)

    Lim, Mie Jin; Kwon, Seong Ryul; Kim, Sang Gu; Park, Won

    2009-04-01

    Raynaud's phenomenon is characteristic three-phase color change of digits that occurs when hands are exposed to cold and subsequently rewarmed. Raynaud's phenomenon has many possible causes, but evaluation tends to focus on a few notorious etiologies, such as, connective tissue diseases. Thus, having reached a diagnosis, detailed physical exam to rule out other possible causes is often not performed. The authors present a case of mixed connective tissue disease (MCTD) and Takayasu's arteritis overlap in a woman, who showed Raynaud's phenomenon as an initial manifestation. She was first diagnosed as having MCTD, but her treatment did not improve the persistent Raynaud's phenomenon. Several years later, follow-up chest CT showed underlying Takayasu's arteritis and a subsequent physical examination revealed that typical abnormalities consistent with Takayasu's arteritis were present. The authors advocate thorough history taking and complete physical examinations on a routine basis to help unearth other underlying causes.

  19. Elevated Lipase during Initial Presentation of Ulcerative Colitis in a Pediatric Patient: Do We Check for It

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    Piyali Ray

    2016-10-01

    Full Text Available There are very few reports of elevated lipase in pediatric inflammatory bowel disease (IBD. Symptoms of pancreatitis may be masked by abdominal pain in pediatric IBD. During the initial presentation of IBD in our patient, lipase was elevated to more than 3 times the upper limit of normal. Normalization of values coincided with remission of IBD. This may be due to extraintestinal involvement of the pancreas as part of the inflammatory process or due to leakage of pancreatic enzymes from an inflamed gut or mediated by inflammatory cytokines. Checking pancreatic enzymes during initial presentation of IBD may, therefore, be important to determine if pancreatic involvement has resulted from the inflammation in IBD or as an adverse effect of therapy. If unchecked, recurrent subclinical pancreatitis may be masked by IBD symptoms and missed prior to starting IBD therapy. This may result in chronic pancreatic insufficiency as reported in 50% of adults with IBD. Early detection of elevated pancreatic enzymes in IBD may help direct the management strategy, as treatment of the underlying inflammation in IBD may be the most important management for resolution of pancreatitis instead of cessation of therapy for fear of iatrogenic medication-induced pancreatitis.

  20. 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

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

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    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.

  2. Risk factors for late-stage HIV disease presentation at initial HIV diagnosis in Durban, South Africa.

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    Paul K Drain

    Full Text Available After observing persistently low CD4 counts at initial HIV diagnosis in South Africa, we sought to determine risk factors for late-stage HIV disease presentation among adults.We surveyed adults prior to HIV testing at four outpatient clinics in Durban from August 2010 to November 2011. All HIV-infected adults were offered CD4 testing, and late-stage HIV disease was defined as a CD4 count <100 cells/mm(3. We used multivariate regression models to determine the effects of sex, emotional health, social support, distance from clinic, employment, perceived barriers to receiving healthcare, and foregoing healthcare to use money for food, clothing, or housing ("competing needs to healthcare" on presentation with late-stage HIV disease.Among 3,669 adults screened, 830 were enrolled, newly-diagnosed with HIV and obtained a CD4 result. Among those, 279 (33.6% presented with late-stage HIV disease. In multivariate analyses, participants who lived ≥5 kilometers from the test site [adjusted odds ratio (AOR 2.8, 95% CI 1.7-4.7], reported competing needs to healthcare (AOR 1.7, 95% CI 1.2-2.4, were male (AOR 1.7, 95% CI 1.2-2.3, worked outside the home (AOR 1.5, 95% CI 1.1-2.1, perceived health service delivery barriers (AOR 1.5, 95% CI 1.1-2.1, and/or had poor emotional health (AOR 1.4, 95% CI 1.0-1.9 had higher odds of late-stage HIV disease presentation.Independent risk factors for late-stage HIV disease presentation were from diverse domains, including geographic, economic, demographic, social, and psychosocial. These findings can inform various interventions, such as mobile testing or financial assistance, to reduce the risk of presentation with late-stage HIV disease.

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

    Directory of Open Access Journals (Sweden)

    Rashmi Patel

    Full Text Available 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.Retrospective cohort study using anonymised electronic mental health record data from the South London and Maudsley NHS Foundation Trust (SLaM Biomedical Research Centre (BRC Case Register on 1364 adults diagnosed with bipolar disorder between 2007 and 2012. The following predictor variables were analysed in a multivariable Cox regression analysis: age, gender, ethnicity, compulsory admission to hospital under the UK Mental Health Act, marital status and other diagnoses prior to bipolar disorder. The outcomes were time to recorded diagnosis from first presentation to specialist mental health services (the diagnostic delay, and time to the start of appropriate therapy (treatment delay.The median diagnostic delay was 62 days (interquartile range: 17-243 and median treatment delay was 31 days (4-122. Compulsory hospital admission was associated with a significant reduction in both diagnostic delay (hazard ratio 2.58, 95% CI 2.18-3.06 and treatment delay (4.40, 3.63-5.62. Prior diagnoses of other psychiatric disorders were associated with increased diagnostic delay, particularly alcohol (0.48, 0.33-0.41 and substance misuse disorders (0.44, 0.31-0.61. Prior diagnosis of schizophrenia and psychotic depression were associated with reduced treatment delay.Some individuals experience a significant delay in diagnosis and treatment of bipolar disorder after initiation of specialist mental healthcare, particularly those who have prior diagnoses of alcohol and substance misuse disorders. These findings highlight a need for further study on strategies to better identify underlying symptoms and offer appropriate treatment

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

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    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. 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

  6. 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

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

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    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.

  8. 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)

  9. 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.

  10. 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

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    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.

  11. Iron deficiency anemia as initial presentation of a non-small cell lung carcinoma: A case report

    NARCIS (Netherlands)

    P.V.M. Linsen (Philip V.M.); V.M.J. Linsen (Victor M.J.); G. Buunk (Gerba); D.E. Arnold (Dorothee E.); J.G.J.V. Aerts (Joachim)

    2015-01-01

    textabstractDuodenal metastases secondary to lung cancer are very rare and most of the time asymptomatic. When symptomatic they usually present with bowel obstruction or perforation. We here describe the case of a 68 year-old man with a solitary metastasis in the duodenum from a non-small cell lung

  12. Docetaxel for non small cell lung cancer harboring the activated EGFR mutation with T790M at initial presentation

    Directory of Open Access Journals (Sweden)

    Yamane H

    2013-03-01

    Full Text Available Hiromichi Yamane,1 Nobuaki Ochi,1 Masayuki Yasugi,2 Takayuki Tabayashi,1 Tomoko Yamagishi,1 Yasumasa Monobe,3 Akiko Hisamoto,4 Katsuyuki Kiura,4 Nagio Takigawa1 1Department of General Internal Medicine 4, Kawasaki Medical School, Okayama, Japan; 2Department of Respiratory Medicine, National Hospital Organization Fukuyama Medical Center, Fukuyama, Japan; 3Department of Pathology, Kawasaki Medical School Kawasaki Hospital, Okayama, Japan; 4Department of Hematology, Oncology, and Respiratory Medicine, Okayama University Graduate School of Medicine, Okayama, Japan Abstract: A 72-year-old woman was referred to our hospital with Stage IV non-small-cell lung cancer (NSCLC. Chest computed tomography revealed a mass in the upper lobe of the right lung, with pleural effusion. Cytologic examination identified adenocarcinoma cells in the right pleural effusion. Furthermore, both a deletion mutation in exon 19 and a threonine–methionine substitution mutation at position 790 in exon 20 (T790M were detected in the epidermal growth factor receptors (EGFR in the malignant cells. As systemic chemotherapy consisting of carboplatin and pemetrexed or erlotinib proved ineffective, docetaxel monotherapy was initiated as a third-line treatment. Following salvage chemotherapy, her Eastern Cooperative Oncology Group performance status improved from 3 to 1, with tumor regression over 5 months. To the best of our knowledge, this is the first report of successful docetaxel treatment for a patient with NSCLC harboring the T790M EGFR-activating mutation identified before treatment with EGFR tyrosine kinase inhibitors. Keywords: non-small-cell lung cancer, EGFR mutation, pretreatment mutation, T790M, docetaxel

  13. Clinical analysis of 12 cases of ovarian carcinosarcoma%卵巢癌肉瘤12例临床分析

    Institute of Scientific and Technical Information of China (English)

    朱安娜; 李俊东; 冯艳玲; 徐漫漫; 庄圆

    2011-01-01

    To evaluate the clinicalpathological characteristics, treatment and prognosis of ovarian carcinosarcorma. Methods The clinical, pathological and follow-up data of 12 cases of ovarian carcinosarcoma treated in Cancer Center of Sun Yat-sen University from May, 2002 to May, 2009 were analyzed retrospectively. Results The 12 patients with ovarian carcinosarcoma had a median age of 55 years at diagnosis, among whom 10 were postmenopausal women. The patients sought medical attention for such symptoms as pelvic and/or abdominal pain, abdominal distention and ascites. Ten patients showed elevated serum CA125 level ad admission, and postoperative chemotherapy resulted in lowered CA125 level within normal range in 7 of them; in 8 cases, CA125 level increased with disease recurrence. Pelvic mass was found by such imaging examinations as CT, MRI and ultrasound in all cases. A definite diagnosis was obtained by postoperative pathological examination. All the patients received surgical resection and platinum-based adjuvant chemotherapy. Two patients achieved disease-free survival after the treatment. Disease relapse occurred in 10 cases within 2 years after surgery, among whom 2 showed disease remission after a secondary surgery and/or chemotherapy, and 1 was receiving chemotherapy; death occurred in 5 cases, and 2 cases were lost to the follow-up. Conclusions Ovarian carcinosarcoma has a poor prognosis. Primary surgery and platinum-based postoperative adjuvant chemotherapy is the main treatment for ovarian carcinosarcoma. The prognosis of ovarian carcinosarcoma is associated with the residual disease after surgery. The patients with disease recurrence may obtain remission and survival through a secondary surgery and/or chemotherapy. Serum CA125 can be used as a marker for monitoring the chemotherapeutic effect in clinical observation and follow-up visits.%目的 探讨卵巢癌肉瘤的临床特征、治疗方法及预后.方法 收集中山大学肿瘤防治中心2002年5

  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 tubercul......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...

  15. 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.

  16. 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)

  17. 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

  18. 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...

  19. 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.)

  20. 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.

  1. 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.

  2. Isolated Mass-Forming IgG4-Related Cholangitis as an Initial Clinical Presentation of Systemic IgG4-Related Disease.

    Science.gov (United States)

    Kim, Seokhwi; Bae, Hyunsik; Choi, Misun; Kim, Binnari; Heo, Jin Seok; Kim, Ho Seong; Choi, Seung Hee; Jang, Kee-Taek

    2016-07-01

    IgG4-related disease (IgG4-RD) may involve multiple organs. Although it usually presents as diffuse organ involvement, localized mass-forming lesions have been occasionally encountered in pancreas. However, the same pattern has been seldom reported in biliary tract. A 61-year-old male showed a hilar bile duct mass with multiple enlarged lymph nodes in imaging studies and he underwent trisectionectomy under impression of cholangiocarcinoma. Gross examination revealed a mass-like lesion around hilar bile duct. Histopathologically, dense lymphoplasmacytic infiltration and storiform fibrosis were identified without evidence of malignancy. Immunohistochemical stain demonstrated rich IgG4-positive plasma cell infiltration. Follow-up imaging studies disclosed multiple enlarged lymph nodes with involvement of pancreas and perisplenic soft tissue. The lesions have been significantly reduced after steroid treatment, which suggests multi-organ involvement of systemic IgG4-RD. Here, we report an unusual localized mass-forming IgG4-related cholangitis as an initial presentation of IgG4-RD, which was biliary manifestation of systemic IgG4-related autoimmune disease.

  3. Isolated Mass-Forming IgG4-Related Cholangitis as an Initial Clinical Presentation of Systemic IgG4-Related Disease.

    Science.gov (United States)

    Kim, Seokhwi; Bae, Hyunsik; Choi, Misun; Kim, Binnari; Heo, Jin Seok; Kim, Ho Seong; Choi, Seung Hee; Jang, Kee-Taek

    2016-07-01

    IgG4-related disease (IgG4-RD) may involve multiple organs. Although it usually presents as diffuse organ involvement, localized mass-forming lesions have been occasionally encountered in pancreas. However, the same pattern has been seldom reported in biliary tract. A 61-year-old male showed a hilar bile duct mass with multiple enlarged lymph nodes in imaging studies and he underwent trisectionectomy under impression of cholangiocarcinoma. Gross examination revealed a mass-like lesion around hilar bile duct. Histopathologically, dense lymphoplasmacytic infiltration and storiform fibrosis were identified without evidence of malignancy. Immunohistochemical stain demonstrated rich IgG4-positive plasma cell infiltration. Follow-up imaging studies disclosed multiple enlarged lymph nodes with involvement of pancreas and perisplenic soft tissue. The lesions have been significantly reduced after steroid treatment, which suggests multi-organ involvement of systemic IgG4-RD. Here, we report an unusual localized mass-forming IgG4-related cholangitis as an initial presentation of IgG4-RD, which was biliary manifestation of systemic IgG4-related autoimmune disease. PMID:26755360

  4. 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

  5. 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

  6. Southern Cone Initiative for the elimination of domestic populations of Triatoma infestans and the interruption of transfusion Chagas disease: historical aspects, present situation, and perspectives

    Directory of Open Access Journals (Sweden)

    João Carlos Pinto Dias

    2007-10-01

    Full Text Available Created in 1991 by the governments of Argentina, Bolivia, Brazil, Chile, Paraguay, and Uruguay, the Southern Cone Initiative (SCI has been extremely important for Chagas disease control in this region. Its basic objective was to reach the interruption of this disease, chiefly by means of the elimination of the principal vector Triatoma infestans and by the selection of safe donors in the regional blood banks. After a summarized historic of SCI, the text shows the advance of technical and operative activities, emphasizing some factors for the initiative success, as well as some difficulties and constraints. The future of SCI will depend of the continuity of the actions and of political priority. Scientific community has been highly responsible for this initiative and its maintenance. At the side of this, national and international efforts must be involved and reinforced to assure the accomplishment of the final targets of SCI. Very specially, the Pan American Health Organization has cooperated with the Initiative in all its moments and activities,being the most important catalytic and technical factor for SCI success.

  7. Southern Cone Initiative for the elimination of domestic populations of Triatoma infestans and the interruption of transfusional Chagas disease. Historical aspects, present situation, and perspectives.

    Science.gov (United States)

    Dias, João Carlos Pinto

    2007-10-30

    Created in 1991 by the governments of Argentina, Bolivia, Brazil, Chile, Paraguay, and Uruguay, the Southern Cone Initiative (SCI) has been extremely important for Chagas disease control in this region. Its basic objective was to reach the interruption of this disease, chiefly by means of the elimination of the principal vector Triatoma infestans and by the selection of safe donors in the regional blood banks. After a summarized historic of SCI, the text shows the advance of technical and operative activities, emphasizing some factors for the initiative success, as well as some difficulties and constraints. The future of SCI will depend of the continuity of the actions and of political priority. Scientific community has been highly responsible for this initiative and its maintenance. At the side of this, national and international efforts must be involved and reinforced to assure the accomplishment of the final targets of SCI. Very specially, the Pan American Health Organization has cooperated with the Initiative in all its moments and activities,being the most important catalytic and technical factor for SCI success.

  8. 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.''

  9. 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.

  10. 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

  11. 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.

  12. 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.

  13. 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)

  14. 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...

  15. RHUM-RUM, a Large-Scale Effort to Seismologically Image a Mantle Plume Under the Reunion Hotspot: Experiment Presentation and Initial Results

    Science.gov (United States)

    Sigloch, K.; Barruol, G.

    2014-12-01

    RHUM-RUM is a German-French geophysical experiment based on the seafloor and on islands surrounding the hotspot of La Réunion, western Indian Ocean. Its primary objective is to clarify the presence or absence of a mantle plume beneath the Reunion hotspot, which is thought to have first pierced the surface 65 million years ago with the eruption of the Deccan Traps on India. RHUM-RUM's central component is a one-year deployment (Oct 2012 - Nov 2013) of 57 broadband ocean-bottom seismometers (OBS) and hydrophones on an area of 2000x2000 km2 surrounding the hotspot. All OBS have been successfully recovered. We also have been operating 37 land seismometers on the islands of La Réunion, Mauritius, Rodrigues, southern Seychelles, îles Eparses, and on Madagascar between 2011 and 2014. As the data collection stage is drawing to a close, we discuss data yield and quality with respect to RHUM-RUM's primary purpose (passive seismological imaging through all depth levels of the mantle) and secondary applications ("environmental seismology" in a sparsely instrumented area, e.g., tracking of tropical cyclones). We give an overview of the research questions investigated by the RHUM-RUM group, and present preliminary results.

  16. INITIAL AND PRESENT SITUATION OF FOOD CONTAMINATION IN JAPAN AFTER THE ACCIDENT AT THE FUKUSHIMA DAI-ICHI NUCLEAR POWER PLANT.

    Science.gov (United States)

    Aono, Tatsuo; Yoshida, Satoshi; Akashi, Makoto

    2016-09-01

    The accident at the Fukushima Dai-ichi Nuclear Power Plant (NPP) in March 2011 affected not only the terrestrial environment of Fukushima prefecture and the surrounding area, but also the marine area facing the NPP. Our present study is focused on the concentrations of radionuclides in agricultural products of Fukushima and sea-foods collected off Fukushima after the accident. The regulation value for radiocesium in vegetables, meat and fish was revised from 500 Bq/kg-wet to 100 Bq/kg-wet on 1 April 2012. The overall activity of radiocesium in these products was found to be within the limit of tolerance in respect to Japanese and also international regulations, but there is still radiocesium found at activities greater than this level in edible wild plants, wild mushrooms and game such as boar meat. Although the activities of radionuclides exceeding the regulatory limits were not detected in marine products collected off Fukushima after April 2015, the commercial marine fishery has not received approval in the affected areas except for certain species. We learned from the Fukushima accident that long-term kinetic studies of radionuclides in terrestrial and marine environments is extremely important for prevention of internal contamination, since contamination with radionuclides occurs via the food chain in the environment.

  17. 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

  18. 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

  19. 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

  20. Initial Study

    DEFF Research Database (Denmark)

    Torp, Kristian

    2009-01-01

    Congestion is a major problem in most cities and the problem is growing (Quiroga, 2000) (Faghri & Hamad, 2002). When the congestion level is increased the drivers notice this as delays in the traffic (Taylor, Woolley, & Zito, 2000), i.e., the travel time for the individual driver is simply...... 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...

  1. 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

  2. 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

  3. 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.

  4. 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

  5. CATCHY PRESENTATIONS

    DEFF Research Database (Denmark)

    Eriksen, Kaare; Tollestrup, Christian; Ovesen, Nis

    2011-01-01

    An important competence for designers is the ability to communicate and present ideas and proposals for customers, partners, investors and colleagues. The Pecha Kucha principle, developed by Astrid Klein and Mark Dytham, has become a widely used and easy format for the presentation of new concepts...... 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...

  6. 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

  7. Information Presentation

    Science.gov (United States)

    Holden, Kritina L.; Thompson, Shelby G.; Sandor, Aniko; McCann, Robert S.; Kaiser, Mary K.; Adelstein, Barnard D.; Begault, Durand R.; Beutter, Brent R.; Stone, Leland S.; Godfroy, Martine

    2009-01-01

    The goal of the Information Presentation Directed Research Project (DRP) is to address design questions related to the presentation of information to the crew. In addition to addressing display design issues associated with information formatting, style, layout, and interaction, the Information Presentation DRP is also working toward understanding the effects of extreme environments encountered in space travel on information processing. Work is also in progress to refine human factors-based design tools, such as human performance modeling, that will supplement traditional design techniques and help ensure that optimal information design is accomplished in the most cost-efficient manner. The major areas of work, or subtasks, within the Information Presentation DRP for FY10 are: 1) Displays, 2) Controls, 3) Procedures and Fault Management, and 4) Human Performance Modeling. The poster will highlight completed and planned work for each subtask.

  8. 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

  9. 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

  10. Voting Present

    Directory of Open Access Journals (Sweden)

    James Lo

    2013-12-01

    Full Text Available During his time as a state senator in Illinois, Barack Obama voted “Present” 129 times, a deliberate act of nonvoting that subsequently became an important campaign issue during the 2008 presidential elections. In this article, I examine the use of Present votes in the Illinois state senate. I find evidence that Present votes can largely be characterized as protest votes used as a legislative tool by the minority party. Incorporating information from Present votes into a Bayesian polytomous item-response model, I find that this information increases the efficiency of ideal point estimates by approximately 35%. There is little evidence of significant moderation by Obama when Present votes are accounted for, though my results suggest that Obama’s voting record may have moderated significantly before his subsequent election to the U.S. Senate. My results also suggest that because legislative nonvoting may occur for a variety of reasons, naive inclusion of nonvoting behavior into vote choice models may lead to biased results.

  11. Policy and Practice in Initial Teacher Training. Quality in Basic Education: Professional Development of Teachers. Papers Presented at a South Asian Colloquium on Teacher Training (Colombo, Sri Lanka, April 1992).

    Science.gov (United States)

    Thomas, Elwyn

    This publication is one of two prepared for a South Asian colloquium on issues related to teacher training in Bangladesh, India, Pakistan, and Sri Lanka. This volume includes four papers presented at the conference. The papers present an analytical view of both policy and practical measures on teacher education. The first paper, "The Professional…

  12. 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

  13. 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...

  14. Overview Presentation

    Science.gov (United States)

    Lytle, John

    2001-01-01

    This report provides an overview presentation of the 2000 NPSS (Numerical Propulsion System Simulation) Review and Planning Meeting. Topics include: 1) a background of the program; 2) 1999 Industry Feedback; 3) FY00 Status, including resource distribution and major accomplishments; 4) FY01 Major Milestones; and 5) Future direction for the program. Specifically, simulation environment/production software and NPSS CORBA Security Development are discussed.

  15. 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...

  16. Technical presentation

    CERN Multimedia

    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

  17. The Yekaterinburg headache initiative

    DEFF Research Database (Denmark)

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

    2013-01-01

    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...... 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 initiative...

  18. 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.

  19. 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.

  20. Two patients with osteoporosis : initial presentation of systemic mastocytosis

    NARCIS (Netherlands)

    Donker, Marjolein L.; Bakker, Nicolaas A.; Jaspers, Wim J. M.; Verhage, Albert H.

    2008-01-01

    In two patients with osteoporosis, systemic mastocytosis ultimately turned out to be the underlying disease. Both patients had a history of anaphylactic reactions caused by wasp stings but did not have any skin or other symptoms. This observation reflects the need for careful history taking and phys

  1. Best Practices & Outstanding Initiatives

    Science.gov (United States)

    Training, 2011

    2011-01-01

    In this article, "Training" editors recognize innovative and successful learning and development programs and practices. They share best practices from Automatic Data Processing, Inc., Farmers Insurance Group, FedEx Express, InterContinental Hotels Group, and Oakwood Temporary Housing. They also present the outstanding initiatives of EMD Serono,…

  2. Win-win initiatives

    Energy Technology Data Exchange (ETDEWEB)

    Specter, Herschel

    1999-03-01

    This paper explores the use of win-win initiatives as a means of making safety improvements while simultaneously reducing plant operating costs. A two-phased process for implementing these initiatives is provided. Near-term progress is emphasized in the first phase by using presently available information. The second phase addresses complex issues such as closure in the regulatory process, modernizing the role of determinism in decisionmaking, closer coupling of performance-based regulation and risk-informed regulation, modernizing the testing of important plant equipment, and the treatment of uncertainties.

  3. Initial conditions for inflation

    CERN Document Server

    Dimopoulos, Konstantinos

    2016-01-01

    A novel proposal is presented, which manages to overcome the initial conditions problem of inflation with a plateau. An earlier period of proto-inflation, beginning at Planck scale, accounts for the Universe expansion and arranges the required initial conditions for inflation on the plateu to commence. We show that, if proto-inflation is power-law, it does not suffer from any eternal inflationary stage. A simple model realisation is constructed in the context of $\\alpha$-attractors, which can both generate the inflationary plateau and the exponential slopes around it, necessary for the two inflation stages. Our mechanism allows to assume chaotic initial conditions at the Planck scale for proto-inflation, it is generic and it is shown to work without fine-tunings.

  4. 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)

  5. 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.

  6. 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.

  7. 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.

  8. 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

  9. 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...

  10. 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

  11. 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.

  12. 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

  13. 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...

  14. Wilson's Disease Presenting With Pancytopenia

    OpenAIRE

    Acıpayam, Can; Altunay, Ali; Nilüfer İLHAN; Atçı, Nesrin

    2015-01-01

    Wilson’s disease is an autosomal recessive disorder of copper metabolism characterized by excessive amount of copper in liver, brain, eye and other body tissues. Diagnosis is based on the presence of Kayser-Fleischer rings, typical neurological symptoms, and/or a low serum ceruloplasmin concentration. The main clinical symptoms are usually due to hepatic and/or neurologic involvement. Pancytopenia is a rare initial symptom of Wilson Disease. An 11-year-old female presented with pancytopenia. ...

  15. 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...

  16. 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

  17. 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.

  18. 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.

  19. 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.

  20. 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…

  1. 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

  2. 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

  3. 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.

  4. 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

  5. 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...

  6. 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...

  7. 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.

  8. RAS Initiative - Events

    Science.gov (United States)

    The NCI RAS Initiative has organized multiple events with outside experts to discuss how the latest scientific and technological breakthroughs can be applied to discover vulnerabilities in RAS-driven cancers.

  9. 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...

  10. 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....

  11. 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.

  12. Organizing MHC Class II Presentation

    Directory of Open Access Journals (Sweden)

    David R Fooksman

    2014-04-01

    Full Text Available Major histocompatibility complex (MHC class II molecules are ligands for CD4+ T cells and are critical for initiating the adaptive immune response. This review is focused on what is currently known about MHC class II organization at the plasma membrane of antigen presenting cells and how this affects antigen presentation to T cells. The organization and diffusion of class II molecules have been measured by a variety of biochemical and microscopic techniques. Membrane lipids and other proteins have been implicated in MHC class II organization and function. However, when compared with the organization of MHC class I or TCR complexes, much less is known about MHC class II. Since clustering of T cell receptors occurs during activation, the organization of MHC molecules prior to recognition and during synapse formation may be critical for antigen presentation.

  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. CubeSat Launch Initiative

    Science.gov (United States)

    Higginbotham, Scott

    2016-01-01

    The National Aeronautics and Space Administration (NASA) recognizes the tremendous potential that CubeSats (very small satellites) have to inexpensively demonstrate advanced technologies, collect scientific data, and enhance student engagement in Science, Technology, Engineering, and Mathematics (STEM). The CubeSat Launch Initiative (CSLI) was created to provide launch opportunities for CubeSats developed by academic institutions, non-profit entities, and NASA centers. This presentation will provide an overview of the CSLI, its benefits, and its results.

  15. 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.

  16. 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)

  17. 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...

  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. 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

  20. 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.

  1. 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...

  2. 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

  3. 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

  4. 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.

  5. 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

  6. 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.

  7. Presentism meets black holes

    CERN Document Server

    Romero, Gustavo E

    2014-01-01

    Presentism is, roughly, the metaphysical doctrine that maintains that whatever exists, exists in the present. The compatibility of presentism with the theories of special and general relativity was much debated in recent years. It has been argued that at least some versions of presentism are consistent with time-orientable models of general relativity. In this paper we confront the thesis of presentism with relativistic physics, in the strong gravitational limit where black holes are formed. We conclude that the presentist position is at odds with the existence of black holes and other compact objects in the universe. A revision of the thesis is necessary, if it is intended to be consistent with the current scientific view of the universe.

  8. 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 a...

  9. 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...

  10. 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.

  11. 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…

  12. 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...

  13. 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).

  14. 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.

  15. 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)

  16. Fostering oral presentation performance

    NARCIS (Netherlands)

    Ginkel, van Stan; Gulikers, Judith; Biemans, Harm; Mulder, Martin

    2016-01-01

    Previous research revealed significant differences in the effectiveness of various feedback sources for encouraging students’ oral presentation performance. While former studies emphasised the superiority of teacher feedback, it remains unclear whether the quality of feedback actually differs bet

  17. 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.

  18. 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...

  19. 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...

  20. 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.

  1. 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.

  2. 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...

  3. 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.

  4. 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.

  5. 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.)

  6. 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.

  7. Industrial energy initiatives; Initiatives energetiques industrielles

    Energy Technology Data Exchange (ETDEWEB)

    Lach, P. [Gestion Lach Inc., Anjou, PQ (Canada)

    2003-09-01

    The energy intensive Parmalat dairy processing plant located in Victoriaville, Quebec, produces butter, milk powder, margarine, cheese and condensed milk. Significant energy savings were realized in the past two years through modifications to the production system and by developing energy recovery projects. This paper presents a brief overview of the various projects implemented at the Parmalat dairy processing plant. An economizer was installed on the milk powder dryer which typically used only 50 per cent of the heat to evaporate water from the milk. Careful consideration was given to the selection of the heating medium, Glycol was chosen because it met all the requirements of the food transformation industry. Annual energy savings are estimated at $100,000, at a cost of $125,000 (including equipment and installation costs), for a payback period of 15 months. A better pumping system for the condensed milk increased the return rate by 10 per cent. In addition, the installation of a recovery pipe to preheat water going to an instantaneous water heater resulted in a 10 per cent reduction in steam requirements. Other ongoing projects involve a better electric energy management system, and the implementation of a preventive maintenance program for steam traps.

  8. 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.

  9. 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.

  10. 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.

  11. 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

  12. 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.

  13. [Atypical presentation of preeclampsia].

    Science.gov (United States)

    Ditisheim, A; Boulvain, M; Irion, O; Pechère-Bertschi, A

    2015-09-01

    Preeclampsia is a pregnancy-related syndrome, which still represents one of the major causes of maternal-fetal mortality and morbidity. Diagnosis can be made difficult due to the complexity of the disorder and its wide spectrum of clinical manifestations. In order to provide an efficient diagnostic tool to the clinician, medical societies regularly rethink the definition criteria. However, there are still clinical presentations of preeclampsia that escape the frame of the definition. The present review will address atypical forms of preeclampsia, such as preeclampsia without proteinuria, normotensive preeclampsia, preeclampsia before 20 weeks of gestation and post-partum preeclampsia.

  14. The Earth: Present Scenario

    OpenAIRE

    Nishad Gopal Deshpande

    2009-01-01

    In this article, the present scenario of our motherly loved planet ‘Earth’ is presented. We are living in one of the most developed phases of the Earth’s life cycle. The choices we make today will determine the life on the Earth, tomorrow. Problems that are been created by us and the consequences we are going to face are discussed in length. Some statistical data is provided to get a brief idea. Measure/prevention(s) to combat the upcoming problems have been putforth.

  15. 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

  16. 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

  17. Tuberculosis endometritis presenting as a leiomyoma.

    Science.gov (United States)

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

    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. PMID:25780530

  18. 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.

  19. 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)

  20. 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.)

  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. 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.

  3. Creating Meaningful Multimedia Presentations

    NARCIS (Netherlands)

    Hardman, L.; Ossenbruggen, J.R. van

    2006-01-01

    Finding relevant information is one step in the chain of understanding information. Presenting material to a user in a suitable way is a further step. Our research focuses on using semantic annotations of multimedia elements to increase the ”presentability” of retrieved info

  4. 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…

  5. The Persistence of Presentism

    Science.gov (United States)

    Hargreaves, Andy; Shirley, Dennis

    2009-01-01

    Background/Context: This study draws on the voluminous research on teachers' workplace orientations and especially on Dan Lortie's documentation of conservatism, individualism, and presentism among teachers. Purpose/Objective/Research Question/Focus of Study: This study investigated a school reform network of over 300 secondary schools entitled…

  6. 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.)

  7. 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)

  8. 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.

  9. 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

  10. 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.

  11. Analyzing in the present

    DEFF Research Database (Denmark)

    Revsbæk, Line; Tanggaard, Lene

    2015-01-01

    the interdependency between researcher and researched. On this basis, we advocate an explicit “open-state-of mind” listening as a key aspect of analyzing qualitative material, often described only as a matter of reading transcribed empirical materials, reading theory, and writing. The article contributes......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...

  12. 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 [...

  13. 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...

  14. 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, ...

  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. 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.

  17. 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.

  18. 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.

  19. 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.

  20. UNLV Nuclear Hydrogen Initiative

    Energy Technology Data Exchange (ETDEWEB)

    Hechanova, Anthony E.; Johnson, Allen; O' Toole, Brendan; Trabia, Mohamed; Peterson, Per

    2012-10-25

    Evaluation of the Crack growth rate (CGR) of Alloy 617 and Alloy 276 under constant K at ambient temperature has been completed. Creep deformation of Alloy 230 at different temperature range and load level has been completed and heat to heat variation has been noticed. Creep deformation study of Alloy 276 has been completed under an applied initial stress level of 10% of yield stress at 950ºC. The grain size evaluation of the tested creep specimens of Alloy 276 has been completed.

  1. 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

  2. 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).

  3. 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.

  4. 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

  5. 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

  6. 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.

  7. Hibernoma - an unusual presentation

    Directory of Open Access Journals (Sweden)

    Amitabh Jena

    2013-04-01

    Full Text Available Hibernomas are rare benign tumours of brown adipose tissue. They are usually encountered in young males usually in their third decade of life. A 50-year-old lady presented with a swelling over the right forearm region that was soft, nontender and was gradually increasing in size over the last one year. The patient underwent surgical excision of the mass which was confirmed to be hibernoma (mixed variant. This case is being reported for documenting the occurrence of hibernoma in a rare location (forearm and in an older women aged 50 years.

  8. 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.

  9. 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....

  10. 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.

  11. 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

  12. 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

  13. Global cancer research initiative

    Directory of Open Access Journals (Sweden)

    Richard R Love

    2010-05-01

    Full Text Available Richard R LoveThe Ohio State University Comprehensive Cancer Center, Columbus, OH, USAAbstract: Cancer is an increasing problem for low- and middle-income countries undergoing an epidemiologic transition from dominantly acute communicable disease to more frequent chronic disease with increased public health successes in the former domain. Progress against cancer in high-income countries has been modest and has come at enormous expense. There are several well-conceived global policy and planning initiatives which, with adequate political will, can favorably impact the growing global cancer challenges. Most financial resources for cancer, however, are spent on diagnosis and management of patients with disease in circumstances where specific knowledge about effective approaches is significantly limited, and the majority of interventions, other than surgery, are not cost-effective in resource-limited countries by global standards. In summary, how to intervene effectively on a global scale for the majority of citizens who develop cancer is poorly defined. In contrast to technology-transfer approaches, markedly increased clinical research activities are more likely to benefit cancer sufferers. In these contexts, a global cancer research initiative is proposed, and mechanisms for realizing such an effort are suggested.Keywords: breast cancer, research, global, international, low-income, middle-income

  14. 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.

  15. 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

  16. 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...

  17. 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.

  18. 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...

  19. Presenting practice financial information.

    Science.gov (United States)

    Webster, Lee Ann H

    2007-01-01

    Medical practice leadership teams, often consisting primarily of physicians with limited financial backgrounds, must make important business decisions and continuously monitor practice operations. In order to competently perform this duty, they need financial reports that are relevant and easy to understand. This article explores financial reporting and decision-making in a physician practice. It discusses reports and tools, such as ratios, graphs, and comparisons, that practices typically include in their reports. Because profitability and cash flow are often the most important financial considerations for physician practices, reports should generally focus on the impact of various activities and potential decisions upon these concerns. This article also provides communication tips for both those presenting practice financial information and those making the decisions. By communicating effectively, these leaders can best use financial information to improve decision-making and maximize financial performance. PMID:17974087

  20. 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

  1. Giving effective presentations.

    Science.gov (United States)

    Englehart, Nadine

    2004-03-01

    Apprehension about oral communication, or public speaking is rated as the number one fear among most individuals. Developing skill in, and comfort with, public speaking is important whether we are presenting oral reports and proposals, responding to questions, or training co-workers. Effective speakers are able to communicate information in a way that stimulates interest, helps the audience to understand and remember, and influences attitudes and behaviours. Many of us think that effective speakers are born rather than made. In truth most successful speakers work hard and invest a great deal of time and effort in to improving their speaking capabilities. Effective public speaking is a learned skill and activity that requires lots of practice. Like other learned skills, having a strategy with clear action steps can help you achieve your goal. PMID:15116467

  2. 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.

  3. 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

  4. 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.

  5. The Knowledge Stealing Initiative?

    Science.gov (United States)

    Goshorn, Larry

    2005-01-01

    I have the honor of being on the Academy of Program and Project Leadership (APPL) Knowledge Sharing Feedback and Assessment Team (FAA), and as such, I am privileged to receive the feedback written by many of you as attendees of the Project Management (PM) Master s Forums. It is the intent of the FAA Team and APPL leadership to use this feedback as a tool for continuous program improvement. As a retired (sort of) PM in the payload contracting industry, I'm a big supporter of NASA s Knowledge Sharing Initiative (KSI), especially the Master's Forums. I really enjoy participating in them. Unfortunately I had to miss the 8th forum in Pasadena this past Spring, but I did get the feedback package for the Assessment Team work. So here I was, reviewing twelve pages of comments, reflections, learning notes and critiques from attendees of the 8th forum.

  6. 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.

  7. The Ombudperson Initiative Group

    CERN Document Server

    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...

  8. 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

  9. 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.

  10. 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...

  11. THE UPSIDE OF PRESENTISM

    Directory of Open Access Journals (Sweden)

    Lynn Fendler

    2009-01-01

    Full Text Available El presentismo es visto generalmente como un mal necesario en historiografía. Este artículo explora lo positivo de esta inevitabilidad. Aplicando un enfoque filosófico al análisis discursivo en la tradición de la nueva historia cultural, se distingue -de una parte-¿ entre un uso estratégico del presentismo, y -de otra- un enfoque racionalista en historia. El artículo concluye considerando algunas implicaciones políticas en historiografía de las explicaciones racionalistas y de las explicaciones estratégicamente presentistas. Los modos de comprensión racionalistas inscriben las expectativas del pasado en las visiones del futuro; asignando al historiador el papel de profeta; y perpetuando nociones de agentes ahistóricos. En contraste, las historias estratégicamente presentistas incorporan una orientación que deliberadamente emplea las lentes y perspectivas del presente en orden a tener en cuenta supuestos y perspectivas actuales. Cuando las asunciones son examinadas en relación a las perspectivas presentistas, dichos presupuestos sueltan su rienda en el pensamiento. Dado que el presentismo es inevitable, no debe ser desestimado por completo, sino que debe ser una cuestión sondeada y examinada críticamente. Con dicho foco, el presentismo estratégico en la historiografía debe posibilitar una reflexión sobre los límites de lo que es posible pensar.

  12. 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.

  13. 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.

  14. 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

  15. 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

  16. MONTANA PALLADIUM RESEARCH INITIATIVE

    Energy Technology Data Exchange (ETDEWEB)

    Peters, John

    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

  17. 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

  18. 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.

  19. 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.

  20. 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.

  1. 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.

  2. 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...

  3. 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

  4. Crystallography: past and present

    Science.gov (United States)

    Hodeau, J.-L.; Guinebretiere, R.

    2007-12-01

    structure (chemical order, anisotropy, charge transfer, magnetic order) versus an external parameter like temperature, pressure, magnetic or electric field. Modern crystallography is also extended to the study of very small crystals, powders, ill-ordered or non-crystallized materials. Thus presently, crystallography is concerned with any solid that “scatters” an incident beam. Nevertheless, as quoted by A. Guinier, “the problems facing crystallographers have only changed, ... new ones have appeared which require reflection and imagination, ... and which in turn may still bring much joy to all those who like crystallography” [4]. Such developments open up crystallography to modern materials like artificial ones and nanostructures with low- and/or multi-scaled-periodicities and/or extremely small “crystal size” and to materials of the “real world”, with mixtures of phases and/or amorphous contribution and/or defects, a common characteristic of ancient materials analysed in patrimonial research. In our contribution we will show by selected examples that these improvements were allowed (i) by the use of powerful sources, apparatus and detectors which allow micro-diffraction, in-situ diffraction, spectroscopy, resonant scattering, inelastic scattering, coherent scattering, (ii) by the development of methods like diffraction anomalous fine structure (DAFS), pair distribution function (PDF), simulated annealing, single object reconstruction, (iii) by combination of scattering and spectroscopy and by combination of scattering and microscopy. Such combination of different approaches is very efficient and, as said by H. Curien at the IUCr Bordeaux Congress in 1990, “in crystallography, there is a constant alternation between the crystal space and its associated reciprocal space, ... the alternation between experiment and model building is another feature of crystallography activity ..., the crystallographer relies both on his computer and on his diffractometer

  5. 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...

  6. The hydrogen mine introduction initiative

    Energy Technology Data Exchange (ETDEWEB)

    Betournay, M.C.; Howell, B. [Natural Resources Canada, Ottawa, ON (Canada). CANMET Mining and Mineral Sciences Laboratories

    2009-07-01

    In an effort to address air quality concerns in underground mines, the mining industry is considering the use fuel cells instead of diesel to power mine production vehicles. The immediate issues and opportunities associated with fuel cells use include a reduction in harmful greenhouse gas emissions; reduction in ventilation operating costs; reduction in energy consumption; improved health benefits; automation; and high productivity. The objective of the hydrogen mine introduction initiative (HMII) is to develop and test the range of fundamental and needed operational technology, specifications and best practices for underground hydrogen power applications. Although proof of concept studies have shown high potential for fuel cell use, safety considerations must be addressed, including hydrogen behaviour in confined conditions. This presentation highlighted the issues to meet operational requirements, notably hydrogen production; delivery and storage; mine regulations; and hydrogen behaviour underground. tabs., figs.

  7. 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...

  8. 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

  9. 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

  10. 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

  11. 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

  12. 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...

  13. 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...

  14. 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

  15. 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...

  16. 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...

  17. 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 ...

  18. 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

  19. A mechanical energy analysis of gait initiation

    Science.gov (United States)

    Miller, C. A.; Verstraete, M. C.

    1999-01-01

    The analysis of gait initiation (the transient state between standing and walking) is an important diagnostic tool to study pathologic gait and to evaluate prosthetic devices. While past studies have quantified mechanical energy of the body during steady-state gait, to date no one has computed the mechanical energy of the body during gait initiation. In this study, gait initiation in seven normal male subjects was studied using a mechanical energy analysis to compute total body energy. The data showed three separate states: quiet standing, gait initiation, and steady-state gait. During gait initiation, the trends in the energy data for the individual segments were similar to those seen during steady-state gait (and in Winter DA, Quanbury AO, Reimer GD. Analysis of instantaneous energy of normal gait. J Biochem 1976;9:253-257), but diminished in amplitude. However, these amplitudes increased to those seen in steady-state during the gait initiation event (GIE), with the greatest increase occurring in the second step due to the push-off of the foundation leg. The baseline level of mechanical energy was due to the potential energy of the individual segments, while the cyclic nature of the data was indicative of the kinetic energy of the particular leg in swing phase during that step. The data presented showed differences in energy trends during gait initiation from those of steady state, thereby demonstrating the importance of this event in the study of locomotion.

  20. 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.

  1. 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.

  2. 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.

  3. 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.

  4. 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).

  5. 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

  6. 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

  7. The OpenPlanetary initiative

    Science.gov (United States)

    Manaud, Nicolas; Rossi, Angelo Pio; Hare, Trent; Aye, Michael; Galluzzi, Valentina; van Gasselt, Stephan; Martinez, Santa; McAuliffe, Jonathan; Million, Chase; Nass, Andrea; Zinzi, Angelo

    2016-10-01

    "Open" has become attached to several concepts: science, data, and software are some of the most obvious. It is already common practice within the planetary science community to share spacecraft missions data freely and openly [1]. However, this is not historically the case for software tools, source code, and derived data sets, which are often reproduced independently by multiple individuals and groups. Sharing data, tools and overall knowledge would increase scientific return and benefits [e.g. 2], and recent projects and initiatives are helping toward this goal [e.g. 3,4,5,6].OpenPlanetary is a bottom-up initiative to address the need of the planetary science community for sharing ideas and collaborating on common planetary research and data analysis problems, new challenges, and opportunities. It started from an initial participants effort to stay connected and share information related to and beyond the ESA's first Planetary GIS Workshop [7]. It then continued during the 2nd (US) Planetary Data Workshop [8], and aggregated more people.Our objective is to build an online distributed framework enabling open collaborations within the planetary science community. We aim to co-create, curate and publish resource materials and data sets; to organise online events, to support community-based projects development; and to offer a real-time communication channel at and between conferences and workshops.We will present our current framework and resources, developing projects and ideas, and solicit for feedback and participation. OpenPlanetary is intended for research and education professionals: scientists, engineers, designers, teachers and students, as well as the general public that includes enthusiasts and citizen scientists. All are welcome to join and contribute at openplanetary.co[1] International Planetary Data Alliance, planetarydata.org. [2] Nosek et al (2015), dx.doi.org/10.1126/science.aab2374. [3] Erard S. et al. (2016), EGU2016-17527. [4] Proposal for a PDS

  8. Lunar base initiative 1992

    Science.gov (United States)

    Koelle, H. H.

    The return to the Moon is no longer a question of yes or no, but a question of when and how. The first landing of a human being on the lunar surface in 1969 was a purely national effort of the U.S.A. Building a lunar base and operating it in the next century is rather a task for all nations of this planet, even if one nation could do it alone. However, there are several alternatives to carry out such a program and these will and should be debated during the next years on an urgent basis. To do this, one has to take into account not only the historical accomplishments and the present trends of cooperation in space programs, but also recent geopolitical developments as well as the frame of reference established by international law. The case for an International Lunar Base (ILB) has been presented to the International Academy of Astronautics on 11 October 1987 by the IAA Ad Hoc Committee "Return-to-the-Moon". This draft of a position paper was subsequently published in Acta Astronautica Vol. 17, No. 5, (pp. 463-489) with the request of public debate particularly by the members of the Academy. Some 80 Academicians responded to this invitation by the President of the Academy and voiced their opinions on the questions and issues raised by this draft of a position paper. This led to a refinement of the arguments and assumptions made and it is now possible to prepare an improved position paper proposing concrete steps which may lead to an ILB. An issue of this proportion must start with a discussion of goals and objectives to be arranged in some kind of a ranked order. It also has to take note of the limitations existing at any time by the availability of suitable space transportation systems. These will determine the acquisition date and rate of growth of a lunar base. The logistics system will also greatly influence the base characteristics and layout. The availability of heavy lift launch vehicles would simplify the task and allow to concentrate the construction

  9. 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

  10. European initiatives in postgraduate education in gerontology.

    Science.gov (United States)

    van Rijsselt, René J T; Parkatti, Terttu; Troisi, Joseph

    2007-01-01

    This paper describes three innovative European initiatives in postgraduate education in gerontology. The first is the European Masters Program in Gerontology (EuMaG), developed as an interdisciplinary joint program, supported and delivered by 22 European universities. Second, the Nordplus initiative to increase mobility of students and staff in the field of gerontology in the European Nordic countries is elaborated. Third, two postgraduate Gerontology and Geriatrics programs offered by the European Centre of Gerontology and Geriatrics, University of Malta are presented. In 1995, the Centre was designated a WHO Collaborating Centre for healthy aging. To provide a context for these initiatives, a short overview is presented of developments in the European Higher Education Area, and the current state and recent developments in gerontology training in Europe is elaborated. The article concludes with discussion of the feasibility and sustainability of European internationalization efforts in education and training in gerontology.

  11. 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

  12. 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.

  13. 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. .

  14. An Archean Biosphere Initiative

    Science.gov (United States)

    Anbar, A. D.; Boyd, E. S.; Buick, R.; Claire, M.; DesMarais, D.; Domagal-Goldman, D.; Eigenbrode, J.; Erwin, D.; Freeman, K.; Hazen, R.; Johnson, C.; Lyons, T.; Meadows, V.; Ohmoto, H.; Ono, S.; Peters, J. W.; Shapiro, B.; Summons, R.; Walter, M.

    2011-01-01

    The search for life on extrasolar planets will necessarily focus on the imprints of biolgy on the composition of planetary atmospheres. The most notable biological imprint on the modern terrestrial atmosphere is the presence of 21 % O2, However, during most of the past 4 billion years, life and the surface environments on Earth were profoundly different than they are today. It is therefore a major goal of the astrobiology community to ascertain how the O2 content of the atmosphere has varied with time. and to understand the causes of these variations. The NAI and NASA Exobiology program have played critical roles in developing our current understanding of the ancient Earth's atmosphere, supporting diverse observational, analytical, and computational research in geoscience, life science, and related fields. In the present incarnation of the NAI, ongoing work is investigating (i) variations in atmospheric O2 in the Archean to the Cambrian, (ii) characterization of the redox state of the oceans shortly before, during and after the Great Oxidation Event (GOE), and (iii) unraveling the complex connections between environmental oxygenation, global climate, and the evolution of life.

  15. 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.

  16. 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

  17. 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.

  18. Some Initiatives in a Business Forecasting Course

    Science.gov (United States)

    Chu, Singfat

    2007-01-01

    The paper reports some initiatives to freshen up the typical undergraduate business forecasting course. These include (1) students doing research and presentations on contemporary tools and industry practices such as neural networks and collaborative forecasting (2) insertion of Logistic Regression in the curriculum (3) productive use of applets…

  19. 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...

  20. 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

  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. Brain metastasis as initial presentation of papillary adenocarcinoma of the lung: case report

    Directory of Open Access Journals (Sweden)

    Irving Gabriel Araujo Bispo

    2013-09-01

    Full Text Available The authors describe the case of a 33-year-old patient with history of seizures alone without any previous symptom, being diagnosed with brain metastases from primary papillary adenocarcinoma of the lung. Emphasis is given to the diagnostic investigation for brain metastasis and prognostic evaluation of papillary adenocarcinoma of the lung, and a brief literature review on such diseases is performed.

  3. Mutation in PNKP presenting initially as axonal Charcot-Marie-Tooth disease.

    Science.gov (United States)

    Pedroso, José Luiz; Rocha, Clarissa R R; Macedo-Souza, Lucia I; De Mario, Vitor; Marques, Wilson; Barsottini, Orlando G P; Bulle Oliveira, Acary S; Menck, Carlos F M; Kok, Fernando

    2015-12-01

    PNKP (polynucleotide kinase 3'-phosphatase, OMIM #605610) product is involved in the repair of strand breaks and base damage in the DNA molecule mainly caused by radical oxygen species. Deleterious variants affecting this gene have been previously associated with microcephaly, epilepsy, and developmental delay.(1) According to a previous report, homozygous loss-of-function substitution in PNKP was associated with cerebellar atrophy, neuropathy, microcephaly, epilepsy, and intellectual disability.(2) Recently, whole-exome sequencing (WES) performed in a cohort of Portuguese families with ataxia with oculomotor apraxia (AOA) disclosed pathogenic variants in PNKP in 11 individuals. Other clinical features in that study included neuropathy, dystonia, cognitive impairment, decreased vibration sense, pyramidal signs, mild elevation in α-fetoprotein, and low levels of albumin. This condition was named AOA type 4 (OMIM #616267), as the phenotype of AOA has been previously associated with 3 other genes: APTX, SETX, and PIK3R5.(3) Altogether, these reports demonstrate the great phenotypic diversity associated with PNKP mutations. In this article, we further enlarge this variability by demonstrating that early-onset axonal sensory-motor neuropathy (or axonal Charcot-Marie-Tooth (CMT) disease) followed years later by ataxia without oculomotor apraxia can be caused by deleterious variants in PNKP. Full consent was obtained from the patient and his parents for this publication. This study was approved by institutional ethics committees. PMID:27066567

  4. 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

  5. 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...

  6. Brain metastasis as initial presentation of papillary adenocarcinoma of the lung: case report

    Energy Technology Data Exchange (ETDEWEB)

    Bispo, Irving Gabriel Araujo; Nascimento, Diego Teixeira; Ferreira, Karina Oliveira; Fakhouri, Ricardo; Godinho, Atilano Salvador; Ferrao, Thiago de Oliveira, E-mail: irvingbispo@yahoo.com.br [Universidade Federal de Sergipe (HU-UFS), Aracaju, SE (Brazil). Hospital Universitario

    2013-09-15

    The authors describe the case of a 33-year-old patient with history of seizures alone without any previous symptom, being diagnosed with brain metastases from primary papillary adenocarcinoma of the lung. Emphasis is given to the diagnostic investigation for brain metastasis and prognostic evaluation of papillary adenocarcinoma of the lung, and a brief literature review on such diseases is performed. (author)

  7. JT-60 negative ion beam NBI apparatus. Present state of its construction and initial experimental results

    Energy Technology Data Exchange (ETDEWEB)

    Kuriyama, Masaaki [Japan Atomic Energy Research Inst., Naka, Ibaraki (Japan). Naka Fusion Research Establishment

    1997-02-01

    The NBI (Neutral Beam Injection) apparatus used for negative ion at first in the world, has an aim to actually prove heating and electric current drive with high density plasma at the JT-60 and to constitute physical and technical bases for selection and design of heating apparatus of ITER (International Thermal Nuclear Fusion Experimental Reactor). Construction of 500 KeV negative ion NBI apparatus for the JT-60 started to operate on 1993 was completed at March, 1996. On the way, at a preliminary test on forming and acceleration of the negative ion beam using a portion of this apparatus, 400 KeV and 13.5 A/D of the highest deuterium negative ion beam acceleration in the world was obtained successfully, which gave a bright forecasting of the plasma heating and electric current drive experiment using the negative ion NBI apparatus. After March, 1996, some plans to begin beam incident experiment at the JT-60 using the negative ion NBI apparatus and to execute the heating and electric current drive experiment at the JT-60 under intending increase of beam output are progressed. (G.K.)

  8. 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...

  9. Takayasu Arteritis Initially Mimicking Infective Endocarditis

    Directory of Open Access Journals (Sweden)

    Aytekin Alcelik

    2011-09-01

    Full Text Available Takayasu’s arteritis (TA is a chronic inflammatory disease that affects large vessels, predominantly the aorta and main branches, leading to vessel wall thickening, fibrosis and stenosis. Cardiac and vascular symptoms are also commonly present at disease onset. In TA with thoracic or abdominal involvement, although murmur can be present as a physical examination finding, the pulse difference may be absent. Here, we mention a case of TA who initially looked like infective endocarditis and had widespread thoracic murmur.

  10. EXPERIENCES WITH IDEA PROMOTING INITIATIVES

    DEFF Research Database (Denmark)

    Gish, Liv

    2011-01-01

    to idea work. Furthermore I look into what makes these initiatives ‘work’ or ‘not work’. The analysis builds on an in-depth case study made in Grundfos based on 40 interviews with R&D professionals and managers. The managerial implications of the study are that managers should be aware of what......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 respect...

  11. 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...

  12. 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...

  13. 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.

  14. 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

  15. 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.

  16. 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 ...

  17. 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...

  18. 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

  19. Archaeal translation initiation revisited: the initiation factor 2 and eukaryotic initiation factor 2B alpha-beta-delta subunit families

    Science.gov (United States)

    Kyrpides, N. C.; Woese, C. R.

    1998-01-01

    As the amount of available sequence data increases, it becomes apparent that our understanding of translation initiation is far from comprehensive and that prior conclusions concerning the origin of the process are wrong. Contrary to earlier conclusions, key elements of translation initiation originated at the Universal Ancestor stage, for homologous counterparts exist in all three primary taxa. Herein, we explore the evolutionary relationships among the components of bacterial initiation factor 2 (IF-2) and eukaryotic IF-2 (eIF-2)/eIF-2B, i.e., the initiation factors involved in introducing the initiator tRNA into the translation mechanism and performing the first step in the peptide chain elongation cycle. All Archaea appear to posses a fully functional eIF-2 molecule, but they lack the associated GTP recycling function, eIF-2B (a five-subunit molecule). Yet, the Archaea do posses members of the gene family defined by the (related) eIF-2B subunits alpha, beta, and delta, although these are not specifically related to any of the three eukaryotic subunits. Additional members of this family also occur in some (but by no means all) Bacteria and even in some eukaryotes. The functional significance of the other members of this family is unclear and requires experimental resolution. Similarly, the occurrence of bacterial IF-2-like molecules in all Archaea and in some eukaryotes further complicates the picture of translation initiation. Overall, these data lend further support to the suggestion that the rudiments of translation initiation were present at the Universal Ancestor stage.

  20. 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.

  1. Unilateral Pseudotumoral Presentation of Cerebral Venous Thrombosis

    Directory of Open Access Journals (Sweden)

    Leonardo Halley Carvalho Pimentel

    2014-09-01

    Full Text Available Cerebral venous thrombosis (CVT is an unusual cause of stroke. It is more common in middle-aged women and deep CVT lesions are usually bilateral. CVT can have very diverse clinical presentations and mimic other conditions. We report two women with CVT initially diagnosed as tumors (unilateral pseudotumoral presentation of CVT successfully treated with intravenous heparin. Early diagnosis was important and completely reversed the symptoms. The diagnosis of CVT should be remembered when clinical picture is compatible even if brain imaging suggests unilateral tumor.

  2. 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.

  3. 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

  4. Federal government expands compliance initiatives.

    Science.gov (United States)

    Dugan, J K

    1997-09-01

    In 1995, the Federal government initiated Operation Restore Trust to increase enforcement of fraud and abuse regulations in Medicare and Medicaid programs. With the success of the original initiative, the government is expanding the project to additional states and program areas. The initial scrutiny of home health agencies, nursing homes, hospice care, and durable medical equipment is being expanded to managed care plans and acute care hospitals with an eye toward DRG creep. To manage this increased enforcement activity, healthcare organizations should institute comprehensive corporate compliance programs. Such programs should provide a framework that delineates responsibilities and provides a systematic means to resolve issues in a timely manner.

  5. GALIC: Galaxy initial conditions construction

    Science.gov (United States)

    Yurin, Denis; Springel, Volker

    2014-08-01

    GalIC (GALaxy Initial Conditions) is an implementation of an iterative method to construct steady state composite halo-disk-bulge galaxy models with prescribed density distribution and velocity anisotropy that can be used as initial conditions for N-body simulations. The code is parallelized for distributed memory based on MPI. While running, GalIC produces "snapshot files" that can be used as initial conditions files. GalIC supports the three file formats ('type1' format, the slightly improved 'type2' format, and an HDF5 format) of the GADGET (ascl:0003.001) code for its output snapshot files.

  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. 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...

  9. Self-initiated expatriate academics

    DEFF Research Database (Denmark)

    Selmer, Jan; Lauring, Jakob

    2013-01-01

    . Nonetheless, little research has focused on this group. We investigate if personal characteristics such as age, gender, marital status and seniority affect work outcomes such as work adjustment, work performance, work effectiveness, job satisfaction and time to proficiency. This is done by using data which......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...... 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...

  10. 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…

  11. 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...

  12. Teachers’ perceptions of their own initiative: Collective initiative vs. personal initiative

    Directory of Open Access Journals (Sweden)

    Džinović Vladimir

    2013-01-01

    Full Text Available Current trends in education demand from teachers to exhibit proactive behaviour and assume responsibility for the implementation of changes in school practice. In that sense, it is important to study how teachers perceive their own initiative and to gain insight into the activities where such initiative is demonstrated. This study has been conceived as a mixed-methods research. The qualitative study implied forming four focus groups with subject teachers and class teachers (N=38, while the quantitative study entailed surveying 1441 teachers in forty primary schools in Serbia using the questionnaire constructed based on qualitative data. Data from focus groups were processed by qualitative thematic analysis, while the questionnaire data were processed by principal component analysis and univariate analysis of variance. The findings of the study have shown that teachers mostly demonstrate initiative through co­operative activities that include planning of joint teaching as well as conducting joint projects within school and with the local community actors. Teachers are least ready to demonstrate personal initiative and the initiative aimed at accomplishing considerable changes in school work. The concluding part includes the recommendations for encouraging teachers’ personal initiative and building organizational culture that would support such initiative. [Projekat Ministarstva nauke Republike Srbije, br. br. 47008: Unapređivanje kvaliteta i dostupnosti obrazovanja u procesima modernizacije Srbije i br. 179034: Od podsticanja inicijative, saradnje i stvaralaštva u obrazovanju do novih uloga i identiteta u društvu

  13. 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.)

  14. 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.

  15. The Overture Initiative Integrating Tools for VDM

    DEFF Research Database (Denmark)

    Larsen, Peter Gorm; Battle, Nick; Ferreira, Miguel;

    2010-01-01

    Overture is a community-based initiative that aims to develop a common open-source platform integrating a range of tools for constructing and analysing formal models of systems using VDM. The mission is to both provide an industrial-strength tool set for VDM and also to provide an environment...... that allows researchers and other stakeholders to experiment with modifications and extensions to the tools and language. This paper presents the current status and future vision of the Overture project....

  16. 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...

  17. 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...

  18. 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

  19. Abnormal Presentation of Choriocarcinoma and Literature Review

    Science.gov (United States)

    Yousefi, Zohreh; Mottaghi, Mansorhe; Rezaei, Alireza; Ghasemian, Sedighe

    2016-01-01

    Introduction Gestational trophoblastic neoplasms have highly been malignant potential, which usually occurred in child-bearing age women. Unusual feature of this malignancy would be rare, it was important to take in mind the possibility of GTN in different manifestation. Based on the above mentioned, the aim of this presentation would be the management and outcome of a case series of choriocarcinoma patients with abnormal manifestation. Case Presentation We have presented four patients, first who initially manifestation with signs of septic shock, the second case with severe gastrointestinal hemorrhage, the third case with postpartum infection and the forth case was a postmenopausal bleeding patient. Conclusions In case of metastatic choriocarcinoma with precise history, accurate diagnosis and appropriate treatment have led us to curable results. PMID:27482332

  20. Multiple myeloma presenting as gingival hyperplasia.

    Science.gov (United States)

    Jain, Sanjeev; Kaur, Harjit; Kansal, Gaurav; Gupta, Parul

    2013-05-01

    Multiple myeloma is a malignant neoplasm that is characterized by a monoclonal proliferation of plasma cells. Oral and maxillofacial manifestations as an initial sign or symptom of multiple myeloma are rare. A 58-year-old male patient presented with generalized gingival enlargement for last 6 months. Based on clinical presentation, a diagnosis of gingival hyperplasia was made. After Phase I therapy, excisional biopsy was taken in anterior mandibular region and excised tissue was sent for histopathological examination. The histopathology report revealed a lining of stratified squamous epithelium with foci of ulceration. The subepithelial zone showed infiltration by sheets of mainly binucleate and multinucleate plasma cells, few cells being less differentiated. Rounded cytoplasmic inclusion bodies were identified in many of these cells. After a series of clinical investigations, a case of "multiple myeloma" was diagnosed. Patient presenting with generalized gingival hyperplasia should be worked up for systemic disease like multiple myeloma.

  1. 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.

  2. 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.)

  3. 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...

  4. 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 ...

  5. 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

  6. 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.

  7. Giant ascending colonic diverticulum presenting with intussusception.

    Science.gov (United States)

    Kim, Ho Jin; Kim, Jin Ha; Moon, Ok In; Kim, Kyung Jong

    2013-10-01

    Diverticular disease of the colon is a common disease, and its incidence is increasing gradually. A giant colonic diverticulum (GCD) is a rare entity and is defined as a diverticulum greater than 4 cm in size. It mainly arises from the sigmoid colon, and possible etiology is a ball-valve mechanism permitting progressive enlargement. A plain abdominal X-ray can be helpful to make a diagnosis initially, and a barium enema and abdominal computed tomography may confirm the diagnosis. Surgical intervention is a definite treatment for a GCD. We report a case of an ascending GCD presenting with intussusception in a young adult.

  8. Atypical presentation of childhood obsessive compulsive disorder

    Directory of Open Access Journals (Sweden)

    Satyakam Mohapatra

    2016-01-01

    Full Text Available Obsessive-compulsive disorder (OCD is one of the most prevalent psychiatric disorders in children and adolescents. The phenomenology of OCD in children and adolescent is strikingly similar to that of adults. But at times, the presentation of OCD may be so atypical or unusual in children and adolescents that may lead to misdiagnosis or delay in diagnosis. We report a case of 10-year-old child who was initially misdiagnosed with schizophrenia, and treated with antipsychotic for 2 months. But once the core symptoms were recognized as obsessions and compulsions and appropriately treated in the line of OCD, the symptoms resolved significantly.

  9. 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

  10. Dressed to Present: Ratings of Classroom Presentations Vary with Attire

    Science.gov (United States)

    Gurung, Regan A. R.; Kempen, Laura; Klemm, Kayla; Senn, Rebecca; Wysocki, Rosie

    2014-01-01

    This study investigates the effects of formality of dress on ratings of classroom presentations. Participants (N = 65, 66% women) from a Midwestern university in the United States rated three female students giving a presentation designed for a health psychology class in one of four outfits: casual, party, business casual, or business formal.…

  11. 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.

  12. [Initiation and monitoring of contraception].

    Science.gov (United States)

    Sannisto, Tuire; Kuortti, Marjo; Kuukankorpi, Aki; Niitty, Siina

    2012-01-01

    The majority of those requiring contraception may safely use any available contraceptive method. Each method has, however, its particular contraindications, which should be screened by applying careful anamnesis and focused status, when contraception is being initiated. Gynecologic examination is not a prerequisite for the initiation of hormonal contraception, but measurement and monitoring of blood pressure is important. Testing for sexually transmitted diseases is readily worthwhile. Follow-up visits provide a chance for comprehensive support for a woman or a young person concerning sexual health. PMID:22822602

  13. Initiation of HIV Reverse Transcription

    Directory of Open Access Journals (Sweden)

    Roland Marquet

    2010-01-01

    Full Text Available Reverse transcription of retroviral genomes into double stranded DNA is a key event for viral replication. The very first stage of HIV reverse transcription, the initiation step, involves viral and cellular partners that are selectively packaged into the viral particle, leading to an RNA/protein complex with very specific structural and functional features, some of which being, in the case of HIV-1, linked to particular isolates. Recent understanding of the tight spatio-temporal regulation of reverse transcription and its importance for viral infectivity further points toward reverse transcription and potentially its initiation step as an important drug target.

  14. The Region of the Tara Mountain – Entrepreneurial Initiatives

    Directory of Open Access Journals (Sweden)

    Tamara Lukić

    2013-01-01

    Full Text Available The Tara Mountain is situated on the west border of Serbia. Terrain observation has provided comparative analysis of attractive mountains in Serbia. It has explained the position of the Tara Mountain in different important categories (geographic, touristic etc. Literature sources have helped in the analysis of the past entrepreneurial initiatives. Some important facts are provided by the questionnaire, in the form of the interview. The article has presented entrepreneurial initiatives on the two levels. “Time level” has divided entrepreneurial initiatives on: the time before socialist period, socialist period, then initiatives in the period from 1991 to 1999 and initiatives from the period of transition and owner transformation. “Space level” has differed entrepreneurial initiatives from the two points of view. Depending on the relief, different entrepreneurial initiatives have found “perfect place under the sun” on the different exposure of the Tara Mountain and on the different altitude levels. Short survey of genders and professions of entrepreneurs is given. Synthesis of explorations results has showed some common characteristics of all entrepreneurial initiatives. Data obtained in the Republic Statistic Bureau have used for analyze of tourist circulation in the last ten years. It has contributed illustration of the last results of new entrepreneurial initiatives. The article search the answer on the following questions: How entrepreneurial initiatives contributed to the development of the Tara Mountain? Which entrepreneurial initiatives can improve the quality of life on the Tara Mountain? Using interview, the answer was gotten and formed by locals, tourists and experts.

  15. Modeling and assessment of electricity market initiatives

    Science.gov (United States)

    Mokrian, Pedram

    This body of work is dedicated to the modeling and assessment of initiatives within electricity markets using the underlying hourly market dynamics. The dissertation presents two separate frameworks that take a bottom-up approach for assessing benefits associated with various demand-side initiatives and other emerging interventions in power markets. Models in support of each framework are presented, and numerical results are used to highlight some impacts based on hourly dynamics. The first framework uses stochastic optimization models to explore the economic feasibility of grid-scale energy storage from the perspective of a price taking, profit maximizing firm facing uncertain market dynamics. This model is then extended to incorporate intermittent wind generation, demonstrating how storage can be used as a potential substitute for transmission capacity. The second framework uses a new dynamic market equilibrium simulation model to address broader economic and environmental impacts of various demand-side initiatives including: energy efficiency, distributed generation, and plug-in hybrid electric vehicles. The general model is calibrated for the California electricity market. The model is used to estimate impacts of the various interventions, taking into account varying market adoption levels and natural gas prices.

  16. Initial Educational Experiences of Tertiary Students. LSAY Briefing Number 14

    Science.gov (United States)

    Hillman, Kylie

    2008-01-01

    This "Briefing" presents information about the initial tertiary education experiences, such as satisfaction with aspects of student life and changes to initial enrolments, of two groups of young people, based on two recent Longitudinal Surveys of Australian Youth (LSAY) research reports. One study focused on the first year experiences of a group…

  17. Evolution of passive continental margins and initiation of subduction zones

    NARCIS (Netherlands)

    Cloetingh, S.A.P.L.

    1982-01-01

    The initiation of subduction is a key element in plate tectonic schemes for the evolution of the Earth's lithosphere. Nevertheless, up to present, the underlying mechanism has not been very well understood (e.g. Dickinson and Seely, 1979; Hager, 1980; Kanamori, 1980). The insight into the initiation

  18. 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.

  19. Big Data Initiatives for Agroecosystems

    Science.gov (United States)

    NAL has developed a workspace for research groups associated with the i5k initiative, which aims to sequence the genomes of all insesct species known to be important to worldwide agriculture, food safety, medicine, and energy production; all those used as models in biology; the most abundant in worl...

  20. Missouri: Early Head Start Initiative

    Science.gov (United States)

    Center for Law and Social Policy, Inc. (CLASP), 2012

    2012-01-01

    Missouri's Early Head Start/Child Care Partnership Project expands access to Early Head Start (EHS) services for children birth to age 3 by developing partnerships between federal Head Start, EHS contractors, and child care providers. Head Start and EHS contractors that participate in the initiative provide services through community child care…

  1. 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.

  2. 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.

  3. Fayette County Better Buildings Initiative

    Energy Technology Data Exchange (ETDEWEB)

    Capella, Arthur

    2015-03-04

    The Fayette County Better Buildings Initiative represented a comprehensive and collaborative approach to promoting and implementing energy efficiency improvements. The initiative was designed to focus on implementing energy efficiency improvements in residential units, while simultaneously supporting general marketing of the benefits of implementing energy efficiency measures. The ultimate goal of Fayette County’s Better Buildings Initiative was to implement a total of 1,067 residential energy efficiency retrofits with a minimum 15% estimated energy efficiency savings per unit. Program partners included: United States Department of Energy, Allegheny Power, and Private Industry Council of Westmoreland-Fayette, Fayette County Redevelopment Authority, and various local partners. The program was open to any Fayette County residents who own their home and meet the prequalifying conditions. The level of assistance offered depended upon household income and commitment to undergo a BPI – Certified Audit and implement energy efficiency measures, which aimed to result in at least a 15% reduction in energy usage. The initiative was designed to focus on implementing energy efficiency improvements in residential units, while simultaneously supporting general marketing of the benefits of implementing energy efficiency measures. Additionally, the program had components that involved recruitment and training for employment of persons in the energy sector (green jobs), as well as marketing and implementation of a commercial or community facilities component. The residential component of Fayette County’s Better Buildings Initiative involved a comprehensive approach, providing assistance to low- moderate- and market-rate homeowners. The initiative will also coordinate activities with local utility providers to further incentivize energy efficiency improvements among qualifying homeowners. The commercial component of Fayette County’s Better Building Initiative involved grants

  4. Initial Aging Studies of Unfilled VCE

    Energy Technology Data Exchange (ETDEWEB)

    Letant, S E; Herberg, J L; Wilson, T S; Alviso, C T; Chinn, S C; Maxwell, R S

    2008-10-09

    This report presents initial data on the effects of temperature, oxygen, and radiation on the chemical and structural properties of newly formulated, unfilled VCE. This initial effort focused on a pristine sample, and a replicate sample irradiated in air at a dose of 25MR. Thermal degradation was investigated by performing Thermogravimetric Analysis (TGA), and radiation-induced degradation was investigated using Differential Scanning Calorimetry (DSC), X-ray Diffraction (XRD), Solid Phase MicroExtraction--Gas Chromatography/Mass Spectrometry (SPME-GC/MS), as well as various Nuclear Magnetic Resonance (NMR) techniques including: {sup 13}C, {sup 13}C {sup 1}H cross polarization (CP), and {sup 1}H magic angle spinning (MAS) NMR.

  5. Considerations about mediative in initial petition

    Directory of Open Access Journals (Sweden)

    Maria das Vitórias Nunes Silva Lourenço

    2013-12-01

    Full Text Available This paper presents considerations about Initial Petition, textual/discursive genre, which is a genre circumscribed in the judicial domain with relation to the Commitment. For this purpose, this article exposes the text plan of the Initial Petition from the postulations of Adam (2011. In the same way, it studies the mediative frameworks based on Guentchéva (1994, 1996, which develop the notion of mediative grammatical categories, that permits the linguistic marking of distance and engagement of the enunciator with regard to the information expressed. It evidences the relevance of the use of mediated constructions in the judicial text, as they function as attenuated strategies to the responsibility of the producer of the text with what is said, and at the same time points to a discourse of authority through the entrance of the sources of law.

  6. Initial dynamic load estimates during configuration design

    Science.gov (United States)

    Schiff, Daniel

    1987-01-01

    This analysis includes the structural response to shock and vibration and evaluates the maximum deflections and material stresses and the potential for the occurrence of elastic instability, fatigue and fracture. The required computations are often performed by means of finite element analysis (FEA) computer programs in which the structure is simulated by a finite element model which may contain thousands of elements. The formulation of a finite element model can be time consuming, and substantial additional modeling effort may be necessary if the structure requires significant changes after initial analysis. Rapid methods for obtaining rough estimates of the structural response to shock and vibration are presented for the purpose of providing guidance during the initial mechanical design configuration stage.

  7. Nuclear space propulsion initiative in Brazil

    Energy Technology Data Exchange (ETDEWEB)

    Guimaraes, Lamartine Nogueira Frutuoso; Nascimento, Jamil Alves do [Institute for Advanced Studies, Sao Jose dos Campos, SP (Brazil). Nuclear Energy Div.]. E-mail: guimarae@ieav.cta.br; Camillo, Giannino Ponchio [Instituto Tecnologico de Aeronautica (ITA), Sao Jose dos Campos, SP (Brazil)]. E-mail: gianninocamillo@gmail.com

    2007-07-01

    This paper presents an account of the initial nuclear space propulsion activities at the Institute for Advanced Studies. At this point two laboratories have been assembled: one for heat pipe construction and testing and another one for thermal cycle analysis. It has also started the design of a thermal loop to study heat extraction and electricity generation in a NEP, the development of a dynamic mathematical model to represent this thermal loop, the selection of gas mixtures as working fluids to the thermal cycle, the production of two heat pipes for properties measurements and to establish design criteria to assemble heat pipes to be used as a heat rejection system. For the reactor core area a review of the core concepts proposed in other countries for space applications was initiated. This review will enable the choice of a core concept suitable to Brazilian needs in space. (author)

  8. 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.

  9. 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.

  10. Multiphasic presentation of Rasmussen's encephalitis

    NARCIS (Netherlands)

    A. Avbersek; A. Miserocchi; A.W. McEvoy; A.V. Patel; E. Aronica; I. Blumcke; T.S. Jacques; J. Acheson; M. Thom; S.M. Sisodiya

    2015-01-01

    Rasmussen's encephalitis is a rare, chronic inflammatory disorder of unknown cause, characterised by drug-resistant focal epilepsy that may rarely present in adolescence or adulthood. We present a case of Rasmussen's encephalitis with prominent recurrent fluctuation in symptoms and well-documented f

  11. Presenting the discovery of W

    CERN Multimedia

    1983-01-01

    The UA1 results were presented by Carlo Rubbia in the Main Auditorium on 20 January. The photo shows Alan Astbury from back talking to Carlo Rubbia (centre), Between them is Bernard Aubert. On the background, left, stands Peter Kalmus, and, right, massimo Placidi. The UA2 results were presented in the Main Auditorium by Luigi Di Lella on 21 January.

  12. Presentation Skills Workshops for Nurses.

    Science.gov (United States)

    Kinn, S.; Kenyon, M.

    2002-01-01

    Workshops were held to prepare nurses (n=87) to present results of professional activities. One year after the course, 20 had made oral and 30 written presentations. The workshops increased their confidence and were considered practical, informal, and nonthreatening. (Contains 31 references.) (SK)

  13. 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)

  14. 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.

  15. Glioblastoma Multiforme Presenting as Spontaneous Intracerebral Hemorrhage

    Directory of Open Access Journals (Sweden)

    Cagatay Ozdol

    2014-06-01

    Full Text Available Brain tumors with concomitant intracerebral hemorrhage are rarely encountered. Hemorrhage as the initial presentation of a brain tumour may pose some diagnostic problems, especially if the tumour is small or the hemorrhage is abundant. We present a 47-year-old man who admitted to the emergency department with sudden onset headache, right blurred vision and gait disturbance. A non-contrast cranial computerized tomography scan performed immediately after his admission revealed a well circumscribed right occipitoparietal haematoma with intense peripheral edema causing compression of the ipsilateral ventricles. On 6th hour of his admission the patient%u2019s neurological status deteriorated and he subsequently underwent emergent craniotomy and microsurgical evacuation of the haematoma. The histopathological examination of the mass was consistent with a glioblastoma multiforme. Neoplasms may be hidden behind each case of spontaneous intracerebral hemorrhage. Histological sampling and investigation is mandatory in the presence of preoperative radiological features suggesting a neoplasm.

  16. The IMERSPEC methodology: presentation and preliminary applications

    Energy Technology Data Exchange (ETDEWEB)

    Neto, A Silveira; Moreira, L Q [Federal University of Uberlandia - Mechanical Engineering Faculty - Fluids Mechanic Laboratory, Av. Joao Naves de Avilla, 1121 - Campus Santa Monica - Bl.: 5P - Uberlandia - MG (Brazil); Mariano, F P, E-mail: aristeus@mecanica.ufu.br [Federal University of Goias - School of Electrical and Computational Engineering, Av. Universitria, 1488, Qd. 86 - Bl.: A, Setor Leste Universitrio, Goiania - GO (Brazil)

    2011-12-22

    A new numerical methodology, named IMERSPEC, to solve the Navier-Stokes equations is presented in the present work and applied to solve two kinds of complex flows. It is based on Fourier pseudo-spectral (FPSM) and on immersed boundary methods (IBM). It was developed, initially, for incompressible flows. Wall boundary conditions are modeled using an IBM method. This methodology combines some advantages of high accuracy and low computational cost provided by the FPSM. Another very important characteristic is that, even for incompressible flow, there is no more pressure and velocity coupling. The performance of this new methodology is exemplified in three-dimensional numerical simulations of flows a over backward-facing step geometry and a spatial developing jet. The results are compared with experimental and with numerical results, giving very good agreement.

  17. Biaxial fatigue of metals the present understanding

    CERN Document Server

    Schijve, Jaap

    2016-01-01

    Problems of fatigue under multiaxial fatigue loads have been addressed in a very large number of research publications. The present publication is primarily a survey of biaxial fatigue under constant amplitude loading on metal specimens. It starts with the physical understanding of the fatigue phenomenon under biaxial fatigue loads. Various types of proportional and non-proportional biaxial fatigue loads and biaxial stress distributions in a material are specified. Attention is paid to the fatigue limit, crack nucleation, initial micro crack growth and subsequent macro-crack in different modes of crack growth. The interference between the upper and lower surfaces of a fatigue crack is discussed. Possibilities for predictions of biaxial fatigue properties are analysed with reference to the similarity concept. The significance of the present understanding for structural design problems is considered. The book is completed with a summary of major observations.

  18. Atypical presentations of Wolframs syndrome

    Directory of Open Access Journals (Sweden)

    S Saran

    2012-01-01

    Full Text Available Background: Wolfram syndrome is a rare hereditary or sporadic neurodegenerative disorder also known as DIDMOAD. The classically described presentation is of insulin-dependent diabetes, followed by optic atrophy, central diabetes insipidus, and sensory neural deafness. Also included are less well-described presentations of Wolframs syndrome. We here present three cases of atypical presentation of this syndrome. Case 1: A 15-year-old boy with insulin-dependent diabetes was presented for evaluation of depressive symptoms associated with suicidal tendency. Neuropsychiatric manifestations are described with Wolframs syndrome, and wolframin gene, in recessive inheritance, is associated with psychiatric illnesses without other manifestations of Wolframs syndrome. Case 2: A 17-year-old diabetic boy on insulin with good control of blood sugar presented for evaluation of delayed puberty. Central hypogonadism and other anterior pituitary hormone dysfunctions are the less publicized hormone dysfunctions in Wolframs syndrome. Case 3: A 23-year-old female who was on insulin for diabetes for the past 14 years, got admitted for evaluation of sudden loss of vision. This patient had developed a vitreous hemorrhage and, on evaluation, was found to have optic atrophy, sensory neural hearing loss, and diabetes insipidus, and presented differently from the gradual loss of vision described in Wolframs syndrome. Conclusion: Wolframs syndrome being a multisystem degenerative disorder can have myriad other manifestations than the classically described features. Neuropsychiatric manifestations, depression with suicidal risk, central hypogonadism, and secondary adrenal insufficiency are among the less well-described manifestations of this syndrome.

  19. Development of the Rational Behavior Inventory: Initial Validity and Reliability

    Science.gov (United States)

    Shorkey, Clayton T.; Whiteman, Victor L.

    1977-01-01

    The results of initial validity and reliability studies on the Rational Behavior Inventory are presented. The instrument was developed to be used for assessment, treatment planning, and evaluation of clients by counselors who use Rational Emotive Therapy. (Author/JKS)

  20. An unusual presentation of sporotrichosis

    Directory of Open Access Journals (Sweden)

    S S Vaishampayan

    2013-01-01

    Full Text Available Sporotrichosis can mimic a few diseases. Sporotrichosis presenting as a hypoaesthetic plaque or plaque suggestive of leprosy has not been mentioned in literature. Herein we present a case of a 26 years old man who presented with hypoesthetic plaque on left ankle and was clinically diagnosed to have borderline tuberculoid leprosy who later developed few nodules in linear fashion on left leg, which ruptured to form non healing ulcers. Culture from ulcer grew Sporothrix schenckii. Patient was successfully treated with oral potassium iodide.

  1. QCD machines - present and future

    International Nuclear Information System (INIS)

    The present status of the currently working and nearly working dedicated QCD machines is reviewed and proposals for future machines are discussed with particular emphasis on the QCD Teraflop Project in the US. (orig.)

  2. A centralized audio presentation manager

    Energy Technology Data Exchange (ETDEWEB)

    Papp, A.L. III; Blattner, M.M.

    1994-05-16

    The centralized audio presentation manager addresses the problems which occur when multiple programs running simultaneously attempt to use the audio output of a computer system. Time dependence of sound means that certain auditory messages must be scheduled simultaneously, which can lead to perceptual problems due to psychoacoustic phenomena. Furthermore, the combination of speech and nonspeech audio is examined; each presents its own problems of perceptibility in an acoustic environment composed of multiple auditory streams. The centralized audio presentation manager receives abstract parameterized message requests from the currently running programs, and attempts to create and present a sonic representation in the most perceptible manner through the use of a theoretically and empirically designed rule set.

  3. Childhood Exposure Factors [Presentation 2015

    Science.gov (United States)

    This is a presentation to be delivered at the Children's Health Protection Advisory Committee Meeting to inform them about the type of data included in the EFH and how it is used in EPA's decision making.

  4. Wind Technologies & Evolving Opportunities (Presentation)

    Energy Technology Data Exchange (ETDEWEB)

    Robichaud, R.

    2014-07-01

    This presentation covers opportunities for wind technology; wind energy market trends; an overview of the National Wind Technology Center near Boulder, Colorado; wind energy price and cost trends; wind turbine technology improvements; and wind resource characterization improvements.

  5. BioFuels Atlas (Presentation)

    Energy Technology Data Exchange (ETDEWEB)

    Moriarty, K.

    2011-02-01

    Presentation for biennial merit review of Biofuels Atlas, a first-pass visualization tool that allows users to explore the potential of biomass-to-biofuels conversions at various locations and scales.

  6. AN UNUSUAL PRESENTATION OF DIC

    Directory of Open Access Journals (Sweden)

    Manish

    2015-10-01

    Full Text Available Placenta Praevia is a common obstetric problem which presents with antepartum H aemorrhage and is treated by the obstetrician. It is very rare to see a patient with placenta praevia treated in medical ward for post - partum H aemorrhage due to disseminated intravascular coagulation defect with the added complication of acute kidney injury, P ost - partum H ypertension and PRES (posterior reversible encephalopathy syndrome, hence the presentation

  7. A rare presentation of hypothyroidism

    Directory of Open Access Journals (Sweden)

    Betsy Mathew

    2014-02-01

    Full Text Available In this case report, we have brought out a very rare presentation of hypothyroidism in the form of cataplexy and this case is of significance because there have been no similar case reports of hypothyroidism presenting as cataplexy so far. The other highlight of the case is that treatment of hypothyroidism alone resulted in complete freedom from cataplexy without the need for agrypnotic drugs. [Int J Res Med Sci 2014; 2(1.000: 328-329

  8. Ngbugu digital wordlist: Presentation form

    Directory of Open Access Journals (Sweden)

    Kenneth S. Olson

    2007-01-01

    Full Text Available This paper presents a 204-item digital wordlist of Ngbugu, an Ubangian language spoken in Central African Republic. The wordlist includes orthographic and broad phonetic transcriptions of the words, French and English glosses, an individual WAV recording of each word, GIF images of the original field transcriptions, and metadata for resource discovery. This presentation form of the wordlist was generated from an archived version (Olson 2006 following the procedure laid out in Simons, Olson and Frank (2007.

  9. Presenting and Evaluating Qualitative Research

    OpenAIRE

    Anderson, Claire

    2010-01-01

    The purpose of this paper is to help authors to think about ways to present qualitative research papers in the American Journal of Pharmaceutical Education. It also discusses methods for reviewers to assess the rigour, quality, and usefulness of qualitative research. Examples of different ways to present data from interviews, observations, and focus groups are included. The paper concludes with guidance for publishing qualitative research and a checklist for authors and reviewers.

  10. E-Business Initiatives in Indonesian Manufacturing SMEs

    Directory of Open Access Journals (Sweden)

    Singgih Saptadi

    2014-01-01

    Full Text Available The role of information technology (IT in improving companies’ competitiveness, including small and medium enterprises (SMEs, has been widely accepted. But, the IT investment will be in vain, if SMEs do not align their business and IT. There is a need to develop a framework of business-IT alignment. The framework development requires an understanding of the patterns of IT implementation in supporting SMEs’ business (e-business initiatives. This paper presents an empirical study on e-business initiatives in Indonesian manufacturing SMEs. The study uses 41 business processes that are grouped into three business focuses: supplier side, internal side and customer side. Based on the complexity of IT support to business processes, supplier side score, internal side score, customer side score and global score can be calculated. These scores are used to develop e-business initiative groups by using cluster analysis. After validated using discriminant analysis, the cluster analysis gives five e-business initiatives. First initiative is e-business implementation in three sides of business focuses, although in the early stage. Second initiative is IT implementation with internal side focus. Third initiative is e-business with customer side focus. The fourth is initiative that focuses on internal and customer side. The last is e-business initiative that balances and extends IT implementation on the three sides of business focuses. Then, this paper explains the differences between e-business initiatives.

  11. Initial Semantics for Strengthened Signatures

    CERN Document Server

    Hirschowitz, André; 10.4204/EPTCS.77.5

    2012-01-01

    We give a new general definition of arity, yielding the companion notions of signature and associated syntax. This setting is modular in the sense requested by Ghani and Uustalu: merging two extensions of syntax corresponds to building an amalgamated sum. These signatures are too general in the sense that we are not able to prove the existence of an associated syntax in this general context. So we have to select arities and signatures for which there exists the desired initial monad. For this, we follow a track opened by Matthes and Uustalu: we introduce a notion of strengthened arity and prove that the corresponding signatures have initial semantics (i.e. associated syntax). Our strengthened arities admit colimits, which allows the treatment of the \\lambda-calculus with explicit substitution.

  12. Initial Semantics for Strengthened Signatures

    Directory of Open Access Journals (Sweden)

    André Hirschowitz

    2012-02-01

    Full Text Available We give a new general definition of arity, yielding the companion notions of signature and associated syntax. This setting is modular in the sense requested by Ghani and Uustalu: merging two extensions of syntax corresponds to building an amalgamated sum. These signatures are too general in the sense that we are not able to prove the existence of an associated syntax in this general context. So we have to select arities and signatures for which there exists the desired initial monad. For this, we follow a track opened by Matthes and Uustalu: we introduce a notion of strengthened arity and prove that the corresponding signatures have initial semantics (i.e. associated syntax. Our strengthened arities admit colimits, which allows the treatment of the λ-calculus with explicit substitution.

  13. Hydrodynamics from Landau initial conditions

    Energy Technology Data Exchange (ETDEWEB)

    Sen, Abhisek [University of Tennessee, Knoxville (UTK); Gerhard, Jochen [Frankfurt Institute for Advanced Studies (FIAS), Germany; Torrieri, Giorgio [Universidade Estadual de Campinas, Instituto de Física " Gleb Wataghin" (IFGW), Sao Paulo, Brazil; Read jr, Kenneth F. [University of Tennessee (UTK) and Oak Ridge National Laboratory (ORNL); Wong, Cheuk-Yin [ORNL

    2015-01-01

    We investigate ideal hydrodynamic evolution, with Landau initial conditions, both in a semi-analytical 1+1D approach and in a numerical code incorporating event-by-event variation with many events and transverse density inhomogeneities. The object of the calculation is to test how fast would a Landau initial condition transition to a commonly used boost-invariant expansion. We show that the transition to boost-invariant flow occurs too late for realistic setups, with corrections of O (20 - 30%) expected at freezeout for most scenarios. Moreover, the deviation from boost-invariance is correlated with both transverse flow and elliptic flow, with the more highly transversely flowing regions also showing the most violation of boost invariance. Therefore, if longitudinal flow is not fully developed at the early stages of heavy ion collisions, 2+1 dimensional hydrodynamics is inadequate to extract transport coefficients of the quark-gluon plasma. Based on [1, 2

  14. Initial conditions for cosmological perturbations

    CERN Document Server

    Ashtekar, Abhay

    2016-01-01

    Penrose proposed that the big bang singularity should be constrained by requiring that the Weyl curvature vanishes there. The idea behind this past hypothesis is attractive because it constrains the initial conditions for the universe in geometric terms and is not confined to a specific early universe paradigm. However, the precise statement of Penrose's hypothesis is tied to classical space-times and furthermore restricts only the gravitational degrees of freedom. These are encapsulated only in the tensor modes of the commonly used cosmological perturbation theory. Drawing inspiration from the underlying idea, we propose a quantum generalization of Penrose's hypothesis using the Planck regime in place of the big bang, and simultaneously incorporating tensor as well as scalar modes. Initial conditions selected by this generalization constrain the universe to be as homogeneous and isotropic in the Planck regime \\emph{as permitted by the Heisenberg uncertainty relations}.

  15. Rethinking the National Export Initiative

    OpenAIRE

    Caroline Freund

    2014-01-01

    Four years ago, President Barack Obama set the goal of doubling exports within five years and creating 2 million new export-related jobs. The strategy put in place, however, has failed to achieve superior growth. Freund argues that the emphasis on small and medium enterprises in the National Export Initiative, while attractive, was misguided and recommends a specific set of policies that the administration should concentrate on to boost exports. An export boom requires a system that encourage...

  16. Surface contamination initiated laser damage

    International Nuclear Information System (INIS)

    We are engaged in a comprehensive effort to understand and model the initiation and growth of laser damage initiated by surface contaminants. This includes, for example, the initial absorption by the contaminant, heating and plasma generation, pressure and thermal loading of the transparent substrate, and subsequent shockwave propagation, ''splashing'' of molten material and possible spallation, optical propagation and scattering, and treatment of material fracture. The integration use of large radiation hydrodynamics codes, optical propagation codes and material strength codes enables a comprehensive view of the damage process The following picture of surface contaminant initiated laser damage is emerging from our simulations. On the entrance optical surface, small particles can ablate nearly completely. In this case, only relatively weak shockwaves are launched into the substrate, but some particulate material may be left on the surface to act as a diffraction mask and cause further absorption. Diffraction by wavelength scale scattering centers can lead to significant intensity modulation. Larger particles will not be completely vaporized. The shockwave generated in this case 1642is larger and can lead to spallation of contaminant material which then may be deposited in the substrate. A gaseous atmosphere can lead to radiation trapping with concomitant increases in temperature and pressure near the surface. In addition, supersonic ionization waves in air may be generated which greatly extend the plasma plume spatially and temporally. Contaminants on the exit optical surface behave differently. They tend to heat and pop off completely in which case significant damage may not occur. Since plasma formed at the interface of the optic and absorbing particle is confined, much stronger pressures are generated in this case. Imaging of contaminants resulting in ''writing'' a diffraction pattern on the exit surface due to contamination on the entrance surface has been

  17. Guam Initial Technical Assessment Report

    Energy Technology Data Exchange (ETDEWEB)

    Baring-Gould, I.; Conrad, M.; Haase, S.; Hotchkiss, E.; McNutt, P.

    2011-04-01

    Under an interagency agreement, funded by the Department of Interior's (DOI) Office of Insular Affairs (OIA), the National Renewable Energy Laboratory (NREL) was tasked to deliver technical assistance to the island of Guam by conducting an island initial technical assessment that would lay out energy consumption and production data and establish a baseline. This assessment will be used to conduct future analysis and studies by NREL that will estimate energy efficiency and renewable energy potential for the island of Guam.

  18. Air sea ratio reduction initiative

    Energy Technology Data Exchange (ETDEWEB)

    Oberle, Jean

    2010-09-15

    Airfreight is the most expensive mode of transportation as well as the most impacting in terms of CO{sup 2} emissions. It is 7 times more expensive on average to ship by air than shipping by sea 1. Airfreight transportation mode emits 30 times more CO{sup 2} than sea freight mode 2. These elements provided a compelling platform to design a global logistics program to initiate a modal shift from air to sea freight without compromising service to customers.

  19. Smoking Initiation: Peers and Personality

    OpenAIRE

    Hsieh, Chih-Sheng; van Kippersluis, Hans

    2015-01-01

    Social interactions are generally thought to play an important role in smoking initiation among adolescents. In this paper we exploit detailed friendship nominations in the US Add Health data, and extend the Spatial Autoregressive Model (SAR) model to deal with (i) endogenous peer selection, and (ii) unobserved contextual effects, in order to identify the endogenous peer effect. We show that peer effects in the uptake of smoking are predominantly affecting individuals who are emotionally unst...

  20. PARENTING AND ADOLESCENTS’ SEXUAL INITIATION

    OpenAIRE

    Longmore, Monica A.; Eng, Abbey L.; Giordano, Peggy C.; Manning, Wendy D.

    2009-01-01

    This study draws on social control and social learning theories to examine the role of dating-specific attitudes and practices as predictors of adolescents’ sexual initiation. We include attention to the adolescent’s reaction to control attempts as a further means of assessing family dynamics (i.e., frequency of dating disagreements). The study uses longitudinal data from 697 adolescents who were not sexually active at the first interview as well as separate interviews with parents. In models...

  1. Initial steps of aerosol growth

    Directory of Open Access Journals (Sweden)

    O. Kulmala

    2004-09-01

    Full Text Available The formation and growth of atmospheric aerosols depend on several steps, namely nucleation, initial steps of growth and subsequent – mainly condensational – growth. This work focuses on the initial steps of growth, meaning the growth right after nucleation, where the interplay of curvature effects and thermodynamics has a significant role on the growth kinetics. More specifically, we investigate how ion clusters and aerosol particles grow from 1.5 nm to 20 nm in atmospheric conditions using experimental data obtained by air ion and aerosol spectrometers. The measurements have been performed at a boreal forest site in Finland. The observed trend that the growth rate seems to increase as a function of size can be used to investigate possible growth mechanisms. Such a growth rate is consistent with a recently suggested nano-Köhler mechanism, in which growth is activated at a certain size with respect to condensation of organic vapors. The results also imply that charge-enhance growth associated with ion-mediated nucleation plays only a minor role in the initial steps of growth, since it would imply a clear decrease of the growth rate with size. Finally, further evidence was obtained on the earlier suggestion that atmospheric nucleation and the subsequent growth of fresh nuclei are likely to be uncoupled phenomena via different participating vapors.

  2. Initial steps of aerosol growth

    Directory of Open Access Journals (Sweden)

    M. Kulmala

    2004-01-01

    Full Text Available The formation and growth of atmospheric aerosols depend on several steps, namely nucleation, initial steps of growth and subsequent – mainly condensational – growth. This work focuses on the initial steps of growth, meaning the growth right after nucleation, where the interplay of curvature effects and thermodynamics has a significant role on the growth kinetics. More specifically, we investigate how ion clusters and aerosol particles grow from 1.5 nm to 20 nm (diameter in atmospheric conditions using experimental data obtained by air ion and aerosol spectrometers. The measurements have been performed at a boreal forest site in Finland. The observed trend that the growth rate seems to increase as a function of size can be used to investigate possible growth mechanisms. Such a growth rate is consistent with a recently suggested nano-Köhler mechanism, in which growth is activated at a certain size with respect to condensation of organic vapors. The results also imply that charge-enhanced growth associated with ion-mediated nucleation plays only a minor role in the initial steps of growth, since it would imply a clear decrease of the growth rate with size. Finally, further evidence was obtained on the earlier suggestion that atmospheric nucleation and the subsequent growth of fresh nuclei are likely to be uncoupled phenomena via different participating vapors.

  3. Initial steps of aerosol growth

    Science.gov (United States)

    Kulmala, M.; Laakso, L.; Lehtinen, K. E. J.; Riipinen, I.; Dal Maso, M.; Anttila, T.; Kerminen, V.-M.; Hõrrak, U.; Vana, M.; Tammet, H.

    2004-12-01

    The formation and growth of atmospheric aerosols depend on several steps, namely nucleation, initial steps of growth and subsequent - mainly condensational - growth. This work focuses on the initial steps of growth, meaning the growth right after nucleation, where the interplay of curvature effects and thermodynamics has a significant role on the growth kinetics. More specifically, we investigate how ion clusters and aerosol particles grow from 1.5 nm to 20 nm (diameter) in atmospheric conditions using experimental data obtained by air ion and aerosol spectrometers. The measurements have been performed at a boreal forest site in Finland. The observed trend that the growth rate seems to increase as a function of size can be used to investigate possible growth mechanisms. Such a growth rate is consistent with a recently suggested nano-Köhler mechanism, in which growth is activated at a certain size with respect to condensation of organic vapors. The results also imply that charge-enhanced growth associated with ion-mediated nucleation plays only a minor role in the initial steps of growth, since it would imply a clear decrease of the growth rate with size. Finally, further evidence was obtained on the earlier suggestion that atmospheric nucleation and the subsequent growth of fresh nuclei are likely to be uncoupled phenomena via different participating vapors.

  4. Preliminary Identification of Accident Initiating Events for IFE Power Plants

    Energy Technology Data Exchange (ETDEWEB)

    Cadwallader, Lee Charles; Latkowsk, J. F.

    2001-10-01

    This paper presents initial results of a task to identify accident initiating events for inertial fusion energy (IFE) power plant designs. Initiating events (IEs) are a fundamental building block of a probabilistic risk assessment; they are the ‘accident starters’ that are analyzed to determine the risks posed to members of the public in the vicinity of the power plant. The IE results for the SOMBRERO design are presented in tabular form. The SOMBRERO design was analyzed since it is representative of dry chamber wall, laser driven designs. This work is used to characterize IFE plant risk and to identify potential design changes that would mitigate the plant risk.

  5. The next generation safeguards initiative

    International Nuclear Information System (INIS)

    NGSI or the Next Generation Safeguards Initiative is designed to revitalize the U.S. safeguards technical base, as well as invest in human resources, and to mobilize our primary asset - the U.S. National Laboratories - as well as industry and academia to restore capabilities. While NGSI is a U.S. effort it is intended to serve as a catalyst for a much broader commitment to international safeguards in partnership with the IAEA and other countries. Initiatives over the last years include such as the Proliferation Security Initiative, UN Security Council Resolution 1540, the Global Initiative to Combat Nuclear Terrorism, and initiatives of the G-8 and NSG to discourage the spread of enrichment and reprocessing. NGSI augments this agenda by providing a means to strengthen the technical and political underpinnings of IAEA safeguards. Priorities and envisioned activities under NGSI are the following. (1) Cooperation with IAEA and others to promote universal adoption of safeguards agreements and the Additional Protocol including greater information sharing between member states and the IAEA, investigation of weaponization and procurement activities, and options to strengthen the state-level approach to safeguards. (2) NGSI anticipates the deployment of new types of reactors and fuel cycle facilities, as well as the need to use limited safeguards resources effectively and efficiently, especially in plants that pose the largest burden specifically complex, bulk-handling facilities. (3) NGSI will encourage a generational improvement in current safeguards technologies including improvement of precision and speed of nuclear measurements, performance of real-time process monitoring and surveillance in unattended mode, enabling in-field, pre-screening and analysis of nuclear and environmental samples, and collection, integration, analysis and archiving safeguards-relevant information from all available sources.(4) NGSI will address human capital management. Training and

  6. Sitosterolemia Presenting as Pseudohomozygous Familial Hypercholesterolemia.

    Science.gov (United States)

    Renner, Christian; Connor, William E; Steiner, Robert D

    2016-06-01

    A young girl, age 8.5 years, presented with profound hypercholesterolemia and early xanthomatosis, suggesting homozygous familial (or type II) hypercholesterolemia. The patient's low density lipoprotein (LDL) receptor function and parental lipoprotein profiles were determined to be normal, prompting revision of the initial diagnosis to pseudohomozygous familial hypercholesterolemia. When she subsequently presented with giant platelets, the case was presented to colleagues on an electronic mailing list. It was recommended that plasma and sterol analysis be performed, which led to a diagnosis of sitosterolemia. The presentation of profound hypercholesterolomia in childhood that ultimately is not attributed as due to homozygous or compound heterozygous defects in the LDL receptor gene has been termed pseudohomozygous familial (or type II) hypercholesterolemia (PHT2HC). Patients diagnosed with PHT2HC subsequently confirmed to have sitosterolemia have been previously reported only rarely. The challenge of achieving accurate specific diagnosis and appropriate workup for these conditions in children is discussed in the context of this rare case and review of the historical literature concerning these conditions. PMID:27231115

  7. Initial Scraper Measurements in SPEAR 3

    CERN Document Server

    Corbett, Jeff; Terebilo, Andrei

    2005-01-01

    Horizontal and vertical scraper assemblies have been installed in a standard straight section of SPEAR 3 (beta-x=10.2 m, beta-y=4.8 m, epsx=18 nm-rad, 0.1% coupling). Each scraper has stepper motor accuracy and transductor resolution on the order of 1 micron and a MATLAB/EPICS interface to simplify data acquisition. In this paper we present initial scraper measurements and analysis of the results. Of particular importance are comparison of measured dynamic aperture and momentum acceptance with model and measurement of vertical acceptance for future beam lines.

  8. The First Nations Biomonitoring Initiative-FNBI.

    Science.gov (United States)

    La Corte, Elsa; Wuttke, Stuart

    2012-02-01

    The First Nations Biomonitoring Initiative (FNBI) pilot study was implemented in the winter 2010/2011, sampling 252 First Nations people on reserve in Canada for a suite of chemical contaminants following Cycle 1 of the Canadian Health Measures Survey (CHMS). Results will be sent confidentially to participants and a community report will be presented after the analysis of results, expected to be completed by fall of 2011. The national scale of the study will take place during the summer 2011/2012 and aims to sample thirteen communities with a participation of 42 First Nations people per community. Results are expected for spring 2012/2013.

  9. Initial performance of the High Speed Photometer

    Science.gov (United States)

    Richards, Evan; Percival, Jeff; Nelson, Matt; Hatter, ED; Fitch, John; White, Rick

    1991-01-01

    The Hubble Space Telescope High Speed Photometer has four image dissector tubes, two with UV sensitive photocathodes, two sensitive to the near UV and to visual light, and a single red sensitive photomultiplier tube. The HSP is capable of photometric measurements from 1200 to 7500 A with time resolution of 11 microseconds and has no moving parts. An initial analysis of the on-orbit engineering performance of the HSP is presented with changes in operating procedures resulting from the primary mirror spherical aberration and experience gained during the verification period.

  10. Session Initiation Protocol Attacks and Challenges

    CERN Document Server

    Keshavarz, Hassan; Noor, Rafidah Md

    2012-01-01

    In recent years, Session Initiation Protocol (SIP) has become widely used in current internet protocols. It is a text-based protocol much like Hyper Text Transport Protocol (HTTP) and Simple Mail Transport Protocol (SMTP). SIP is a strong enough signaling protocol on the internet for establishing, maintaining, and terminating session. In this paper the areas of security and attacks in SIP are discussed. We consider attacks from diverse related perspectives. The authentication schemes are compared, the representative existing solutions are highlighted, and several remaining research challenges are identified. Finally, the taxonomy of SIP threat will be presented.

  11. Korean initiatives on nuclear knowledge management

    International Nuclear Information System (INIS)

    Korean atomic energy activities have been the vigorous and ever expanding in the peaceful use of atomic energy. However for the last ten-year period, the new recruitments have been drastically reduced. The paper presents the nuclear manpower status in each nuclear related institute, which was surveyed in 2002. The ageing problem appears but is not very serious as a whole. The research institutes show more serious ageing problems compared to the industries. The paper also summarises the initiatives taken by Korean institutes related to the nuclear knowledge management activities with focus on the NtUss (Nuclear Technology Undergraduate Student Society) programme. (author)

  12. Test set for initial value problem solvers

    OpenAIRE

    Lioen, W.M.; Swart, de, Jacques

    1998-01-01

    The CWI test set for IVP solvers presents a collection of Initial Value Problems to test solvers for implicit differential equations. This test set can both decrease the effort for the code developer to test his software in a reliable way, and cross the bridge between the application field and numerical mathematics. This document contains the descriptive part of the test set. It describes the test problems and their origin, and reports on the behavior of a few state-of-the-art solvers on thes...

  13. Korean initiatives on nuclear knowledge management

    Energy Technology Data Exchange (ETDEWEB)

    Chung, B.-J. [Cheju National University, Ara 1-Dong, Jeju-Si, Jeju-Do 690-756 (Korea, Republic of)]. E-mail: bjchung@cheju.ac.kr; Kim, W.-G. [Ministry of Science and Technology, Government Complex 2, Gwachon-Si, Kyunggi-Do, 427-715 (Korea, Republic of)]. E-mail: wgkim@most.go.kr

    2006-07-01

    Korean atomic energy activities have been the vigorous and ever expanding in the peaceful use of atomic energy. However for the last ten-year period, the new recruitments have been drastically reduced. The paper presents the nuclear manpower status in each nuclear related institute, which was surveyed in 2002. The ageing problem appears but is not very serious as a whole. The research institutes show more serious ageing problems compared to the industries. The paper also summarises the initiatives taken by Korean institutes related to the nuclear knowledge management activities with focus on the NtUss (Nuclear Technology Undergraduate Student Society) programme. (author)

  14. Technology initiatives with government/business overlap

    Science.gov (United States)

    Knapp, Robert H., Jr.

    2015-03-01

    Three important present-day technology development settings involve significant overlap between government and private sectors. The Advanced Research Project Agency for Energy (ARPA-E) supports a wide range of "high risk, high return" projects carried out in academic, non-profit or private business settings. The Materials Genome Initiative (MGI), based in the White House, aims at radical acceleration of the development process for advanced materials. California public utilities such as Pacific Gas & Electric operate under a structure of financial returns and political program mandates that make them arms of public policy as much as independent businesses.

  15. The Initial Conditions of Fractional Calculus

    International Nuclear Information System (INIS)

    During the past fifty years , Fractional Calculus has become an original and renowned mathematical tool for the modelling of diffusion Partial Differential Equations and the design of robust control algorithms. However, in spite of these celebrated results, some theoretical problems have not yet received a satisfying solution. The mastery of initial conditions, either for Fractional Differential Equations (FDEs) or for the Caputo and Riemann-Liouville fractional derivatives, remains an open research domain. The solution of this fundamental problem, also related to the long range memory property, is certainly the necessary prerequisite for a satisfying approach to modelling and control applications. The fractional integrator and its continuously frequency distributed differential model is a valuable tool for the simulation of fractional systems and the solution of initial condition problems. Indeed, the infinite dimensional state vector of fractional integrators allows the direct generalization to fractional calculus of the theoretical results of integer order systems. After a reminder of definitions and properties related to fractional derivatives and systems, this presentation is intended to show, based on the results of two recent publications [1,2], how the fractional integrator provides the solution of the initial condition problem of FDEs and of Caputo and Riemann-Liouville fractional derivatives. Numerical simulation examples illustrate and validate these new theoretical concepts.

  16. NASA's Climate Data Services Initiative

    Science.gov (United States)

    McInerney, M.; Duffy, D.; Schnase, J. L.; Webster, W. P.

    2013-12-01

    Our understanding of the Earth's processes is based on a combination of observational data records and mathematical models. The size of NASA's space-based observational data sets is growing dramatically as new missions come online. However a potentially bigger data challenge is posed by the work of climate scientists, whose models are regularly producing data sets of hundreds of terabytes or more. It is important to understand that the 'Big Data' challenge of climate science cannot be solved with a single technological approach or an ad hoc assemblage of technologies. It will require a multi-faceted, well-integrated suite of capabilities that include cloud computing, large-scale compute-storage systems, high-performance analytics, scalable data management, and advanced deployment mechanisms in addition to the existing, well-established array of mature information technologies. It will also require a coherent organizational effort that is able to focus on the specific and sometimes unique requirements of climate science. Given that it is the knowledge that is gained from data that is of ultimate benefit to society, data publication and data analytics will play a particularly important role. In an effort to accelerate scientific discovery and innovation through broader use of climate data, NASA Goddard Space Flight Center's Office of Computational and Information Sciences and Technology has embarked on a determined effort to build a comprehensive, integrated data publication and analysis capability for climate science. The Climate Data Services (CDS) Initiative integrates people, expertise, and technology into a highly-focused, next-generation, one-stop climate science information service. The CDS Initiative is providing the organizational framework, processes, and protocols needed to deploy existing information technologies quickly using a combination of enterprise-level services and an expanding array of cloud services. Crucial to its effectiveness, the CDS

  17. Presentation of the ASTRAL software; Presentation du logiciel ASTRAL

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2011-07-01

    This report presents the ASTRAL software (ASTRAL means technical assistance in post-accidental radioprotection) which is aimed to be used as an aid-to-decision tool in the case of an important release of radionuclides in the environment by assessing radionuclide concentration in different environments and food products, determining the potential exposure to irradiation of concerned populations, foreseeing the evolution of the situation, and proposing different scenarios for the management of contaminated areas. The report describes the software general operation, presents the calculation module (main functionalities, concentration index calculation, dose calculation or radiological impact calculation, how countermeasures are taken into account), the data bases (contextual data, data for radio-ecological calculations and for radiological calculations), the software ergonomics (general principles, result selection and display, result printing and input data). Its briefly evokes the development quality assurance, and describes the software implementation architecture

  18. Polycythemia vera presenting as acute myocardial infarction: An unusual presentation

    OpenAIRE

    Bahbahani, Hussain; Aljenaee, Khaled; Bella, Abdelhaleem

    2014-01-01

    Acute myocardial infarction (AMI) is usually seen in the setting of atherosclerosis and its associated risk factors. Myocardial infarction in the young poses a particular challenge, as the disease is less likely, due to atherosclerosis. We report the case of a 37-year-old female patient who presented with ST segment elevation anterolateral AMI. The only abnormality on routine blood investigation was raised hemoglobin and hematocrit. After further testing, she was diagnosed according to the Wo...

  19. A Rare Presentation of Leishmaniasis.

    Science.gov (United States)

    Prajapati, Ritesh; Kumar, Ashish; Sharma, Praveen; Singla, Vikas; Bansal, Naresh; Dhawan, Shashi; Arora, Anil

    2016-06-01

    Leishmaniasis or kala-azar is a protozoan disease that can present as cutaneous, mucocutaneous, visceral, and disseminated disease. In India, it is usually localized in distinct areas of Bihar, Jharkhand, West Bengal, and parts of Eastern Uttar Pradesh. Visceral leishmaniasis (VL) involves the visceral organs, mainly the liver, the spleen and bone marrow. VL is characterized by prolonged fever, massive splenomegaly, weight loss, progressive anemia, pancytopenia, and hypergammaglobulinemia, and can be complicated by serious infections. In most of the patient the diagnosis is made on bone marrow biopsy or splenic aspirate. We hereby present an unusual case of kala-azar in a 52-year-old patient non-resident of endemic area presenting with pyrexia of unknown origin, in whom bone marrow biopsy was negative for Leishmanin Donovan (LD) bodies, and diagnosis was made by liver biopsy in which LD bodies were seen. PMID:27493461

  20. Comprehensible Presentation of Topological Information

    Energy Technology Data Exchange (ETDEWEB)

    Weber, Gunther H. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Beketayev, Kenes [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Bremer, Peer-Timo [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Hamann, Bernd [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Haranczyk, Maciej [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Hlawitschka, Mario [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Pascucci, Valerio [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2012-03-05

    Topological information has proven very valuable in the analysis of scientific data. An important challenge that remains is presenting this highly abstract information in a way that it is comprehensible even if one does not have an in-depth background in topology. Furthermore, it is often desirable to combine the structural insight gained by topological analysis with complementary information, such as geometric information. We present an overview over methods that use metaphors to make topological information more accessible to non-expert users, and we demonstrate their applicability to a range of scientific data sets. With the increasingly complex output of exascale simulations, the importance of having effective means of providing a comprehensible, abstract overview over data will grow. The techniques that we present will serve as an important foundation for this purpose.