Sample records for case study involving

  1. Caregiver Involvement in Hospice Interdisciplinary Team Meetings: A case study


    Wittenberg-Lyles, Elaine; Oliver, Debra Parker; Demiris, George; Petty, Bethany; Day, Michele


    Involving caregivers in hospice interdisciplinary team (IDT) meetings has been offered as a potential solution to caregivers' unmet communication needs. This case study details one caregiver's participation in her mother's hospice interdisciplinary team care planning meetings, both in person and via videophone technology. This preliminary case is offered as part of a larger National Cancer Institute sponsored study investigating involvement of caregivers in team meetings using videophone tech...

  2. Experimental quantum annealing: case study involving the graph isomorphism problem. (United States)

    Zick, Kenneth M; Shehab, Omar; French, Matthew


    Quantum annealing is a proposed combinatorial optimization technique meant to exploit quantum mechanical effects such as tunneling and entanglement. Real-world quantum annealing-based solvers require a combination of annealing and classical pre- and post-processing; at this early stage, little is known about how to partition and optimize the processing. This article presents an experimental case study of quantum annealing and some of the factors involved in real-world solvers, using a 504-qubit D-Wave Two machine and the graph isomorphism problem. To illustrate the role of classical pre-processing, a compact Hamiltonian is presented that enables a reduced Ising model for each problem instance. On random N-vertex graphs, the median number of variables is reduced from N(2) to fewer than N log2 N and solvable graph sizes increase from N = 5 to N = 13. Additionally, error correction via classical post-processing majority voting is evaluated. While the solution times are not competitive with classical approaches to graph isomorphism, the enhanced solver ultimately classified correctly every problem that was mapped to the processor and demonstrated clear advantages over the baseline approach. The results shed some light on the nature of real-world quantum annealing and the associated hybrid classical-quantum solvers.

  3. Three case studies involving Leptospira interrogans serovar pomona infection in mixed farming units : case report

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    B. Gummow


    Full Text Available Three case studies involving Leptospira interrogans serovar pomona outbreaks within mixed farming systems in South Africa are described. On 2 farms, pigs constituted the main enterprise with cattle and sheep of secondary importance. On each of these 2 farms, abortion due to L. pomona in sows was confirmed by culture, and antibody titres to pomona were detected in cattle, sheep, horses and dogs. On the 3rd farm, a piggery was ofsecondary importance to cattle farming. Abortion and death in cows occurred on this farmand serology showed titres to various serovars, including pomona. L. pomona was also isolated from bovine urine, an aborted bovine foetus and kidneys from slaughtered pigs. This particular case study was regarded as clinically atypical in that adult Jersey cattle died of acute leptospirosis in a semiarid region of South Africa. In all 3 case studies, the poor management of pig effluent and of the drinking water and its sources played a pivotal role in the transmission of the disease. Inadequate vaccination of animals against Leptospira and poor record-keeping within the secondary farming enterprises were also contributing factors to the spread of leptospirosis.

  4. Governing integration through sports. A case study of civil society involvement in welfare policy

    DEFF Research Database (Denmark)

    Agergaard, Sine; Michelsen la Cour, Annette


    governing techniques of the welfare state. To do so, a case study approach is applied. First of all, the article will describe the ways in which the issues of enhancing ethnic integration through sports is represented (thought of as a problem) by the involved public authorities and non-state actors using...

  5. Organizational values in general practice and public involvement: case studies in an urban district. (United States)

    Brown, I


    A multiple case study design was used to explore dimensions of organizational values in general practice with respect to developing public involvement. The study was undertaken in an urban district in England with data collected through in-depth individual and focus group interviews with service providers and service users. Four general practice organizations were randomly selected for study after sorting all in the district according to their record of developing involvement activities. The case studies provide evidence of how organizational values can differ markedly in general practice in relation to ideas of public involvement, with consequences for the quantity and quality of activities for involving local people and service users. The differences manifest themselves in the beliefs and attitudes of service providers about the purpose of the organization and the types of relationships that are appropriate with service users and local people. Service users appear to be very perceptive to the underlying ethos and purpose to their practice organization and this affects their responsiveness to initiatives for their involvement. The dimensions of the different values found in the study appear to be essentially the same as a number of established empirical findings of variations in values in general practice: an orientation to a narrow medical role and to general practice as a business are associated with a low valuation of involvement; an orientation to teamwork and to a broader social role appear more congruent with the development of involvement. Power is a critical issue in this setting with evidence in the study of the dominance of the medical practitioners in establishing organizational values and the nature of public involvement activities.

  6. The contribution of advisory committees and public involvement to large studies: case study

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    Tew Jerry


    Full Text Available Abstract Background Many large studies have complex advisory committee structures, yet there is no empirical evidence regarding their optimal composition, scope and contribution. The aim of this study was to inform the committee and advice infrastructure for future research studies. Methods In the context of a five-year study funded by the UK National Institute for Health Research, three advisory committees were formed. In addition, advice was obtained from individual experts. All recommendations received in the start-up phase (first seven months of the study were recorded, along with the decision about implementation of the recommendation. A particular focus was on the impact of public involvement. Results A total of 172 recommendations were made, including 70 from 20 individual experts. The recommendations were grouped into five emergent themes: Scientific, Pragmatic, Resources, Committee and Collaboration. Most recommendations related to strengthening existing components or adding new components to the study protocol. Very few recommendations either proposed removing study components or contradicted other recommendations. Three 'implementation criteria' were identified: scientific value, pragmatic feasibility, and paradigmatic consistency. 103 (60% of recommendations were implemented and 25 (15% were not implemented. The benefits identified by the research team were improved quality and confidence, and the costs were increased cognitive demands, protocol revision time, and slower progress. Conclusions The findings are discussed in the context of the wider literature on public involvement in research. Six recommendations are identified. First, have a clear rationale for each advisory committee expressed as terms of reference, and consider the best balance between committees and individual consultation with experts. Second, an early concern of committees is inter-committee communication, so consider cross-representation and copying minutes

  7. Three case studies involving Leptospira interrogans serovar pomona infection in mixed farming units. (United States)

    Gummow, B; Myburgh, J G; Thompson, P N; van der Lugt, J J; Spencer, B T


    Three case studies involving Leptospira interrogans serovar pomona outbreaks within mixed farming systems in South Africa are described. On 2 farms, pigs constituted the main enterprise with cattle and sheep of secondary importance. On each of these 2 farms, abortion due to L. pomona in sows was confirmed by culture, and antibody titres to pomona were detected in cattle, sheep, horses and dogs. On the 3rd farm, a piggery was of secondary importance to cattle farming. Abortion and death in cows occurred on this farm and serology showed titres to various serovars, including pomona. L. pomona was also isolated from bovine urine, an aborted bovine foetus and kidneys from slaughtered pigs. This particular case study was regarded as clinically atypical in that adult Jersey cattle died of acute leptospirosis in a semiarid region of South Africa. In all 3 case studies, the poor management of pig effluent and of the drinking water and its sources played a pivotal role in the transmission of the disease. Inadequate vaccination of animals against Leptospira and poor record-keeping within the secondary farming enterprises were also contributing factors to the spread of leptospirosis.

  8. Reflective processes and competencies involved in teaching practice at university: a case study

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    Caetano da Costa


    Full Text Available Founded on practical rationality, this qualitative case study aimed to explore the teaching practice at university, focusing on teacher's reflections and competencies. To this end, teaching practices were described, analyzed, and interpreted. These interactions with students on a course in the pharmacy program, brought about situations involving dilemmas and learning opportunities for problem-solving and decision-making skills. Throughout the study, students were encouraged to use knowledge-in-action, reflection-in-action, and reflection-on-action, and these processes were also experienced by the teacher. Analysis of the records from classroom observation and the interviews with students and the teacher showed the fundamental role of such reflective processes, which led to attainment of the intended objectives. In this sense, the teacher's reflective practice was essential for supporting the application of each curricular component of the course.


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    Prediscan Mariana


    Full Text Available Innovation, competitive advantage, change are some concepts that should be on every organization's agenda, due to the fact the global market leads to global competition so in order to increase the market share, turnover or profit organizations have to incorporate those concepts in their strategies. The outside environment is very unstable and things are evolving very fast so managers from all levels have to acknowledge the importance of change and to identify as soon as possible several new ideas that should be the subject of different change processes. Openness to organizational change has become a mandatory feature for those organizations that want to survive and adapt to the external pressure, helping them to be efficient. Even if in many cases managers are the initiators of change, this process is very complex and needs support and involvement from all the members of the organization, so the employee's attitude and commitment to change is crucial. In many cases employees have a negative attitude towards change and manifest a strong resistance, due to the fact that they are not consulted and are not involved in the process of the identification for the need of change. Without understanding and knowing very well what it is expected from them, employees are afraid of the unknown and prefer to perform their tasks as they did before. Creating a climate and a culture for change is very important, because like this change will be something normal, continuous and people will feel comfortable with any change initiatives, without being surprised, confused or scared. Even if any change process should improve the current state of the organization, sometimes change efforts fail because the ones that resist change are stronger than the ones supporting change. The purpose of this paper is to analyze how often are Romanian employees involved in the processes of change and how important is the role they play. We have also tried to see the Romanian manager

  10. "You Have the Right to Remain Silent." Two Case Studies in Forensic Linguistics Involving Spanish Speaking Suspects. (United States)

    Perissinotto, Giorgio

    Two case studies involving possible violations of the rights of Spanish speaking criminal suspects are presented. In cases where suspects do not understand English, the Miranda warnings regarding the right to remain silent must be delivered in their native language and in a way that is understandable to the suspects. In the two cases involving…

  11. Involvement of external stakeholders in local Health policymaking process: a case study from Odense Municipality, Denmark

    DEFF Research Database (Denmark)

    Eklund Karlsson, Leena; Jakobsen, Mette Winge; Winblad Heiberg, Malin;


    Collaboration between research and policy is an essential element for knowledge-based public health. However, only half of the Danish municipalities have experience with collaborating with researchers or other stakeholders. Through content analysis of interviews and policy documents the study...... explores the involvement of external stakeholders in local health policymaking and public officials’ perceptions on involving them. Main involvement was through a personal contact or through a regular hearing. The purpose of involvement was mostly tactical or to solve problems. Politicians had substantial...... influence on the involvement of external stakeholders, allowing only a few to contribute in a closed policymaking process....

  12. Structural influences on involvement in European homegrown jihadism : A case study

    NARCIS (Netherlands)

    Schuurman, B.W.; Bakker, E.; Eijkman, Q.A.M.


    his article empirically assesses the applicability of structural-level hypotheses for involvement in terrorism within the context of European homegrown jihadism. It uses these hypotheses to study how structural factors influenced involvement in the Dutch “Hofstadgroup.” Structural factors enabled th

  13. Anyang:A Case Study of Foreign University Involvement in Chinese Sustainable New Town Planning

    Institute of Scientific and Technical Information of China (English)

    Menelaos Triantafillou; David J.Edelman


    Over the last ten to fifteen years,planning and design professionals in the United States and Europe have increasingly been engaged in consulting work in China.Major Architectural & Engineering firms from the United Kingdom and the United States,for example,have been opening offices in Beijing and Shanghai.Recently,the concern with sustainable urban development and China’s policies to alleviate pressures of urbanization has been an engine for commissions for new town plans and city expansion plans across China’s provinces.During the 2007-2009 academic years,the School of Planning at the University of Cincinnati prepared a conceptual plan for the expansion of the City of Anyang through a collaborative agreement between the city and it.The experience of the faculty leading this project with field work,the planning process,plan preparation,and the engagement of students has revealed some important issues that need to be addressed by planning schools and planning professionals engaged in planning in provincial China.Thus,this paper is a case study of foreign university involvement in Chinese sustainable new town planning,and the following sections discuss the Anyang Eastern New Town Conceptual Plan,identify the key issues regarding preparing the plan,contracting and payment,data availability,data sharing and field investigation,and finally discuss the lessons learned regarding the planning process,project program and expectations.

  14. Involving Children With Cancer in Health Promotive Research: A Case Study Describing Why, What, and How (United States)

    Lindberg, Susanne; Wärnestål, Pontus; Svedberg, Petra


    Background Participatory research approaches have been introduced to meet end-users’ needs in the development of health promotion interventions among children. However, whereas children are increasingly involved as passive informants in particular parts of research, they are rarely involved as partners, equal to adult researchers, throughout the research process. This is especially prominent in the context of child health where the child is commonly considered to be vulnerable or when the research concerns sensitive situations. In these cases, researchers and gatekeepers to children’s involvement base their resistance to active involvement of children on potential adverse effects on the accuracy or quality of the research or on ethical or moral principles that participation might harm the child. Thus most research aimed at developing health promotion interventions for children in health care is primarily based on the involvement of parents, caregivers, and other stakeholders. Objective The objective of this paper is to discuss reasons for involving children in health promotive research and to explore models for children’s participation in research as a basis for describing how researchers can use design methodology and participatory approaches to support the participation and contribution of children in a vulnerable context. Methods We developed and applied a model for children's participation in research to the development of a digital peer support service for children cancer survivors. This guided the selection of appropriate research and design methodologies (such as interviews, focus groups, design sessions, and usability evaluation) for involving the children cancer survivors (8-12 years) in the design of a digital peer support service. Results We present a model for what children’s participation in research means and describe how we practically implemented this model in a research project on children with cancer. This paper can inform researchers in

  15. Community involvement in health services at Namayumba and Bobi health centres: A case study

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    Jane F. Namatovu


    Full Text Available Background: Community involvement has been employed in the development of both vertical and horizontal health programmes. In Uganda, there is no empirical evidence on whether and how communities are involved in their health services.Aim and Setting: The aim of this study was to establish the existence of community involvement in health services and to identify its support mechanisms in Namayumba and Bobi health centres in Wakiso and Gulu districts, respectively.Methods: Participants were selected with the help of a community mobiliser. Key informants were selected purposively depending on their expertise and the roles played in their respective communities. The focus group discussions and key informant interviews were audio-recorded and transcribed verbatim. The transcripts were analysed manually for emerging themes and sub-themes.Results: Several themes emerged from the transcripts and we categorised them broadly into those that promote community involvement in health services and those that jeopardise it. Easy community mobilisation and several forms of community and health centre efforts promote community involvement, whilst lack of trust for health workers and poor communication downplay community involvement in their health services.Conclusion: Community involvement is low in health services in both Namayumba and Bobi health centres.

  16. Managing Supplier Involvement in New Product Development: A Multiple-Case Study

    NARCIS (Netherlands)

    F.E.A. van Echtelt (Ferrie); J.Y.F. Wynstra (Finn); A.J. van Weele (Arjan); G.M. Duysters (Geert)


    textabstractExisting studies of supplier involvement in new product development have mainly focused on project-related short-term processes and success-factors. This study validates and extends an existing exploratory framework, which comprises both long-term strategic processes and short-term opera

  17. The Management of Parental Involvement in Multicultural Schools in South Africa: A Case Study

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    Sathiapama Michael


    Full Text Available The aim of this study was to investigate the management of parental involvement in three multicultural schools in the Umlazi District in Durban, South Africa. A literature survey resulting in a theoretical framework on parental involvement in schools, multicultural schools, and the managing of parental involvement in schools has been done. The contextual background of schools in contemporary South Africa is depicted. A qualitative research design has been used. Focus group discussions have been conducted, with a total of thirty-three principals, teachers and parents. It has found that there is a low level of meaningful contact between school and parents. Apathy exists on the side of parents, low expectations on the side of principals and teachers, and an organisational structure facilitating parent-school interaction is lacking. In managing parental involvement in multicultural schools, school managers display a lack of intercultural sensitivity.

  18. A Case Study in Classroom Management and School Involvement: Designing an Art Room for Effective Learning (United States)

    Broome, Jeffrey L.


    The purpose of this research project is to investigate the design of classroom environments through the lens of a uniquely selected art educator. More specifically, the purpose is to use case study methodology (Stake, 1995) to characterize the resulting instructional experiences for an art educator who had the unique opportunity to collaborate…

  19. International public health research involving interpreters: a case study from Bangladesh

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    van Teijlingen Edwin


    Full Text Available Abstract Background Cross-cultural and international research are important components of public health research, but the challenges of language barriers and working with interpreters are often overlooked, particularly in the case of qualitative research. Methods A case-study approach was used to explore experiences of working with an interpreter in Bangladesh as part of a research project investigating women's experiences of emergency obstetric care. The case study Data from the researcher's field notes provided evidence of experiences in working with an interpreter and show how the model of interviewing was adapted over time to give a more active role to the interpreter. The advantages of a more active role were increased rapport and "flow" in interviews. The disadvantages included reduced control from the researcher's perspective. Some tensions between the researcher and interpreter remained hard to overcome, irrespective of the model used. Independent transcription and translation of the interviews also raised questions around accuracy in translation. Conclusion The issues examined in this case study have broader implications for public health research. Further work is needed in three areas: 1 developing effective relationships with interpreters; 2 the impact of the interpreter on the research process; and 3 the accuracy of the translation and level of analysis needed in any specific public health research. Finally, this paper highlights the importance to authors of reflecting on the potential impact of translation and interpretation on the research process when disseminating their research.

  20. Student Involvement as a Vehicle for Empowerment: A Case Study of the Student Platform for Engineering Education Development (United States)

    Delaine, David A.; Seif-Naraghi, Sonya B.; Al-Haque, Shahed; Wojewoda, Nicolo; Meninato, Yvonne; DeBoer, Jennifer


    This paper examines the mission, structure and outputs of one organisation, the Student Platform for Engineering Education Development (SPEED), as a case study for how student-led organisations can use student involvement to promote and sustain student self-efficacy in an academic field. SPEED attracts young people to engineering through student…

  1. Retrospective study of sonographic findings in bone involvement associated with rotator cuff calcific tendinopathy: preliminary results of a case series

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    Marcello H. Nogueira-Barbosa


    Full Text Available Abstract Objective: The present study was aimed at investigating bone involvement secondary to rotator cuff calcific tendonitis at ultrasonography. Materials and Methods: Retrospective study of a case series. The authors reviewed shoulder ultrasonography reports of 141 patients diagnosed with rotator cuff calcific tendonitis, collected from the computer-based data records of their institution over a four-year period. Imaging findings were retrospectively and consensually analyzed by two experienced musculoskeletal radiologists looking for bone involvement associated with calcific tendonitis. Only the cases confirmed by computed tomography were considered for descriptive analysis. Results: Sonographic findings of calcific tendinopathy with bone involvement were observed in 7/141 (~ 5% patients (mean age, 50.9 years; age range, 42-58 years; 42% female. Cortical bone erosion adjacent to tendon calcification was the most common finding, observed in 7/7 cases. Signs of intraosseous migration were found in 3/7 cases, and subcortical cysts in 2/7 cases. The findings were confirmed by computed tomography. Calcifications associated with bone abnormalities showed no acoustic shadowing at ultrasonography, favoring the hypothesis of resorption phase of the disease. Conclusion: Preliminary results of the present study suggest that ultrasonography can identify bone abnormalities secondary to rotator cuff calcific tendinopathy, particularly the presence of cortical bone erosion.

  2. Multivariate analysis of variance of designed chromatographic data. A case study involving fermentation of rooibos tea. (United States)

    Marini, Federico; de Beer, Dalene; Walters, Nico A; de Villiers, André; Joubert, Elizabeth; Walczak, Beata


    An ultimate goal of investigations of rooibos plant material subjected to different stages of fermentation is to identify the chemical changes taking place in the phenolic composition, using an untargeted approach and chromatographic fingerprints. Realization of this goal requires, among others, identification of the main components of the plant material involved in chemical reactions during the fermentation process. Quantitative chromatographic data for the compounds for extracts of green, semi-fermented and fermented rooibos form the basis of preliminary study following a targeted approach. The aim is to estimate whether treatment has a significant effect based on all quantified compounds and to identify the compounds, which contribute significantly to it. Analysis of variance is performed using modern multivariate methods such as ANOVA-Simultaneous Component Analysis, ANOVA - Target Projection and regularized MANOVA. This study is the first one in which all three approaches are compared and evaluated. For the data studied, all tree methods reveal the same significance of the fermentation effect on the extract compositions, but they lead to its different interpretation.

  3. Student involvement as a vehicle for empowerment: a case study of the student platform for engineering education development (United States)

    Delaine, David A.; Seif-Naraghi, Sonya B.; Al-Haque, Shahed; Wojewoda, Nicolò; Meninato, Yvonne; DeBoer, Jennifer


    This paper examines the mission, structure and outputs of one organisation, the Student Platform for Engineering Education Development (SPEED), as a case study for how student-led organisations can use student involvement to promote and sustain student self-efficacy in an academic field. SPEED attracts young people to engineering through student participation in engineering education (EE). SPEED is a global, non-profit student organisation that functions as an interdisciplinary network to diversify dialogue, stimulate change and impact the development of EE and its effect on society. SPEED is directly attracting young people to engineering in various ways: the organisation of its keynote event, the Global Student Forum; facilitating interactions between globally minded, socially inclined engineers with aspirations to change the world; and through the global dissemination of SPEED's work and practices through broad and relevant channels. Short-term outcomes are highlighted here. This case study can serve as a model for student engagement and involvement in other disciplines.

  4. The timing of drug funding announcements relative to elections: a case study involving dementia medications.

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    Sudeep S Gill

    Full Text Available BACKGROUND: Following initial regulatory approval of prescription drugs, many factors may influence insurers and health systems when they decide whether to add these drugs to their formularies. The role of political pressures on drug funding announcements has received relatively little attention, and elections represent an especially powerful form of political pressure. We examined the temporal relationship between decisions to add one class of drugs to publicly funded formularies in Canada's ten provinces and elections in these jurisdictions. METHODS: Dates of provincial formulary listings for cholinesterase inhibitors, which are drugs used to treat Alzheimer's disease and related dementias, were compared to the dates of provincial elections. Medical journal articles, media reports, and proceedings from provincial legislatures were reviewed to assemble information on the chronology of events. We tested whether there was a statistically significant increase in the probability of drug funding announcements within the 60-day intervals preceding provincial elections. RESULTS: Decisions to fund the cholinesterase inhibitors were made over a nine-year span from 1999 to 2007 in the ten provinces. In four of ten provinces, the drugs were added to formularies in a time period closely preceding a provincial election (P = 0.032; funding announcements in these provinces were made between 2 and 47 days prior to elections. Statements made in provincial legislatures highlight the key role of political pressures in these funding announcements. CONCLUSIONS: Impending elections appeared to affect the timing of drug funding announcements in this case study. Despite an established structure for evidence-based decision-making, drug funding remains a complex process open to influence from many sources. Awareness of such influences is critical to maintain effective drug policy and public health decision-making.

  5. Using Technology to Enhance Research-Based Best Practices for Increasing Parental Involvement: A Case Study (United States)

    Helgesen, Rhonda L.


    The No Child Left Behind Act of 2001 (NCLB) established guidelines pertaining to student achievement and included requirements regarding parental involvement and communication between the school and home. Various issues stand in the way of realizing the level of parental engagement desired by educators and ordered by NCLB. Parental participation…

  6. Community Involvement in Tourism Development: A Case Study of Lenggong Valley World Heritage Site

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    A. Khadar Nur Zafirah


    Full Text Available This paper examines the empirical relationship between the economic impact and community involvement in the Lenggong Valley. Recommendations for improvement in development effectiveness through the development of a community centre for economic and social activities, with specific attention given to types of activity and community involvement stimulating the economic development in the Lenggong Valley. Heritage tourism development is a tourism in which arts, culture and heritage form a key attraction for visitors and it can be represented as an area of significant economic benefit to heritage sites. The tourism industry in Hulu Perak became more widespread after Lenggong Valley is recognized as a World Heritage Site. There is shown a positive effect on the development and economic prosperity.

  7. Roles, authority and involvement of the management accounting function: a multiple case-study perspective


    Lambert, Caroline; Sponem, Samuel


    Recent techniques and shifts in the environment are often foreseen as leading management accountants to adopt a business orientation. However, empirical evidence pointing to fundamental shifts in the roles played by management accountants remains relatively scarce. The authors explore this paradox and give sense to the various roles played by the management accounting function by focusing on how management accountants are involved in and endowed with authority in decision-making situations.

  8. Using role analysis to plan for stakeholder involvement: a Wyoming case study (United States)

    Burkardt, Nina; Ponds, Phadrea D.


    Prior to implementing laws and policies regulating water, wildlife, wetlands, endangered species, and recreation, natural resource managers often solicit public input. Concomitantly, managers are continually seeking more effective ways to involve stakeholders. In the autumn of 1999, the Wyoming Game and Fish Department sought to develop a state management plan for its portion of the Yellowstone grizzly bear (Ursus arctos horribilis) population if it was removed from the federal threatened species list. A key aspect of developing this plan was the involvement of federal, state, and local agencies, representatives from nongovernmental organizations, and citizens. Wyoming wildlife managers asked researchers from the United States Geological Survey to demonstrate how the Legal-Institutional Analysis Model could be used to initiate this process. To address these needs, we conducted similar workshops for a group of state and federal managers or staffers and a broad group of stakeholders. Although we found similarities among the workshop groups, we also recorded differences in perspective between stakeholder groups. The managers group acknowledged the importance of varied stakeholders but viewed the grizzly bear planning process as one centered on state interests, influenced by state policies, and amenable to negotiation. The other workshops identified many stakeholders and viewed the decision process as diffuse, with many opportunities for entry into the process. These latter groups were less certain about the chance for a successful negotiation. We concluded that if these assumptions and differences were not reconciled, the public involvement effort was not likely to succeed.

  9. A Case Study of Ethnic Minorities as Tourism Entrepreneurs: Their Involvement in Sustainable Tourism Development

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    Ceren Miral


    Full Text Available Most tourism activities excluding the e-tourism activities as matter of their nature (service taker and provider take place face to face between people. In addition tourism activities encourage bonding people both for tourists and the tourism services providers. Tourism creates cohesion for many different cultural groups. One of the cities in Turkey, Izmir is a good example with including too many culturally oriented groups such as Levantines, Greek, Jewish, rarely Armenians. In this paper there are two research questions are hold; how is being the other (ethnic minority as tourism entrepreneurs in tourism industry in Izmir and their involvement in sustainable tourism development is investigated and if tourism activities help connecting different cultural groups together and closer is investigated. So regarding these research questions, the research methodology in this paper is qualitative. For that reason, semi structured interview technique is applied to people are belong to different cultural groups and identities whom entrepreneurs in tourism industry. Semi structured interview technique is a commonly used an interview method depending on providing deep understanding of participants` perceptions, thoughts and behaviors. In general, understanding of the other brings feeling respect to others` cultural beliefs and lifestyle and this will make peace and harmony to where they live together. As a result, with the light of these research questions being the other entrepreneurship in sustainable tourism development in Izmir is evaluated. Furthermore, in this research is tried to indicate the advantageous and disadvantageous and importance of different cultural groups for sustainable tourism development

  10. Clinical Significance of Auditive Involvement in Rheumatoid Arthritis: A Case-Control Study (United States)

    Alonso, Laura; Gutierrez-Farfan, Ileana; Peña-Ayala, Angelica; Perez-Bastidas, Maria-Esther; Espinosa, Rolando


    Introduction. Rheumatoid arthritis (RA) can involve the incudomalleolar or incudostapedial articulations. Objective. To know the punctual prevalence of audiological alterations in patients with RA. Patients and Methods. RA patients and their controls (Cs), were evaluated by Tonal Audiometry (AU); if there were alterations in the air conduction (AC), bone conduction (BC), Logoaudiometry (LG), and Tympanometry (T) were performed. Results. 45 RA patients and 45 Cs were evaluated. RA patients had 40% of bilateral and 17.8% unilateral alteration versus Cs with 22.2% bilateral and 4.4% unilateral alteration versus Cs with 22.2% bilateral and 4.4% unilateral in AC audiometry. In conventional T (CT) As-type curves in patients with RA, there were 22 LE (48.8%) and 26 RE (57.7%) versus Cs, there were16 RE (35.5%) and 20 LE (44.4%). In High-frequency T (HFT): the 3B1G pattern in RA more frequent versus Controls (Cs) in RE (P = .002 and LE (P = .01). There were no differences according to RA activity or RA disease evolution. Conclusions. There is a greater tendency of auditive loss of As curves in CT (rigidity in ossicular chain) and of the 3B1G pattern in HFT in RA. PMID:22482066

  11. Considering the air quality impacts of bioenergy crop production: a case study involving Arundo donax. (United States)

    Porter, William C; Barsanti, Kelley C; Baughman, Eowyn C; Rosenstiel, Todd N


    The expanding production of bioenergy crops may impact regional air quality through the production of volatile organic compounds such as isoprene. To investigate the effects of isoprene-emitting crops on air quality, specifically ozone (O(3)) and secondary organic aerosol (SOA) formation, we performed a series of model runs using the Weather Research and Forecasting model with Chemistry (WRF/Chem) coupled with the Model of Emissions of Gases and Aerosols from Nature (MEGAN) simulating a proposed cropland conversion to the giant cane Arundo donax for biomass production. Cultivation of A. donax in the relatively clean air of northeastern Oregon resulted in an average increase in 8 h O(3) levels of 0.52 ppb, while SOA was largely unaffected (<+0.01 μg m(-3)). Conversions in U.S. regions with reduced air quality (eastern Texas and northern Illinois) resulted in average 8 h O(3) increases of 2.46 and 3.97 ppb, respectively, with daily increases up to 15 ppb in the Illinois case, and daytime SOA increases up to 0.57 μg m(-3). While cultivation of isoprene-emitting bioenergy crops may be appropriate at some scales and in some regions, other areas may experience increased O(3) and SOA, highlighting the need to consider isoprene emissions when evaluating potential regional impacts of bioenergy crop production.

  12. Community involvement in the development of an environmental education programme: the Tswaing meteorite crater conservation area as a case study

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    C.H. Swanepoel


    Full Text Available A key requirement for the relevance of applied research in education is its actual impact on society. A case study was undertaken to determine how research insights could be implemented by involving a local community in the design and implementation of environmental education programmes in their environment. The Tswaing Meteorite Crater conservation area project was undertaken with the active participation of teachers, learners and education officers from the communities living around Tswaing, as well as subject specialists. Issues which should be considered in the development of similar programmes were also highlighted.

  13. How to involve stakeholders in fisheries management : a country case study in Trinidad and Tobago

    NARCIS (Netherlands)

    Soma, K.


    The main purpose of this study is to show how the analytic hierarchy process (AHP) methodology can be applied to prepare and facilitate desired changes which the fishery sector with its stakeholders face. This is shown by an application of the AHP methodology in the shrimp fishery sector in Trinidad

  14. Learning through Political Participation: A Case Study of Spanish Elders Involved in Political Organizations (United States)

    Serrat, Rodrigo; Petriwskyj, Andrea; Villar, Feliciano; Warburton, Jeni


    Older people's civic participation contributes to community development while at the same time providing opportunities for personal growth in later life. One important dimension of civic participation that has been largely underexplored is informal learning. The aim of this study is to explore the learnings experienced by Spanish older people…

  15. Exploratory Study of MOOC Learners' Demographics and Motivation: The Case of Students Involved in Groups (United States)

    Bayeck, Rebecca Yvonne


    This paper reports preliminary findings on students enrolled in a massive open online course, who were also assigned to work in groups. Part of a larger study on the effect of groups on retention and completion in MOOCs, the paper provides students' demographics (i.e., location, gender, education level, and employment status), and motivation for…

  16. Student involvement as a vehicle for empowerment: a case study of the student platform for engineering education development

    KAUST Repository

    Delaine, David A.


    This paper examines the mission, structure and outputs of one organisation, the Student Platform for Engineering Education Development (SPEED), as a case study for how student-led organisations can use student involvement to promote and sustain student self-efficacy in an academic field. SPEED attracts young people to engineering through student participation in engineering education (EE). SPEED is a global, non-profit student organisation that functions as an interdisciplinary network to diversify dialogue, stimulate change and impact the development of EE and its effect on society. SPEED is directly attracting young people to engineering in various ways: the organisation of its keynote event, the Global Student Forum; facilitating interactions between globally minded, socially inclined engineers with aspirations to change the world; and through the global dissemination of SPEED\\'s work and practices through broad and relevant channels. Short-term outcomes are highlighted here. This case study can serve as a model for student engagement and involvement in other disciplines. © 2010 SEFI.

  17. A case study involving a blunt abdominal trauma leading to disruption of the aortic bifurcation in an infant

    Directory of Open Access Journals (Sweden)

    Seleno Glauber de Jesus-Silva


    Full Text Available The incidence of aortic disruption secondary to blunt abdominal trauma is rarely reported in the pediatric population. In general, most of the cases described are the result of motor vehicle accidents. We report on the treatment and outcomes of a 5-year-old child with aortic bifurcation disruption secondary to an unusual case of blunt abdominal trauma who was admitted to the emergency room in hypovolemic shock and subjected to immediate exploratory laparotomy and vascular repair. The mechanical forces involved in aortic disruption and the management options for repair and treatment of this injury will be discussed.

  18. Chronic eosinophilic pneumonia involving with mediastinal lymph nodes: radiologic study of three cases. Neumonia eosinofila cronica asociada a adenopatias mediastinicas: estudio radiologico de tres casos

    Energy Technology Data Exchange (ETDEWEB)

    Calvo Garcia, A.; Gordillo Gutierrez, I.; Guembe Urtiaga, P. (Hospital Gregorio Maraon, Madrid (Spain))


    Chronic eosinophilic pneumonia (CEP) is an uncommon disorder in our setting. Chest x-ray is essential to diagnosis. To date, we have found only three reported cases in which mediastinal lymph nodes were involved. We present three additional cases with standard thoracic study. (Author)

  19. Clinical studies involving probiotics


    Degnan, Fred H


    Researchers from a diverse array of scientific disciplines have focused and continue to focus on opportunities and areas for responsible clinical research involving the possible beneficial health effects of “probiotics.” Investigators and researchers should be aware that not all clinical research involving probiotics reasonably falls within the requirements of the “investigational new drug” (IND) rubric administered and enforced by the US Food and Drug Administration. In determining whether a...

  20. Diabetes, cardiac disorders and asthma as risk factors for severe organ involvement among adult dengue patients: A matched case-control study (United States)

    Pang, Junxiong; Hsu, Jung Pu; Yeo, Tsin Wen; Leo, Yee Sin; Lye, David C.


    Progression to severe organ involvement due to dengue infection has been associated with severe dengue disease, intensive care treatment, and mortality. However, there is a lack of understanding of the impact of pre-existing comorbidities and other risk factors of severe organ involvement among dengue adults. The aim of this retrospective case-control study is to characterize and identify risk factors that predispose dengue adults at risk of progression with severe organ involvement. This study involved 174 dengue patients who had progressed with severe organ involvement and 865 dengue patients without severe organ involvement, matched by the year of presentation of the cases, who were admitted to Tan Tock Seng Hospital between year 2005 and 2008. Age group of 60 years or older, diabetes, cardiac disorders, asthma, and having two or more pre-existing comorbidities were independent risk factors of severe organ involvement. Abdominal pain, clinical fluid accumulation, and hematocrit rise and rapid platelet count drop at presentation were significantly associated with severe organ involvement. These risk factors, when validated in a larger study, will be useful for triage by clinicians for prompt monitoring and clinical management at first presentation, to minimize the risk of severe organ involvement and hence, disease severity. PMID:28045096

  1. Queer Student Leaders: An Exploratory Case Study of Identity Development and LGBT Student Involvement at a Midwestern Research University (United States)

    Renn, Kristen A.; Bilodeau, Brent


    Using the first phase of a longitudinal study of student leaders of the 2002 Midwest Bi-, Lesbian, Gay, Transgender and Allies College Conference (MBLGTACC), the authors explore the intersections of involvement in identity-specific leadership activities and development of LGBT/Queer identity. LGBT leadership experiences appear to have contributed…

  2. Relational Underpinnings and Professionality--A Case Study of a Teacher's Practices Involving Students with Experiences of School Failure (United States)

    Frelin, Anneli


    Relational features of the educational environment, such as positive teacher-student relationships, are important for students' academic success. This case study explores the relational practices of a teacher who negotiates educational relationships with students who have a history of school failure. "Gunilla", a secondary school teacher…

  3. Foreign intervention in medical education: a case study of the Rockefeller Foundation's involvement in a Thai medical school. (United States)

    Donaldson, P J


    A case study of the process of foreign intervention in medical education in the developing world is presented. Material collected from the Rockefeller Foundation Archives on a Foundation program in Thailand is used to analyze the conditions under which foreign agencies and their personnel intervene in the development of medical professionals in the Third World and to study the problems that may occur as a result of such intervention. The importance of value consensus and the competitive advantage foreigners have in the marketing of professional models are highlighted as reasons for the diffusion of Western models of medical education throughout the developing world.

  4. Habitat evaluation using suitability index and habitat type diversity: a case study involving a shallow forest stream in central Taiwan. (United States)

    Chou, Wen-Chieh; Chuang, Ming-De


    In recent years, the Taiwanese government has strongly promoted the concept of ecological engineering in the hope that doing so will encourage the maintenance of the ecosystem and its integrity. As a result, the riprap spur dike is one of the most commonly used measures for protecting stream banks. Traditionally, a spur dike is used at concave banks to prevent their scouring and/or to increase their stabilization. An additional benefit of deflector structures, like spur dikes, may be to increase the weighted usable area (WUA) for aquatic life survival during periods of increased flow (examples include typhoon, flood, etc.). A two-dimensional river habitat simulation program (River2D) coupled with a developed shallow water habitat type diversity module was used for the case study at a headwater stream in central Taiwan. The habitat suitability index for this study was established using substrate, depth, and velocity from field surveys for the fish family Cyprinidae by prepositioned area electrofisher. The ungauged flood conditions were calculated using digital elevation models within a watershed delineation and hydrological modeling system in accordance with local regulations. Simulated results indicate that the spur dikes currently in use on the stream in this study need be improved from a WUA point of view more effectively handle a flood event.

  5. How are clinicians involved in EHR planning? A process analysis case study of a region in Denmark. (United States)

    Høstgaard, Anna Marie; Bertelsen, Pernille; Nøhr, Christian


    Experience shows that to achieve a successful implementation of EHR clinicians must obtain joint ownership of the decisions made during the EHR-process. The EHR planning process in the Region of North Jutland, Denmark was studied with the aim of answering the question; "Why are not all Danish physicians overjoyed by the introduction of EHR? A case study was carried out from Oct. 2003 till April 2006 using process analysis. The EHR project management's strategy meant that there was no workload reduction. This was seen as one of the main barriers for the physicians to achieve real influence. History shows that clinician's on the one hand and administrators on the other have different perceptions of the purpose of the patient record and that they both have struggled to influence this definition. To date, the administrators have won the battle. This was the major reason for the approach chosen for the EHR planning process in North Jutland, Denmark. It explains the conditions made available for the physicians, which led to their role being reduced to clinical consultants--rather than real participants.

  6. Kidney involvement in a wegener granulomatosis case

    Directory of Open Access Journals (Sweden)

    Gioacchino Li Cavoli


    Full Text Available Wegener Granulomatosis is a systemic Anti-Neutrophil Cytoplasmic Autoantibody- associated Vasculitis, affecting small-to-medium vessels. Clinical presentation with simultaneous involvement of kidney and upper and lower respiratory tract is unusual. We report an instructive case of WG, analyzing clinical course, laboratory, and radiological features, kidney, lung, and larynx histological pictures. Besides renal biopsy, nephrology team performed larynx and lung biopsies because of unusual clinical presentation, computed tomography chest examination, and relevant malignancy risk regarding following immunosuppressant therapy.

  7. A Case of Neurosarcoidosis with Labyrinthine Involvement

    Directory of Open Access Journals (Sweden)

    Peter B. Johnson


    Full Text Available Sarcoidosis is a chronic granulomatous disease of unknown aetiology, which may involve any organ system. It most commonly occurs in adults with childhood involvement being rare. Central nervous system involvement is seen in up to 25% and typically involves meningeal disease resulting in multiple cranial neuropathies. Other common clinical findings include seizures, headache, dementia, and pituitary dysfunction. Imaging plays a central role in the diagnosis with typical findings including pachymeningeal and leptomeningeal enhancing lesions. Other imaging findings include lacunar and major territory infarcts, hypothalamic and infundibular thickening, hydrocephalus, and cranial nerve enhancement. We present a case of an eight-year-old male patient with progressive headache, visual disturbance, unilateral sensory hearing loss, and multiple cranial neuropathies. Imaging findings demonstrated the classic pachymeningeal and leptomeningeal enhancement along much of the skull base, as well as enhancement of the right and left second and eighth cranial nerves. Extensive inflammatory changes were noted in the temporal bones and paranasal sinuses. There was also enhancement of the right and left labyrinths. Sinus biopsy confirmed sarcoidosis. We present the first case to our knowledge of sarcoid labyrinthitis.

  8. A case study on open innovation on Procter & Gamble. Part II: Co-creation and digital involvement (United States)

    Agafitei, I. G.; Avasilcai, S.


    The first part of the present study case has pointed to the efforts directed by Procter & Gamble over time to keep close to its customers and the manner in which management has supported innovation within the company. Following the principles of disruptive innovation, the CEO of the company has set the goal for the company as to produce at least 50% of the innovations from external ideas. So, the aim of this paper is to continue to analyse the tools and the approach that P&G has taken in order to launch new products by partnering with other companies. Innovating by collaborating with external entities holding a highly specialized level of technology and engineering knowhow has been appreciated to contribute to the value creation process. In order to understand how open innovation strategy has worked for Procter & Gamble and which was the designated tool used to enrich the company with valuable input in order to develop products, we have taken a look at P&G's open innovation platform Connect + Develop.

  9. Involving Older Adults in the Technology Design Process: A Case Study on Mobility and Wellbeing in the Built Environment. (United States)

    Swallow, David; Petrie, Helen; Power, Christopher; Lewis, Andrew; Edwards, Alistair D N


    Older adults benefit from unstructured, lifestyle-based activity that can be carried out in people's houses, neighbourhoods, and the built environment. Technological solutions may support physical activity and encourage wellbeing. To ensure such technology is suitable for, and usable by, older adults, it is crucial they are involved in all stages of design. Participatory design methodologies facilitate collaboration and engagement with potential users. We examine the suitability of participatory design for collaborating and engaging with older adults. Participatory design workshops were conducted with 33 older adults in the UK with the aim of designing mobile applications to support and promote physical activity and wellbeing in the built environment. As well as summarising the outcome of these workshops, the paper outlines several methodological issues relating to the suitability of participatory design for involving older adults in the technology design process.

  10. Spouses’ involvement in older patients’ fast-track programmes during total hip replacement using case management intervention. A study protocol of the SICAM-trial

    DEFF Research Database (Denmark)

    Berthelsen, Connie Bøttcher; Kristensson, Jimmie


    Aim To present the protocol of a two-group quasi-experimental study of spouses’ involvement through case management (The SICAM-trial) in older patients’ fast-track programmes during total hip replacement. Background Patients in fast-track programmes are required to take an active part......-test measures (protocol approved in November 2012). Methods A total of 120 patients aged 65 years or older going through a fast-track programme for a total hip replacement and their spouses will be recruited from one Danish orthopaedic ward. We will initially include the control group for data collection...... and subsequently include the intervention group to avoid contamination of the control group. A case manager will be recruited to perform the case management intervention. Data will be collected from both groups at baseline, 2 weeks and 3 months after surgery. Outcome measures for patients include: functional...

  11. Depression Case Control (DeCC) Study fails to support involvement of the muscarinic acetylcholine receptor M2 (CHRM2) gene in recurrent major depressive disorder. (United States)

    Cohen-Woods, Sarah; Gaysina, Daria; Craddock, Nick; Farmer, Anne; Gray, Joanna; Gunasinghe, Cerisse; Hoda, Farzana; Jones, Lisa; Knight, Jo; Korszun, Ania; Owen, Michael J; Sterne, Abram; Craig, Ian W; McGuffin, Peter


    It has been suggested that alteration in the muscarinic-cholinergic system is involved in modulation of mood. Three studies have reported linkage on chromosome 7 with major depressive disorder (MDD) in or close to a region containing the muscarinic receptor CHRM2 gene. A haplotype of SNPs located in CHRM2 (rs1824024-rs2061174-rs324650) has been significantly associated with MDD in a previous study. We report the first study investigating this gene in a large, adequately powered, clinical depression case-control sample (n = 1420 cases, 1624 controls). Our data fail to support association with the CHRM2 polymorphisms previously implicated in the genetic aetiology of depression. It is possible our failure to replicate may be a consequence of differences in definition of the MDD phenotype and/or ethnic differences.


    Directory of Open Access Journals (Sweden)

    José Carlos Esquierro


    Full Text Available This paper proposes recommendations for improving the implementation of a Project Management Office (PMO in a government organization. Such organizations can face uncertainties due to unpredicted and unexpected environmental events. The methodology used here was based on review of the literature, experience of the authors, and analysis of the process to be employed to create a PMO in the Department of Municipal Water and Sewage Systems (SEMAE, Brazil. This study aims to show how implementing a PMO can ensure proper management of strategic projects related to conservation of water resources. The PMO plays an important role in the implementation of strategic projects for public sanitation. This study also shows that the effectiveness of actions taken by the PMO is strongly influenced by how this process is implemented.

  13. Guided tissue regeneration in Class II furcation involved maxillary molars: a controlled study of 8 split-mouth cases. (United States)

    Avera, J B; Camargo, P M; Klokkevold, P R; Kenney, E B; Lekovic, V


    The purpose of this study was to clinically evaluate the effectiveness of polytetrafluoroethylene membranes in the healing of interproximal Class II furcation defects in maxillary molars using a surgical treatment technique based on the principles of guided tissue regeneration. Eight subjects with similar bilateral Class II furcation lesions on the mesial aspect of maxillary first molars participated in this study. Patients received initial therapy consisting of oral hygiene instructions, scaling and root planing, and occlusal adjustment if necessary. Clinical parameters evaluated included plaque index, sulcular bleeding index, probing depth, attachment level, gingival recession, and open horizontal and vertical furcation fill. An acrylic occlusal stent was used to assure reproducibility of measurements. Experimental sites received a polytetrafluoroethylene membrane following surgical exposure of the furcation. Control sites were treated in the exact same manner but without a membrane. Membranes were removed at 6 weeks after the first surgery. Reentry surgeries were performed at 9 months. Postsurgical results showed a significant improvement in probing depth, attachment level, and open horizontal furcation fill for both groups when compared to baseline values, with experimental sites performing significantly better than controls. Control sites showed a slight loss in open vertical furcation fill while experimental sites remained unchanged. This study suggests that guided tissue regeneration using polytetrafluoroethylene membranes is of some but limited value in the treatment of maxillary molar interpoximal Class II furcation lesions.

  14. Speckled variance optical coherence tomography for the assessment of nail involvement in acrodermatitis continua of Hallopeau: A case study. (United States)

    Conti, Andrea; Ciardo, Silvana; Mandel, Victor Desmond; Bigi, Laura; Pellacani, Giovanni


    Noninvasive techniques for nail imaging would be useful for confirming diagnosis and monitoring treatment response at the microscopic level in patients with nail psoriasis. However, the use of ultrasound and high-resolution magnetic resonance imaging in nail evaluation is limited. Optical coherence tomography (OCT) produces high-resolution images of transversal tissue sections and represents an optimal approach to the study of the nail. This study used a multibeam OCT instrument to produce speckled variance OCT (SV-OCT) blood-flow images, which were used to measure the degree of change over successive scans. Nail changes, inflammation and response to therapy were evaluated in a 75-year-old female patient with psoriasis who had severe acrodermatitis continua of Hallopeau of the hands, treated for 4 weeks with 40 mg adalimumab (administered subcutaneously every other week) and 25 mg prednisone (administered orally, daily). SV-OCT provided a detailed assessment of the nail structures in relation to inflammation of psoriatic tissues. Restoration of the normal anatomy of the nail apparatus was apparent following adalimumab treatment; SV-OCT evaluation correlated with clinical appearance. SV-OCT may have a diagnostic role and provide an objective tool to assess clinical and subclinical inflammation in nail psoriasis.

  15. Third Sector Involvement in Public Education: The Israeli Case (United States)

    Berkovich, Izhak; Foldes, Vincent Jonathan


    Purpose: The purpose of this article is to address the involvement of third sector organizations in state public education in Israel, with emphasis on the decision-making processes affecting the geographic distribution of service provision. Design/methodology/approach: A collective case study approach was used to investigate non-governmental…

  16. Polymorphisms in MicroRNA Genes And Genes Involving in NMDAR Signaling and Schizophrenia: A Case-Control Study in Chinese Han Population. (United States)

    Zhang, Yanxia; Fan, Mei; Wang, Qingzhong; He, Guang; Fu, Yingmei; Li, Huafang; Yu, Shunying


    Disturbances in glutamate signaling caused by disruption of N-methyl-D-aspartate-type glutamate receptor (NMDAR) have been implicated in schizophrenia. Findings suggested that miR-219, miR-132 and miR-107 could involve in NMDAR signaling by influencing the expression of pathway genes or the signaling transmission and single nucleotide polymorphisms (SNPs) within miRNA genes or miRNA target sites could result in their functional changes. Therefore, we hypothesized that SNPs in miRNAs and/or their target sites were associated with schizophrenia. 3 SNPs in hsa-pri-miR-219/132/107 and 6 SNPs in 3'UTRs of GRIN2A/2B/3A and CAMK2G were selected and genotyped in a case-control study of 1041 schizophrenia cases and 953 healthy controls in Chinese Han population. In the present study, GRIN2B rs890 showed significant associations with schizophrenia. Further functional analyses showed that the rs890 variant C allele led to significantly lower luciferase activity, compared with the A allele. MDR analysis showed that a 4-locus model including rs107822, rs2306327, rs890 and rs12342026 was the best model. These findings suggest that GRIN2B may be associated with schizophrenia and interaction effects of the polymorphisms in hsa-miR-219, CAKM2G, GRIN2B and GRIN3A may confer susceptibility to schizophrenia in the Chinese Han population.

  17. The involvement of family in child protection cases in Iceland

    Directory of Open Access Journals (Sweden)

    Anni Haugen


    Full Text Available The aim of this study is to examine the involvement of families in child protection cases in Iceland, as well as to shed light on the attitudes of child protection workers on the importance of including families while working on child protection cases. The study is part of an international comparative analysis called: Social Work with Families: Social Workers’ Constructions of Family in Professional Practice. This article only addresses the Icelandic segment of the research. In the study, qualitative methods were used and three focus groups were conducted, in which the same three-step vignette about a child protection case was presented. The findings highlighted how difficult child protection workers found it to define the family. The main element is that family are those individuals closest to the child and connected to them through emotional ties, as Icelandic child protection workers seem to strive to involve family in child protection cases. However, there are signs which show that when working with more complicated cases the definition of a family becomes narrower, and involvement is restricted mostly to parents and grandparents. The findings also show that attitudes toward fathers differ from those toward mothers. The mother is expected to support and create security for the child, while the father is judged mostly on his violent behaviour and is not automatically regarded as providing support or actively taking responsibility for his child.

  18. Land resources allocation strategies in an urban area involving uncertainty: a case study of Suzhou, in the Yangtze River Delta of China. (United States)

    Lu, Shasha; Guan, Xingliang; Zhou, Min; Wang, Yang


    A large number of mathematical models have been developed to support land resource allocation decisions and land management needs; however, few of them can address various uncertainties that exist in relation to many factors presented in such decisions (e.g., land resource availabilities, land demands, land-use patterns, and social demands, as well as ecological requirements). In this study, a multi-objective interval-stochastic land resource allocation model (MOISLAM) was developed for tackling uncertainty that presents as discrete intervals and/or probability distributions. The developed model improves upon the existing multi-objective programming and inexact optimization approaches. The MOISLAM not only considers economic factors, but also involves food security and eco-environmental constraints; it can, therefore, effectively reflect various interrelations among different aspects in a land resource management system. Moreover, the model can also help examine the reliability of satisfying (or the risk of violating) system constraints under uncertainty. In this study, the MOISLAM was applied to a real case of long-term urban land resource allocation planning in Suzhou, in the Yangtze River Delta of China. Interval solutions associated with different risk levels of constraint violation were obtained. The results are considered useful for generating a range of decision alternatives under various system conditions, and thus helping decision makers to identify a desirable land resource allocation strategy under uncertainty.

  19. Co-Producing Sustainability: Involving Parents and Civil Society in the Governance of School Meal Services. A Case Study from Pisa, Italy

    Directory of Open Access Journals (Sweden)

    Francesca Galli


    Full Text Available There is a rising awareness of the power of the public sector in enhancing sustainable consumption and production practices, in particular related to food procurement and its social, ethical, economical and environmental implications. School meal services have a high resonance in the debate on collective catering services because of the implications on the education to sustainable dietary habits and the orientation of the production system. This contribution focuses on the reciprocal relationship between professionals and users of school meal services as a driver to mobilize new resources—according to the theory of co-production—that steer service innovation and a shift towards more sustainable practices. We illustrate this through a case study on the school meal system in Pisa (Italy, where the Canteen Committee represents an institutional arena for participation and empowerment of actors that has gradually gained a central role in shaping this school meal service. Despite the challenges and obstacles, the institutionalized co-production of services allows consolidation of trust among key players and the introduction of innovations in the service, in the form of several projects oriented to sustainability which would not take place without the joint effort of actors involved, parents in the first place.

  20. Cerebral involvement in pseudoxanthoma elasticum; case report

    Directory of Open Access Journals (Sweden)

    Eylem Değirmenci


    Full Text Available Pseudoxanthoma elasticum (PXE is a rarely seen connective tissue disease which is characterized by progressive fragmentation and calcification of elastic fibers. Generally it is characterized by cutaneus, ocular and vascular system involvement and neurological complications are usually secondary to vascular insufficiency. 43 years old male patient had a progressive dysarthria, ataxia and vision loss which started many years ago referred to our clinic. Loose skin was seen on bilateral his axillar region and neck with atrophic, pale viola macular lesions on his body. There was “angiloid streaks” on fundus examination and skin biopsy showed calcified degenerated elastic fibers on middle and deep dermis. Diffuse white matter lesions were determined on cranial imaging. To keep in mind the diagnosis of rare diseases would be helpful in early diagnosis and treatment, reducing and even preventing systemic complications.

  1. Parental Involvement, Is It Real? A Study of Viewpoints Promoting Parental Involvement That Enhances Student Performance (United States)

    Rucker, Lorretta Faye


    The purpose of this qualitative case study was to explore the motives, practices, attitudes, and barriers of parental involvement as recognized by administrators and teachers in southwest Tennessee in order to improve the school-home and community relationship in southwest Tennessee. This study investigated the benefits of parental involvement and…

  2. Case Study: Testing with Case Studies (United States)

    Herreid, Clyde Freeman


    This column provides original articles on innovations in case study teaching, assessment of the method, as well as case studies with teaching notes. This month's issue discusses using case studies to test for knowledge or lessons learned.

  3. Case Studies in Biology. (United States)

    Zeakes, Samuel J.


    A case study writing exercise used in a course on parasitology was found to be a powerful learning experience for students because it involved discipline-based technical writing and terminology, brought the students in as evaluators, applied current learning, caused interaction among all students, and simulated real professional activities. (MSE)

  4. The Impact of Parent’s Socioeconomic Status on Parental Involvement at Home: A Case Study on High Achievement Indian Students of a Tamil School in Malaysia

    Directory of Open Access Journals (Sweden)

    Suresh Kumar N Vellymalay


    Full Text Available The current study focuses on the impact of parent’s socioeconomic status on parental involvement in their child’s education at home. Forty Indian students studying in one the best performance- based National Type Tamil Schools in the state of Kedah, Malaysia were chosen based on purposive sampling. The sample comprised 10 students from Year Two, 10 students from Year Three, 10 students from Year Four and 10 students from Year Five. Those were the high achievement students identified based on the previous final year school examination results. Questionnaires were used by the researcher to obtain quantitative data related to the parent’s socioeconomic background and their involvement strategies in their children’s education at home from the students’ parent. In addition, in-depth interviews with twenty students, that is, five students from each Year were conducted to gather information on their parent’s involvement. The findings of this study indicate that most parents are from a higher socioeconomic background and they show a high degree of involvement in most of the involvement strategies at home to ensure their child’s educational success. Moreover, the economic and academic capital among the middle-class parents serve to enhance their understanding and knowledge on the actual values that need to be placed on their child’s education. As a result, these children gain in terms of good skills, behaviour and values, all of which are crucial to their academic success.

  5. Case study

    DEFF Research Database (Denmark)

    Milana, Marcella; Bernt Sørensen, Tore

    of several DHSs. Furthermore ?Udspil? was chosen for being a non-formal learning activity based on individual participation, even though linked to institutionalized learning practices, which were carried out in cooperation between several local institutions.Last but not least, the project represents...... that time Roskilde University Centre and Learning Lab Denmark, DK)3. The case here presented is based on results from research activity carried out over a 1 year period (spring 2006 - spring 2007). Detailed information concerning participation in the project was collected in two DHSs only: the Sports Day......Learning for democratic citizenship is embedded in the general popular education ideal(folkeoplysning), which is the primary source of inspiration for the Day High Schools (DHSs). DHSs are private institutions supported by local authorities, that host primarily low educated and unemployed young...

  6. Langerhans cell histiocytosis with involvement of the pons: case report

    Energy Technology Data Exchange (ETDEWEB)

    Vourtsi, A. [Xatzopoulou, Athens (Greece)]|[Department of Radiology, University of Athens Medical School, Athens (Greece); Papadopoulos, A.; Moulopoulos, L.A.; Vlahos, L. [Department of Radiology, University of Athens Medical School, Athens (Greece); Xenellis, J. [Department of Otorhinolaryngology, University of Athens Medical School, Athens (Greece)


    Central nervous system involvement is uncommon in Langerhans cell histiocytosis. The suprasellar region is more frequently affected. There have been few reports of involvement of the brain parenchyma shown on CT or MRI. We present a case of involvement of the pons, showing marked contrast enhancement on MRI. (orig.) With 2 figs., 17 refs.

  7. Osteoarticular Involvement among Brucellosis Cases in Konya City

    Directory of Open Access Journals (Sweden)

    Hale Turan Ozden


    Full Text Available Purpose: Brucellosis is a systemic disease that can affect many organs and tissues. Musculoskeletal system is one of the most commonly affected systems. Disease may present itself with sacroiliitis, peripheral arthritis, spondylitis, paraspinal abscess, bursitis or osteomyelitis. The objective of the present study was to determine the frequency, types and clinical features of osteoarticular involvement among cases with brucellosis in Konya city and to establish the differences between patients with and without osteoarticular involvement. Material and Methods: Three hundred and sixteen patients with Brucellosis who presented between June 2003 and June 2014 were included in the study. Brucellosis was diagnosed by positive Brucella Standard Agglutination Test ( and #61619;1/160 titer and/or growth of Brucella spp. in blood culture in addition to the presence of clinical signs and findings. Diagnosis of osteoarticular system complications was established by physical examination and radiological findings obtained by diagnostic imaging tools. Magnetic resonance images of the thoracic, lumbar or sacral vertebrae were acquired in patients with back pain, low back pain and sacro-iliac joint pain. Results: Osteoarticular involvement was noted in 129 patients (40.8% (females: 52% and males: 48%. The most common route of transmission was employment in farming and/or consumption of un-pasteurized milk or dairy products, especially fresh cheese, in 97 (75% cases. Mean age was 46 and #61617;18 years. Sacroiliitis was the most frequent osteoarticular involvement (n: 68, 52.7%, 70.5% of which were bilateral. Sacroiliitis was followed by spondylodiscitis in 35 (38.7%, peripheral arthritis in 20 (15.5%, bursitis in 1 (0.8% cases. Patients with osteoarticular involvement received medical treatment for at least three months. Discussion: Ratio and anatomical region of osteoarticular involvement in brucellosis shows variability among areas. In the present study, we

  8. The possible involvement of Mycobacterium avium ssp. paratuberculosis in the aetiology of Crohn's disease: a case control study in the Netherlands

    NARCIS (Netherlands)

    Herrewegh AAPM; Overduin P; Roholl PJM; Gielis FK; Robinson JE; Mahmmod N; Lieverse RJ; Robijn RJ; Zanden AGM van der; Soolingen D van; Dept of Medical Microbiology; Biomedics Scientific Consultancy; LIS; LPI


    A case control study was performed to investigate the possible role of Mycobacterium avium ssp. paratuberculosis (Map) in the aetiology of Crohn's disease (CD). Biopsy samples were collected from the ileum and colon of CD patients, Ulcerative Colitis (UC) patients and control persons. The biopsy sam

  9. Neurosyphilis Involving Cranial Nerves in Brain Stem: 2 Case Reports

    Energy Technology Data Exchange (ETDEWEB)

    Jang, Ji Hye [Dept. of Radiology, Kyung Hee University College of Medicine, Seoul (Korea, Republic of); Choi, Woo Suk; Kim, Eui Jong [Dept. of Radiology, Kyung Hee University Hospital, Seoul (Korea, Republic of); Yoon, Sung Sang; Heo, Sung Hyuk [Dept. of Neurology, Kyung Hee University Hospital, Seoul (Korea, Republic of)


    Neurosyphilis uncommonly presents with cranial neuropathies in acute syphilitic meningitis and meningovascular neurosyphilis. We now report two cases in which the meningeal form of neurosyphilis involved cranial nerves in the brain stem: the oculomotor and trigeminal nerve.

  10. Langerhans cell histiocytosis involving central nervous system: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Moon, Won Jin; Park, Dong Woo; Lee, Seung Ro; Hahm, Chang Kok; Ju, Kyung Bin [Hanyang University College of Medicine, Seoul (Korea, Republic of); Kim, Sung Tae [Ulsan University College of Medicine, Seoul (Korea, Republic of)


    Langerhans cell histiocytosis(LCH) is a systemic disorder characterized by idiopathic proliferation of histiocytes in the reticuloendothelial system; CNS involvement outside the hypothalamus or pituitary gland is uncommon. We present a case of LCH involving the brainstem, cerebellum, and temporal lobes, and also showing hypothalamic involvement. The lesions were isointense or hypointense on T1WI and hyperintense on T2WI, and showed multifocal enhancing nodules on post-contrast CT and Gd-enhanced MRI.

  11. Ophaceous Gout Involving the Whole Spine: An Unusual Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Min Woo; Lee, Ji Hae; Cho, Woo Ho [Dept. of Radiology, Sanggye Paik Hospital, Inje University College of Medicine, Seoul (Korea, Republic of)


    Gout is a relatively common, crystal deposition disease, in which monosodium urate crystals are deposited in joint and periarticular tissues of the extremities. Involvement of the spine is exceedingly rare. Most patients with spinal gout present with symptomatic spinal cord compression. Diffuse involvement of tophi deposition inside the spinal central canal has not been reported. We now present a case of chronic tophaceous gout with extensive spinal involvement that resulted in diffuse spinal cord compression and led to paraplegia.

  12. [A case of brucellosis presenting with suppurative parotitis involvement]. (United States)

    Kanmaz, Lutfi; Karakeçili, Faruk; Çıkman, Aytekin; Özçiçek, Fatih; Karavaş, Erdal


    Brucellosis is a common zoonotic infection caused by Brucella bacteria. Brucella infections are usually presented with various clinical manifestations, and often accompanied by multiple organ involvements. In this article, we present a case of brucellosis with suppurative parotitis involvement accompanied by parotid abscess and fistula in a 60-year-old male patient. According to the literature review we conducted regarding complications of brucellosis, our case is the first case reported in the literature. Significant improvement in patient's suppurative parotitis and clinical findings was observed at the fifth week of combination antibiotic therapy. Patient's complaints resolved completely after eight weeks of treatment.

  13. Case Study: Writing a Journal Case Study (United States)

    Prud'homme-Genereux, Annie


    This column provides original articles on innovations in case study teaching, assessment of the method, as well as case studies with teaching notes. This month's issue describes incorporating a journal article into the classroom by first converting it into a case study.

  14. Food Habits, Lifestyle Factors, and Risk of Prostate Cancer in Central Argentina: A Case Control Study Involving Self-Motivated Health Behavior Modifications after Diagnosis (United States)

    Pacheco, Sandaly O. S.; Pacheco, Fabio J.; Zapata, Gimena M. J.; Garcia, Julieta M. E.; Previale, Carlos A.; Cura, Héctor E.; Craig, Winston J.


    Cancer is the second most important non-communicable disease worldwide and disproportionately impacts low- to middle-income countries. Diet in combination with other lifestyle habits seems to modify the risk for some cancers but little is known about South Americans. Food habits of Argentinean men pre- and post-diagnosis of prostate cancer (n = 326) were assessed along with other lifestyle factors. We studied whether any of the behaviors and risk factors for prostate cancer were found in men with other cancers (n = 394), compared with control subjects (n = 629). Before diagnosis, both cases reported a greater mean consumption of meats and fats and lower intakes of fruits, green vegetables, cruciferous vegetables, legumes, nuts, seeds, and whole grains than the controls (all p < 0.001). After diagnosis, cases significantly reduced the intake of meats and fats, and reported other dietary modifications with increased consumption of fish, fruits (including red fruits in prostate cancer), cruciferous vegetables, legumes, nuts, and black tea (all p < 0.001). Additional lifestyle aspects significantly predominant in cases included a reduced quality of sleep, emotional stress, low physical activity, tobacco smoking, alcohol consumption, living in rural areas, and being exposed to environmental contaminants. Argentinian men were predisposed to modify their unhealthy dietary habits and other lifestyle factors after cancer diagnosis. PMID:27409631

  15. Food Habits, Lifestyle Factors, and Risk of Prostate Cancer in Central Argentina: A Case Control Study Involving Self-Motivated Health Behavior Modifications after Diagnosis

    Directory of Open Access Journals (Sweden)

    Sandaly O. S. Pacheco


    Full Text Available Cancer is the second most important non-communicable disease worldwide and disproportionately impacts low- to middle-income countries. Diet in combination with other lifestyle habits seems to modify the risk for some cancers but little is known about South Americans. Food habits of Argentinean men pre- and post-diagnosis of prostate cancer (n = 326 were assessed along with other lifestyle factors. We studied whether any of the behaviors and risk factors for prostate cancer were found in men with other cancers (n = 394, compared with control subjects (n = 629. Before diagnosis, both cases reported a greater mean consumption of meats and fats and lower intakes of fruits, green vegetables, cruciferous vegetables, legumes, nuts, seeds, and whole grains than the controls (all p < 0.001. After diagnosis, cases significantly reduced the intake of meats and fats, and reported other dietary modifications with increased consumption of fish, fruits (including red fruits in prostate cancer, cruciferous vegetables, legumes, nuts, and black tea (all p < 0.001. Additional lifestyle aspects significantly predominant in cases included a reduced quality of sleep, emotional stress, low physical activity, tobacco smoking, alcohol consumption, living in rural areas, and being exposed to environmental contaminants. Argentinian men were predisposed to modify their unhealthy dietary habits and other lifestyle factors after cancer diagnosis.

  16. [A case of Sotos syndrome associated with peripheral nerve involvements]. (United States)

    Funakawa, I; Katoh, H; Hara, K; Yasuda, T; Terao, A


    A case of the Sotos syndrome associated with peripheral nerve involvements was reported. A 52-year-old male was admitted to Kawasaki Medical School Hospital because of gait disturbance, muscle atrophy, and weakness in both hands. This case was diagnosed as the Sotos syndrome based on the following symptoms and findings, acromegaloid features, hypertrophic changes in the hands and feet, a history of epileptic episodes, a low IQ, a normal growth hormone value, and no tumor lesion in the pituitary gland. Radiological examination disclosed a cauliflower-like appearance of the finger tips and thickness of the heel pads. Brain CT and MRI revealed diffuse mild brain atrophy. An electroencephalogram showed diffuse theta waves with sharp waves in the right parietal region. A needle electromyogram revealed neurogenic change in both upper and lower limbs. A nerve conduction study disclosed the carpal tunnel syndrome and cubital tunnel syndrome. These findings suggest that, as in the case of acromegaly, entrapment neuropathy and peripheral neuropathy can also be induced in the Sotos syndrome.

  17. Can the Epstein Model of Parental Involvement Work in a High-Minority, High-Poverty Elementary School? A Case Study (United States)

    Bower, Heather A.; Griffin, Dana


    The literature has lauded parental involvement as an effective strategy to increase student achievement, but schools still struggle with how to effectively involve parents of color and low-income families. In an effort to assess the effectiveness of the Epstein Model of Parental Involvement in high-poverty, high-minority schools, the authors…

  18. Interaction of activity involvement and recreational location selection behavior in Lowland City: A case study of public parks in Saga City, Japan

    Institute of Scientific and Technical Information of China (English)

    IAMTRAKUL Pawinee; TEKNOMO Kardi; GE Jian; HOKAO Kazunori


    Public parks provide many benefits to the community as the representatives of green area. The allocation of public places plays an extremely important role in the daily lives of inhabitants especially for recreational use that could enhance the quality of life of residents in the vicinity. To understand park users' behavior is one of the most important prerequisites for assessing the participation in public service from the park users' point of view. The pattern of park utilization on location and activity selection are important elements in behavioral study, while the public parks topograph may also influence the typical user's behavior. Questionnaire survey on park utilization was used to investigate the interaction between activity involvement and recreational location with the use of linear discriminant analysis (LDA) model. The study found that public park users' behavior is influenced not only by social characteristics but also by the recreational activities and their specific location characteristics. We found that about 45 percent of park visitors are local residents living within a radius of 3 km preferred travel to parks near their residential area. This implies that location selection behavior is correlated with travel distance, travel time and travel cost. Visit frequencies and on site expenditures reflect the recreation behavior for different type of activities. The overall information can be usefully applied by decision makers to launch appropriate public policy in consistence with the useful results of this study.


    Directory of Open Access Journals (Sweden)

    A. S. Aladin


    Full Text Available Neck cysts are rather commonly encountered in the practice of a surgeon, including an oncologist, who treats diseases of the head and neck. At the same time there are rare involvements of the organs and soft tissues of the neck. In particular, echinococcosis of neck soft tissues is an unusual site for hydatid cyst. Accounts of this involvement are found only as single communications in the literature. The presented case of hydatid cyst illustrates a variety of neck abnormalities.

  20. Leukemic meningitis involving the cauda equina: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Dong Hyun; Kim, Ho Kyun; Lee, Young Hwan [School of Medicine, Catholic University of Daegu, Daegu (Korea, Republic of)


    The CNS involvement by leukemia may either be meningeal or parenchymal, although meningeal infiltration of leukemic cells, known as leukemic meningitis is more common. We report a case of leukemic meningitis involving the cauda equina in a patient with an acute lymphoblastic crisis which transformed from the chronic phase of chronic myeloid leukemia. An MR image revealed diffuse enlargement and peripheral ring enhancement of the nerve roots of the cauda equina.

  1. Food Habits, Lifestyle Factors, and Risk of Prostate Cancer in Central Argentina: A Case Control Study Involving Self-Motivated Health Behavior Modifications after Diagnosis. (United States)

    Pacheco, Sandaly O S; Pacheco, Fabio J; Zapata, Gimena M J; Garcia, Julieta M E; Previale, Carlos A; Cura, Héctor E; Craig, Winston J


    Cancer is the second most important non-communicable disease worldwide and disproportionately impacts low- to middle-income countries. Diet in combination with other lifestyle habits seems to modify the risk for some cancers but little is known about South Americans. Food habits of Argentinean men pre- and post-diagnosis of prostate cancer (n = 326) were assessed along with other lifestyle factors. We studied whether any of the behaviors and risk factors for prostate cancer were found in men with other cancers (n = 394), compared with control subjects (n = 629). Before diagnosis, both cases reported a greater mean consumption of meats and fats and lower intakes of fruits, green vegetables, cruciferous vegetables, legumes, nuts, seeds, and whole grains than the controls (all p cancer), cruciferous vegetables, legumes, nuts, and black tea (all p cancer diagnosis.


    Directory of Open Access Journals (Sweden)

    Bala Raju Gundam


    Full Text Available BACKGROUND Diphtheria still endemic in many developing countries and is responsible for high case fatality. Myocardial involvement is a serious complication of diphtheria and diphtheria myocarditis frequently complicated by arrhythmias causes sudden death if not managed properly. So, early and adequate administration of Anti-Diphtheritic Serum (ADS and frequent monitoring particularly 24 hrs. ECG monitoring is helpful to detect any serious cardiac arrhythmias. METHODS A prospective study on patients who were culture positive diagnosed on the basis of WHO definition were treated and analysed in respect to homographic details, immunisation strategy, and clinical features with particular attention to myocarditis. RESULTS In the study, common age group affected by diphtheria was 5 to 10 years. Incidence of myocarditis more in same age group. Out of 64 patients with myocarditis, 23 patients died. CONCLUSION Incidence of diphtheria has increased in the recent years. Commonly effected age group is 5 to 10 years and most of them are presented with asymptomatic myocarditis. Symptomatic diphtheritic myocarditis has high mortality rate even with aggressive management. Patient who presented with either LBBB alone are with combination of other conduction of abnormalities has high mortality rate.

  3. Involvement of Mycoplasma synoviae in Respiratory Distress Cases of Broilers

    Directory of Open Access Journals (Sweden)

    S. Ehtisham-ul-Haque*, S. U. Rahman, M. Siddique and A. S. Qureshi1


    Full Text Available Mycoplasma synoviae (MS is an important pathogen of poultry worldwide, causing respiratory tract infection and infectious synovitis in chickens and turkeys. The study was designed to detect M. synoviae through serology, culture isolation and polymerase chain reaction (PCR assay to document the involvement of MS infection in respiratory distress cases of broiler birds. The validated PCR assay amplifying the conserved gene region of 16SrRNA gene was applied for the detection of M. synoviae from culture as well as in clinical samples. The results indicated that 04 out of total 17 commercial broiler flocks showing respiratory distress signs were found positive with M. synoviae infection indicating 76.57% sero-positivity as, determined with rapid serum agglutination (RSA test. Out of 85 clinical specimens (collected from sero-positive birds; M. synoviae culture isolation was successfully attained in 36 (42.35% samples. Whereas, PCR test has detected 84 (98.82% positive cases. The prevalence of MS in broiler birds was observed maximum as measured through PCR. It is suggested that the true prevalence of MS may best be reflected by combining RSA and PCR test findings.

  4. `Cranach Inc.' A case study determining the nature and extent of Lucas Cranach the Elder's involvement in his industrious workshop using image processing (United States)

    Lubashevsky, Ruth


    Lucas Cranach the Elder (LCE) (1472-1553) maintained an organized and highly efficient workshop, served as councilor in Wittenberg from 1519-1544, established a publishing house in 1520, held a pharmacy from 1520, and served as mayor of Wittenberg from 1537 to 1543. He was known as the 'swiftest of painters,' resulting in 1,000 surviving panel paintings, canvas paintings, drawings, and etchings in a career that spanned 53 years (1500-1553). Facing this astoundingly enormous oeuvre, the question that this paper seeks to answer is unavoidable: what was LCE's involvement in this oeuvre, which most is still attributed to him, in light of his many other time-consuming engagements? To answer this question, this paper becomes a study of stylistic comparisons of LCE's oeuvre, in order to assess, analyze and identify his style to determine whether all of the works attributed to him were indeed his own handiwork. Classifying LCE's style, together with the fact that he ran his workshop in factory-like conditions, supplying his apprentices with pigments, designs they could trace, copies, modelling versions, and patterns, making him an artist turned businessman, LCE becomes an artist who turned art into an industrial operation, earning the title 'Cranach Inc.' The conclusion of this paper will be based inter-alia on comparisons between Infra-red images and the visible paintings, in order to undermine the established attributions made to LCE.

  5. Primary tuberculosis involving epiglottis: a rare case report. (United States)

    Edizer, Deniz Tuna; Karaman, Emin; Mercan, Hasan; Alimoglu, Yalcin; Esen, Tugce; Cansiz, Harun


    The case of a 29-year-old patient with active laryngeal tuberculosis predominantly involving the epiglottis, without pulmonary disease, is presented. The predominant symptoms are dysphagia, odynophagia, and hoarseness. Laryngeal carcinoma, which shares almost the same symptoms and signs, should be ruled out immediately. Laryngeal tuberculosis is discussed with a brief literature review.

  6. Case Study Teaching (United States)

    Herreid, Clyde Freeman


    This chapter describes the history of case study teaching, types of cases, and experimental data supporting their effectiveness. It also describes a model for comparing the efficacy of the various case study methods. (Contains 1 figure.)

  7. Informal care givers’ experiences with support in primary palliative care when a case manager is involved: a descriptive study in the Netherlands.

    NARCIS (Netherlands)

    Plas, A.G.M. van der; Francke, A.L.; Deliens, L.; Jansen, W.J.J.; Vissers, K.C.; Onwuteaka-Philipsen, B.D.


    Introduction: Case managers have been introduced in primary palliative care in the Netherlands; these are nurses with expertise in palliative care who offer support to patients and informal care givers. The case manager provides support in addition to the care provided by the home care nurse and gen

  8. The complex clinical issues involved in an athlete's decision to retire from collision sport due to multiple concussions: a case study of a professional athlete

    Directory of Open Access Journals (Sweden)

    Andrew eGardner


    Full Text Available The issue of retirement from athletic participation due to repetitive concussive injuries remains controversial. The complexity of providing recommendations to elite athletes is highlighted by the prospect that offering inappropriate advice may foreseeably lead to engagement in a medico-legal challenge. Currently no evidenced-based, scientifically validated guidelines for forming the basis of such a decision exist. The current paper discusses the complexities of this challenge in addition to presenting a case study of a professional athlete. A number of central issues to consider when discussing athlete retirement revolve around the player’s medical and concussion histories, the current clinical profile, the athlete’s long-term life goals and understanding of the potential long-terms risks. Ensuring that thorough investigations of all possible differential diagnosis, that may explain the presenting symptoms, are conducted is also essential. Discussion pertaining to recommendations for guiding the clinical approach to the retirement issue for athletes with a history of multiple concussions is presented.

  9. Acclimation of fine root respiration to soil warming involves starch deposition in very fine and fine roots: a case study in Fagus sylvatica saplings. (United States)

    Di Iorio, Antonino; Giacomuzzi, Valentino; Chiatante, Donato


    Root activities in terms of respiration and non-structural carbohydrates (NSC) storage and mobilization have been suggested as major physiological roles in fine root lifespan. As more frequent heat waves and drought periods within the next decades are expected, to what extent does thermal acclimation in fine roots represent a mechanism to cope with such upcoming climatic conditions? In this study, the possible changes in very fine (diameter Fagus sylvatica saplings subjected to a simulated long-lasting heat wave event and to co-occurring soil drying. For both very fine and fine roots, soil temperature (ST) resulted inversely correlated with specific root length, respiration rates and SSs concentration, but directly correlated with root mass, root tissue density and starch concentration. In particular, starch concentration increased under 28 °C for successively decreasing under 21 °C ST. These findings showed that thermal acclimation in very fine and fine roots due to 24 days exposure to high ST (∼ 28 °C), induced starch accumulation. Such 'carbon-savings strategy' should bear the maintenance costs associated to the recovery process in case of restored favorable environmental conditions, such as those occurring at the end of a heat wave event. Drought condition seems to affect the fine root vitality much more under moderate than high temperature condition, making the temporary exposure to high ST less threatening to root vitality than expected.

  10. Feasibibility study - cases

    DEFF Research Database (Denmark)

    Lund, Henrik; Hvelplund, Frede Kloster; Sukkumnoed, Decharut


    The chapter presents two case studies to show the tools of feasibiliy studies within the context of technological innovation.......The chapter presents two case studies to show the tools of feasibiliy studies within the context of technological innovation....

  11. Application of CRISPRi for prokaryotic metabolic engineering involving multiple genes, a case study: Controllable P(3HB-co-4HB) biosynthesis. (United States)

    Lv, Li; Ren, Yi-Lin; Chen, Jin-Chun; Wu, Qiong; Chen, Guo-Qiang


    Clustered regularly interspaced short palindromic repeats interference (CRISPRi) is used to edit eukaryotic genomes. Here, we show that CRISPRi can also be used for fine-tuning prokaryotic gene expression while simultaneously regulating multiple essential gene expression with less labor and time consumption. As a case study, CRISPRi was used to control polyhydroxyalkanoate (PHA) biosynthesis pathway flux and to adjust PHA composition. A pathway was constructed in Escherichia coli for the production of poly(3-hydroxybutyrate-co-4-hydroxybutyrate) [P(3HB-co-4HB)] from glucose. The native gene sad encoding E. coli succinate semi-aldehyde dehydrogenase was expressed under the control of CRISPRi using five specially designed single guide RNAs (sgRNAs) for regulating carbon flux to 4-hydroxybutyrate (4HB) biosynthesis. The system allowed formation of P(3HB-co-4HB) consisting of 1-9mol% 4HB. Additionally, succinate, generated by succinyl-coA synthetase and succinate dehydrogenase (respectively encoded by genes sucC, sucD and sdhA, sdhB) was channeled preferentially to the 4HB precursor by using selected sgRNAs such as sucC2, sucD2, sdhB2 and sdhA1 via CRISPRi. The resulting 4HB content in P(3HB-co-4HB) was found to range from 1.4 to 18.4mol% depending on the expression levels of down-regulated genes. The results show that CRISPRi is a feasible method to simultaneously manipulate multiple genes in E. coli.

  12. Project management case studies

    CERN Document Server

    Kerzner, Harold R


    A new edition of the most popular book of project management case studies, expanded to include more than 100 cases plus a ""super case"" on the Iridium Project Case studies are an important part of project management education and training. This Fourth Edition of Harold Kerzner''s Project Management Case Studies features a number of new cases covering value measurement in project management. Also included is the well-received ""super case,"" which covers all aspects of project management and may be used as a capstone for a course. This new edition:Contains 100-plus case studies drawn from re

  13. Benign fibrous histiocytoma: A rare case involving jaw bone

    Directory of Open Access Journals (Sweden)

    Hitesh Shoor


    Full Text Available Benign fibrous histiocytoma (BFH is a soft tissue neoplasm which occurs mostly on the skin of extremities. BFH rarely occurs in bone and may affect femur, tibia, and pelvic bone. Jaw bone involvement is very unusual with only 11 cases reported till date. This report describes a case of BFH occurring in a 30-year-old female patient affecting left mandibular posterior region. Computed tomography revealed a well-defined expansile lytic lesion in the posterior mandible. Gross examination of the tumor revealed an admixture of fibroblasts and histiocytes in a fascicular and storiform pattern. Immunohistochemical staining was positive for CD68.

  14. Benign fibrous histiocytoma: A rare case involving jaw bone. (United States)

    Shoor, Hitesh; Pai, Keerthilatha M; Shergill, Ankur Kaur; Kamath, Abhay Taranath


    Benign fibrous histiocytoma (BFH) is a soft tissue neoplasm which occurs mostly on the skin of extremities. BFH rarely occurs in bone and may affect femur, tibia, and pelvic bone. Jaw bone involvement is very unusual with only 11 cases reported till date. This report describes a case of BFH occurring in a 30-year-old female patient affecting left mandibular posterior region. Computed tomography revealed a well-defined expansile lytic lesion in the posterior mandible. Gross examination of the tumor revealed an admixture of fibroblasts and histiocytes in a fascicular and storiform pattern. Immunohistochemical staining was positive for CD68.

  15. More about the Dads: Exploring Associations between Nonresident Father Involvement and Child Welfare Case Outcomes (United States)

    Malm, Karin; Zielewski, Erica; Chen, Henry


    This study follows up on a prior study of child welfare agencies' efforts to identify, locate, and involve nonresident fathers of children in foster care. These analyses use information from the original survey and administrative data on case outcomes to explore three research questions: (1) Is nonresident father involvement associated with case…

  16. Monomelic amyotrophy with proximal upper limb involvement: a case report


    Al-Ghawi, Eman; Al-Harbi, Talal; Al-Sarawi, Adnan; Binfalah, Mohamed


    Background Monomelic amyotrophy is an uncommon, benign, unilateral disorder of the lower motor neurons, affecting predominantly the hand and forearm muscles. Proximal involvement of the arm and shoulder muscles is an unusual presentation that has been rarely reported in the literature. Case presentation A 28-year-old white man presented with insidious-onset, slowly progressive, unilateral weakness and atrophy of his left shoulder girdle and deltoid muscles. A neurological examination revealed...

  17. [Monomelic segmental amyotrophy: a Spanish case involving the leg]. (United States)

    Moreno Martinez, J M; Garcia de la Rocha, M L; Martin Araguz, A


    A 65-year old male presented with selective amyotrophy of the right lower limb which, after a progressive course of some months, had stabilized 12 years previously. Physical examination showed amyotrophy involving the gastrocnemius and the quadriceps extensor femoris without sensory impairment. EMG suggested motor neuron disease. This case meets Hirayama and Serratrice's criteria for benign chronic monomelic amyotrophy. We support the hypothesis of a casual vascular factor, as proposed by Hirayama.

  18. A case of extensive synovial involvement by tophaceous gout

    Directory of Open Access Journals (Sweden)

    Nausheen Khan


    Full Text Available Gout is the most common form of microcrystal arthropathy that results in deposition of uric acid crystals in and around the joints and soft tissues. The most common cause is decreased uric acid clearance by the kidneys. The radiological manifestations of gout are generally well known and have remained unchanged. We describe a case of chronic tophaceous gout with diffuse extensive involvement of synovium around the knees bilaterally.

  19. Cystic Echinococcosis: A Case of Extrahepatic Intra-Abdominal Involvement (United States)

    Carvalho, André; Fernandes, Teresa; Gonçalves, José


    Hydatid disease, or echinococcal disease, is a parasitic infestation caused by the larval stage of the Echinococcus tapeworm and it primarily affects the liver and lung but involvement of other organs is also possible secondary to peritoneal seeding or hematogeneous dissemination. We describe a rare case of extensive abdominal disease, with lesions affecting the liver, peritoneum, and lesser omentum, requiring aggressive surgical intervention. Complementary diagnostic exams were crucial to reach the diagnosis and evaluate the extension of the disease. PMID:28194292

  20. Case study research. (United States)

    Taylor, Ruth; Thomas-Gregory, Annette


    This article describes case study research for nursing and healthcare practice. Case study research offers the researcher an approach by which a phenomenon can be investigated from multiple perspectives within a bounded context, allowing the researcher to provide a 'thick' description of the phenomenon. Although case study research is a flexible approach for the investigation of complex nursing and healthcare issues, it has methodological challenges, often associated with the multiple methods used in individual studies. These are explored through examples of case study research carried out in practice and education settings. An overview of what constitutes 'good' case study research is proposed.

  1. What is involved in medicines management across care boundaries? A qualitative study of healthcare practitioners' experiences in the case of acute kidney injury (United States)

    Morris, Rebecca L; Blakeman, Tom; Ashcroft, Darren M


    Objectives To examine the role of individual and collective cognitive work in managing medicines for acute kidney injury (AKI), this being an example of a clinical scenario that crosses the boundaries of care organisations and specialties. Design Qualitative design, informed by a realist perspective and using semistructured interviews as the data source. The data were analysed using template analysis. Setting Primary, secondary and intermediate care in England. Participants 12 General practitioners, 10 community pharmacists, 7 hospital doctors and 7 hospital pharmacists, all with experience of involvement in preventing or treating AKI. Results We identified three main themes concerning participants' experiences of managing medicines in AKI. In the first theme, challenges arising from the clinical context, AKI is identified as a technically complex condition to identify and treat, often requiring judgements to be made about renal functioning against the context of the patient's general well-being. In the second theme, challenges arising from the organisational context, the crossing of professional and organisational boundaries is seen to introduce problems for the coordination of clinical activities, for example by disrupting information flows. In the third theme, meeting the challenges, participants identify ways in which they overcome the challenges they face in order to ensure effective medicines management, for example by adapting their work practices and tools. Conclusions These themes indicate the critical role of cognitive work on the part of healthcare practitioners, as individuals and as teams, in ensuring effective medicines management during AKI. Our findings suggest that the capabilities underlying this work, for example decision-making, communication and team coordination, should be the focus of training and work design interventions to improve medicines management for AKI or for other conditions. PMID:28100559

  2. The Value of a "Core" Business--A Case Study of the Involvement of an Australian University in Vietnam: 1993-1998. (United States)

    Pidgeon, John; Di Virgilio, Patricia


    Describes how two dovetailing processes led Swinburne University of Technology of Melbourne, Australia, to the setting up of business studies programs in Vietnam: the increased need to make higher education in Australia more cost efficient and the Vietnamese government's decision to move to a market-based economy. Thus, the Vietnamese government…

  3. A history of the working group to address Los Alamos community health concerns - A case study of community involvement and risk communication

    Energy Technology Data Exchange (ETDEWEB)

    Harry Otway; Jon Johnson


    In May 1991, at a Department of Energy (DOE) public hearing at Los Alamos, New Mexico, a local artist claimed there had been a recent brain tumor cluster in a small Los Alamos neighborhood. He suggested the cause was radiation from past operations of Los Alamos National Laboratory. Data from the Laboratory's extensive environmental monitoring program gave no reason to believe this charge to be true but also could not prove it false. These allegations, reported in the local and regional media, alarmed the community and revealed an unsuspected lack of trust in the Laboratory. Having no immediate and definitive response, the Laboratory offered to collaborate with the community to address this concern. The Los Alamos community accepted this offer and a joint Community-Laboratory Working Group met for the first time 29 days later. The working group set as its primary goal the search for possible carcinogens in the local environment. Meanwhile, the DOE announced its intention to fund the New Mexico Department of Health to perform a separate and independent epidemiological study of all Los Alamos cancer rates. In early 1994, after commissioning 17 environmental studies and meeting 34 times, the working group decided that the public health concerns had been resolved to the satisfaction of the community and voted to disband. This paper tells the story of the artist and the working group, and how the media covered their story. It summarizes the environmental studies directed by the working group and briefly reviews the main findings of the epidemiology study. An epilogue records the present-day recollections of some of the key players in this environmental drama.

  4. Imaging of Various Aspects of Neurofibromatosis Involvement: Case Series

    Directory of Open Access Journals (Sweden)

    Nazila Tayari


    Full Text Available Neurofibromatosis (NF is often noticed at birth or soon after. NF is divided into two types: NF type 1 is a complex of cutaneous and deep neural tumors. It is an autosomal dominant familial disorder. CNS is affected in about 15% of the cases. Optic nerve gliomas have a high degree of association with NF 1."nNF type 2 is much less commonly seen. It is also inherited as an autosomal dominant trait. Bilateral acoustic neuromas are pathognomonic of NF 2 and may be associated with meningiomas or ependymo-mas."nTypical clinical manifestations of neurofibromatosis are cafe-au-lait spots and multiple cutaneous tumors. There are also bone involvement as scoliosis, pseudoarthrosis of long bones, scalloping of vertebral bodies, abnormal rib tubulation, and defective ossification of the posterior superior wall of the orbit."nExtraskeletal manifestations of neurofibromatosis include gliomas of the optic nerves, pheochromocytoma, aneurysms of cerebral and renal arteries, acoustic neurilemmoma and superficial skin nodular neurofibromas."nHere, we intend to present images of several cases of neurofibromatosis with different aspects of involvement of the body. "nKeywords: Neurofibromatosis, Glioma, Schwannoma, Neurinoma

  5. Evaluating genotoxicity data to identify a mode of action and its application in estimating cancer risk at low doses: A case study involving carbon tetrachloride. (United States)

    Eastmond, David A


    In the new USEPA cancer risk assessment guidelines, mode of action (MoA) information, combined with a determination of whether or not a chemical is mutagenic, plays an important role in determining whether a linear or nonlinear approach should be used to estimate cancer risks at low doses. In this article, carbon tetrachloride (CT) is used as an example to illustrate how mixed genotoxicity data can be evaluated and used to identify a likely MoA. CT is essentially negative in inducing gene mutations in Salmonella, but is consistently positive in inducing recombination and aneuploidy in fungi. Negative or equivocal results were seen in most in vitro and in vivo studies in mammals, including mutation studies in transgenic mice. However, DNA adducts, primarily those derived from oxidation- and lipid-peroxidation-derived products as well as DNA double-strand breaks and micronucleated cells, have been seen repeatedly in the liver of CT-treated animals. On the basis of the weight of evidence, CT should not be considered a directly mutagenic agent. Mutagenic as well as other genotoxic effects, as they occur, will most likely be generated through indirect mechanisms resulting from oxidative and lipid peroxidative damage and/or damage occurring during necrosis or apoptosis. As key events in this process are expected to occur in a nonlinear fashion, the expected relationship between CT dose and carcinogenic response in the liver is likely to be nonlinear with a steep dose response. This conclusion is consistent with rodent cancer bioassay results in which steep nonlinear dose responses have been seen.

  6. A case of Crohn's disease involving the gallbladder

    Institute of Scientific and Technical Information of China (English)

    Akira Andoh; Yoshihiro Endo; Ryoji Kushima; Kazunori Hata; Tomoyuki Tsujikawa; Masaya Sasaki; Eiji Mekata; Toru Tani; Yoshihide Fujiyama


    Crohn's disease is well known to affect any part of the gastrointestinal tract including the oral cavity and anus.Various extraintestinal complications have been reported in Crohn's disease, but extraintestinal involvement characterized by granulomatous lesions is uncommon. Here, we have reported a case about the involvement of the gallbladder in Crohn's disease. A 33-year-old woman was diagnosed having panperitonitis due to intestinal perforation and cholecystitis. The patient was moved to the surgical service for an emergency operation. On the resected specimen, there was a broad longitudinal ulcer at the mesenteric side. The mucosa of the gallbladder was nodular and granular, and the wall was thickened.The surface epithelium of the gallbladder was partially eroded and pyloric gland metaplasia was observed focally. Rokitansky-Aschoff sinuses were also present.From the lamina propria to the subserosal layer, there were several well-formed epithelioid cell granulomas,which were the non-caseating sarcoidal type different from the foreign-body and xanthomatous granulomas.Periodic-acid Schiff and acid fast stains revealed no organism within the granulomas. Lymphoid aggregates were present throughout the gallbladder wall. Sections from the resected ileum showed typical features of the Crohn's disease. When cholecystectomy is performed in a patient with Crohn's disease, the possibility of gallbladder involvement should be carefully examined by histopathological tests.

  7. 儿童福利机构中特教介入类家庭的个案研究%Case Study on Special Education Involved in Families in Child Welfare Agencies

    Institute of Scientific and Technical Information of China (English)

    曾线; 张梅


    现阶段儿童福利机构中家庭单一的养育模式已不能满足特殊儿童独立能力发展的需要,因此,特殊教育介入儿童所在的类家庭是迫切需要的。本研究针对一例特殊儿童的介入情况,探讨了特教介入类家庭的积极作用,并对积极作用进行了讨论。%Present child welfare agencies in single family parenting pattern can not meet the needs of children with special ne-eds an independent capacity development, therefore, involved in special education classes for children where the family is ur-gently needed. In this study, the case for intervention in the case of children with special needs, discuss the positive role of the special education class family involvement, and positive role were discussed.

  8. [Congenital toxoplasmosis with ocular involvment--case report]. (United States)

    Constantin, Farah; Denislam, Dogan


    Two thirds of the congenital toxoplasmosis cases describe minimal or inapparent symptoms present at birth, being diagnosed from a psychomotor retard. The forms of chorioretinitis may be described by repeated outbursts in the first years of life. Chorioretinitis or focal necrotizing retinitis usually develops in a bilateral way, being progressive and leading to blindness. Usually there is only one focal inflammatory beginning at the edge of a pigmented scar and the local inflammatory process may extend through successive spikes in other regions of the retina. Active chorioretinitis is expressed clinically by a blurred misty eyesight, with the advent of scotomas, photophobia, and if the macula is involved, the loss of the central eyesight may occur. In this paper I present the patient R.A., 6 years old from Constanta who is hospitalized in the Clinic of Infectious Diseases for investigations and treatment continuity because positive IgG Toxoplasma was previously found. The child has spastic quadriplegia and profound mental retardation.

  9. Intestinal arteriovenous malformation involving the descending colon: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Eun Jin; Park, Young Chan; Lee, Young Hwan; Jung, Kyung Jae; Kim, Ho Kyun [Catholic University of Daegu, Daegu (Korea, Republic of)


    Arteriovenous malformations (AVMs) comprising a feeding artery, nidus, and draining vein rarely develop in the gastrointestinal tract. Although almost all AVMs are asymptomatic, they cause massive painless rectal bleeding and subsequent chronic anemia. The definitive diagnosis of AVM is achieved by selective mesenteric angiography, and surgical resection is the treatment of choice. We detected an intestinal AVM involving the descending colon in a patient with severe hematochezia. The diagnosis was made by CT angiography performed using a 64-channel MDCT and the obtained 3D reconstruction images. The AVM showed an extensive vascular network on CT images, and it was treated by surgical resection. Here, we report this case of an intestinal AVM along with its imaging findings.

  10. Parental Involvement in an Emerging Democracy: The Case of Croatia

    Directory of Open Access Journals (Sweden)

    Carmen Luca Sugawara


    Full Text Available Parental involvement in schools in an emerging democracy has gained significant attention among school administrators, educators, parents, local governments, and the international development community; yet, empirical data on this subject remains sparse. This study aims to examine the patterns of parental involvement in schools in Croatian communities. Using mixed-methods, the sample size consists of 294 elementary school parents, two focus groups (parents and teachers, and nine interviews with national and international stakeholders. The study found that, apart from the educational outcomes for children, parental involvement also may be an important platform through which parents can practice democratic behaviors and engage in community-building initiatives. Through school-related activities, parents learn to interact with a government institution, voice their interests, participate in decision-making, leverage and use power, and cooperate with each other and the community. Findings from this study can have implications for social work practice and social development assistance by recognizing how engaging parents in school-based activities can become a platform for community participation and democratic behavior.

  11. A multifocal angiosarcoma involving bones of foot: A case report

    Directory of Open Access Journals (Sweden)



    Full Text Available Angiosarcomas of bone are rare tumors constituting 1% of all malignant bone tumors. They can be either solitary or multifocal and can easily be misinterpreted as multiple myeloma or metastasis radiologically. We present a case of multifocal angiosarcoma arrising in foot bones, the diagnosis of which was difficult clinically, radiologically and pathologically. The histologic findings observed in both bioptic and amputation specimens were provided.The patient was a 56 years-old man who has undergone coronary by-pass and saphenous vein surgery 3 months ago. He has been suffering from pain and swelling on left foot since then. The lesion was suspicious for atypical fungal infection, metastasis or lymphoma radiologically. “Tru-cut” biopsy revealed extensive necrosis and the lesion resembled an inflammatory and reactive process at first glance. Morphologic mimickers of the lesion like lymphoma, metastasis and small round cell tumors were excluded immunohistochemically and the diagnosis of “malignant vasculary tumor” was made upon CD- 31 positivity of tumor cells, presence of erytrocytes, cells with intracytoplasmic lumina and increased mitotic activity. In amputation specimen a multifocal tumor having areas of necrosis and hemorrhages was observed involving predominantly calcaneus but also infiltrating talus, distal tibia and achilles tendon. The maximum diameter of tumor was 5 cm in calcaneus. Adjuvant chemotherapy could not be given because of cardiac problems.The case was presented to increase awareness on this rare, diagnostically problematic issue, the classification of which is controversial.

  12. New high-order, semi-implicit Hybridized Discontinuous Galerkin - Spectral Element Method (HDG-SEM) for simulation of complex wave propagation involving coupling between seismic, hydro-acoustic and infrasonic waves: numerical analysis and case studies. (United States)

    Terrana, S.; Vilotte, J. P.; Guillot, L.


    New seismological monitoring networks combine broadband seismic receivers, hydrophones and micro-barometers antenna, providing complementary observation of source-radiated waves. Exploiting these observations requires accurate and multi-media - elastic, hydro-acoustic, infrasound - wave simulation methods, in order to improve our physical understanding of energy exchanges at material interfaces.We present here a new development of a high-order Hybridized Discontinuous Galerkin (HDG) method, for the simulation of coupled seismic and acoustic wave propagation, within a unified framework ([1],[2]) allowing for continuous and discontinuous Spectral Element Methods (SEM) to be used in the same simulation, with conforming and non-conforming meshes. The HDG-SEM approximation leads to differential - algebraic equations, which can be solved implicitly using energy-preserving time-schemes.The proposed HDG-SEM is computationally attractive, when compared with classical Discontinuous Galerkin methods, involving only the approximation of the single-valued traces of the velocity field along the element interfaces as globally coupled unknowns. The formulation is based on a variational approximation of the physical fluxes, which are shown to be the explicit solution of an exact Riemann problem at each element boundaries. This leads to a highly parallel and efficient unstructured and high-order accurate method, which can be space-and-time adaptive.A numerical study of the accuracy and convergence of the HDG-SEM is performed through a number of case studies involving elastic-acoustic (infrasound) coupling with geometries of increasing complexity. Finally, the performance of the method is illustrated through realistic case studies involving ground wave propagation associated to topography effects.In conclusion, we outline some on-going extensions of the method.References:[1] Cockburn, B., Gopalakrishnan, J., Lazarov, R., Unified hybridization of discontinuous Galerkin, mixed and

  13. Objectivist case study research

    DEFF Research Database (Denmark)

    Ridder, Hanne Mette Ochsner; Fachner, Jörg


    be achieved through the use of objectivist case study research. The strength of the case study design is that it allows for uncovering or suggesting causal relationships in real-life settings through an intensive and rich collection of data. According to Hilliard (1993), the opposite applies for extensive...... designs, in which a small amount of data is gathered on a large number of subjects. With the richness of data, the intensive design is ―the primary pragmatic reason for engaging in single-case or small N research‖ (p. 374) and for working from an idiographic rather than a nomothetic perspective....

  14. Stakeholder involvement in stages of a participatory process illustrated in interior design cases

    DEFF Research Database (Denmark)

    Vink, Peter; van Rhijn, Gu; Seim, Rikke


    In a previous study (Vink et al., 2008) an overview was made of the involvement of different stakeholders in a participatory design process. In this paper this overview was used to describe four participatory design cases focused on improvising productivity, health, and comfort by interior design...

  15. 21q21 deletion involving NCAM2: report of 3 cases with neurodevelopmental disorders. (United States)

    Petit, Florence; Plessis, Ghislaine; Decamp, Matthieu; Cuisset, Jean-Marie; Blyth, Moira; Pendlebury, Maria; Andrieux, Joris


    Here we report three patients affected with neurodevelopmental disorders and harbouring 21q21 deletions involving NCAM2 gene. NCAM (Neural Cell Adhesion Molecule) proteins are involved in axonal migration, synaptic formation and plasticity. Poor axonal growth and fasciculation is observed in animal models deficient for NCAM2. Moreover, this gene has been proposed as a candidate for autism, based on genome-wide association studies. In this report, we provide a comprehensive molecular and phenotypical characterisation of three deletion cases giving additional clues for the involvement of NCAM2 in neurodevelopment.

  16. Dengue encephalitis with predominant cerebellar involvement: Report of eight cases with MR and CT imaging features

    Energy Technology Data Exchange (ETDEWEB)

    Hegde, Vinay; Bhat, Maya; Prasad, Chandrajit; Gupta, A.K.; Saini, Jitender [National Institute of Mental Health and Neurosciences, Department of Neuroimaging and Interventional Radiology, Bangalore, Karnataka (India); Aziz, Zarina [Sri Sathya Sai Institute of Medical Science, Department of Radiology, Bangalore (India); Kumar, Sharath [Apollo Hospital, Department of Neuroradiology, Bangalore (India); Netravathi, M. [National Institute of Mental Health and Neurosciences, Department of Neurology, Bangalore (India)


    CNS dengue infection is a rare condition and the pattern of brain involvement has not been well described. We report the MR imaging (MRI) features in eight cases of dengue encephalitis. We retrospectively searched cases of dengue encephalitis in which imaging was performed. Eight cases (three men, five women; age range: 8-42 years) diagnosed with dengue encephalitis were included in the study. MR studies were performed on 3-T and 1.5-T MR clinical systems. Two neuroradiologists retrospectively reviewed the MR images and analysed the type of lesions, as well as their distribution and imaging features. All eight cases exhibited MRI abnormalities and the cerebellum was involved in all cases. In addition, MRI signal changes were also noted in the brainstem, thalamus, basal ganglia, internal capsule, insula, mesial temporal lobe, and cortical and cerebral white matter. Areas of susceptibility, diffusion restriction, and patchy post-contrast enhancement were the salient imaging features in our cohort of cases. A pattern of symmetrical cerebellar involvement and presence of microbleeds/haemorrhage may serve as a useful imaging marker and may help in the diagnosis of dengue encephalitis. (orig.)

  17. Case report 449: Chondroblastoma involving C5 and C6

    Energy Technology Data Exchange (ETDEWEB)

    Howe, J.W.; Yochum, T.R.; Sladich, M.A.; Baumgard, S.


    A case of chondroblastoma of the cervical spine is presented in a sixteen year old male. Both the axial location and the presence of an associated soft tissue mass make this an unusual case. Treatment is briefly considered. (orig.)

  18. Associative visual agnosia: a case study. (United States)

    Charnallet, A; Carbonnel, S; David, D; Moreaud, O


    We report a case of massive associative visual agnosia. In the light of current theories of identification and semantic knowledge organization, a deficit involving both levels of structural description system and visual semantics must be assumed to explain the case. We suggest, in line with a previous case study, an alternative account in the framework of (non abstractive) episodic models of memory.

  19. Associative Visual Agnosia: A Case Study


    A. Charnallet; S. Carbonnel; David, D.; Moreaud, O.


    We report a case of massive associative visual agnosia. In the light of current theories of identification and semantic knowledge organization, a deficit involving both levels of structural description system and visual semantics must be assumed to explain the case. We suggest, in line with a previous case study [1], an alternative account in the framework of (non abstractive) episodic models of memory [4].

  20. Who and What Does Involvement Involve? A Multi-Sited Field Study of Involvement of Relatives in Danish Psychiatry. (United States)

    Oute, Jeppe; Petersen, Anders; Huniche, Lotte


    This article gives an account of aspects of a multi-sited field study of involvement of relatives in Danish psychiatry. By following metaphors of involvement across three sites of the psychiatric system-a family site, a clinical site and a policy site-the first author (J.O.) investigated how, and on what grounds, involvement of relatives is perceived in Danish psychiatry. Paradoxically, the current understanding of involvement of relatives fails to take into consideration the perspectives of the relatives per se and families that were being studied. By analyzing involvement from a discourse theoretical perspective laid out by Ernesto Laclau and Chantal Mouffe, the aim of this study is to show how the dominant discourse about involvement at the political and clinical sites is constituted by understandings of mentally ill individuals and by political objectives of involvement. The analysis elucidates how a psycho-ideological discourse positions the mentally ill person as weak, incapable, and ineffective. By contrast, the supporting relative is positioned as a strong, capable, and effective co-therapist. Furthermore, the analysis considers how this dominant discourse of involvement is constituted by a broader discourse of neoliberalism and market orientation, which justifies involvement as a subtle institutionalization of social control. The article highlights that the role of the relative as a co-therapist may be contested by the families' discourse, which emphasizes issues concerning the responsibility toward the mental health of the ill individual as well as toward the psychological milieu of the family.

  1. The Effects of Student Involvement and College Environment on Students' Learning and Living Experience at World-Class Research Universities in China: A Comparative Case Study of the University of Hong Kong (HKU) and Shanghai Jiao Tong University (SJTU) (United States)

    Chan, Roy Yew-Hung


    This comparative research examined the effects of student involvement and college environment on students' learning and living experience delivered by two aspiring world-class universities in Hong Kong and Shanghai. Few studies have shown how the levels of student involvement and college environment can benefit students at world-class institution.…

  2. Grip strength measurements at two different wrist extension positions in chronic lateral epicondylitis-comparison of involved vs. uninvolved side in athletes and non athletes: a case-control study

    Directory of Open Access Journals (Sweden)

    Bhargava Arti S


    Full Text Available Abstract Background Lateral epicondylitis is a common sports injury of the elbow caused due to altered muscle activation during repetitive wrist extension in many athletic and non-athletic endeavours. The amount of muscle activity and timing of contraction eventually is directly dependent upon joint position during the activity. The purpose of our study was to compare the grip strength in athletes with lateral epicondylalgia in two different wrist extension positions and compare them between involved and uninvolved sides of athletes and non-athletes. Methods An assessor-blinded case-control study of eight athletes and twenty-two non-athletes was done. The grip strength was measured using JAMAR® hand dynamometer in kilograms-force at 15 degrees (slightly extended and 35 degrees (moderately extended wrist extension positions (maintained by wrist splints on both involved and uninvolved sides of athletes and non-athletes with unilateral lateral epicondylitis of atleast 3 months duration. Their pain was to be elicited with local tenderness and two of three tests being positive- Cozen's, Mill's manoeuvre, resisted middle finger extension tests. For comparisons of grip strength, Wilcoxon signed rank test was used for within-group comparison (between 15 and 35 degrees wrist extension positions and Mann-Whitney U test was used for between-group (athletes vs. non-athletes comparisons at 95% confidence interval and were done using SPSS 11.5 for Windows. Results Statistically significant greater grip strength was found in 15 degrees (27.75 ± 4.2 kgms in athletes; 16.45 ± 4.2 kgms in non-athletes wrist extension than at 35 degrees (25.25 ± 3.53 kgm in athletes and 14.18 ± 3.53 kgm in non-athletes. The athletes had greater grip strength than non-athletes in each of test positions (11.3 kgm at 15 degrees and 11.07 kgm at 35 degrees measured. There was also a significant difference between involved and uninvolved sides' grip strength at both wrist

  3. Darier disease with oral and esophageal involvement: A case report

    Directory of Open Access Journals (Sweden)

    Magesh Karuppur Thiagarajan


    Full Text Available A 58-year-old man presented with itchy papular eruptions all over the body since 15 years. Intraoral examination revealed raised papular lesions on the labial mucosa, hard palate, and tongue. The histopathology of the oral and skin lesions was confirmative of Darier disease (DD. This patient also showed esophageal involvement, which was confirmed histopathologically. Such a presentation of DD, with oral and esophageal involvement, is rare.

  4. Perception of the Impact of Freshmen Academic Involvement Activities, and Use of Academic Support Services on Academic Performance - (A Case Study of Virginia Tech Second Year Engineering Students): Implications for Counseling


    Amenkhienan, Charlotte A


    This study identifies and discusses the academic activities and support services that second-year-engineering students perceived as having impacted their freshman year academic performance. Guided by Astin's (1984) student involvement theory, this investigation involved a total of 34 participants, and was conducted at a large land-grant university in the southeastern United States during the spring semester of the 1998/99 academic year. The following questions were addressed by this study...

  5. Musical Hallucinations And Antidepressants: Case Report Involving Serotoninergic Ways



    A case of musical hallucination (MII) triggered by different antidepressive drugs is described. This is an uncommon side effect, probably more related to individual factors than to high doses. Musical hallucinations seems to be a releasing phenomenon, associated to sensorial deficit and neuronal compensatory activation. The present case report suggests that not only classical tricyclic antidepressives (AD) can cause MH, but also more selective drugs such as the SSRIs and venlafaxine. Aminedip...

  6. The Danish National Case Study Report

    DEFF Research Database (Denmark)

    Brodersen, Søsser; Jørgensen, Michael Søgaard

    Three case studies from Danish science shops within the environmental field are analysed with respect to societal background, interaction between the involved actors and the societal impact of the co-operation. The report is one of the seven national case study reports from the EU...

  7. Ameloblastic fibrodentinoma involving anterior maxilla: A rare case report

    Directory of Open Access Journals (Sweden)

    Shailaja Sankireddy


    Full Text Available Ameloblastic fibroma (AF and related lesions comprise a complex group of mixed odontogenic tumors. Ameloblastic fibrodentinoma (AFD is a rare tumor and is considered as a histological variant of AF showing inductive changes that lead to the formation of dentin. Although the most common site for this tumor is the posterior mandible, hereby we are reporting a case of AFD in the anterior maxillary region which is a very rare site for this group of tumors. The present case report highlights the clinical, radiological and histological presentation of AFD in order to raise awareness for the earlier diagnosis and precise management of this rare pathological entity.

  8. Case Studies - Cervical Cancer

    Centers for Disease Control (CDC) Podcasts


    Dr. Alan Waxman, a professor of obstetrics and gynecology at the University of New Mexico and chair of the American College of Obstetricians and Gynecologists (ACOG) committee for the underserved, talks about several case studies for cervical cancer screening and management.  Created: 10/15/2010 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Division of Cancer Prevention and Control (DCPC).   Date Released: 6/9/2010.

  9. A review of consumer involvement in evaluations of case management: consistency with a recovery paradigm. (United States)

    Marshall, Sarah L; Crowe, Trevor P; Oades, Lindsay G; Deane, Frank F; Kavanagh, David J


    This Open Forum examines research on case management that draws on consumer perspectives. It clarifies the extent of consumer involvement and whether evaluations were informed by recovery perspectives. Searches of three databases revealed 13 studies that sought to investigate consumer perspectives. Only one study asked consumers about experiences of recovery. Most evaluations did not adequately assess consumers' views, and active consumer participation in research was rare. Supporting an individual's recovery requires commitment to a recovery paradigm that incorporates traditional symptom reduction and improved functioning, with broader recovery principles, and a shift in focus from illness to well-being. It also requires greater involvement of consumers in the implementation of case management and ownership of their own recovery process, not just in research that evaluates the practice.

  10. A Rare Case: Gastric Cancer; Involving Primery Thoracal Vertebral Metastases

    Directory of Open Access Journals (Sweden)

    Harun Arslan


    Full Text Available Primery bone metastases rarely occur in gastric cancer. Bone metastases indicate that the prognosis is bad. In that article we present a case that is diagnosed as a gastric cancer with primary bone metasteses that caused pathologic thoracal vertebral fracture seenby computer ised tomography.

  11. Mitochondrial myopathy with respiratory muscle involvement: a case report

    Directory of Open Access Journals (Sweden)

    J. A. Levy


    Full Text Available A case of a 10-year-old patient with a benign congenital myopathy, suddenly aggravated because of an accentuated deficit in respiratory muscles is reported. The institution of assisted respiration at night allowed the patient to return to her daily activities. Examination of muscular biopsy with ultra-microscope permitted the diagnosis of mitochondrial myopathy.

  12. Allergic contact dermatitis: immune system involvement and distinctive clinical cases. (United States)

    Imbesi, S; Minciullo, P L; Isola, S; Gangemi, S


    The aim of this review is drawing the attention to the contact dermatitis, an inflammatory skin condition due to pro-inflammatory and toxic factors able to activate the skin innate immunity (irritant contact dermatitis) or caused by a T-cell- mediated hypersensitivity reaction (allergic contact dermatitis). The immune system involvement and a variety of clinical pictures are described in order to better diagnose, prevent and treat allergic contact dermatitis.

  13. A Case of Paget’s Disease with Scapula Involvement

    Directory of Open Access Journals (Sweden)

    Nilgün Mesci


    Full Text Available Paget’s disease is a common bone disorder which is characterized by excessive bone turnover. This condition rarely involves sternum, patella, scapula, hand, foot and facial bones. A 65-year-old male patient was admitted to our outpatient clinic with the complaint of right-sided pain that radiated from his groin to his knee for the last 5-6 years. His physical examination revealed limited hip movements and pain. Whole body bone scintigraphy detected diffuse, increased activity in the right coxa and entire scapula. Elevated alkaline phosphatase (ALP (367 U/L was observed in laboratory results. Further investigations and examinations were performed in order to exclude possible malignancies (eg. prostate, lung due to involvement of scapula which is atypical for Paget’s disease. Finally, poliostotic Paget’s disease with pelvic and scapular involvement was considered as the definite diagnosis. Treatment with risedronate sodium was started at a dose of 35 mg daily which led to marked improvement in hip pain and reduction in ALP level to 150 U/L after one month. While making a differential diagnosis of scintigraphic lesions at an unusual location such as scapula, consideration should be given to the fact that Paget’s disease may affect any bone in the body although this is rare

  14. Two cases of aggressive nontumoral folliculotropic mycosis fungoides with visceral involvement. (United States)

    Brugière, C; Karanian-Philippe, M; Comoz, F; Dompmartin, A; Galateau-Sallé, F; Verneuil, L


    Mycosis fungoides (MF) is the most common type of primary cutaneous T-cell lymphoma (CTCL), and folliculotropic MF (FMF) is one clinical variant of classic MF. MF generally has a good prognosis with an indolent clinical course, but for FMF greater therapeutic resistance is suggested. Visceral involvement is very rare in these two clinical forms. We report two exceptional cases of FMF with pulmonary and hepatic involvement. Five years after their initial diagnoses, patient 1 presented with a pulmonary localization of his FMF, and patient 2 with liver involvement, without lymph node or T-cell clones in the blood. These two patients had FMF corresponding to stage T2N0M1B0. These two cases highlight the aggressiveness of this rare variant of MF. They suggest that the T lymphocytes found in the folliculotropic form of CTCL could be characterized by greater visceral tropism. They raise the question of the molecular and functional characteristics of these T lymphocytes, and the possibility of a common target in the hair follicles and certain organs. Studies have shown that chemokine receptors are likely to be involved in the skin tropism that characterizes CTCL. These two cases show the aggressiveness of FMF and point to the interest in comparing the molecular characteristics of T lymphocytes in the folliculotropic and nonfolliculotropic forms of CTCL.

  15. Benign monomelic amyotrophy with proximal upper limb involvement: case report


    Neves,Marco Antonio Orsini; Marcos R. Freitas; Mello,Mariana Pimentel; Dumard,Carlos Henrique; Gabriel R. de Freitas; Nascimento, Osvaldo J.M.


    Monomelic amyotrophy (MA) is a rare condition in which neurogenic amyotrophy is restricted to an upper or lower limb. Usually sporadic, it usually has an insidious onset with a mean evolution of 2 to 4 years following first clinical manifestations, which is, in turned, followed by stabilization. We report a case of 20-years-old man who presented slowly progressive amyotrophy associated with proximal paresis of the right upper limb, which was followed by clinical stabilization 4 years later. E...

  16. Candida Parapsilosis Arthritis Involving the Ankle in a Diabetes Patient: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Sung, Jin Kyeong; Chun, Kyung Ah [Dept. of Radiology, The Catholic University of Korea Uijeongbu St. Mary' s Hospital, Uijeongbu (Korea, Republic of)


    Candida parapsilosis is a rare opportunistic fungal pathogen of the musculoskeletal region. Immune function of almost all patients is severely disturbed. Most reported cases of septic arthritis of joints by Candida involve the knee, especially Candida parapsilosis. To our knowledge, there has been only one case report of Candida parapsilosis involving the ankle presented on only plain radiography. We report a case of Candida parapsilosis arthritis involving the ankle in a diabetes patient which was shown on MR imaging.

  17. A fatal case of chikungunya virus infection with liver involvement. (United States)

    Chua, H H; Abdul Rashid, K; Law, W C; Hamizah, A; Chem, Y K; Khairul, A H; Chua, K B


    Recovery from chikungunya is previously considered universal and mortality due to the virus is rare and unusual. Findings from recent chikungunya outbreaks occurred in Reunion Island and India have since challenged the conventional view on the benign nature of the illness. Malaysia has experienced at least of 4 outbreaks of chikungunya since 1998. In the present on-going large outbreak due to chikungunya virus of Central/East African genotype, a previous healthy sixty six years gentleman without co-morbidity was noted to have severe systemic infection by the virus and involvement of his liver. He subsequently passed away due to cardiovascular collapse after 5 days of illness.

  18. Benign monomelic amyotrophy with proximal upper limb involvement: case report. (United States)

    Neves, Marco Antonio Orsini; Freitas, Marcos R G de; Mello, Mariana Pimentel de; Dumard, Carlos Henrique; Freitas, Gabriel R de; Nascimento, Osvaldo J M


    Monomelic amyotrophy (MA) is a rare condition in which neurogenic amyotrophy is restricted to an upper or lower limb. Usually sporadic, it usually has an insidious onset with a mean evolution of 2 to 4 years following first clinical manifestations, which is, in turned, followed by stabilization. We report a case of 20-years-old man who presented slowly progressive amyotrophy associated with proximal paresis of the right upper limb, which was followed by clinical stabilization 4 years later. Eletroneuromyography revealed denervation along with myofasciculations in various muscle groups of the right upper limb. We call attention to this rare location of MA, as well as describe some theories concerning its pathophysiology .

  19. Case Study - Alpha

    Directory of Open Access Journals (Sweden)

    Stephen Leybourne


    Full Text Available This case study was developed from an actual scenario by Dr. Steve Leybourne of Boston University.  The case documents the historical evolution of an organization, and has been used successfully in courses dealing with organizational and cultural change, and the utilization of ‘soft skills’ in project-based management. This is a short case, ideal for classroom use and discussion.  The issues are easily accessible to students, and there is a single wide ranging question that allows for the inclusion of many issues surrounding strategic decision-making, and behavioural and cultural change. Alpha was one of the earlier companies in the USA to invest in large, edge-of-town superstores, with plentiful free vehicle parking, selling food and related household products. Alpha was created in the 1950s as a subsidiary of a major publicly quoted retail group.  It started business by opening a string of very large discount stores in converted industrial and warehouse premises in the south of the United States. In the early days shoppers were offered a limited range of very competitively priced products. When Alpha went public in 1981 it was the fourth largest food retailer in the US, selling an ever-widening range of food and non-food products.  Its success continued to be based on high volume, low margins and good value for money, under the slogan of ‘Alpha Price.’

  20. Endoscopic biopsy of a B-cell lymphoma involving the entire ventricular system: A case report (United States)



    A 62-year-old male suffering from vomiting and mild preceding nausea for 15 days was examined in the present case report. Magnetic resonance imaging revealed a homogeneously enhancing cluster-like lesion involving the lateral, third and fourth ventricles. An endoscopic biopsy was performed, and histopathological examination led to the diagnosis of a high-grade diffuse large B-cell lymphoma. To the best of our knowledge, the present study reports the first case of a primary lymphoma involving the entire ventricular system. Therefore, primary lymphomas should be considered in the list of ventricular tumors. An endoscopic biopsy requires minimal invasion to obtain an adequate tissue sample, and frequently leads to the correct diagnosis and subsequent treatment protocols. PMID:26889262

  1. Langerhans cell histiocytosis with multisystem involvement in an infant: A case report (United States)



    Langerhans cell histiocytosis (LCH) is a proliferative disease of histiocyte-like cells, with a wide range of clinical presentations that vary from a solitary lesion to more severe multifocal or disseminated lesions. The disease can affect any age group; however, the peak incidence rate is in infants aged between 1 and 3 years-old. Diagnosis of LCH should be based on the synthetical analysis of clinical presentations, in addition to features of imaging and histopathology. Although certain cases regress spontaneously, other patients require systemic chemotherapy together with the administration of steroids. The present study reports the case of an infant with LDH with multisystem involvement, including that of the bone, skin, orbit, spleen and lungs. The patient received chemotherapy and obtained rapid improvement in the involved systems. A total of 2.5 years after completion of the therapy, the patient still remains in follow-up and no evidence of active disease has been noted. PMID:26136948

  2. Studies of Genes Involved in Congenital Heart Disease

    Directory of Open Access Journals (Sweden)

    Tushar K. Ghosh


    Full Text Available Congenital heart disease (CHD affects the intricate structure and function of the heart and is one of the leading causes of death in newborns. The genetic basis of CHD is beginning to emerge. Our laboratory has been engaged in identifying mutations in genes linked to CHD both in families and in sporadic cases. Over the last two decades, we have employed linkage analysis, targeted gene sequencing and genome wide association studies to identify genes involved in CHDs. Cardiac specific genes that encode transcription factors and sarcomeric proteins have been identified and linked to CHD. Functional analysis of the relevant mutant proteins has established the molecular mechanisms of CHDs in our studies.

  3. Fulminant Mucormycosis Involving Paranasal Sinuses: A Rare Case Report

    Directory of Open Access Journals (Sweden)

    Komali Garlapati


    Full Text Available Mucormycosis is an opportunistic fulminant fungal infection, which has the ability to cause significant morbidity and frequently mortality in the susceptible patient. Common predisposing factors include diabetes mellitus and immunosuppression. The infection begins in the nose and paranasal sinuses due to inhalation of fungal spores. The fungus invades the arteries leading to thrombosis that subsequently causes necrosis of the tissue. The infection can spread to orbital and intracranial structures either by direct invasion or through the blood vessels. Here we describe a case of mucormycosis of maxillary antrum extending to ethmoidal and frontal sinus and also causing necrosis of left maxilla in an uncontrolled diabetic individual to emphasize early diagnosis and treatment of this fatal fungal infection.

  4. Infected Thyroglossal Duct Cyst Involving Submandibular Region: A Case Report

    Directory of Open Access Journals (Sweden)

    Rahul A. Gandhi


    Full Text Available Thyroglossal duct cyst presents most frequently in the midline of the neck, either at or just below the level of the hyoid bone. They generally manifest as painless neck swelling, and they move on protrusion of tongue and during swallowing. A case of thyroglossal cyst was reported in the left submandibular region in a 14-year-old girl, above the level of hyoid bone; ultrasound examination favored a cystic lesion which moved in a vertical fashion on swallowing whereas fine needle aspiration cytology report was suggestive of simple cystic lesion of thyroglossal cyst. No lymphoid or malignant cells were present. The cyst was excised completely by surgical procedure under general anesthesia. Histopathological analysis revealed thyroglossal cyst showing columnar and flattened epithelium of cyst with focal aggregate of chronic inflammatory cells supported by fibrocollagenous cyst wall. The clinical, ultrasound, and histopathological findings suggested that the lesion was an infected thyroglossal cyst. There was no evidence of recurrence 6 months after surgery.

  5. Rosai–Dorfman disease involving gallbladder and liver—Report of a case (United States)

    Arabadzhieva, Elena; Yonkov, Atanas; Bonev, Sasho; Bulanov, Dimitar; Taneva, Ivanka; Pirdopska, Tatyana; Terziev, Ivan; Dimitrova, Violeta


    Introduction Rosai–Dorfman disease (RDD), also known as sinus histiocytosis with massive lymphadenopathy, is a rare histiocytic disorder of unclear etiology. Lymphadenopathy commonly affects the lymph nodes of the neck and the head, but extranodal involvement has been observed too. Presentation of case We describe an unusual case of RDD with involvement of the gallbladder, liver and cystic lymph node, clinically manifested as an exacerbated cholecystitis. The patient underwent a cholecystectomy with atypical liver resection because the finding was macroscopically suspected of gallbladder cancer. The diagnosis of RDD was confirmed by immunohistochemical study. Discussion Histological features of RDD include histiocytic proliferation, emperipolesis and positive immunostaining for S-100 protein and typically negative for CD1a. Gastrointestinal localization of RDD, especially in the liver and pancreas, is extremely rare. Typically, the liver is affected as a part of systematic spread of RDD. We have not found reports for involvement of the gallbladder. Conclusion The presented case is valuable due to its rarity and difficulty in differential diagnosis. PMID:26073916

  6. Associative Visual Agnosia: A Case Study

    Directory of Open Access Journals (Sweden)

    A. Charnallet


    Full Text Available We report a case of massive associative visual agnosia. In the light of current theories of identification and semantic knowledge organization, a deficit involving both levels of structural description system and visual semantics must be assumed to explain the case. We suggest, in line with a previous case study [1], an alternative account in the framework of (non abstractive episodic models of memory [4].

  7. CHEK2*1100delC and susceptibility to breast cancer : A collaborative analysis involving 10,860 breast cancer cases and 9,065 controls from 10 studies

    NARCIS (Netherlands)

    Easton, D; McGuffog, L; Thompson, D; Dunning, A; Tee, L; Baynes, C; Healey, C; Pharoah, P; Ponder, B; Seal, S; Barfoot, R; Sodha, N; Eeles, R; Stratton, M; Rahman, N; Peto, J; Spurdle, AB; Chen, XQ; Chenevix-Trench, G; Hopper, JL; Giles, GG; McCredie, MRE; Syrjakoski, K; Holli, K; Kallioniemi, O; Eerola, H; Vahteristo, P; Blomqvist, C; Nevanlinna, H; Kataja, Vesa; Mannermaa, A; Dork, T; Bremer, M; Devilee, P; de Bock, GH; Krol-Warmerdam, EMM; Kroese-Jansema, K; Wijers-Koster, P; Cornelisse, CJ; Tollenaar, RAEM; Meijers-Heijboer, H; Berns, E; Nagel, J; Foekens, J; Klijn, JGM; Schutte, M


    Previous studies of families with multiple cases of breast cancer have indicated that a frameshift alteration in the CHEK2 gene, 1100delC, is associated with an elevated frequency of breast cancer in such families, but the risk associated with the variant in other situations is uncertain. To evaluat

  8. Unexplained False Negative Results in Noninvasive Prenatal Testing: Two Cases Involving Trisomies 13 and 18

    Directory of Open Access Journals (Sweden)

    R. Hochstenbach


    Full Text Available Noninvasive prenatal testing (NIPT validation studies show high sensitivity and specificity for detection of trisomies 13, 18, and 21. False negative cases have rarely been reported. We describe a false negative case of trisomy 13 and another of trisomy 18 in which NIPT was commercially marketed directly to the clinician. Both cases came to our attention because a fetal anatomy scan at 20 weeks of gestation revealed multiple anomalies. Karyotyping of cultured amniocytes showed nonmosaic trisomies 13 and 18, respectively. Cytogenetic investigation of cytotrophoblast cells from multiple placental biopsies showed a low proportion of nontrisomic cells in each case, but this was considered too small for explaining the false negative NIPT result. The discordant results also could not be explained by early gestational age, elevated maternal weight, a vanishing twin, or suboptimal storage or transport of samples. The root cause of the discrepancies could, therefore, not be identified. The couples involved experienced difficulties in accepting the unexpected and late-adverse outcome of their pregnancy. We recommend that all parties involved in caring for couples who choose NIPT should collaborate to clarify false negative results in order to unravel possible biological causes and to improve the process of patient care from initial counseling to communication of the result.

  9. Wineries' Involvement in Promoting Tourism Online: The Case of Texas

    Directory of Open Access Journals (Sweden)

    Rasch, Leslie


    Full Text Available Wine tourism has become an important driver of business for wineries in many regions around the world, while Texas wine regions are only starting to emerge as important tourism destinations. A study was conducted to investigate how effectively Texas wineries market tourism to their own establishments as well as in a regional context. A specific focus was placed on indications of collaborative wine tourism marketing practices on winery websites. The results indicate that wineries provide basic visitor information but are missing out on strategic opportunities to market wine tourism to their areas.

  10. [The SAPHO syndrome: a study of 16 cases]. (United States)

    Olivé, A; Pérez-Andrés, R; Rivas, A; Holgado, S; Casado, E; Gumá, M; Tena, X


    The SAPHO syndrome is characterized by synovitis, acne, palmo-plantar pustulosis, hyperostosis and osteitis. SAPHO syndrome has been occasionally described in Spain. We present our experience of 16 cases with the SAPHO syndrome diagnosed between 1984-1995. The predominant clinical symptoms were: anterior thoracic pain (14 cases), sacroiliac pain (7 cases) and peripheral arthritis (2 cases). Cutaneous involvement was characterized by palmo-plantar pustulosis (8 cases) acne (3 cases) and psoriasis (2 cases). The histocompatibility antigen B27 was negative in all cases. A computerized tomographic study revealed involvement of sterno-costo-clavicular and manubriosternal joints (14 cases) and sacroiliitis (8 cases).

  11. Program evaluation and case study


    Kushner, S


    This entry looks at the convergence of case study methodology and program evaluation. An early insight of some educational evaluation theorists was of the convergence of case study and program evaluation – the fusion of method with purpose. Program evaluation and case study came to be mutually-bracketed. In the educational evaluation field 'Responsive', 'Democratic', 'Illuminative' methodologies were developed in parallel with case study methods - the same authors contributing freely to both ...

  12. Examples and Case Studies

    NARCIS (Netherlands)

    Asbach, C.; Aguerre, O.; Bressot, C.; Brouwer, D.H.; Gommel, U.; Gorbunov, B.; Bihan, O. le; Jensen, K.A.; Kaminski, H.; Keller, M.; Koponen, I.K.; Kuhlbusch, T.A.J.; Lecloux, A.; Morgeneyer, M.; Muir, R.; Shandilya, N.; Stahlmecke, B.; Todea, A.M.


    Release of nanomaterials may occur during any stage of the life-cycle and can eventually lead to exposure to humans, the environment or products. Due to the large number of combinations of release processes and nanomaterials, release scenarios can currently only be tested on a case-by-case basis. Th

  13. Final report on case studies

    DEFF Research Database (Denmark)

    Ljungberg, Daniel; McKelvey, Maureen; Lassen, Astrid Heidemann


    Case study as a research design means investigating a single or multiple instance(s) or setting(s) (i.e. a case) and its entire context to explain a phenomenon and its processes. This is achieved through detailed understanding, usually comprised of multiple sources of information. In this way, case...... studies attempt to provide as a complete an understanding of a (complex) phenomenon as possible. Within the AEGIS project, survey and case study research are complementary. They are complementary in the sense that the former can provide more generalizable evidence on a phenomenon in terms of cross......-sectional data, while the latter can provide more in-depth (qualitative) understanding on specific issues. In systematically examining the case studies, however, this report goes beyond a typical single case study. Here we provide a synthesis of 86 case studies. Multiple case studies, following similar focus...

  14. Natural Learning Case Study Archives (United States)

    Lawler, Robert W.


    Natural Learning Case Study Archives (NLCSA) is a research facility for those interested in using case study analysis to deepen their understanding of common sense knowledge and natural learning (how the mind interacts with everyday experiences to develop common sense knowledge). The database comprises three case study corpora based on experiences…

  15. Dioxin: a case study. (United States)

    Bond, G G


    The need to notify individuals of a possible health risk from their past exposure to potentially hazardous agents frequently extends beyond workers to include community groups. The issues to consider in community notification are frequently similar to those that are important for worker notification but may include some that are unique. This case study traces the evolution of one company's strategy for communicating with the public about possible dioxin contamination associated with its operations. Early communications tended to emphasize the technical aspects of the issues in the fashion of scientists talking to other scientists. This was interpreted by some to be symptomatic of an arrogant and uncaring attitude. Beginning in the early 1980s, the company's management recognized the need to reach out to a variety of audiences on multiple levels, and shifted to a more comprehensive communications strategy. A similar shift is now occurring throughout the chemical manufacturing industry as top managers realize that, if they expect to continue to operate, they must become more accountable and responsive to the public.

  16. KAIZEN – A case study

    Directory of Open Access Journals (Sweden)

    Manjunath Shettar


    Full Text Available The ultimate objective of manufacturing industries is to increase productivity with high quality. At present, many manufacturing companies are facing problems such as high quality rejection, high inventories, high lead time, high costs of production, and inability to cope with customer orders. By implementing and practicing the lean production system many problems can be solved without employing high-tech and high-touch approaches but by involving people on the shop floor in Kaizen activities. Kaizen is one of the powerful tools of lean manufacturing. Kaizen refers to continuous improvement in performance, cost and quality. Kaizen ensures that manufacturing processes become leaner and fitter, but eliminate waste (problem where value is added. The main objective of this paper is to provide a background on kaizen, present an overview of kaizen concepts that are used to transform a company into a high performing lean enterprise. A case study of implementation of Kaizen‟s has been discussed.

  17. Association between the Interaction of Key Genes Involved in Effector T-Cell Pathways and Susceptibility to Develop allergic Rhinitis: A Population-Based Case-Control Association Study.

    Directory of Open Access Journals (Sweden)

    Yuan Zhang

    Full Text Available Evidence suggests that interaction between key genes mediating signaling and transcriptional networks involving effector T-cell responses may influence an individual's susceptibility to develop allergic rhinitis(AR.The aim of this study was todetermine whether specific interactions between key genes involved in effector T-cell pathways are associated with an individual's susceptibility to develop AR in Han Chinese subjects.A cohort of 489 patients with AR and 421 healthy controls was enrolled from the Han Chinese population in Beijing, China. AR was established by questionnaire and clinical examination, and peripheral blood was drawn from all subjects for DNA extraction. A total of 96 single nucleotide polymorphisms (SNPs in 26 reprehensive candidate genes involved in T helper 1 (Th1, Th2, Th17, Th9 and T regulatory cell pathways were selected from the International Haplotype Mappingdatabase for Han Chinese in Beijing (CHB population, and IlluminaGoldenGate assay was conducted for SNP genotyping. The PLINK software package was used to perform statistical analyses.Simple SNP-phenotype association analysis using logistic regression showed SNP rs8193036 in IL17A gene, rs2569254 in IL-12 and rs1898413 in RORα weresignificantlyassociatedwith AR.Simple SNP-phenotype association analysis with genetic models demonstrated thatrs2569254 in IL-12, rs1031508 in STAT4, and rs3741809 in IL-26 were likely to be recessive, rs8193036 in IL17A allelic, rs897200in STAT4 genotypic, and rs1898413 in RORα dominant. Epistasis analyses exhibited that 83 SNPs in 23 genes were significantly interactive; of which 59 interactions/SNP pairs demonstrated OR values higher than 2 or lower than 0.5, and 12 interactions/SNP pairs OR values higher than 4 or lower than 0.25. STAT3, RORα and IL-26, involved in Th17 pathway,were the mostfrequentlyinteractive genes.This study suggests that interactions between several SNPs in key genes involved in effector T-cell pathways are

  18. Five case studies of multifamily weatherization programs

    Energy Technology Data Exchange (ETDEWEB)

    Kinney, L; Wilson, T.; Lewis, G. [Synertech Systems Corp. (United States); MacDonald, M. [Oak Ridge National Lab., TN (United States)


    The multifamily case studies that are the subject of this report were conducted to provide a better understanding of the approach taken by program operators in weatherizing large buildings. Because of significant variations in building construction and energy systems across the country, five states were selected based on their high level of multifamily weatherization. This report summarizes findings from case studies conducted by multifamily weatherization operations in five cities. The case studies were conducted between January and November 1994. Each of the case studies involved extensive interviews with the staff of weatherization subgrantees conducting multifamily weatherization, the inspection of 4 to 12 buildings weatherized between 1991 and 1993, and the analysis of savings and costs. The case studies focused on innovative techniques which appear to work well.

  19. Temporal and Pontine Involvement in a Case of Herpes Simplex Encephalitis, Presenting as Kluver Bucy Syndrome - A Case Report

    Directory of Open Access Journals (Sweden)

    Suresh Thirunavukarasu


    Full Text Available Bilateral temporal and frontal lobe involvement is a common characteristic of herpes simplex encephalitis (HSE. Clinical sequelae of herpes simplex encephalitis may manifest sometimes as Kluver Bucy syndrome (KBS. In herpes simplex encephalitis, apart from frontal lobe, extra temporal involvement is rare and uncommon. We report a case of HSE manifesting clinically as KBS with a rare radiological finding of temporal and extratemporal involvement of pons.

  20. Intercultural Communicative Case Study

    Institute of Scientific and Technical Information of China (English)



    The essay is mainly about the author's comprehension of cultural differences and intercultural communication after reading the book Communication Between Cultures.In addition,the author also analyses three cases with the theories and approaches mentioned in Communication Between Cultures.

  1. Meningeal involvement in Wegener granulomatosis: case report and review of the literature. (United States)

    Soriano, A; Lo Vullo, M; Casale, M; Quattrocchi, C C; Afeltra, A


    Wegener Granulomatosis (WG) is a multisystem autoimmune disorder characterized by necrotizing granulomatous vasculitis that most commonly involves the upper respiratory tract, lungs, and kidneys. The involvement of the central nervous system (CNS) is infrequent and can cause stroke, cranial nerve abnormalities, cerebrovascular events, seizures, and meningeal involvement. Meningeal involvement is rare and may occur due to local vasculitis, directly spread from adjacent disease in the skull base, paranasal or orbital region. We describe the case of a 20-year-old Caucasian man who was diagnosed with sinonasal WG with frontal focal meningeal involvement. A literature review on diagnosis and treatment of meningeal involvement in course of WG was carried out. The importance of an early diagnosis and treatment of localized WG has been emphasized, in order to avoid the progression to a severe form of disease, especially in younger patients and in paucisymptomatic cases.

  2. Emotion, Engagement, and Case Studies (United States)

    Herreid, Clyde Freeman; Terry, David R.; Lemons, Paula; Armstrong, Norris; Brickman, Peggy; Ribbens, Eric


    Three college faculty taught large general biology classes using case studies and personal response systems (clickers). Each instructor taught the same eight cases in two different sections, except the questions within the cases differed. In one section the questions were lower order (LO) factual inquiries, and in the other they were largely…

  3. 20 CFR 416.1262 - Special resource provision applicable in cases involving essential persons. (United States)


    ... cases involving essential persons. 416.1262 Section 416.1262 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SUPPLEMENTAL SECURITY INCOME FOR THE AGED, BLIND, AND DISABLED Resources and Exclusions § 416.1262... limit and exclusions (as specified in § 416.1260) applicable to cases in which the needs of an...

  4. WP6 - The Ag2020 Case Studies

    DEFF Research Database (Denmark)

    Hansen, Jens G; Borch, Kristian; Trombi, Giacomo;


    of the Future are presented. Finally, in section 1.4, is described the structure of the present report,which is firmly followed by the four case studies involved in the Project, namely the Rhodope Mountainous region in Bulgaria (CS1), The Kastelli region (Herakleion nomos) in Greece (CS2), the Central Denmark...

  5. Disrupt, Support and Document: The Role of Social Media in International Parental Child Abduction Cases Involving Japan

    Directory of Open Access Journals (Sweden)

    Geraldine Carney


    Full Text Available In this article, I examine the use of social media by parents involved in cases of international parental abduction to and from Japan, with a focus on cases of abduction to Japan. I argue that the use of social media in these cases is a symptom of and a counter to a legal system which has been outpaced by changes in society, particularly the creation and dissolution of international families. This article discusses a number of case studies of social media usage and locates these in the context of the contemporary Japanese legal system. While not ignoring the nefarious potential of social media usage, I come to a positive assessment of its use in cases of international parental child abduction involving Japan. I also question how its utility will change over time, depending on the legal system’s ability to adapt to societal changes and expectations.

  6. Mucous membrane pemphigoid with exclusive gingival involvement: Report of a case and review of literature

    Directory of Open Access Journals (Sweden)

    Shamimul Hasan


    Full Text Available According to Sir William Osler, Mouth is the mirror of the body which reflects systemic -diseases. The oral mucosa may be affected by a variety of mucocutaneous diseases and oral lesions may occur first or very early in several mucocutaneous disorders. The erosive gingival lesions associated with vesiculobullous diseases such as lichen planus, cicatricial pemphigoid, and pemphigus vulgaris have been collectively referred to as "Desquamative gingivitis" (DG. Gingival desquamation is a clinical sign in which the gingiva appears reddish, painful, glazed and friable with destruction of the epithelium. This gingival desquamation is due to various disease processes in gingiva. The disease process may be a localized disease of gingiva or a systemic disease which manifests in the gingiva. It is important to be aware of this rare clinical entity so as to distinguish DG from plaque induced gingivitis which is an extremely common condition, easily recognized and treated daily by the dental surgeon. Accurate diagnosis and effective treatment of these lesions may greatly diminish or reverse disease progression. Here by, we present a case of mucous membrane pemphigoid presenting as gingival desquamation in a 45 year old female. Our patient presented with generalized erythematous gingiva and gingival desquamation involving the free, attached and marginal gingiva of left maxillary and mandibular dentition. However, other mucosal and skin involvement was not appreciated in the present case. Thorough history, clinical examination, histopathology and immunofluorescence studies helped us to arrive at the diagnosis of this rare sub-epithelial blistering disorder.

  7. Carcinoma involving the gallbladder: a retrospective review of 23 cases - pitfalls in diagnosis of gallbladder carcinoma

    Directory of Open Access Journals (Sweden)

    Giang Tran H


    Full Text Available Abstract Background Carcinoma of the gallbladder (GBC clinically mimics benign gallbladder diseases and often escapes detection until advanced stage. Despite the frequency of cholecystectomy, diagnosis of GBC remains problematic in many situations. We sought to identify pathologic features that contribute to the difficulty in recognition of GBC. Methods We identified 23 patients (ranged from 45 to 86 years, male to female ratio 1:4.5 with carcinoma involving the gallbladder referred to an academic medical center over a period of 10 years for study. This includes 10 cases of primary GBC, 6 cases of metastatic tumor to gallbladder, 6 cases of directly invasive adenocarcinoma arising elsewhere in the biliary tree, and one case of unidentified origin adenocarcinoma. Primary tumors include adenocarcinoma not otherwise specified (NOS in 6 cases, papillary adenocarcinoma in 2 cases, and single cases of undifferentiated carcinoma and combined adenocarcinoma and neuroendocrine carcinoma (NEC. Metastatic tumors to gallbladder were from a wide range of primary sites, predominantly the gastrointestinal tract. Results These cases illustrate seven potential pitfalls which can be encountered. These include: 1 mistakenly making a diagnosis of adenocarcinoma of gallbladder when only benign lesions such as deeply penetrating Rokitansky-Aschoff sinuses are present (overdiagnosis, 2 misdiagnosing well-differentiated invasive carcinoma with minimal disease as benign disease (underdiagnosis, 3 differentiating between primary NEC of gallbladder and metastasis, 4 confusing primary mucinous adenocarcinoma of gallbladder with pseudomyxoma peritonei from a low grade appendiceal neoplasm disseminated to gallbladder, 5 confusing gangrenous necrosis related to cholecystitis with geographic tumoral necrosis, 6 undersampling early, grossly occult disease, and 7 misinterpreting extracellular mucin pools. Conclusions Clinical history and a high index of suspicion are

  8. Case Study: Case Studies and the Flipped Classroom (United States)

    Herreid, Clyde Freeman; Schiller, Nancy A.


    This column provides original articles on innovations in case study teaching, assessment of the method, as well as case studies with teaching notes. This month's issue discusses the positive and negative aspects of the "flipped classroom." In the flipped classroom model, what is normally done in class and what is normally done as…

  9. Building theories from case study research: the progressive case study

    NARCIS (Netherlands)

    Steenhuis, Harm-Jan; Bruijn, de Erik J.


    Meredith (1998) argues for more case and field research studies in the field of operations management. Based on a literature review, we discuss several existing approaches to case studies and their characteristics. These approaches include; the Grounded Theory approach which proposes no prior litera

  10. Theory Testing Using Case Studies

    DEFF Research Database (Denmark)

    Møller, Ann-Kristina Løkke; Dissing Sørensen, Pernille


    testing using case studies, including the associated research goal, analysis, and generalisability. We argue that research designs for theory testing using case studies differ from theorybuilding case study research designs because different research projects serve different purposes and follow different......The appropriateness of case studies as a tool for theory testing is still a controversial issue, and discussions about the weaknesses of such research designs have previously taken precedence over those about its strengths. The purpose of the paper is to examine and revive the approach of theory...... research paths....

  11. [Gastro-intestinal involvement in non Hodgkin's lymphomas, 31 cases (author's transl)]. (United States)

    Najman, A; Gorin, N C; Barranger, C; Duhamel, G


    Gastro-intestinal involvement is a distinctive feature of non-Hodgkin's lymphomas. 31 cases are reported among 200 cases on NHL observed between 1960 and 1976. Multiple involvement appeared in 61%; a diffuse histological pattern is frequent (67%). The relapse of primary isolated gastro-intestinal localization (always) affected extra-digestive tissues (nodes, cavum). Chemotherapy is the mainstay of treatment COP, COAP and MOCA. Surgery is associated in localized involvement or in case of obstruction. High energy radiation therapy is indicated only in lymphosarcomas: -- to residual tumor after chemotherapy--in localized involvement diffuse on all the abdomen at 25 grays after surgery and a brief course of chemotherapy versus surgery and long course of chemotherapy alone.

  12. Direct Cranial Nerve Involvement by Gliomas: Case series and review of the literature (United States)

    Mabray, Marc C.; Glastonbury, Christine M.; Mamlouk, Mark D.; Punch, Gregory E.; Solomon, David A.; Cha, Soonmee


    Malignant gliomas are characterized by infiltrative growth of tumor cells, including along white matter tracts. This may result in clinical cranial neuropathy due to direct involvement of a cranial nerve rather than by leptomeningeal spread along cranial nerves. Gliomas directly involving cranial nerves III-XII are rare with only eleven cases reported in the literature prior to 2014, including eight with imaging. We present eight additional cases demonstrating direct infiltration of a cranial nerve by glioma. Asymmetric cisternal nerve expansion as compared to the contralateral nerve was noted with a mean length of involvement of 9.4 mm. Based on our case series, the key imaging feature to recognize direct cranial nerve involvement by a glioma is the detection of an intra-axial mass in the pons or midbrain that is directly associated with expansion, signal abnormality, and/or enhancement of the adjacent cranial nerve(s). PMID:25857757

  13. Involvement of interstitial telomeric sequences in two new cases of mosaicism for autosomal structural rearrangements. (United States)

    Lévy, Jonathan; Receveur, Aline; Jedraszak, Guillaume; Chantot-Bastaraud, Sandra; Renaldo, Florence; Gondry, Jean; Andrieux, Joris; Copin, Henri; Siffroi, Jean-Pierre; Portnoï, Marie-France


    Mosaicism for an autosomal structural rearrangement that does not involve ring or marker chromosomes is rare. The mechanisms responsible for genome instability have not always been explained. Several studies have shown that interstitial telomeric sequences (ITSs), involved in some mosaic constitutional anomalies, are potent sources of genomic instability. Here we describe two cases of mosaicism for uncommon constitutional autosomal rearrangements, involving ITSs, identified by karyotyping and characterized by FISH and SNP-array analysis. The first patient, a boy with global developmental delay, had a rare type of pure distal 1q inverted duplication (1q32-qter), attached to the end of the short arm of the same chromosome 1, in approximately 35% of his cells. The second patient, a phenotypically normal man, was diagnosed as having mosaic for a balanced non-reciprocal translocation of the distal segment of 7q (7q33qter), onto the terminal region of the short arm of a whole chromosome 12, in approximately 80% of his cells. The remaining 20% of the cells showed an unbalanced state of the translocation, with only the der(7) chromosome. He was ascertained through his malformed fetus carrying a non-mosaic partial monosomy 7q, identified at prenatal diagnosis. We show that pan-telomeric and subtelomeric sequences were observed at the interstitial junction point of the inv dup(1q) and of the der(12)t(7;12), respectively. The present cases and review of the literature suggest that the presence of ITSs at internal sites of the chromosomes may explain mechanisms of the patients's mosaic structural rearrangements.

  14. Theory testing using case studies

    DEFF Research Database (Denmark)

    Dissing Sørensen, Pernille; Løkke Nielsen, Ann-Kristina

    Case studies may have different research goals. One such goal is the testing of small-scale and middle-range theories. Theory testing refers to the critical examination, observation, and evaluation of the 'why' and 'how' of a specified phenomenon in a particular setting. In this paper, we focus...... on the strengths of theory-testing case studies. We specify research paths associated with theory testing in case studies and present a coherent argument for the logic of theoretical development and refinement using case studies. We emphasize different uses of rival explanations and their implications for research...... design. Finally, we discuss the epistemological logic, i.e., the value to larger research programmes, of such studies and, following Lakatos, conclude that the value of theory-testing case studies lies beyond naïve falsification and in their contribution to developing research programmes in a progressive...

  15. Instructional Computing: Ten Case Studies. (United States)

    Hargan, Carol; Hunter, Beverly

    These case studies are written for educational institutions that wish to plan, extend, or improve their use of computers for learning and teaching. Each case study includes a brief description of each of the following: profile of the institution, history of the development of instructional computing, organization and management, student access to…

  16. Three Community College Case Studies (United States)

    Wojtysiak, Joseph; Sutton, William J., II; Wright, Tommy; Brantley, Linda


    This article presents three case studies that focus on specific projects that are underway or have been completed. In the first case study, Joseph Wojtysiak and William J. Sutton, II discuss the Green Center of Central Pennsylvania, which is designed to serve as the state's preeminent source for education, training and public information about…

  17. The emotional involvement in the workplace: An empirical study

    Directory of Open Access Journals (Sweden)

    Ana María Lucia-Casademunt


    Full Text Available Purpose: In a multitude of studies, it is verified that the generation of positive attitudes for employees such as job satisfaction or job involvement, have a positive influence on productivity levels of companies. The current investigation focus on the identification of employee-profile -who is emotionally involved with their work activity- through the use of a set of individual, job related and attitudinal factors.Design/methodology: A review of the literature about the main factors that affect the job involvement particularly on its emotional dimension has been completed. For its measurement at the empirical level, various items related to psychological well being of employees included in the IV European Working Conditions Survey-2010 are used. Moreover, those items are identified in Job Involvement Questionnaire (Lodahl & Kejner, 1965. Since then, an empirical and multidimensional study is carried out by applying a logistic regression model on the sample of 11,149 employees obtained with European survey cited previously.Findings: The logistic regression model identifies the factors, which are directly related to emotional involvement at the workplace. Ultimately, is raised a definitive model that define the European employee-profile -who is emotionally involved at the workplace-: a rather aged person who has been working at his/her present place of employment for several years in a medium-sized company where possibly there exist a good working relationship between workers and their superiors –social support-. These employees are “white-collar” workers, have career advancement opportunities in the organizational hierarchy. They perform variety, flexible and complex tasks, which leads to satisfaction in terms of pay and working conditions.Research limitations/implications: Emotional involvement has been measured through self-awareness and, therefore, the corresponding bias in the key variable must be assumed. In addition, the casual

  18. In what sequence are information sources consulted by involved comsumers? The case of automobile pre-purchase search

    NARCIS (Netherlands)

    Rijnsoever, F.J. van; Castaldi, C.; Dijst, M.J.


    This study investigates the relationship between involvement and use of multiple information sources in the case of pre-purchase information search for automobiles. We consider the moderating role played by the sequence in which information sources are consulted. We explore our theoretical framework

  19. Broadening Public Participation in Systematic Reviews: A Case Example Involving Young People in Two Configurative Reviews (United States)

    Oliver, Kathryn; Rees, Rebecca; Brady, Louca-Mai; Kavanagh, Josephine; Oliver, Sandy; Thomas, James


    Background: Arguments supporting the involvement of users in research have even more weight when involving the public in systematic reviews of research. We aimed to explore the potential for public involvement in systematic reviews of observational and qualitative studies. Methods: Two consultative workshops were carried out with a group of young…

  20. Servelle-Martorell syndrome with extensive upper limb involvement: a case report

    Directory of Open Access Journals (Sweden)

    Karuppal Raju


    Full Text Available Abstract Introduction Angio-osteohypotrophic syndrome is also known as Servelle-Martorell angiodysplasia. It is characterized by venous or, rarely, arterial malformations, which may result in limb hypertrophy and bony hypoplasia. Extensive involvement of the upper limb is a rare feature of Servelle-Martorell syndrome. Cases with minimal upper limb involvement have been described in the literature. Case presentation A young man presented with multiple separate swollen areas over the right upper limb and functional difficulty since birth. The arm muscles and muscles of the limb girdle were atrophic. The forearm and hand bones were hypoplastic and tender. Conclusion We report a case of Servelle-Martorell syndrome with extensive involvement of the entire upper limb and periscapular region. Servelle-Martorell syndrome is highlighted as one of the causes of angiodysplastic limb hypertrophy.

  1. A case of childhood Brucellosis with neurological involvement and epididymo-orchitis. (United States)

    Kanık-Yüksek, Saliha; Gülhan, Belgin; Ozkaya-Parlakay, Aslınur; Tezer, Hasan


    Brucellosis is a common zoonotic infection worldwide caused by Brucella species. Central nervous system involvement is a serious complication of brucellosis, and the clinical presentation is quite heterogeneous. The genitourinary system may be affected. Epididymo-orchitis is the most common type of urinary tract involvement, which can cause serious complications. Herein, we present a case of brucellosis in a child with a rare combination of epididymo-orchitis and neurobrucellosis not encountered previously in the literature.


    Directory of Open Access Journals (Sweden)

    Braja Mohan


    Full Text Available Cystosarcoma phyllodes is a rare, predominantly benign tumor of the female breast, comprising less than 1% of all breast neoplasms. The incidence of malignancy in phyllodes tumor is even less, only 25% which usually does not ulcerate the skin or involve the nipple areola complex. 1, 2 Herein we report a case of 16years old girl with a right sided big malignant phyllodes tumor with nipple areola complex involvement and skin ulceration

  3. Roundabouts Canada case study

    Energy Technology Data Exchange (ETDEWEB)

    Jamieson, M. [Ryerson Polytechnic Univ., Toronto, ON (Canada); Lenters, M. [Roundabouts Canada, Whitby, ON (Canada)


    A modern roundabout was constructed in the community of Ancaster, Ontario in response to growing complaints regarding speeding along the major roadway, and queuing on the minor roadway. The roundabout opened on October 25, 2002. The before and after speeds at the roundabout are being studied, and the fastest path characteristics are assessed in an effort to determine whether the predicted fastest path data correlates with the in-service operating speeds. The speed at R1, R2 and R3 locations on the east west, and north south approaches are measured. tabs., figs.

  4. Pituitary involvement in Wegener ' s granulomatosis: a case report and review of the literature

    Institute of Scientific and Technical Information of China (English)

    陶建瓴; 董怡


    Wegener ' s Granulomatosis (WG) is a multi-system disorder characterized by necrotizing granulomas in the upper and/or lower respiratory tract, with or without focal necrotizing glomerulonephritis and other systemic vasculitis.1 Clinical manifestations may vary with the site of involvement and the extension of the lesions. Pituitary involvement is rare, and to our knowledge no more than ten cases with this complication have been published in the literature in English. We report here an additional WG case complicated by pan-hypopituitarism.

  5. Tumour location and axillary lymph node involvement in breast cancer: a series of 3472 cases from Sweden

    DEFF Research Database (Denmark)

    Manjer, J; Balldin, G; Garne, J P


    AIM: This study investigates the potential relation between breast cancer location and axillary lymph node involvement (ALNI). METHODS: Out of all cases with unilateral first-time diagnosis of invasive breast cancer in Malmö, Sweden, between 1961 and 1991, 3472 underwent axillary dissection. The .......19-2.18), and for central tumours 3.50 (2.32-5.28). CONCLUSIONS: Outer and central breast tumours are associated with a high risk of axillary lymph node involvement. Udgivelsesdato: 2004-Aug......AIM: This study investigates the potential relation between breast cancer location and axillary lymph node involvement (ALNI). METHODS: Out of all cases with unilateral first-time diagnosis of invasive breast cancer in Malmö, Sweden, between 1961 and 1991, 3472 underwent axillary dissection...

  6. Case Studies in Science Ethics (United States)

    Williams, Karen


    Everyone in science should have ethics education training. I have seen graduate students taken advantage of by their mentors. Many of us have seen misconduct...but what should we do about it? Young scientists are often unaware of the rules in science and make mistakes because of their ignorance of the rules in that particular field of study. Then there are an increasing number of cases in the news of overt cases of misrepresentation in science. All are welcome to attend this discussion of case studies. A case study on topics such as: how to treat data properly, how our values in science affect our work, who gets authorship on scientific papers, who is first author on a paper, what you should do if you uncover misconduct or plagiarism in your university, and we will discuss the scientist's role in society. This will be a painless, non-confrontational small group, then large group discussion of each case

  7. MYC translocation-negative classical Burkitt lymphoma cases: an alternative pathogenetic mechanism involving miRNA deregulation

    DEFF Research Database (Denmark)

    Leucci, E; Cocco, M; Onnis, A


    at the standardization of FISH procedures in lymphoma diagnosis, we found that five cases out of 35 classic endemic BLs were negative for MYC translocations by using a split-signal as well as a dual-fusion probe. Here we investigated the expression pattern of miRNAs predicted to target c-Myc, in BL cases, to clarify...... whether alternative pathogenetic mechanisms may be responsible for lymphomagenesis in cases lacking the MYC translocation. miRNAs are a class of small RNAs that are able to regulate gene expression at the post-transcriptional level. Several studies have reported their involvement in cancer...

  8. Prodominant hypertensive brainstem encephalopathy with supratentorial involvement: Case report and literature review

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Ji Hee; Park, Sung Tae; Lim, Hyun Kyung [Dept. of Radiology, Soonchunhyang University Hospital, Soonchunhyang University School of Medicine, Seoul (Korea, Republic of); Kim, Sung Tae; Cha, Ji Hoon [Dept. of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)


    Hypertensive encephalopathy typically presents with bilateral parietooccipital vasogenic edema. Brainstem and cerebellar edema are uncommon in association with typical supratentorial changes. We experienced three cases of atypical hypertensive encephalopathy involving brainstem and cerebellum as well as cerebral white matter, which showed characteristic alternating linear bright and low signals in the pons, the so-called 'stripe sign'. We report these cases here with a brief literature review.

  9. Focal osteoporotic bone marrow defect involving dental implant: a case report


    Garcia, Natália Galvão; Barros, Francisco Barbara Abreu; Carvalho, Márcia Maria Dalmolin; Oliveira, Denise Tostes


    In oral implantology, the most serious complications occur intraoperatively or within a short period. We describe an unusual case of focal osteoporotic bone marrow defect involving dental implant in the posterior mandibular region of the adult woman. Despite the fact that this condition requires no treatment, it could lead to the displacement of the dental implant. Additionally, this case report reinforces that histopathological analysis is mandatory for precise diagnosis of the radiolucency ...

  10. A case of crusted scabies with a bullous pemphigoid-like eruption and nail involvement. (United States)

    Nakamura, Eri; Taniguchi, Hiroko; Ohtaki, Noriko


    We report a case of a 71-year-old man infected at a nursing home who developed a bullous pemphigoid-like eruption with nail involvement. He was diagnosed by his family doctor as suffering from eczema and was treated with topical corticosteroids, then blisters started appearing. He was next diagnosed as suffering from bullous pemphigoid and treated with oral prednisolone, which worsened his condition. He was finally diagnosed as having crusted scabies with bullous pemphigoid-like eruptions and nail involvement at our clinic. He was then prescribed oral ivermectin (two doses of 12 mg ivermectin with a 1-week interval) and topical lindane (1%gamma-BHC in petrolatum) for scabies with 5% salicylic acid in plastibase as an additional treatment for the crusted lesions on his soles. He showed remarkable improvement in 2 weeks, and his nails showed complete recovery after 7 weeks of occlusive dressing treatment with 1%gamma-BHC. One and a half years later, the patient showed no sign of a recurrence of scabies. The histology of a blister taken from this patient was similar to that of bullous pemphigoid. Direct immunofluorescence showed immunoglobulin (Ig)G and C3 deposition at the dermoepidermal junction similar to that of bullous pemphigoid, but indirect immunofluorescence was negative. The bullous symptoms of this patient were considered to be due to the scabies, because the patient recovered completely after receiving treatment for scabies. Indirect immunofluorescent study is important to distinguish between scabies with blister formation and true bullous pemphigoid.

  11. Magnifying Endoscopic Features of Follicular Lymphoma Involving the Stomach: A Report of Two Cases (United States)

    Takata, Katsuyoshi; Kawano, Seiji; Fujii, Nobuharu; Kawahara, Yoshiro; Yoshino, Tadashi; Okada, Hiroyuki


    A 70-year-old woman presented with follicular lymphoma involving the stomach, duodenum, jejunum, bone, and lymph nodes. Esophagogastroduodenoscopy revealed multiple depressed lesions in the stomach. Examination with magnifying endoscopy showed branched abnormal vessels along with gastric pits, which were irregularly shaped but were preserved. The second case was a 45-year-old man diagnosed with stage II1 follicular lymphoma with duodenal, ileal, and colorectal involvement, as well as lymphadenopathy of the mesenteric lymph nodes. Esophagogastroduodenoscopy performed six years after the diagnosis revealed multiple erosions in the gastric body and angle. Magnifying endoscopic observation with narrow-band imaging showed that the gastric pits were only partially preserved and were destroyed in most of the stomach. Branched abnormal vessels were also seen. Pathological features were consistent with follicular lymphoma in both cases. The structural differences reported between the two cases appear to reflect distinct pathologies. Disappearance of gastric pits in the latter case seems to result from loss of epithelial cells, probably due to chronic inflammation. In both cases, branched abnormal vasculature was observed. These two cases suggest that magnified observations of abnormal branched microvasculature may facilitate endoscopic detection and recognition of the extent of gastric involvement in patients with follicular lymphoma.

  12. Renal involvement in MELAS syndrome - a series of 5 cases and review of the literature. (United States)

    Seidowsky, Alexandre; Hoffmann, Maxime; Glowacki, François; Dhaenens, Claire-Marie; Devaux, Jean-Philippe; de Sainte Foy, Celia Lessore; Provot, François; Gheerbrant, Jean-Dominique; Hummel, Aurelie; Hazzan, Marc; Dracon, Michel; Dieux-Coeslier, Anne; Copin, Marie-Christine; Noël, Christian; Buob, David


    Renal dysfunction is increasingly recognized as a potential clinical feature of mitochondrial cytopathies such as mitochondrial encephalomyopathy, lacticacidosis and stroke-like episodes (MELAS) syndrome. Five cases of MELAS syndrome with renal involvement from 4 unrelated families are presented in this case series. Three of the 5 patients had a history of maternally-inherited diabetes and/or deafness. Focal and segmental glomerulosclerosis and arteriolar hyaline thickening were the most striking findings on renal biopsy. In addition to clinical presentation with the typical symptoms of MELAS syndrome, genetic testing in these patients identified the A3243G point mutation in the tRNALeu gene of the mitochondrial DNA (mtDNA). The diagnosis of MELAS syndrome was thus considered to be unequivocal. The incidence of kidney disease in MELAS syndrome may be underestimated although a study is required to investigate this hypothesis. As the A3243G mtDNA mutation leads to a progressive adult-onset form of focal segmental glomerulosclerosis (FSGS), screening for the MELAS A3243G mtDNA mutation should therefore be performed especially in patients with maternally-inherited diabetes or hearing loss presenting with FSGS.

  13. Resection of Huge Liver Cancer Involving the Second Porta Hepatis:A Report of 55 Cases

    Institute of Scientific and Technical Information of China (English)

    CHENHan; WUMengchao; WANGYi; WEIGongtian; HULei


    Objective To investigate the possibility and surgical procedures for huge liver cancer involving the second porta hepatis.Methods 55 cases of huge liver cancer, with the diameter of 8-28 cm(mean 12.7 cm) were studied. Right subcostal or “rooftop” incision was made, the liver ligments were divided, good exposure of the tumor and access to retrohepatic inferior vena cava were achieved.Hepatectomies were completed under intermittent interruption of first porta hepatis. Occluding tape around vena cava was applied before liver resection if necessary.Results All tumors were successfully resected without death during operation.The longest survival time was now 4 years in one case. The 1-4 year postoperative survival rates were 63%,50%,50% and 30% respectively.Conclusion Young patients with solitary large liver tumor, which grows slowly over a long period on basis of non-cirrhotic or mild cirrhotic liver, should undergo an exploration in an attempt of resection irrespective of the image contraindication, provided that there is no extra-hepatic metastasis.

  14. Hydrogeologic Case Studies (Seattle, WA) (United States)

    Hydrogeology is the foundation of subsurface site characterization for evaluations of monitored natural attenuation (MNA). Three case studies are presented. Examples of the potentially detrimental effects of drilling additives on ground-water samples from monitoring wells are d...

  15. Nasopharyngeal Case-Control Study (United States)

    A case-control study conducted in Taiwan between 1991-1994 among approximately 1,000 individuals to examine the role of viral, environmental, and genetic factors associated with the development of nasopharyngeal carcinoma

  16. Case Studies in Strategic Planning (United States)


    Contains developed case studies in strategic planning on The Navy General Board, Joint Service War Planning 1919 to 1941, Navy Strategic Planning , Strategic Planning NPS-56-88-031-PR of September 1988. Strategic planning , Strategic Management.

  17. Case Study: del Amo Bioventing (United States)

    The attached presentation discusses the fundamentals of bioventing in the vadose zone. The basics of bioventing are presented. The experience to date with the del Amo Superfund Site is presented as a case study.

  18. A case of polymicrobial infective endocarditis involving Neisseria mucosa occurring in an intravenous drug abuser. (United States)

    Giles, M W; Andrew, J H; Tellus, M M


    The incidence of polymicrobial endocarditis has increased markedly in recent years, in association with the increasing level of abuse of intravenous drugs. Neisseria mucosa, an upper respiratory tract commensal, is a rare cause of infective endocarditis. We report the first case of polymicrobial infective endocarditis involving Neisseria mucosa occurring in an intravenous drug abuser.

  19. 29 CFR 1904.10 - Recording criteria for cases involving occupational hearing loss. (United States)


    ... 29 Labor 5 2010-07-01 2010-07-01 false Recording criteria for cases involving occupational hearing loss. 1904.10 Section 1904.10 Labor Regulations Relating to Labor (Continued) OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR RECORDING AND REPORTING OCCUPATIONAL INJURIES AND ILLNESSES Recordkeeping Forms and Recording Criteria...

  20. TB or not TB?: a case of isolated testicular TB with scrotal involvement.

    LENUS (Irish Health Repository)

    Bhargava, A


    Despite the genitourinary tract being the most common site affected by extrapulmonary TB, isolated testicular TB remains a rare clinical entity. In patients with co-morbidities such as hepatic impairment, treatment proves a challenge, as first-line hepatotoxic pharmaceuticals are contraindicated. Here, we report a case of isolated testicular TB with scrotal involvement, on a background of hepatic dysfunction.

  1. A Case of Immunoglobulin G4-Related Disease with Extensive Multiorgan Involvements

    Directory of Open Access Journals (Sweden)

    Kazuhiko Higashioka


    Full Text Available We report a case of IgG4-related disease (IgG4-RD with multiple ten-organ involvement. This case showed many clinical findings, such as bilateral swelling of salivary and lacrimal glands, autoimmune pancreatitis, interstitial nephritis, retroperitoneal fibrosis, periaortitis, systemic swelling of lymph nodes, pulmonary lesions, splenomegaly, and jejunal lesions. He was suspected as having SLE or malignant lymphoma but diagnosed as having IgG4-RD by the elevated serum IgG4 level and histological findings from kidney and lymph node. We report a case of IgG4-RD with multiple ten-organ involvement that was successfully treated with prednisolone therapy.

  2. Cryostat design case studies, principles and engineering

    CERN Document Server


    This book enables the reader to learn the fundamental and applied aspects of practical cryostat design by examining previous design choices and resulting cryostat performance. Through a series of extended case studies the book presents an overview of existing cryostat design covering a wide range of cryostat types and applications, including the magnet cryostats that comprise the majority of the Large Hadron Collider at CERN, space-borne cryostats containing sensors operating below 1 K, and large cryogenic liquid storage vessels. It starts with an introductory section on the principles of cryostat design including practical data and equations. This section is followed by a series of case studies on existing cryostats, describing the specific requirements of the cryostat, the challenges involved and the design choices made along with the resulting performance of the cryostat. The cryostat examples used in the studies are chosen to cover a broad range of cryostat applications and the authors of each case are ...

  3. Department Involvement in Instructional Materials Development for ODL Study at the Zimbabwe Open University (ZOU) (United States)

    Tanyanyiwa, Vincent Itai; Mutambanengwe, Betty


    The teaching and designing of modules at Zimbabwe Open University (ZOU) is the principal responsibility of a single body of teaching staff, although some authors and content reviewers could be sourced from elsewhere if they are not available in ZOU. This survey, through a case study, examines the involvement of lecturers and staff in the…

  4. Nail involvement in leprosy: a study of 300 patients. (United States)

    Kaur, Inderjeet; Chakrabarti, Aditi; Dogra, Sunil; Rai, Ranju; Kumar, Bhushan


    Three hundred leprosy patients were recruited to study the pattern and frequency of nail changes. Nail changes, like longitudinal ridging in finger nails, transverse striations involving both finger and toe nails etc. which occurred with similar frequency in the PB and MB patients in comparison with the control group, were excluded from the analysis. Out of a total number of 150 PB patients, 84 (56%) showed nail changes. Fifty-eight (38.6%) patients showed changes in the finger nails, with an average of 3.2 involved nails per patient. Fifty-three (35.3%) patients showed changes in the toe nails, with an average of 3.0 nails per patient. The most common change observed was longitudinal melanonychia (32.4%) in the finger nails and longitudinal ridging (46.3%) in the toe nails.In comparison, 131/150 (87.3%) MB patients showed nail changes. Finger nail changes were seen in 102 (68%) patients with an average of 5.5 nails affected per patient. Changes in toe nails were seen in 116 (77.3%) patients, with an average of 6.0 nails involved per patient. The most common nail change observed was longitudinal melanonychia in 89/523, (17%) of the total involved finger nails and subungual hyperkeratosis in 164/702, (23.4%) of the total toe nails involvement. Out of a total of 32 colony patients, 31 (96.9%) showed nail changes both in finger and toe nails with an average of 7.9 and 8.4 affected nails per patient, respectively. The most common nail change observed was rudimentary nail(s) on fingers (29%) and toes (21.1%). Among MB patients, a significantly higher number had finger nail involvement in LL group. The frequency of nail involvement for both fingers and toes was significantly greater in LL as compared to BL group of patients. The frequency of nail involvement was significantly more in patients having disease for more than 5 years and in those having trophic changes secondary to loss of sensations and impaired circulation.

  5. Extent of metastatic axillary involvement in 1446 cases of breast cancer. (United States)

    Veronesi, U; Luini, A; Galimberti, V; Marchini, S; Sacchini, V; Rilke, F


    One thousand, four hundred and forty-six patients with carcinoma of the breast treated with Halsted mastectomy (167), Patey mastectomy (732), and conservative surgery with axillary dissection, either at the same time (340), or separately (207), were evaluated with regard to the number and distribution of axillary lymph nodes. A total of 29,378 were removed and examined, on average 20.3 per patient. The average number of nodes was 13.5 at the first level, 4.5 at the second and 2.3 at the third. The same number of nodes were removed in patients treated with extensive surgery, such as Halsted mastectomy and limited surgery such as lumpectomy and in independent axillary dissection. In 839 cases metastases were found in the axilla. The average number of involved nodes was 6.4. Out of 839 patients, the first level was the site of metastases in 828, the second level in 364 and the third in 187. When a single lymph node was involved, it was nearly always at the first level. In only 11 cases, were the second and/or third levels invaded without metastases at the first level. Therefore, the percentage of cases with skipping metastases was very low (1.3%). It appears from the present data that the spread of breast cancer to the axilla follows a regular pattern; the first level is invaded first, whilst in most cases, the second and third levels are involved only when the first is substantially affected.

  6. Swordfish bill injury involving abdomen and vertebral column: case report and review

    Directory of Open Access Journals (Sweden)

    Drossos Charalambos


    Full Text Available Abstract Background Penetrating injuries of the abdomen and spinal canal that involve organic material of animal origin are extremely rare and derive from domestic and wild animal attacks or fish attacks. Case presentation In this case report we present the unique, as far as the literature is concerned, unprovoked woman's injury to the abdomen by a swordfish. There are only four cases of swordfish attacks on humans in the literature - one resulted to thoracic trauma, two to head trauma and one to knee trauma, one of which was fatal - none of which were unprovoked. Three victims were professional or amateur fishermen whereas in the last reported case the victim was a bather as in our case. Our case is the only case where organic debris of animal's origin remained in the spinal canal after penetrating trauma. Conclusions Although much has been written about the management of penetrating abdominal and spinal cord trauma, controversy remains about the optimal management. Moreover, there is little experience in the management of patients with such spinal injuries, due to the fact that such cases are extremely rare. In this report we focus on the patient's treatment with regard to abdominal and spinal trauma and present a review of the literature.

  7. SAPHO syndrome with TMJ involvement: review of the literature and case presentation. (United States)

    McPhillips, A; Wolford, L M; Rodrigues, D B


    Synovitis, acne, pustulosis, hyperostosis, osteitis (SAPHO) syndrome is a rare group of sterile, inflammatory osteoarticular disorders classically associated with skin manifestations. The etiology is unknown but probably involves genetic, infectious, and immunological components. The characteristic feature of the disease is found in the bone lesions, which typically involve the anterior chest wall and axial skeleton. In the literature review, six case reports discussed involvement of the TMJ. Treatment of SAPHO is geared toward symptom management as there is no cure. Surgery for mandibular lesions is usually a last resort as results are reported to be temporary with symptoms recurring within a year. Surgery appears to be performed early after diagnosis of TMJ related pathology; probably because lesions affecting the TMJ involve some limitation in mouth opening with varying degrees of ankylosis. The authors provide a literature review and describe a case of SAPHO syndrome with ankylosis of the left TMJ. The patient was treated with joint reconstruction using a patient-fitted total joint prosthesis (TMJ Concepts Inc., Ventura CA) in single stage surgery. This paper is the first to report maxillary involvement in SAPHO syndrome.

  8. Necrotizing Fasciitis: A Study of 48 Cases. (United States)

    Singh, Gurjit; Bharpoda, Pragnesh; Reddy, Raghuveer


    Necrotizing fasciitis represents a group of highly lethal infections characterized by rapidly progressing inflammation and necrosis. The aim of the study was to analyze the clinical profile, microbial flora, and predisposing risk factors in patients with necrotizing fasciitis. Lastly, we aimed to formulate a protocol for management of necrotizing fasciitis. Forty-eight cases of necrotizing fasciitis patients who reported to our hospital between April 2007 and September 2009 were included in the study. The commonest predisposing factors were age greater than 50 years (58 % cases) and diabetes mellitus (52 % cases). The commonest site involved was extremity (70.8 %). Majority of infections were polymicrobial (87.5 %). Repeated aggressive debridement was the commonest surgical procedure performed. Early and aggressive surgical debridement, often in multiple sittings, supplemented by appropriate antibiotics and supportive therapy, forms the key to a successful outcome in necrotizing fasciitis.

  9. 政治联系、涉案行为与审计意见——基于上海社保基金案的实证研究%Political Connections, Involved Behaviors and Audit Opinions:Empirical Study on the Legal Case of Shanghai Social Security Fund

    Institute of Scientific and Technical Information of China (English)

    杜颖洁; 杜兴强


    选择上海社保基金案为研究对象,根据2004~2008年年末注册地为上海的上市公司的年报、临时公告和纸质新闻媒体报道资料,手工搜集了关键高管(董事长与总经理)的政治联系数据和公司涉案与否的数据,实证研究了涉案行为与政治联系之间的关系,以及涉案行为在上海社保基金案之前、期间和之后对公司审计意见的影响.研究结果表明,政治联系的上市公司显著地更可能涉案,且在上海社保基金案曝光的2006年,涉案公司被出具非标审计意见的概率显著更高;但若以2006年为基准,在上海社保基金案之前的2004~2005年、之后的2007~2008年,涉案公司被出具非标审计意见的概率显著更低.%This paper focuses on the legal case of Shanghai social security fund. Firstly, based on the annual reports and temporary announcements of public listed companies registered in Shanghai from 2004 to 2008, as well as some reports from news media, this paper manually collects political connections data of key top managers of sample companies and the involved data. Secondly, it empirically studies the relation between political connections and involved behaviors, and the impact of involved behaviors on audit opinions before, during and after the case. The results show that among sample companies registered in Shanghai, the ones with political cònnections have a significantly higher possibility to be involved in the case than others. In 2006 when the legal case was exposed, involved companies have a higher possibility of receiving unqualifiedaudit opinions; however, from the year 2004 through 2005 and from the year 2007 through 2008, the possibility of involved companies to receive unqualified auditor opinions from auditors was lower.

  10. Tumefactive immunoglobulin G4-related disease involving the dura mater: A case report and literature review

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jeong Hoon; Lee, Ji Hoon; Ko, Yong; Paik, Seoung Sam; Lee, Young Jun [Dept. of Radiology, Hanyang University Hospital, Seoul (Korea, Republic of); Park, Dong Woo [Dept. of Radiology, Hanyang University Hospital, Seoul (Korea, Republic of)


    Immunoglobulin G4 (IgG4)-related disease is a well-known disorder characterized by an inflammatory reaction with an increase in the number of IgG4-positive plasma cells associated with sclerosis. IgG4-related disease often affects the dura mater with a pattern of diffuse thickening when the central nervous system is involved. However, some nodular dural thickening requires discrimination from tumors because of obviously different treatment options. We report of a case of IgG4-related disease with tumefactive dural involvement.

  11. Ocular involvement in acute febrile neutrophilic dermatosis (Sweet syndrome): new cases and review of the literature. (United States)

    Gottlieb, Chloe C; Mishra, Aditya; Belliveau, Dan; Green, Peter; Heathcote, J Godfrey


    Sweet syndrome (acute febrile neutrophilic dermatosis) is a dermatologic disorder with accompanying features of systemic inflammation. It is commonly associated with conjunctivitis, but a variety of types of ocular inflammation have been reported. The ocular manifestations of Sweet syndrome include periorbital and orbital inflammation, dacryoadenitis, conjunctivitis, episcleritis, scleritis, limbal nodules, peripheral ulcerative keratitis, iritis, glaucoma, and choroiditis. The ocular inflammation appears concurrently with skin lesions. An overview of Sweet syndrome is presented with a review of cases in the literature describing ocular involvement. We report two additional cases of ocular involvement, one with conjunctivitis and a second with iritis, peripheral ulcerative keratitis, and episcleritis. Of the 20 cases, half were bilateral. Thirteen cases occurred in the setting of classical or idiopathic Sweet syndrome and seven in association with malignancy. Biopsies of ocular tissue were infrequent, but, in the seven cases where ocular tissue was analyzed, the histopathology was similar to that of the cutaneous lesions. The ocular complications of Sweet syndrome resolved with systemic administration of corticosteroid or cyclosporine. Topical ocular steroid treatment was frequently used in conjunction with oral steroid but may not have been valuable.

  12. Colorectal cancer manifesting with metastasis to prolactinoma: report of a case involving symptoms mimicking pituitary apoplexy. (United States)

    Thewjitcharoen, Yotsapon; Shuangshoti, Shanop; Lerdlum, Sukalaya; Siwanuwatn, Rungsak; Sunthornyothin, Sarat


    Pituitary metastasis is an uncommon first presentation of systemic malignancy. The most common presenting symptom of pituitary metastasis is diabetes insipidus reflecting involvement of the stalk and/or posterior pituitary. We herein present a unique case of the coexistence of both a functioning pituitary adenoma (prolactinoma) and pituitary metastasis of advanced colorectal cancer with pituitary apoplexy as the first manifestation of underlying malignancy. The present case emphasizes the need to consider pituitary metastasis as a differential diagnosis in patients presenting with pituitary lesions and be aware that tumor-to-tumor metastasis can occur unexpectedly in those with pituitary metastases.

  13. A rare case of acute poster ior reversible encephalopathy syndrome involving brainstem in a child

    Directory of Open Access Journals (Sweden)

    Olfa Chakroun-Walha


    Full Text Available Posterior reversible encephalopathy syndrome (PRES is a rare entity involving brainstem in very rare reported cases. We describe here the case of a boy who presented to the emergency department for headaches and strabismus. Diagnosis of PRES was retained by magnetic resonance imaging. The causes were blood pressure urgency and renal failure. Location of lesions was very rarely reported in literature and neurological troubles were persistent. Emergency physicians should evocate PRES each time there is a clinical context associated with neurological troubles by a normal brain CT scan. Early diagnosis is very important to treat its causes and improve prognosis.

  14. A rare case of acute posterior reversible encephalopathy syndrome involving brainstem in a child

    Institute of Scientific and Technical Information of China (English)

    Olfa Chakroun-Walha; Ichrak Bacha; Mehdi Frikha; Kheireddine Ben Mahfoudh; Noureddine Rekik


    Posterior reversible encephalopathy syndrome (PRES) is a rare entity involving brainstem in very rare reported cases. We describe here the case of a boy who presented to the emergency department for headaches and strabismus. Diagnosis of PRES was retained by magnetic resonance imaging. The causes were blood pressure urgency and renal failure. Location of lesions was very rarely reported in literature and neurological troubles were persistent. Emergency physicians should evocate PRES each time there is a clinical context associated with neurological troubles by a normal brain CT scan. Early diagnosis is very important to treat its causes and improve prognosis.

  15. Nevus of ota with rare palatal involvement: a case report with emphasis on differential diagnosis. (United States)

    Sharma, Gaurav; Nagpal, Archna


    Nevus of Ota, a dermal melanocytic nevus, is rare in the Indian subcontinent. It presents as a brown, blue, or gray patch on the face and is within the distribution of the ophthalmic and maxillary branches of the trigeminal nerve. The oral cavity is infrequently involved in nevus of Ota. Only 11 cases have been documented in the English literature. We report a rare case of intraoral nevus of Ota in a 22-year-old male patient. This paper focuses on the differential diagnosis of oral manifestations of nevus of Ota to assist in proper followup to avert malignant transformation.

  16. Nevus of Ota with Rare Palatal Involvement: A Case Report with Emphasis on Differential Diagnosis

    Directory of Open Access Journals (Sweden)

    Gaurav Sharma


    Full Text Available Nevus of Ota, a dermal melanocytic nevus, is rare in the Indian subcontinent. It presents as a brown, blue, or gray patch on the face and is within the distribution of the ophthalmic and maxillary branches of the trigeminal nerve. The oral cavity is infrequently involved in nevus of Ota. Only 11 cases have been documented in the English literature. We report a rare case of intraoral nevus of Ota in a 22-year-old male patient. This paper focuses on the differential diagnosis of oral manifestations of nevus of Ota to assist in proper followup to avert malignant transformation.

  17. Pulmonary and hepatic involvement of toxocariasis in an aduIt: case report

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Soo Jin; Kim, Jee Eun; Park, Chul Hi; Yang, Dal Mo [Gil Medical Center, Incheon (Korea, Republic of)


    Toxocariasis is known as visceral larva migrans in humans and it is caused by T. canis and T. catis, especially in children, but it is less commonly reported in adults. Although several cases of toxocariasis in adults have been reported, there have been no descriptions of toxocariasis involving the liver or, the lungs and the pleura. We report here on a case of T. canis infection in an immunocompetent adult with peripheral eosinophilia, elevated serum levels of Ig E and CT findings displaying multiple focal air space consolidations in the lungs, bilateral pleural effusion and low attenuated hepatic nodules.

  18. eCompetence Case Studies

    DEFF Research Database (Denmark)

    Jensen, Helle Bækkelund


    In this paper we present some details of the processes undertaken in the European eCompetence Initiative. We present two illustrative and representative case studies. The research aims to identify and understand patterns of individual and organisational eCompetence approaches.......In this paper we present some details of the processes undertaken in the European eCompetence Initiative. We present two illustrative and representative case studies. The research aims to identify and understand patterns of individual and organisational eCompetence approaches....

  19. Case Study on Logistics Performance

    Directory of Open Access Journals (Sweden)

    Shahryar Sorooshian


    Full Text Available The paper presents research carried out at a medium‐size manufacturing organization in east Asia. The study tries to highlight the importance of supply chain management; specifically, our aim for this study is to understand logistics and performance measurement in the logistics and supply chain, and we include a theoretical discussion of online data collected and a case study of the logistic performance of a real organization. The study also examines the performance of the selected company, identifies the problems and provides recommendations for improvements. This study can be a guide for business advisers and those interested in analysing company performance, especially from a logistics viewpoint. We also suggest the methodology of this case study for those who want to have a better understanding of a business environment before starting their own business, or for benchmarking practice during strategic planning.

  20. Teaching Case: Enterprise Architecture Specification Case Study (United States)

    Steenkamp, Annette Lerine; Alawdah, Amal; Almasri, Osama; Gai, Keke; Khattab, Nidal; Swaby, Carval; Abaas, Ramy


    A graduate course in enterprise architecture had a team project component in which a real-world business case, provided by an industry sponsor, formed the basis of the project charter and the architecture statement of work. The paper aims to share the team project experience on developing the architecture specifications based on the business case…

  1. Churg-Strauss Syndrome with Cardiac Involvement: A Case Report with CT and MRI Findings

    Energy Technology Data Exchange (ETDEWEB)

    Lim, Seong Joo; Cho, Young Jun; Kim, Keum; Hwang, Cheol Mok; Kim, Dae Ho [Dept. of Radiology, Konyang University College of Medicine, Daegu (Korea, Republic of); Choi, Eu Gene [Dept. of Internal Medicine, Konyang University College of Medicine, Daegu (Korea, Republic of)


    This is a case report of Churg-Strauss Syndrome (CSS) associated with cardiac involvement which is demonstrated in chest CT and cardiac MRI (CMR) without specific cardiac symptoms. A 32-year-old woman had a 3-year history of bronchial asthma, chronic sinusitis, and otitis media. The patient had various typical findings of CSS. The patient had no specific cardiac symptoms or signs such as chest pain, palpitations, syncope, or murmur, but she had diffuse low attenuation lesions in the inner wall of the left ventricle (LV) in contrast-enhanced CT. This corresponded to the area of subendocardial hyperenhancement in delayed contrast-enhanced CMR images. She was treated with steroids for 2 months. Follow-up delayed contrast-enhanced CMR of the LV showed a decrease in the size of the subendocardial enhancement area, and she had no symptoms. Therefore, the radiologist and clinician both should pay careful attention to observe possible cardiac involvement in case of CSS.

  2. The prognostic importance of parotid involvement by head and neck squamous cell carcinoma - Case report* (United States)

    Gouveia, Bruna Melhoranse; Barbosa, Maria Helena de Magalhães; Carneiro, Leonardo Hoehl; Hadj, Luzia Abrao El; Fernandes, Nurimar Conceição


    Squamous cell carcinoma (SCC) is the second-most common malignant cutaneous cancer, with 60% occurring in the head and neck region. Metastases are uncommon and imply a more conservative prognosis. This report describes a case of parotid-invasive, facial squamous cell carcinoma, highlighting the importance of its prognostic and therapeutic management. The patient is an 81-year-old female, exhibiting extensive tumoral lesions in the pre-auricular region, affecting the parotid parenchyma and implying the metastatic involvement of the intra-parotid lymph node. Parotid involvement caused by SCC in specificity tumors is discussed herein. Parotid invasion is currently recognized as an isolated variable. It affects survival rates and determines certain changes in case management, such as the broadening of resection areas and adjuvant radiotherapy. PMID:27438204

  3. Attitudinal and individual differences influence perceptions of mock child sexual assault cases involving gay defendants. (United States)

    Wiley, Tisha R A; Bottoms, Bette L


    Many people hold negative attitudes and stereotypes about gay men, including the stereotype that gay men are likely to be child molesters. This article explored the implications of this stereotype for judgments made in a hypothetical legal case involving child sexual abuse accusations against a male teacher by either a male or female victim. Mock jurors who held the most anti-gay attitudes and those who endorsed the stereotype of gay men as child molesters made the most pro-prosecution judgments in scenarios involving gay defendants. A new scale (the Stereotypes about Gays and Child Abuse scale) was developed to assess the extent to which participants endorsed the stereotype of gay men as being likely to sexually abuse children. This scale was a stronger predictor of case judgments than existing, more general scales measuring biases against homosexuality.

  4. Magnetic Resonance Finding of Acute Marchiafava-Bignami Disease with Diffuse Involvement: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Heo, Young Jin; Jeong, Hae Woong; In, Hyun Sin [Dept. of Radiology, Busan Paik Hospital, Inje University College of Medicine, Busan (Korea, Republic of)


    Marchiafava-Bignami disease (MBD) is a rare toxic disorder strongly associated with chronic alcoholism. It is characterized by progressive demyelination and necrosis of the corpus callosum. The process may extend to neighboring white matter and subcortical regions. We report a case of MBD in which fluid-attenuated inversion recovery and diffusion-weighted imaging revealed symmetrical hyperintense lesions with diffuse involvement of the corpus callosum, white matter, corticospinal tract, internal capsule, and middle cerebellar peduncle.

  5. Chinese immigrant entrepreneurs’ involvement in internationalization and innovation: Three Canadian cases

    DEFF Research Database (Denmark)

    Zhang, Xiaotian; Vissak, Tiia


    that these immigrants’ experience of doing business in China and Canada, their network relationships and knowledge of these markets quickened their firms’ internationalization considerably. Moreover, these firms became active in product or service innovation as the case immigrants also involved other immigrants...... and locals. Consequently, immigrant entrepreneurs should actively use their connections both in their new country of residence and also in their previous home country, but to become even more successful, they should also reach beyond their ethnic ties....

  6. Pulmonary Involvement of Peripheral T-cell Lymphoma, Unspecified: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Chung, Jin; Shim, Hyo Sub; Ham, Seok Jin; Kim, Tae Hoon; Kim, Sang Jin [Gangnam Severance Hospital, Seoul (Korea, Republic of)


    Peripheral T-cell lymphoma is a rare type of lymphoma that's derived from postthymic lymphoid T cells. Pulmonary involvement of peripheral T-cell lymphoma of the unspecified type is very rare and the imaging findings of this illness have rarely been reported. We present here a case of peripheral T-cell lymphoma of the unspecified type with a cavitary lesion in the lung parenchyma, and we pathologically confirmed this illness by performing video-assisted thoracoscopic surgery.

  7. A case of primary spinal myoclonus: clinical presentation and possible mechanisms involved


    Campos Cynthia Resende; Limongi João Carlos Papaterra; Machado Flávia Costa Nunes; Brotto Mário Wilson Iervolino


    Spinal myoclonus is a rare movement disorder characterized by myoclonic involvement of a group of muscles supplied by a few contiguous segments of the spinal cord. Structural lesions are usually the cause, but in primary spinal myoclonus the etiology remains unknown. We present the case of a 26-year-old woman with cervical spinal myoclonus in which both clinical and electromyographic findings pointed to the segment C1-C3 as the origin of the myoclonus. Laboratorial examinations were normal an...

  8. Meningeal Castleman's disease with multifocal involvement: a case report and review of literature. (United States)

    Coca, Santiago; Salas, Isabel; Martínez, Roberto; Saez, Miguel Angel; Vaquero, Jesús


    Castleman's disease is an uncommon lymphoproliferative disorder characterized by lymph node enlargement, hyperplasia of lymphoid follicles surrounded by mature lymphocytes, and capillary proliferation with endothelial hyperplasia. Although intracranial location is very uncommon, it should be considered in the differential diagnosis of meningeal tumors. We describe a new case appearing as two solid extraaxial masses simulating meningiomas. This multifocal meningeal involvement can be considered as an exceptional form of presentation of intracranial Castleman's disease.

  9. Cervical spondylolysis in child with four levels of simultaneous involvement: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Gang Deuk; Kim, Hye Won; Jang, Sung Jo; Oh, Jung Taek [Wonkwang University School of Medicine, Gunsan (Korea, Republic of)


    Cervical spondylolysis is a rare condition, and less than 100 cases have been reported in the world literature. Cervical spondylolysis is defined as a well corticated defect in the posterior element of a cervical vertebra. Although the etiology of cervical spondylolysis is unknown, its association with dysplastic changes and spina bifida occulta suggest that the lesion is congenital. Here, we describe the radiographs and CT images of cervical spondylolysis involving four levels in a 9 year old boy.


    Directory of Open Access Journals (Sweden)



    Full Text Available The purpose of this study is to investigate family involvement activities at preschool educational institutions in province of Denizli. 25 female teachers working at preschool educational institutions under Ministry of National Education in city centre of Denizli were included in the study. The results revealed that while a great majority of 32 family involvement activities included in the questionnaire (parents' corner, posters, education board, communication board, brochures, booklets, periodicals-newspapers, newsletters, correspondences, photographs, phone/ internet calls, video/tape records, conferences, home visits, article box, request box, parents' libraries, family involvement to non-classroom activities, diaries, family involvement into management and decision-making process, group meeting weren’t performed, 11 activities were implemented. While 4 of 11 activities were performed by all teachers, there were teachers who didn't perform 7 family involvement activities (parents' meetings, individual interview, development reports, collective files, involvement to classroom activities, invitation of parents to the school in special occasions, activities held at home. Considering the reasons why twenty two family involvement activities were not performed; lack of space, time and possibilities was the most frequent reason. Home visits took place on the top among family involvement activities the teachers had difficulties at most. The individual interviews were among activities conducted by the teachers in the easiest/ comfortable way.

  11. Physical therapy combined with corticosteroid intervention for systemic lupus erythematosus with central nervous system involvement: a case report. (United States)

    Lee, In-Hee; Ryu, Young Uk


    [Purpose] Systemic lupus erythematosus (SLE) is a chronic, immune-mediated disease, affecting 0.1% of the general population. To date, few studies have investigated the efficacy of physical therapy for SLE patients with CNS involvement. The aim of this study was to report whether the combined use of corticosteroids and physical therapy, consisting of reflex inhibition and functional training, was beneficial to functional recovery. [Subjects and Methods] A 22-year-old male SLE patient with CNS involvement requested physical therapy due to strong spasticity of the trunk and limbs in a bedridden state. Corticosteroid intervention and physical therapy were undertaken for 16 days. [Result] After 16 days of the interventions, the patient demonstrated stabilized and alleviated neurological symptoms and an improved functional level. [Conclusion] The present case indicates that physical therapy combined with corticosteroids might be a possible treatment and rehabilitation method to effectively recover motor function for SLE patients who have strong spasticity due to CNS involvement.

  12. Brucella spondylodiscitis: Multifocal involvement in thoracic and lumbar areas; a rare case

    Directory of Open Access Journals (Sweden)

    Pınar Korkmaz


    Full Text Available Brucellosis is a zoonosis that can affect many organs or systems. Musculoskeletal system is the most commonly affected site in brucellosis and the frequency of musculoskeletal system involvement varies between 2% and 53%. Multifocal spinal involvement is rare. Here, it was aimed to present our case with brucellar spondylodiscitis involving the thoracic and lumbar regions simultaneously. MRI is a useful imaging method in the diagnosis of multifocal spinal infection caused by brucellosis. Especially in endemic regions, at least two serological tests should be used in the diagnosis of brucellosis. Brucellosis should be absolutely kept in mind for the differential diagnosis of the lderly patients with complaint of longstanding thoracic and back pain in the regions where brucellosis is endemic. J Microbiol Infect Dis 2015;5(3: 129-132

  13. A case of exorbitism in association with Wegener′s granulomatosis with renal involvement

    Directory of Open Access Journals (Sweden)

    S Beji


    Full Text Available Wegener′s granulomatosis (WG is a necrotizing granulomatous vasculitis invol-ving the nose, paranasal sinuses, lungs, and kidneys. Ocular involvement can occur in about 50% of cases. There are very few reports of WG with orbital inflammation and exorbitism. We report a case of a female patient who presented with exorbitism related to orbital inflammation secondary to WG, with renal involvement. A 29-year-old woman with a previous history of recurrent pan-sinusitis presented with bilateral exophthalmos and renal failure with rapidly progressive glo-merulonephritis. Computed tomography showed extensive bilateral soft tissue in the retro-orbital area. Immunologic tests showed the presence of type-C anti-neutrophil cytoplasmic antibodies and renal biopsy revealed pauci immune crescentic glomerulonephritis. The patient was treated with corticosteroids and pulses of cyclophosphamide followed by azathioprine and trimethoprim-sulfamethoxazole. After a follow-up of 10 months, the renal outcome was favorable with improvement of renal function but there was persistence of exorbitism and loss of visual function. Our case suggests that WG should be considered in the differential diagnosis of persistent bila-teral exophthalmos. Prompt recognition of this early manifestation is important for the institution of early treatment.

  14. A case of exorbitism in association with Wegener's granulomatosis with renal involvement. (United States)

    Beji, S; Fatma, L Ben; Chebbi, A; Rais, L; Krid, M; Smaoui, W; Maiz, H Ben; Zouaghi, K; Moussa, F Ben


    Wegener's granulomatosis (WG) is a necrotizing granulomatous vasculitis involving the nose, paranasal sinuses, lungs, and kidneys. Ocular involvement can occur in about 50% of cases. There are very few reports of WG with orbital inflammation and exorbitism. We report a case of a female patient who presented with exorbitism related to orbital inflammation secondary to WG, with renal involvement. A 29-year-old woman with a previous history of recurrent pan-sinusitis presented with bilateral exophthalmos and renal failure with rapidly progressive glomerulonephritis. Computed tomography showed extensive bilateral soft tissue in the retro-orbital area. Immunologic tests showed the presence of type-C anti-neutrophil cytoplasmic antibodies and renal biopsy revealed pauci immune crescentic glomerulonephritis. The patient was treated with corticosteroids and pulses of cyclophosphamide followed by azathioprine and trimethoprim-sulfamethoxazole. After a follow-up of 10 months, the renal outcome was favorable with improvement of renal function but there was persistence of exorbitism and loss of visual function. Our case suggests that WG should be considered in the differential diagnosis of persistent bilateral exophthalmos. Prompt recognition of this early manifestation is important for the institution of early treatment.

  15. [Right ventricular involvement in hypertrophic cardiomyopathy. A case report and brief review of the literature]. (United States)

    Comella, Alessandro; Magnacca, Massimo; Gistri, Roberto; Lombardi, Massimo; Neglia, Danilo; Poddighe, Rosa; Pesola, Antonio


    A clinical case of non-obstructive hypertrophic cardiomyopathy with involvement of the right ventricle is reported. The patient was a 42-year-old male with symptoms suggesting an effort angina of recent onset. The diagnosis was established by echocardiography, which showed asymmetric hypertrophy of the interventricular septum (20 mm), hypertrophy of the right ventricular free wall, and severe hypertrophy of the septal papillary muscle of the tricuspid valve. The patient underwent a complete diagnostic evaluation, including exercise stress test, Holter monitoring, magnetic resonance, myocardial tomoscintigraphy and complete hemodynamic assessment. Medical treatment with atenolol 50 mg day was started; at 1-year follow-up the patient's clinical conditions are good, with decrease of anginal episodes. The literature review elicits the paucity of information about this condition, despite a frequent involvement of both ventricles in hypertrophic obstructive cardiomyopathy. The case reported shows two atypical aspects: a) the involvement of the right ventricle in non-obstructive hypertrophic cardiomyopathy is anecdotal; b) this pattern of hypertrophy (right ventricular free wall/septal papillary muscle) has never been previously reported. Right ventricular involvement in patients with hypertrophic cardiomyopathy must be carefully investigated, because it may be more frequent than conventionally deemed.

  16. Mammary Analog Secretory Carcinoma (MASC) Involving the Thyroid Gland: A Report of the First 3 Cases. (United States)

    Dettloff, Jennifer; Seethala, Raja R; Stevens, Todd M; Brandwein-Gensler, Margaret; Centeno, Barbara A; Otto, Kristen; Bridge, Julia A; Bishop, Justin A; Leon, Marino E


    Salivary gland-type tumors have been rarely described in the thyroid gland. Mammary Analog Secretory Carcinoma (MASC) is a recently defined type of salivary gland carcinoma characterized by a t(12;15)(p13;q25) resulting in an ETV6-NTRK3 fusion gene. We report 3 cases of MASC involving the thyroid gland without clinical evidence of a salivary gland or breast primary; the clinico-pathologic characteristics are reviewed. Assessment for rearrangement of the ETV6 (12p13) locus was conducted by fluorescence in situ hybridization (FISH) on representative FFPE sections using an ETV6 break apart probe (Abbott Molecular, Des Plaines, IL, USA). The patients were two females (52 and 55 years-old) and 1 male (74 years-old). The tumors were poorly circumscribed solid white tan nodules involving the thyroid. Histologically, they were invasive and showed solid, microcystic, cribriform, and tubular growth patterns composed of variably bland polygonal eosinophilic cells with vesicular nuclear chromatin and conspicuous nucleoli. All three cases showed metastasis to lymph nodes; one case showed lateral neck involvement. The tumor cells were positive for S100 and mammaglobin. GATA-3 and PAX-8 were positive in 2 cases, one of which only focally so. All three cases were negative for TTF-1 and thyroglobulin. Rearrangement of the ETV6 locus was confirmed in all cases and a diagnosis of MASC rendered for each case. A site of origin distinct from the thyroid gland was not identified, with a median follow up of 24 months. MASC may rarely involve the thyroid gland. The origin of these lesions is unknown; while an origin from ectopic salivary gland-type cells is entertained, a metastatic origin from an occult primary cannot be definitively excluded at this time. Given the histologic (follicular-like microcystic pattern with colloid-like secretions and papillary pattern), immunophenotypic (PAX-8), and even molecular overlap, MASC can be mistaken for papillary thyroid carcinoma and should be

  17. The Case Study of Frank (United States)

    Eynde, Peter Op't; Hannula, Markku S.


    As a unifying feature of this Special Issue, we have asked proponents of each framework to analyse an empirical classroom account of one student's process of solving a mathematical problem. Here, for the case study of "Frank", we give the main data that were available to all authors.

  18. Case Studies in Sports Nutrition. (United States)

    Clark, Nancy


    This article presents case studies of two athletes who wanted to affect a change in their body weight in order to enhance athletic performance. Each athlete's problem and the nutrition approach used to solve it are discussed. Caloric values of fast foods are listed. (JL)

  19. The reflexive case study method

    DEFF Research Database (Denmark)

    Rittenhofer, Iris


    This paper extends the international business research on small to medium-sized enterprises (SME) at the nexus of globalization. Based on a conceptual synthesis across disciplines and theoretical perspectives, it offers management research a reflexive method for case study research of postnational...

  20. Overview of the Case Studies

    DEFF Research Database (Denmark)

    Cameron, Ian; Gani, Rafiqul


    A series of case studies are used to illustrate many of the underlying modelling principles within the book. To facilitate this, the ICAS-MoT modelling tool has been used. A wide range of application areas have been chosen to ensure that the principal concepts of effective and efficient modelling...

  1. Equatorial jet - a case study

    Digital Repository Service at National Institute of Oceanography (India)

    Muraleedharan, P.M.; PrasannaKumar, S.

    Detailed EOF analysis of wind data reportEd. by Wunsch over Gan (00 degrees 41'S; 73 degrees 10'E) is made for the period 1963-70. The year 1964, which exhibited least variability from mean wind structure, has been chosen for the case study. EOF...

  2. On Motivating Customer Involvement in Service Innovation--Theory,Practice Implications and Case Study%顾客参与服务创新的激励问题--理论、实践启示及案例分析

    Institute of Scientific and Technical Information of China (English)

    范秀成; 王静


    服务创新是促进经济发展与增强企业竞争力的驱动力,而顾客在服务创新过程中扮演着十分重要的角色,了解和满足顾客需求已经成为服务创新一个重要的影响因素。随着顾客越来越广泛地参与到创新过程中,企业需要科学、合理地管理顾客参与,其中对顾客参与激励的管理问题尤为突出。借鉴内/外在动机理论,企业应挑选对服务创新具有较强内在参与动机的顾客参与并给予奖励,建立即时、有效的反馈机制,来自企业和其他顾客群体的社会认可及创新平台体验等是保持顾客参与积极性的手段,且这种激励不应限制或损害顾客参与的内在动机,不应降低顾客的创造力水平。借鉴机制设计理论思路,企业可设计相应的激励机制,使顾客群体能够感受到自己的创新努力得到保护和奖赏,迸发出最大的积极性和创造力,进而在参与服务创新时积极主动地创造有价值、新颖的服务产品。%Service innovation is a driving force in promoting economic development and strengthening firm-competency. Customers play the important role during the process of service innovation;understanding and satisfying customers demand has become an important influencing factor for service innovation. With customers increasingly involved into service innovation,the enterprises should scientifically and rationally manage customer participation,especially the incentive problems. Drawing on the theory of intrinsic and extrinsic motivation,the enterprises should choose customers with strong motivation of participation and grant them with rewards;timely and effective feedback system,recognition from enterprises and other customer groups,and the experience on innovation platform are all the incentive means for the enterprises to maintain customer motivation of participation. And all these incentives should not limit or hurt the intrinsic motivation of

  3. Vocabulary Acquisition and Task Effectiveness in Involvement Load Hypothesis: A case in Iran

    Directory of Open Access Journals (Sweden)

    Hassan Soleimani


    Full Text Available Involvement load hypothesis as a cognitive construct states that tasks with higher involvements yield better results in vocabulary retention. This comparison group designed study examined the immediate and delayed effects of tasks with different involvements in involvement load hypothesis (Laufer & Hulstijn, 2001. Applying a version of Nelson Proficiency Test as a homogenizing exclusion criterion, 33 low proficiency Iranian EFL learners were randomly assigned to three experimental groups: blank-filling, sentence making, and reading comprehension. The results of ANOVA and Kruskal-Wallis tests supported task-induced involvement in immediate posttest since the sentence making task (M=5.72 yielded better results in comparison with the other two blank-filling (M=5.45 and reading comprehension (M=3.18 tasks. Nevertheless, sentence making and blank-filling tasks of which the involvements were somehow similar did not yield significant superiority to each other. It is inferred that tasks with nearer involvements yield somehow similar results in vocabulary acquisition. Keywords: task-induced involvement, immediate effect, delayed effect, vocabulary retention, evaluation

  4. Coronary artery involvement in pediatric Takayasu’s arteritis: Case report and literature review

    Directory of Open Access Journals (Sweden)

    Mohan Shaun


    Full Text Available Abstract Takayasu’s arteritis (TA is a form of chronic vasculitis that typically occurs in young adult Asian females, but it can also present in younger patients not fitting this classic profile. In these cases, the sequelae are generally similar to those found in adults. The disease predominantly affects the aorta and its primary branches. However, the coronary arteries are also affected in up to 20% of cases, which may precipitate myocardial infarction. Imaging of the coronary arteries therefore becomes critically important in the evaluation of a patient with possible Takayasu’s arteritis. We present a case of a pediatric patient with TA who had no symptoms of angina but who was found to have significant coronary artery involvement on diagnostic imaging. This necessitated tailoring of traditional management.

  5. Maternal Death Due to Placenta Percreta with Bladder Involvement: A Case Report

    Directory of Open Access Journals (Sweden)

    Sedigheh Ayati M.D.


    Full Text Available Background: Placenta accreta is a life-threatening complication after previous cesarean delivery. The aim of this case report is to present a case of placenta percreta with bladder involvement and subsequent maternal death.Case presentation: The patient was a 37-year old who had an unwanted pregnancy due to tubectomy failure two years afterwards. She was hospitalized at 26th and 30th week of gestation because of gross hematuria. Sonography reported placenta previa. Cesarean section was performed at 34th gestational week. Due to severe hemorrhage, hysterectomy with resection of some part of the bladder was done. Died at the operating room after four hours of severe uncontrollable hemorrhage. Conclusion: The increasing prevalence of different forms of placenta accreta is the result of the ever-increasing rate of cesarean deliveries. One of the strategies to prevent this catastrophic obstetric complication is decreasing the number of cesarean deliveries without appropriate indications.

  6. An unusual presentation of brucellosis, involving multiple organ systems, with low agglutinating titers: a case report

    Directory of Open Access Journals (Sweden)

    Khorvash Farzin


    Full Text Available Abstract Background Brucellosis is a multi-system disease that may present with a broad spectrum of clinical manifestations. While hepatic involvement in brucellosis is not rare, it may rarely involve the kidney or display with cardiac manifestations. Central nervous system involvement in brucellosis sometimes can cause demyelinating syndromes. Here we present a case of brucella hepatitis, myocarditis, acute disseminated encephalomyelitis, and renal failure. Case presentation A 26-year-old man presented with fever, ataxia, and dysarthria. He was a shepherd and gave a history of low grade fever, chilly sensation, cold sweating, loss of appetite, arthralgia and 10 Kg weight loss during the previous 3 months. He had a body temperature of 39°C at the time of admission. On laboratory tests he had elevated level of liver enzymes, blood urea nitrogen, Creatinine, Creatine phosphokinase (MB, and moderate proteinuria. He also had abnormal echocardiography and brain MRI. Enzyme-linked immunosorbent assay for IgG and IgM was negative. Standard tube agglutination test (STAT and 2-mercaptoethanol (2-ME titers were 1:80 and 1:40 respectively. Finally he was diagnosed with brucellosis by positive blood culture and the polymerase chain reaction for Brucella mellitensis. Conclusion In endemic areas clinicians should consider brucellosis in any unusual presentation involving multiple organ systems, even if serology is inconclusive. In endemic areas low STAT and 2-ME titers should be considered as an indication of brucellosis and in these cases additional testing is recommended to rule out brucellosis.

  7. Factors Associated with Involvement in Bullying: A Study in Nicaragua

    Directory of Open Access Journals (Sweden)

    Eva M. Romera


    Full Text Available School bullying is one of the main problems affecting the quality of peer relationships in schools and in general the coexistence. At European level, there are scientific findings that indicate its nature, characteristics and factors related to its involvement. However, in poor and developing countries, where the problem is more serious, there is a high degree of awareness on this matter. The present study aimed to identify what factors may be influencing the occurrence of bullying in a representative sample of primary schools in the Nicaraguan capital. For this propose, 3042 students from Managua and its metropolitan area were explored with instruments comparable to those used in Europe. A multinomial logistic regression analysis indicated that being a boy, to show antisocial behaviors and attitudes and contact with drugs were the three factors most related with the role of aggressor, as well as negative relationships had a significant influence on involvement in this phenomenon, either as a victim, aggressor or victimized aggressor. Results are discussed in relation to the profiles of aggressor and victim of bullying in international studies focusing on differences in developed countries.

  8. What gets dad involved? A longitudinal study of change in parental child caregiving involvement. (United States)

    Wood, Jeffrey J; Repetti, Rena L


    Predictors of change in fathers' and mothers' perceptions of child caregiving involvement were examined. Middle-class 2-parent families (131 mothers and 98 fathers) with a target school-age child participated. Fathers and mothers completed annual questionnaires for 3 consecutive years. Latent growth curve modeling suggested that fathers were likely to increase their relative contribution to child caregiving over the course of 3 years when they had a greater proportion of male children in the family and when life events-particularly changes in employment and financial status-were experienced by the family. Although mothers were responsible for more of the caregiving, their relative level of involvement tended to decrease when there were no young children in the family. Two-parent families may adapt to varying family contexts and life circumstances by shifting caregiving roles and responsibilities over the course of years.

  9. Ombuds’ corner: Is the number of cases involving women related to their percentage in an organization?

    CERN Document Server

    Vincent Vuillemin


    Over the past two years, the Ombuds has seen double the number of cases involving women staff members compared to those involving men, relative to their populations. Two questions can thus be asked: is that a general phenomenon also seen in other organizations? Or is it related to the under-representation of women, namely is this a common situation in organizations with fewer women than men? If so, the Ombuds should notice different statistics in organizations where the number of women and men is comparable.   To answer these questions, several annual reports from international organizations have been analysed. The names of these organizations are kept confidential, as the reports are not public. Relation between the percentage of cases involving women and their percentage in an Organization. The circled data point is CERN’s. The results can be seen in this graph (right), limited solely by the number of Organizations for which such data is available. Note that if the ...

  10. A clinico-pathological study of 70 cases of pemphigus

    Directory of Open Access Journals (Sweden)

    Arya S


    Full Text Available A clinicopalhological study of 70 cases of pemphigus observed over a span of four and a half years from January 1992 to June 1996 at the Sir J.J. Group of Hospitals and Grant Medical College, Mumbai is reported. Pemphigus vulgaris constituted the single largest group of 43 cases, followed by pemphigus foliaceus (25 cases and pemphigus vegetans (2 cases. Majority of the cases were seen in the age group of 21-60 years, with a slight male predominance. The youngest patient was 14 years while the eldest was aged 75 years. Mucosal involvement was seen in 31 cases of pemphigus vulgaris, as opposed to only 5 cases of pemphigus foliaceus. Flaccid bullae were present in 100% cases. Pruritus was complained of in 14 cases, though it was more common in pemphigus vegetans and vulgaris. Salient histopathological features of pemphigus vulgaris observed were (I intraepidermal suprabasal blisters (35 cases, (2 presence of acantholytic cells (40 cases, (3 "Row of tombstone appearance" (I8 cases and (4 acantholysis involving follicular sheath (20 cases. Main histopathological features of pemphigus foliaceus were (1 subcorneal blister (15 case, (2 acantholysis (24 cases and (3 bulla cavity containing inflammatory infiltrate (12 cases. Both cases of pemphigus vegetans showed hyperkeratosis, papillomatosis and irregular acanthosis with intra-epidermal eosinophilic abscesses besides suprabasal lacunae.

  11. Parental involvement in partner choice: The case of Turks and Moroccans in the Netherlands

    NARCIS (Netherlands)

    van Zandvliet, P.I.; Kalmijn, M.; Verbakel, E.


    This study describes and explains parental involvement in partner choice among Turkish and Moroccan immigrants in the Netherlands. It thus contributes to previous research on third-party influence on partner choice. The study provides quantitative findings on the actual extent of parental involvemen

  12. Idiopathic mitral valve prolapse with tricuspid, aortic and pulmonary valve involvement: An autopsy case report

    Directory of Open Access Journals (Sweden)

    Heena M Desai


    Full Text Available Mitral valve prolapse (MVP is usually asymptomatic, but can be associated with complications such as infective endocarditis, mitral regurgitation, thromboembolism and sudden cardiac death. It has been very rarely reported to occur in association with other valvular involvement. A 55-year-old male patient was brought dead and at autopsy the mitral valve orifice was stenotic and the leaflets were enlarged, myxoid and bulging suggestive of MVP and chordae tendinae were thickened, stretched and elongated. Similar changes were seen in the tricuspid valve. The pulmonary and aortic valves also showed myxomatous degeneration of their cusps. Myxomatous degeneration is the most common cause of MVP and it can be associated with involvement of the other valves. Concomitant involvement of the aortic valve has been reported, however it is very rare and simultaneous involvement of the pulmonary valve has not been reported in the literature so far. We report a case of MVP associated with myxomatous degeneration of the tricuspid, pulmonary and aortic valves.

  13. Relapsing Polychondritis with Central Nervous System Involvement: Experience of Three Different Cases in a Single Center. (United States)

    Jeon, Chan Hong


    Relapsing polychondritis (RP) is an autoimmune disorder characterized by inflammation in cartilaginous structures including the ears, noses, peripheral joints, and tracheobronchial tree. It rarely involves the central nervous system (CNS) but diagnosis of CNS complication of RP is challenging because it can present with varying clinical features. Herein we report 3 cases of relapsing polychondritis involving CNS with distinct manifestations and clinical courses. The first patient presented with rhombencephalitis resulting in brain edema and death. The second patient had acute cognitive dysfunction due to limbic encephalitis. He was treated with steroid pulse therapy and recovered without sequelae. The third patient suffered aseptic meningitis that presented as dementia, which was refractory to steroid and immune suppressive agents. We also reviewed literature on CNS complications of RP.

  14. Psychological factors involved in prurigo nodularis: A pilot study. (United States)

    Dazzi, Carla; Erma, Daniela; Piccinno, Roberta; Veraldi, Stefano; Caccialanza, Massimo


    Emotional stresses and psychological disorders seem to be concurrent factors in some cases of prurigo nodularis (PN), a chronic skin condition with a difficult therapeutic approach. In order to improve the therapeutic strategies, we performed a psychometric study on 20 patients affected by generalized and histological proven PN. Specific questionnaires were employed to examine the hypotheses (General Health Questionnaire, State Trait Anxiety Inventory - form Y, Beck Depression Inventory-II, and Eysenck Personality Questionnaire). The results show that symptoms of anxiety and depression associated with PN are more severe than in the control group and that some specific traits of personality are more frequently represented in such subjects. The results of our study represent a first attempt to analyze the psychological problems and the personality dimensions which seem to characterize PN patients. Such evidence supports the importance of a psychological approach in the clinical management of PN, which should always include psychological assessment and treatment together with the other therapeutic options.

  15. Metastatic involvement of the Meckel's cave and trigeminal nerve. A case report. (United States)

    Mastronardi, L; Lunardi, P; Osman Farah, J; Puzzilli, F


    The case of a patient with a right atypical trigeminal neuralgia caused by a metastatic tumor involving the Meckel's cave is reported. His medical history was significant for colon-rectal adenocarcinoma. The preoperative diagnosis of Meckel's cave neoplasm was made by MR. The patient underwent surgery, consisting of total removal of tumor and peeling of the ganglion and of the branches of the nerve, obtaining a histological diagnosis and a resolution of pain. The clinical, radiological findings and the treatment of this rare entity are discussed.

  16. Atypical Vascular Involvement in a Case of Behçet's Disease

    Directory of Open Access Journals (Sweden)

    Alejandro Rodríguez Morata


    Full Text Available Introduction. Behçet's disease (BD is a form of vasculitis of unknown etiology which is rare in our environment. It is characterized by a variety of clinical manifestations and usually affects young adults. Recurrent oral and genital ulcers are a characteristic and extremely frequent symptom, but mortality is linked with more significant symptoms such as aortic pseudoaneurysm, pulmonary pseudoaneurysm, and cerebral venous thrombosis. Patient and Method. We present a case of a young male with atypical BD and severe polyvascular involvement (previous cerebral venous thrombosis and current peripheral venous thrombosis, acute ischemia, and peripheral arterial pseudoaneurysm who required urgent surgical intervention due to a symptomatic external iliac pseudoaneurysm. Result. The pseudoaneurysm was successfully treated, we performed an iliofemoral bypass, and we treated it with steroids and immunosuppressive therapy. Conclusions. These rare clinical manifestations highlight the importance of considering BD in young patients, even in usual cases of vascular intervention, whether arterial or venous in nature.

  17. Malignant otitis externa with bilateral cranial nerve involvement: Report of a unique case

    Directory of Open Access Journals (Sweden)

    Somnath Saha


    Full Text Available Malignant otitis externa is an inflammatory condition caused by pseudomonas infection usually in the elderly diabetics, or an immunosuppressive condition that presents with diffuse otitis externa along with excruciating pain and granulations tissue in the external auditory meatus. Facial paralysis is common along with occasional involvement of other cranial nerves. Case report describing a patient of malignant otitis externa who presented to a tertiary referral hospital of eastern India. This patient had ipsilateral facial and tenth cranial nerve paralysis along with delayed-onset contralateral sixth and twelfth cranial nerve palsy. The patient was treated initially with intravenous anti-pseudomonal antibody followed by tympanic platectomy, facial nerve decompression and medialisation thyroplasty. The contralateral cranial nerve palsy was managed conservatively with partial recovery of function. Malignant otitis externa, though a common disease, may occasionally present with uncommon or unexplained presentations. The management of these cases should be prompt and aggressive and specifically address each of the debilitating complications.

  18. A case study of Impetigo

    Directory of Open Access Journals (Sweden)

    Mansouri P


    Full Text Available This is a report of a case study on 234 patients with impetigo who referred to Razi Dermatology Hospital from April to November, 1989. Treatment was started immediately after obtaining direct smear and performing culture and antibiotic sensitivity test. The most common organism responsible for impetigo was the coagulase-positive staphylococcus (71%. In 13.7% of the cases, the coagulase-negative staphylococcus was grown on culture media, but none of the cultures showed streptococcus as the main organism. Treatment was started with oral penicillin V, oral erythromycin, benzathine penicillin G injection, oral cephalexin, and topical fuccidin. Clinical and bacteriological evaluation after 3-7 days showed that it is preferable to use oral cephalexin instead of other protocols such as oral erythromycin, which has previously been the drug of choice for impetigo. In addition, topical fuccidin with a 75% curative rate was the first drug for treatment, with the same effect as the oral cephalexin

  19. Outage management: A case study

    Energy Technology Data Exchange (ETDEWEB)

    Haber, S.B.; Barriere, M.T. (Brookhaven National Lab., Upton, NY (United States)); Roberts, K.H. (California Univ., Berkeley, CA (United States). Walter A. Haas School of Business)


    Outage management issues identified from a field study conducted at a two-unit commercial pressurized water reactor (PWR), when one unit was in a refueling outage and the other unit was at full power operation, are the focus of this paper. The study was conduced as part of the US Nuclear Regulatory Commission's (NRC) organizational factors research program, and therefore the issues to be addressed are from an organizational perspective. Topics discussed refer to areas identified by the NRC as critical for safety during shutdown operations, including outage planning and control, personnel stress, and improvements in training and procedures. Specifically, issues in communication, management attention, involvement and oversight, administrative processes, organizational culture, and human resources relevant to each of the areas are highlighted by example from field data collection. Insights regarding future guidance in these areas are presented based upon additional data collection subsequent to the original study.

  20. Outage management: A case study

    Energy Technology Data Exchange (ETDEWEB)

    Haber, S.B.; Barriere, M.T. [Brookhaven National Lab., Upton, NY (United States); Roberts, K.H. [California Univ., Berkeley, CA (United States). Walter A. Haas School of Business


    Outage management issues identified from a field study conducted at a two-unit commercial pressurized water reactor (PWR), when one unit was in a refueling outage and the other unit was at full power operation, are the focus of this paper. The study was conduced as part of the US Nuclear Regulatory Commission`s (NRC) organizational factors research program, and therefore the issues to be addressed are from an organizational perspective. Topics discussed refer to areas identified by the NRC as critical for safety during shutdown operations, including outage planning and control, personnel stress, and improvements in training and procedures. Specifically, issues in communication, management attention, involvement and oversight, administrative processes, organizational culture, and human resources relevant to each of the areas are highlighted by example from field data collection. Insights regarding future guidance in these areas are presented based upon additional data collection subsequent to the original study.

  1. Papillary renal cell carcinoma with metastatic laparoscopic port site and vaginal involvement: a case report

    Directory of Open Access Journals (Sweden)

    Fong Kah


    Full Text Available Abstract Introduction Laparoscopic port-site metastasis is a rare but well recognized outcome following surgery in urological cancers, with its etiology not clearly understood. Additionally, vaginal metastasis in clear cell renal cell carcinoma is rare, and has not been previously reported in the setting of papillary renal cell carcinoma. Case presentation We present the case of a 71-year-old Chinese woman with metastatic type II papillary renal cell carcinoma with histologically verified vaginal involvement and a concurrent laparoscopic port-site metastasis. This was also associated with a unique constellation of widely disseminated metastatic sites, which include a local relapse, the peritoneum and the urethra. Conclusion Laparoscopic port-site metastases are associated with the presence of advanced cancer with multiple sites of metastasis. We hypothesize from the findings of our report and background data that this phenomenon is more likely to be related to tumor factors rather than operative factors. We also present what is, to the best of our knowledge, the first reported case in the literature of vaginal and urethral metastasis and the second reported case of laparoscopic port-site recurrence.

  2. Herpesvirus-associated central and peripheral nervous system involvement: two clinical cases

    Directory of Open Access Journals (Sweden)

    T. E. Popova


    Full Text Available Herpesviruses can directly affect the structure of the nervous system, resulting in encephalitis, and also induce immune-mediated disorders of the peripheral nervous system as sensory-predominant chronic inflammatory demyelinating polyneuropathy (CIDP. Patients with immunodeficiency may simultaneously develop two pathological processes, determining the severity of the condition. Parainfectious limbic encephalitis (PILE associated with viruses from the family Herpes viridae is a form of chronic herpes encephalitis, which is characterized by dysfunction of the limbic system and by a long-term course with exacerbations. CIDP is a dysimmune disease leasing to peripheral nervous system involvement, which belongs to a class of myelinopathies. The paper describes two clinical cases of a concurrence of chronic PILE and CIDP in middle-aged men who have symptomatic status epilepticus and iatrogenic complications. It characterizes difficulties in diagnosis and the clinical features of chronic herpes infection involving the central and peripheral nervous systems. The given clinical cases suggest that not only neurologistsand epileptologists, but also resuscitation specialists and ngiosurgeons should be particularly alert to the pathology in question.

  3. Parental Involvement in Foreign Language Learning: The Case of Hong Kong (United States)

    Forey, Gail; Besser, Sharon; Sampson, Nicholas


    It has long been established that parents play a key role in educational achievement. In this paper, we examine parental involvement in children's foreign language learning and the goal of finding ways to support families as they help their children to acquire a foreign language. The study investigated the ways in which Hong Kong families do and…


    Institute of Scientific and Technical Information of China (English)



    In recent years ELT has stressed the role which teachers' beliefs play in shaping what they do in the classroom. But so far as teaching English in China is concerned, we lack empirical insight into the relationship between teachers' beliefs and their classroom practice. With specific reference to the use of English in intensive reading classes, by presenting and discussing data from a case study of a non-native college English teacher,this exploratory qualitative classroom research sheds light on the nature of teachers' beliefs held consciously or unconsciously.Their subsequent change and impact on the classroom will also be reported and discussed.

  5. 22 CFR 99.2 - Reporting requirements for adoption cases involving children emigrating from the United States. (United States)


    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Reporting requirements for adoption cases involving children emigrating from the United States. 99.2 Section 99.2 Foreign Relations DEPARTMENT OF... Convention case, or in a non-Convention case, the reporting provider is the agency, person, public...

  6. Involvement of Kytococcus schroeteri in a case of prosthetic valve endocarditis

    Directory of Open Access Journals (Sweden)

    Antonella D’Andria


    Full Text Available We report a fourth case of prosthetic valve endocarditis caused by the newly described micrococcal species: Kytococcus schroeteri. A 38-year old male was admitted to our hospital with suspected prosthetic valve endocarditis. In three blood cultures and in the prosthetic heart valve culture grew the same type of microrganism, initially identified as Micrococcus luteus. Presuntive assignment to the genus Kytococcus was suggested by the arginina dihydrolase activity and by the resistence to penicillin, oxacillin and methicillin, characteristics which are not shared by other micrococci. Further biochemical tests confirmed that the isolates belonged to the genus Kytococcus (negative reaction for oxydase, esculin and urease, positive for catalase and arginine dihydrolase species schroeteri (alpha-glucosidase positive. The patient was treated with vancomycin, gentamicin and rifampicin. After the valve replacement, on the 20th day of hospitalization, the patient’s biological parameters returned to normal values, and after one mounth the resolution of the disease was completed. The diagnosis of four cases by K. schroeteri endocarditis, described within a short period of time (2003-2006, might indicate a specific pathogenicity of this new species. In case of endocarditis diagnosis, the suspect of the genus Kytococcus involvement should be considered each time the aerobic Gram positive cocci, with arginina dihidrolase activiy and the resistence to penicillin, oxacillin and methicillin, are isolated by significative biological samples.

  7. Study of Systemic Risk Involved in Mutual Funds (United States)

    Dash, Kishore C.; Dash, Monika

    Systemic risk, may be defined as the risk that contaminates to the whole system, consisting of many interacting agents that fail one after another. These agents, in an economic context, could be firms, banks, funds, or other financial institutions. Systemic risk is a macroscopic property of a system which emerges due to the nonlinear interaction of agents on a microscopic level. A stock market itself is a system in which there are many sub-systems, like Dowjones, Nifty, Sensex, Nasdaq, Nikkei and other market indices in global perspective. In Indian market, subsystems may be like Sensex, Nifty, BSE200, Bankex, smallcap index, midcap index, S&P CNX 500 and many others. Similarly there are many mutual funds, which have their own portfolio of different stocks, bonds etc. We have attempted to study the systemic risk involved in a fund as a macroscopic object with regard to its microscopic components as different stocks in its portfolio. It is observed that fund managers do manage to reduce the systemic risk just like we take precautions to control the spread of an epidemic.

  8. Spectroscopic studies of interactions involving horseradish peroxidase and Tb3+. (United States)

    Guo, Shaofen; Zhou, Qing; Lu, Tianhong; Ding, Xiaolan; Huang, Xiaohua


    The spectroscopic properties of interactions involving horseradish peroxidase (HRP) and Tb3+ in the simulated physiological solution was investigated with some electrochemical and spectroscopic methods, such as cyclic voltammetry (CV), circular dichroism (CD), X-ray photoelectron spectroscopy (XPS) and synchronous fluorescence (SF). It was found that Tb3+ can coordinate with oxygen atoms in carbonyl groups in the peptide chain of HRP, form the complex of Tb3+ and HRP (Tb-HRP), and then lead to the conformation change of HRP. The increase in the random coil content of HRP can disturb the microstructure of the heme active center of HRP, in which the planarity of the porphyrin cycle in the heme group is increased and then the exposure extent of the electrochemical active center is decreased. Thus Tb3+ can inhibit the electrochemical reaction of HRP and its electrocatalytic activity for the reduction of H2O2 at the Au/Cys/GC electrode. The changes in the microstructure of HRP obstructed the electron transfer of Fe(III) in the porphyrin cycle of the heme group, thus HRP catalytic activity is inhibited. The inhibition effect of Tb3+ on HRP catalytic activity is increased with the increasing of Tb3+ concentration. This study would provide some references for better understanding the rare earth elements and heavy metals on peroxidase toxicity in living organisms.

  9. Physiologic amputation: a case study. (United States)

    Long, Jeri; Hall, Virginia


    Acute limb ischemia is a complication of severe peripheral arterial disease that can be a threatening limb as well as life. Multiple procedures exist today to help revascularize extremities; however, even with the latest technologies, surgical amputation of the limb may still be necessary. Cryoamputation, or physiologic amputation, is a method used to treat patients who are hemodynamically unstable for the operating room and who are in need of urgent amputation owing to arterial ischemia. This procedure is used in the rare instance where not only a persons' limb is threatened, but also their life. This is a case study regarding one patient who presented to the hospital with limb-threatening ischemia who became hemodynamically unstable owing to the rhabdomyolysis associated with the ischemia of his lower extremity. Cryoamputation was used to stabilize the patient and prevent further deterioration, so that he could safely undergo surgical amputation of the limb without an increase in mortality risk. Cryoamputation must be followed by formal surgical amputation when the patient is hemodynamically stabilized. It is not a limb salvaging, procedure but it is a life-saving procedure. This case study demonstrates the usefulness of the procedure and discusses the technique used for cryoamputation.

  10. Five misunderstandings about Case-study Research

    DEFF Research Database (Denmark)

    Flyvbjerg, Bent

    This article examines five common misunderstandings about case-study research: (1) Theoretical knowledge is more valuable than practical knowledge; (2) One cannot generalize from a single case, therefore the single case study cannot contribute to scientific development; (3) The case study is most...

  11. Five misunderstandings about case study research

    DEFF Research Database (Denmark)

    Flyvbjerg, Bent


    This article examines five common misunderstandings about case-study research: (1) Theoretical knowledge is more valuable than practical knowledge; (2) One cannot generalize from a single case, therefore the single case study cannot contribute to scientific development; (3) The case study is most...

  12. Using Correspondence Analysis in Multiple Case Studies

    NARCIS (Netherlands)

    Kienstra, Natascha; van der Heijden, Peter G.M.


    In qualitative research of multiple case studies, Miles and Huberman proposed to summarize the separate cases in a so-called meta-matrix that consists of cases by variables. Yin discusses cross-case synthesis to study this matrix. We propose correspondence analysis (CA) as a useful tool to study thi

  13. Using correspondence analysis in multiple case studies

    NARCIS (Netherlands)

    Kienstra, N.H.H.; van der Heijden, P.G.M.


    In qualitative research of multiple case studies, Miles and Huberman proposed to summarize the separate cases in a so-called meta-matrix that consists of cases by variables. Yin discusses cross-case synthesis to study this matrix. We propose correspondence analysis (CA) as a useful tool to study thi

  14. Erdheim Chester disease with appendicular skeletal, renal and pleural involvement responding to Zelboraf (BRAF inhibitor) treatment: case report

    Energy Technology Data Exchange (ETDEWEB)

    Borys, Dariusz [Loyola University Medical Center Chicago, Department of Pathology, Maywood, IL (United States); Loyola University Medical Center Chicago, Departmet of Orthopaedic Surgery, Maywood, IL (United States); Loyola University Medical Center, Maywood, IL (United States); Nystrom, Lucas [Loyola University Medical Center Chicago, Departmet of Orthopaedic Surgery, Maywood, IL (United States); Song, Albert [Loyola University Medical Center Chicago, Department of Radiology, Maywood, IL (United States); Lomasney, Laurie M. [Loyola University Medical Center Chicago, Departmet of Orthopaedic Surgery, Maywood, IL (United States); Loyola University Medical Center Chicago, Department of Radiology, Maywood, IL (United States)


    Erdheim Chester disease is a rare non-Langerhans cell histiocytosis which may involve multiple organs including bone, soft tissue, lungs, cardiovascular system, kidneys (retroperitoneum), skin, and central nervous system. Bone involvement is most common followed by other organs. This case report describes a 58-year-old man who presented with progressive renal dysfunction presumed due to obstruction. The patient failed multiple urinary tract interventions, and clinical course was complicated by recurrent low-grade fevers, and bilateral knee pain. Advanced imaging and histopathological features on bone biopsy were consistent with Erdheim Chester disease. Molecular studies of tissue showed BRAF V600 mutation. This patient was treated with Zelboraf (vemurafenib) BRAF inhibitor with subsequent improvement in renal and pleural dysfunction as well as decreased histiocytic soft tissue masses on CT. (orig.)

  15. Hazardous Waste Management and Community Involvement in Canada: The Case of Montreal's Rural-Urban Fringe. (United States)

    Andre, Pierre; And Others


    Deals with conflicts associated with the management, disposal, and storage of hazardous wastes from the perspective of interests expressed in the local community. Analyzes three case studies to demonstrate the changing roles and relative importance of local and nonlocal interests. Draws conclusions regarding the significance of the analysis for…

  16. Visceral leishmaniasis with cardiac involvement in a dog: a case report

    Directory of Open Access Journals (Sweden)

    Goicoa Ana


    Full Text Available Abstract A dog presented with cutaneous nodules, enlarged lymph nodes and oedema in limbs, face and abdomen. The diagnosis of visceral leishmaniasis was established by identification of Leishmania amastigotes within macrophages from skin and popliteal lymph node biopsies. At necropsy, lesions were found in different organs, but it was particularly striking to observe large areas of pallor in the myocardium. Histological examination revealed an intense chronic inflammatory reaction in many organs, and numerous macrophages were found to contain amastigote forms of Leishmania. The inflammatory reaction was especially severe in the heart, where large areas of the myocardium appeared infiltrated with huge numbers of mononuclear immune cells, causing cardiac muscle atrophy and degeneration. Despite the severe inflammation, the number of parasitized macrophages was low in the myocardium, as revealed by immunohistochemical staining of Leishmania amastigotes. Because cardiac involvement is not usually described in this condition, this dog represents a very rare case of canine visceral leishmaniasis with affection of the myocardium.

  17. A Case of Erdheim-Chester Disease with Bilateral Orbital Involvement

    Institute of Scientific and Technical Information of China (English)

    Zhongyao Wu; Jianhua Yan; Wende Hong; Yaoxian Yuan; Lijun Dai


    Purpose: To describe a case of Erdheim-Chester disease with bilateral orbital involvement.Methods: A 43-year-old female with bilateral proptosis was presented. Its clinical features, image findings, pathological character and therapeutic effect were evaluated.Results: CT demonstrated bilateral, diffuse orbital mass. Histopathologic assessment revealed a diffuse xanthogranulomatous process with clusters of lipidladen histocytes. Numerous Touton giant cells were scattered throughout the lesion. Renal and heart failure happened during a 6-year follow-up period. Long bones roentgenogram demonstrated diffuse symmetrical sclerosis with extensive, lytic lesions. Systemicadministration of corticosteroids, chemotherapy, immunoglobulin and traditional Chinese medicine showed good therapeutic result. Conclusions: An administration of systemic corticosteroids, chemotherapy, immuno- globin and traditional Chinese medicine can control Erdheim-Chester disease. Further exploration of its pathogenesis and collection of useful clinical data are required.

  18. Her-2 Positive Gastric Cancer Presented with Thrombocytopenia and Skin Involvement: A Case Report

    Directory of Open Access Journals (Sweden)

    Deniz Arslan


    Full Text Available Gastric cancer is the 5th most frequent cancer around the world and the 3rd most frequent reason of deaths due to cancer. Every year, about 1 million new cases are taking place, with varying geographical distribution. Gastric cancer is often metastatic to liver, lungs, and bones in hematogenous way, to peripheral lymph nodes in lymphogenous way, and to peripheral tissues in adjacency way, yet bone marrow (BM and cutaneous metastasis are quite seldom. Pancytopenia is a more frequent finding identified in BM metastasis of solid organ cancers, and isolated thrombocytopenia is less often. The human epidermal growth factor 2 (HER-2 is positive in gastric cancer at a rate of 7–34%. Here, we have presented our HER-2 positive gastric cancer incident which presented with BM and cutaneous metastasis, and has no 18F-fluoro-2-deoxi-D-glucose (FDG involvement except bone metastases.

  19. Her-2 Positive Gastric Cancer Presented with Thrombocytopenia and Skin Involvement: A Case Report (United States)

    Arslan, Deniz; Tatlı, Ali Murat; Goksu, Sema Sezgin; Başsorgun, Cumhur İbrahim; Coskun, Hasan Senol; Bozcuk, Hakan; Savaş, Burhan


    Gastric cancer is the 5th most frequent cancer around the world and the 3rd most frequent reason of deaths due to cancer. Every year, about 1 million new cases are taking place, with varying geographical distribution. Gastric cancer is often metastatic to liver, lungs, and bones in hematogenous way, to peripheral lymph nodes in lymphogenous way, and to peripheral tissues in adjacency way, yet bone marrow (BM) and cutaneous metastasis are quite seldom. Pancytopenia is a more frequent finding identified in BM metastasis of solid organ cancers, and isolated thrombocytopenia is less often. The human epidermal growth factor 2 (HER-2) is positive in gastric cancer at a rate of 7–34%. Here, we have presented our HER-2 positive gastric cancer incident which presented with BM and cutaneous metastasis, and has no 18F-fluoro-2-deoxi-D-glucose (FDG) involvement except bone metastases. PMID:25045559

  20. A Case of Porokeratosis Showing Different Clinical Patterns of the Disease with Anogenital Involvement

    Directory of Open Access Journals (Sweden)

    Özlem Karabudak


    Full Text Available Porokeratosis (PK is a group of cutaneous entities characterized by marginate scaling lesions, histologically showing a column of parakeratotic keratinocytes (cornoid lamella. Various forms are recognized such as porokeratosis of Mibelli (PM, linear porokeratosis, disseminated superficial actinic porokeratosis, punctate parakeratosis. PM should be treated because of the possibility of developing malignant epithelial tumors. We are presenting a 21 year old male patient suffering from PM on the back of the hands, foot, scrotum, oral mucosa and anal region. The histological biopsy specimens showed the characteristic features of porokeratosis. We destroyed the lesions by cryotherapy sessions. Here, we present a case of PM since it is rarely seen as multiple lesions with oral, anal and scrotal involvements altogether. (Turkderm 2008; 42: 97-9

  1. Case Study: A Picture Worth a Thousand Words? Making a Case for Video Case Studies (United States)

    Pai, Aditi


    A picture, they say, is worth a thousand words. If a mere picture is worth a thousand words, how much more are "moving pictures" or videos worth? The author poses this not merely as a rhetorical question, but because she wishes to make a case for using videos in the traditional case study method. She recommends four main approaches of…

  2. STS Case Study Development Support (United States)

    Rosa de Jesus, Dan A.; Johnson, Grace K.


    The Shuttle Case Study Collection (SCSC) has been developed using lessons learned documented by NASA engineers, analysts, and contractors. The SCSC provides educators with a new tool to teach real-world engineering processes with the goal of providing unique educational materials that enhance critical thinking, decision-making and problem-solving skills. During this third phase of the project, responsibilities included: the revision of the Hyper Text Markup Language (HTML) source code to ensure all pages follow World Wide Web Consortium (W3C) standards, and the addition and edition of website content, including text, documents, and images. Basic HTML knowledge was required, as was basic knowledge of photo editing software, and training to learn how to use NASA's Content Management System for website design. The outcome of this project was its release to the public.

  3. Using teaching case studies for management research


    Ambrosini, Veronique; Bowman, Cliff; Collier, Nardine


    Teaching case studies are widely deployed in business schools. They are contextually rich in detail, and students learn by applying and adapting theoretical concepts to specific business situations described in the case. This article proposes a new way to use teaching case studies, as research materials for academics. The article addresses three questions: (1) Can teaching cases be used as an alternative to field research? (2) When can teaching case studies be used as second...

  4. Value of case studies in disaster assessment? (United States)

    Grynszpan, Delphine; Murray, Virginia; Llosa, Silvia


    Case studies can be useful in assessing and learning lessons from emergency situations. In this paper, different uses for disaster case studies, are explored with identification of potential pitfalls that should be avoided. In addition, ways to improve the rigor and significance of case studies are suggested. Case studies can be used as examples or as a research tool. If conducted properly, they can provide robust and compelling results. It is argued that sharing a common guide to conducting and writing case studies among all disaster risk reduction professionals could improve the quality of case study reports and thereby strengthen their value in advancing the prevention, preparedness, and management of disasters and emergencies.

  5. Contextualising case studies in entrepreneurship: A tandem approach to conducting a longitudinal cross-country case study

    DEFF Research Database (Denmark)

    Chetty, S. K.; Partanen, J.; Rasmussen, Erik Stavnsager


    Using predictive and effectuation logics as a framework, this research note explains how case study research was conducted to demonstrate rigour and relevance. The study involves a longitudinal cross-country case study on small and medium-sized firm growth and networks undertaken by research teams...... in three countries (Finland, Denmark and New Zealand) involving 33 firms. This research note outlines the implications of this research and provides valuable guidance and reflections upon opportunities for future research regarding the conduct of contextual studies in entrepreneurship without compromising...

  6. A proteomic approach for the involvement of the GAPDH in Alzheimer disease in the blood of Moroccan FAD cases. (United States)

    El Kadmiri, Nadia; Cuardos, Raquel; El Moutawakil, Bouchra; Slassi, Ilham; Avila, Jesus; Nadifi, Sellama; Hachem, Ahmed; Soukri, Abdelaziz


    Several articles have highlighted the potential involvement of glyceraldehyde-3-phosphate dehydrogenase (GAPDH) in neurodegeneration by showing a non-glycolytic activity of GAPDH specifically in the brains of subjects with Alzheimer's disease (AD). The novel aim of this study was to elucidate the critical role of GAPDH and its interaction with β-amyloid in the blood of Moroccan patients with familial AD (FAD) carrying presenilin mutations and in sporadic late onset AD (LOAD). Our results show a significant decrease in the activity of GAPDH in blood samples from patients with FAD as compared to sporadic cases and healthy controls. The expression level of GAPDH in brain specimens from mutant tau transgenic mice and patients with FAD was unchanged as compared to healthy controls. In contrast, the expression level of GAPDH in blood samples from mutant tau transgenic mice and patients with FAD was decreased as compared to sporadic cases and healthy controls. Moreover, there is an accumulation of β-amyloid aggregates in the blood samples of patients with FAD and an increase in amyloid fibrils in both the blood and brain samples of these patients. Our study adds new insight to previous ones by showing the involvement of GAPDH in AD, which may influence the pathogenesis of this neurodegenerative disease.

  7. Catalog of NASA-Related Case Studies (United States)

    National Aeronautics and Space Administration — The OCKO has developed over 50 case studies to enhance learning at workshops, training, retreats and conferences. Case studies make mission knowledge attractive and...

  8. Involvement and Complications Associated with Brucellosis Connected Rare Evaluation of 46 Cases

    Directory of Open Access Journals (Sweden)

    Tuba Turunc


    Conclusion: In this study, it is determined that cases were followed with brucellosis (10.2% atypical disease and / or complications, and the first assesses made by outside the Department of Infectious Diseases. For this reason, we think not only experts in Infectious Diseases, all other branches of physicians should keep in mind in the differential diagnosis of brucellosis. [Cukurova Med J 2014; 39(4.000: 829-839

  9. National Environmental Change Information System Case Study (United States)

    Goodman, S. J.; Ritschard, R.; Estes, M. G., Jr.; Hatch, U.


    The Global Hydrology and Climate Center and NASA's Marshall Space Flight Center conducted a fact-finding case study for the Data Management Working Group (DMWG), now referred to as the Data and Information Working Group (DIWG), of the U.S. Global Change Research Program (USGCRP) to determine the feasibility of an interagency National Environmental Change Information System (NECIS). In order to better understand the data and information needs of policy and decision makers at the national, state, and local level, the DIWG asked the case study team to choose a regional water resources issue in the southeastern United States that had an impact on a diverse group of stakeholders. The southeastern United States was also of interest because the region experiences interannual climatic variations and impacts due to El Nino and La Nina. Jointly, with input from the DIWG, a focus on future water resources planning in the Apalachicola-Chattahoochee-Flint (ACF) River basins of Alabama, Georgia, and Florida was selected. A tristate compact and water allocation formula is currently being negotiated between the states and U.S. Army Corps of Engineers (COE) that will affect the availability of water among competing uses within the ACF River basin. All major reservoirs on the ACF are federally owned and operated by the U.S. Army COE. A similar two-state negotiation is ongoing that addresses the water allocations in the adjacent Alabama-Coosa-Tallapoosa (ACT) River basin, which extends from northwest Georgia to Mobile Bay. The ACF and ACT basins are the subject of a comprehensive river basin study involving many stakeholders. The key objectives of this case study were to identify specific data and information needs of key stakeholders in the ACF region, determine what capabilities are needed to provide the most practical response to these user requests, and to identify any limitations in the use of federal data and information. The NECIS case study followed the terms of reference

  10. Case Study of a Participatory Health Promotion Intervention in School

    DEFF Research Database (Denmark)

    Simovska, Venka


    -community approach to influencing determinants of healthy and balanced growing up’. Qualitative case study research was carried out in a school in the Netherlands. Data sources included project documents, interviews and observations. Thematic analysis was carried out combining the different data sources. The case......In this article I discuss the findings from a case study focusing on processes involving pupils to bring about health promotion changes. The case study is related to a large EU intervention project aiming to promote health and wellbeing among children (4-16 years), ‘Shape Up: a school...... study showed that, if given sufficient guidance, children can act as agents of health promoting changes. The main arena for pupils’ influence was the pupils’ council. Pupils were meaningfully involved in two actions, which targeted road safety around the school and a playground for a disadvantaged...

  11. Case Study: The Chemistry of Cocaine (United States)

    Dewprashad, Brahmadeo


    This column provides original articles on innovations in case study teaching, assessment of the method, as well as case studies with teaching notes. This month's case study focuses on the chemistry of cocaine to teach a number of core concepts in organic chemistry. It also requires that students read and analyze an original research paper on…

  12. Writing case studies in information systems research

    NARCIS (Netherlands)

    van der Blonk, H.C.


    Case study research can be reported in different ways. This paper explores the various ways in which researchers may choose to write down their case studies and then introduces a subsequent typology of writing case studies. The typology is based on a 2 x 2 matrix, resulting in four forms of writing

  13. 36 CFR Appendix A to Part 800 - Criteria for Council Involvement in Reviewing Individual section 106 Cases (United States)


    ... 36 Parks, Forests, and Public Property 3 2010-07-01 2010-07-01 false Criteria for Council Involvement in Reviewing Individual section 106 Cases A Appendix A to Part 800 Parks, Forests, and Public... include cases with substantial public controversy that is related to historic preservation issues;...

  14. Concentrated photovoltaics, a case study

    Directory of Open Access Journals (Sweden)

    Antonini Piergiorgio


    Full Text Available Concentrated Photovoltaics (CPV, once a niche technology, has now reached the maturity and reliability for large scale power generation. Especially in regions where temperatures are very high, the use of high efficiency triple junction solar cells with concentrating optics allows stable energy yield. Thus CPV can be seen as complementary and not in concurrence with silicon photovoltaics. The state of the art, the advantages and limitations of this technology will be shown. Among the main advantages of CPV is the possibility of a much higher energy supply, when compared to silicon photovoltaics, both comparing CPV and silicon with same area or the same installed power. The use of recycled and recyclable materials allows a more environmentally friendly production. The possibility to couple CPV with desalination facilities, energy storage will be analysed. As an example a case study of a CPV installation in Northern Italy is discussed. Here the use of mature technologies, derived from automotive and lighting sectors resulted in a simple and efficient module.

  15. Concentrated photovoltaics, a case study (United States)

    Antonini, Piergiorgio; Centro, Sandro; Golfetto, Stelvio; Saccà, Alessandro


    Concentrated Photovoltaics (CPV), once a niche technology, has now reached the maturity and reliability for large scale power generation. Especially in regions where temperatures are very high, the use of high efficiency triple junction solar cells with concentrating optics allows stable energy yield. Thus CPV can be seen as complementary and not in concurrence with silicon photovoltaics. The state of the art, the advantages and limitations of this technology will be shown. Among the main advantages of CPV is the possibility of a much higher energy supply, when compared to silicon photovoltaics, both comparing CPV and silicon with same area or the same installed power. The use of recycled and recyclable materials allows a more environmentally friendly production. The possibility to couple CPV with desalination facilities, energy storage will be analysed. As an example a case study of a CPV installation in Northern Italy is discussed. Here the use of mature technologies, derived from automotive and lighting sectors resulted in a simple and efficient module.

  16. Automated cardiopulmonary resuscitation: a case study. (United States)

    Spiro, Jon; Theodosiou, Maria; Doshi, Sagar


    Rates of survival after cardiac arrest are low and correlate with the quality of cardiopulmonary resuscitation (CPR). Devices that deliver automated CPR (A-CPR) can provide sustained and effective chest compressions, which are especially useful during patient transfer and while simultaneous invasive procedures are being performed. The use of such devices can also release members of resuscitation teams for other work. This article presents a case study involving a man with acute myocardial infarction complicated by cardiogenic shock and pulmonary oedema. It describes how ED nursing and medical teams worked together to deliver A-CPR, discusses the use of A-CPR devices in a tertiary cardiac centre, and highlights the advantages of using such devices.

  17. Late ulnar paralysis. Study of seventeen cases. (United States)

    Mansat, M; Bonnevialle, P; Fine, X; Guiraud, B; Testut, M F


    Seventeen cases of late ulnar paralysis treated by neurolysis-transposition are reported. The clinical characteristics of these paralysis are emphasized. A very prolonged symptom free interval, a rapid onset and a severe involvement. The ulnar transposition was most often done subcutaneously. Cubitus valgus and definite nerve compression proximal to the arcade of the flexor carpi ulnaris muscle are almost always present. The results as regards the neuropathy are notable: no patient is completely cured and only half are improved. An anatomical study of the nerve path shows the essential role, in the compression of the nerve, of the muscular arcade of the flexor carpi ulnaris muscle which acts in a way similar to the bridge of a violin. Hence, opening it longitudinally is the principal procedure of the neurolysis. This should be routine before the first signs of neuropathy occur in an elbow whose axis is out of alignment as a sequela of a childhood injury.

  18. Central nervous system granulomastous phlebitis with limited extracranial involvement of the heart and lungs: An autopsy case. (United States)

    Mlakar, Jernej; Zorman, Jerneja Videčnik; Matičič, Mojca; Vrabec, Matej; Alibegović, Armin; Popović, Mara


    Primary angiitis of the central nervous system is a rare condition, usually with an insidious onset. There is a wide variety of histological types (granulomatous, lymphocytic or necrotizing vasculitis) and types of vessel involved (arteries, veins or both). Most cases are idiopathic. We describe a first case of idiopathic granulomatous central nervous system phlebitis with additional limited involvement of the heart and lung, exclusively affecting small and medium sized veins in a 22-year-old woman, presenting as a sub acute headache. The reasons for this peculiar limitation of inflammation to the veins and the involvement of the heart and lungs are unknown.

  19. Renal and perirenal space involvement in acute pancreatitis: An MRI study

    Energy Technology Data Exchange (ETDEWEB)

    Li, Xing Hui, E-mail: [Sichuan Key Laboratory of Medical Imaging, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000 (China); Zhang, Xiao Ming, E-mail: [Sichuan Key Laboratory of Medical Imaging, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000 (China); Ji, Yi Fan, E-mail: [Sichuan Key Laboratory of Medical Imaging, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000 (China); Jing, Zong Lin, E-mail: [Sichuan Key Laboratory of Medical Imaging, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000 (China); Huang, Xiao Hua, E-mail: [Sichuan Key Laboratory of Medical Imaging, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000 (China); Yang, Lin, E-mail: [Sichuan Key Laboratory of Medical Imaging, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000 (China); Zhai, Zhao Hua, E-mail: [Sichuan Key Laboratory of Medical Imaging, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000 (China)


    Objectives: To study the prevalence and characteristics of renal and perirenal space involvement and its relation to the severity of acute pancreatitis (AP) using MRI. Methods: 115 patients with AP who underwent MRI with the clinical kidney function test were retrospectively analyzed in this study. MRI sequences included conventional and diffusion weighted imaging (DWI) sequences. The renal and perirenal space involvement in AP was noted on MRI. The renal apparent diffusion coefficient (ADC) on DWI was measured for each kidney. The severity of AP on MRI was graded using MR severity index (MRSI). The relationships among the renal and perirenal space involvement on MRI, the renal ADC, MRSI and the results of the kidney function test were analyzed. Results: In the 115 patients with AP, the renal and perirenal space abnormalities detected included renal parenchymal abnormalities (0.8%), abnormalities of the renal collecting system (2.6%), renal vascular abnormalities (1.7%), thickened renal fascia (99%), perirenal stranding (62%) and perirenal fluid collection (40%). The prevalence of perirenal space abnormalities was correlated with the severity of AP based on MRSI (P < 0.05). The renal ADC values were lower in patients with abnormal kidney function than in those without kidney injury (P < 0.05). The prevalence of kidney function abnormalities was 9.4%, 32% and 100% in mild, moderate, and severe AP cases, respectively (P = 0.00). Conclusion: Perirenal space involvement is much more than renal parenchymal involvement in AP. The prevalence of perirenal space involvement in AP on MRI has a positive correlation with the severity of AP according to MRSI.

  20. A drug rape case involving triazolam detected in hair and urine. (United States)

    Johansen, S Stybe; Dahl-Sørensen, R


    In recent years, there has been heightened awareness regarding the use of drugs to modify a person's behavior to facilitate crime. A drug rape case involving the potent, short-acting sedative triazolam will be presented. On three occasions, the victim consumed green tea and chocolate before being massaged and ultimately sexually abused. Screening for alcohol, commonly used drugs and illicit substances in blood and urine sampled during the forensic examination 20 h after the last incident, was negative. Consequently, hair samples for chemical analysis were taken from the assaulted individual 34 days after the last incidents. The hair was cut into three 2-cm segments (0-6 cm) that were washed, dissolved in extraction solvent and screened and verified by ultra performance liquid chromatography coupled with time of flight mass spectrometry (UPLC-TOF-MS) and with tandem mass spectrometry (UPLC-MS/MS), respectively. In the 2-cm hair segment corresponding to the period of the alleged assaults, the presence of the sedative triazolam was revealed at a concentration of 1.0 pg/mg hair. The preserved urine sample, taken 20 h after the last incident, was reanalyzed by UPLC-MS/MS for metabolites of triazolam, and 39 μg/l α-hydroxytriazolam was detected in the hydrolyzed urine. This case illustrates that hair is a valuable forensic specimen in situations where natural processes have eliminated the drug from typical biological specimens due to delays in the crime being reported. Furthermore, it was possible to verify the hair finding with a urine sample by detection of a metabolite of triazolam.

  1. Cerebral involvement in a patient with Goodpasture's disease due to shortened induction therapy: a case report

    Directory of Open Access Journals (Sweden)

    Preul Christoph


    Full Text Available Abstract Introduction Goodpasture's disease is a rare immunological disease with formation of pathognomonic antibodies against renal and pulmonary basement membranes. Cerebral involvement has been reported in several cases in the literature, yet the pathogenetic mechanism is not entirely clear. Case presentation A 21-year-old Caucasian man with Goodpasture's disease and end-stage renal disease presented with two generalized seizures after a period of mild cognitive disturbance. Blood pressure and routine laboratory tests did not exceed the patient's usual values, and examination of cerebrospinal fluid was unremarkable. Cerebral magnetic resonance imaging (MRI revealed multiple cortical and subcortical lesions on fluid-attenuated inversion recovery sequences. Since antiglomerular basement membrane antibodies were found to be positive with high titers, plasmapheresis was started. In addition, cyclophosphamide pulse therapy was given on day 13. Encephalopathy and MRI lesions disappeared during this therapy, and antiglomerular basement membrane antibodies were significantly reduced. Previous immunosuppressive therapy was performed without corticosteroids and terminated early after 3 months. The differential diagnostic considerations were cerebral vasculitis and posterior reversible encephalopathy syndrome. Vasculitis could be seen as an extrarenal manifestation of the underlying disease. Posterior reversible encephalopathy syndrome, on the other hand, can be triggered by immunosuppressive therapy and may appear without a hypertensive crisis. Conclusion A combination of central nervous system symptoms with a positive antiglomerular basement membrane test in a patient with Goodpasture's disease should immediately be treated as an acute exacerbation of the disease with likely cross-reactivity of antibodies with the choroid plexus. In our patient, a discontinuous strategy of immunosuppressive therapy may have favored recurrence of Goodpasture's disease.

  2. Neurologic involvement in Behcet disease. Case report; Morbus Behcet mit neurologischer Beteiligung. Ein Fallbericht

    Energy Technology Data Exchange (ETDEWEB)

    Boehner, C. [Erlangen-Nuernberg Univ., Erlangen (Germany). Inst. fuer Diagnostische Radiologie; Fellner, F. [Erlangen-Nuernberg Univ., Erlangen (Germany). Inst. fuer Diagnostische Radiologie; Reinhardt, F. [Erlangen-Nuernberg Univ., Erlangen (Germany). Neurologische Klinik mit Poliklinik; Eberhardt, K.E.W. [Erlangen-Nuernberg Univ., Erlangen (Germany). Abt. fuer Neuroradiologie


    Morbus Behcet is a very infrequent multi-system disease caused by an immunological vasculitis affecting the arteries and veins. The disease is primarily known in Israel, Turkey, Italy, Great Britain and Japan. It may become manifest as erythema nodosum, polyarthritis, thrombophlebitis, occlusive arterial disease, pulmonary infarction, ulcerous colitis, portal hypertension, or via neurological symptoms (collateral symptoms), and it is not possible to make a clear prognosis. The most frequent signs of the neuro-Behcet syndrome, as in the case reported, is a meningoencephalitis. MRI is an essential modality for diagnosis and follow-up of the disease. In this case, the findings included meningeal irritations as well as an abduction deficit indicating involvement of the brain stem of type 1. As described in the literature, pathologic findings have been obtained by spinal fluid tests, showing increased cell number and proteins and pleocytosis of the granulocytes. (Orig./vhe) [Deutsch] Der Morbus Behcet ist eine seltene Multisystemerkrankung in Form einer immunvermittelten Vaskulitis, die Arterien und Venen betrifft. Die Erkrankung findet man ueberwiegend in Israel, der Tuerkei, Italien, Grossbritannien und Japan. Die Erkrankung ist multisystemisch, kann sich als Erythema nodosum, Polyarthritis, Thrombophlebitis, arterielle Verschlusskrankheit, Lungeninfarkt, ulzeroese Colitis, portale Hypertension oder mit neurologischen Symptomen (Nebensymptome) manifestieren, und basiert auf einer immunvermittelten Vaskulitis mit unklarer Prognose. Am haeufigsten manifestiert sich das Neuro-Behcet-Syndrom, wie beim untersuchten Patienten, in Form einer Meningoenzephalitis. Hierbei fand sich neben meningealen Reizsymptomen ein Abduktionsdefizit als Zeichen der Hirnstammbeteiligung im Sinne eines Typ 1. Wie in der Literatur beschrieben, zeigte sich ein pathologischer Liquorbefund mit Zellzahl- und Proteinerhoehung sowie granulozytaerer Pleozytose. Beim Neuro-Behcet, wie bei den anderen

  3. Minimally invasive use of coloured composite resin in aesthetic restoration of periodontially involved teeth: Case report. (United States)

    Wahbi, M A; Al Sharief, H S; Tayeb, H; Bokhari, A


    Gingival recession causes not only aesthetic problems, but problems with oral hygiene, plaque accumulation, speech, and tooth sensitivity. Replacing the missing gingival tissue with composite resin, when indicated, can be a time- and cost-effective solution. Here we report the case of a 25-year-old female who presented with generalized gingival recession. Black triangles were present between the maxillary and mandibular anterior teeth due to loss of interdental tissues, caused by recent periodontal surgery. She also had slightly malposed maxillary anterior teeth. The patient elected to replace gingival tissue with pink composite resin and to alter the midline with composite resin veneers. The first treatment phase involved placement of pink gingival composite to restore the appearance of interdental papilla to her upper (16, 15, 14, 13, 12, 11, 21, 22, 23, and 24) and lower (34, 33, 32, 31, 41, 42, 43, and 44) teeth. Phase two was to place direct composite resin bonded veneers on her upper (16, 15, 14, 13, 12, 11, 21, 22, 23, and 24) teeth to alter the midline and achieve desired colour. The third treatment phase was to level the lower incisal edge shape by enameloplasty (31, 32, 41, and 42) to produce a more youthful and attractive smile. This case report and brief review attempt to describe the clinical obstacles and the current treatment options along with a suggested protocol. Use of contemporary materials such as gingival coloured composite to restore lost gingival tissue and improve aesthetics can be a simple and cost-effective way to manage patients affected by generalized aggressive periodontitis (AgP).

  4. Implementing the Health Promoting School in Denmark: A Case Study (United States)

    Nordin, Lone Lindegaard


    Purpose: The purpose of this paper is to provide insight into teachers' practice in implementing school-based health promotion. Design/methodology/approach: This qualitative research was designed as a multiple case study. The study involved five schools, 233 pupils in the age 12-16 and 23 teachers. The primary data generation method were focus…

  5. The case study of biomaterials and biominerals (United States)

    Del Hoyo Martínez, Carmen


    The teaching of biomaterials as case study by on-line platform , susceptible to develop both individually and in groups, got different objectives proposed by the European Higher Education System, among which include: participate actively in the teaching-learning process by students, interpreting situations, adapt processes and solutions. It also improves oral and written communication, analytical skills and synthesis and also the ability to think critically. Biomaterials have their origin in biominerals. These are solid inorganic compounds of defined structure, consisting of molecular control mechanisms that operate in biological systems. Its main functions are: structural support, a reservoir of essential elements, sensors, mechanical protection and storage of toxic elements. Following the demand of materials compatible with certain functional systems of our body, developed biomaterials. Always meet the condition of biocompatibility. Should be tolerated by the body and do not provoke rejection. This involves a comprehensive study of physiological conditions and the anatomy of the body where a biomaterial has to be implemented. The possibility of generating new materials from biominerals has a major impact in medicine and other fields could reach as geology, construction, crystallography, etc. While the study of these issues is in its infancy today, can be viewed as an impact on the art and future technology. Planning case study that students would prepare its report for discussion in subgroups. Occurs then the pooling of individual analysis, joint case discussion and adoption by the subgroup of a consensual solution to the problem. The teacher as facilitator and coordinator of the final case analysis, sharing leads to group-wide class and said the unanimous decision reached by the students and gives his opinion on the resolution of the case. REFERENCES D.P. Ausubel. Psicología Educativa. Un punto de vista cognoscitivo. Trillas. Ed. 1983. E.W. Eisner. Procesos

  6. Demystifying Instructional Innovation: The Case of Teaching with Case Studies (United States)

    Kantar, Lina D.


    Issues emerging from instructional innovation are inevitable, yet basing any curriculum shift on a theoretical framework is paramount. This paper grounds the case-based pedagogy in three learning theories: behaviorism, cognitivism, and constructivism. The three theories are described and situated in relation to the case study method. An…

  7. Traumatic L5 over S1 spondyloptosis without neurological involvement managed nonoperatively: a case report

    Institute of Scientific and Technical Information of China (English)

    Vijay Goni; Nirmal Raj Gopinathan; Uttam Chand Saini; Shashidhar B Kantharajanna


    High-grade spondylolisthesis is very rare.We came across a case of high-grade spondylolisthesis at the L5-S1 level in a 32-year-old manual labourer who was hit by a heavy object on his flexed back.The patient presented to us with persistent deformity in the back.He complained of back pain on prolonged standing and after moderate work.Because of that he was unable to return to his work.On clinical examination there was a large step in the lower lumbar region.Detailed neurological evaluation of the lower limbs did not reveal any sensory or motor deficit,neither did bowel or bladder involvement.Radiographic examination showed L5 over S1 traumatic spondyloptosis.CT scan revealed that neural canal was in normal width.MRI confirmed spondyloptosis of L5 over S1 without any compromise of the spinal canal and with normal-looking cauda.Concerning the delayed presentation and no neurological deficit,the patient was managed conservatively after thorough counsel.At 6 months,the patient returned to his work and at the latest follow-up (15 months) he was free from back pain.Conservative means of treatment can lead to satisfactory outcome,especially when the patient has delayed presentation.

  8. Secondary Involvement of the Mandible due to Basal Cell Carcinoma: A Case Report

    Directory of Open Access Journals (Sweden)

    Pegah Mosannen Mozaffary


    Full Text Available Basal cell carcinoma (BCC is the most common cutaneous malignancy among Caucasians. Rare examples of aggressive and neglected BCC have been reported. Here we report a unique case of a neglected BCC with significant jaw involvement. A 50-year-old female, referred by an otorhinologist, presented with a large ulcer on her chin, which was extended to her mandibular vestibule. The ulcer was 9×5.5 cm in size, and tissue destruction, necrosis was observed in the central portion, and the mandibular bone was exposed. On intraoral examination, tooth mobility and severe bone loss were evident. Due to the primary cutaneous origin of the lesion, BCC was considered as preliminary diagnosis. Biopsy was performed and diagnosis of BCC was confirmed. The diseased mandibular bone was resected and reconstructed with a surgical plate. The soft tissue defect was reconstructed with deltopectoral flap. The patient refused secondary stage plastic surgery. Although BCC is not a lethal malignancy, if left untreated and neglected, it can result in severe destruction, disfigurement, and even mortality.

  9. Psammomatoid variant of juvenile ossifying fibroma involving mandible: A rare case report

    Directory of Open Access Journals (Sweden)

    Saurabh Kumar


    Full Text Available The term juvenile ossifying fibroma (JOF is used in literature in naming two microscopically distinct fibro-osseous lesions of the craniofacial skeleton. One is characterized by small uniform spherical ossicles resembling psammoma bodies (psammomatoid JOF [PsJOF]. The other is distinguished by trabeculae of fibrillary osteoid and woven bone (trabecular JOF. Psammomatoid ossifying fibromas represent a unique subset of fibro-osseous lesions of the craniofacial region. PsJOF has been distinguished because of its location, clinical behavior, and age of occurrence. They have distinctive histomorphologic features and a tendency toward locally aggressive behavior, including invasion and destruction of adjacent anatomic structures. It is generally seen in the younger age group, and the most common site is paranasal sinuses, orbits, and frontoethmoidal complex. We report a case of JPOF involving mandible which is rarely been described in literature. An insight into the radiographic progression of this rare entity along with the clinical feature and surgical management is discussed.

  10. Juvenile paradental cyst: presentation of a rare case involving second molar. (United States)

    Borgonovo, A E; Grossi, G B; Maridati, P C; Maiorana, C


    The aim of this article was to describe a rare case of paradental cyst of the permanent mandibular second molar. A 14-year-old girl was referred to Oral Surgery Department, Dental Clinic, IRCSS Fondazione Ca' Granda, University of Milan, Italy, for the evaluation of the deep probing located on the buccal aspect of her erupted mandibular left second molar. Clinical signs of inflammation were absent and the mucosa around the second molar appeared clinically normal. Pulp tests for the second molar were positive. The evaluation of the panoramic radiograph did not revealed radiolucency. The Cone-beam tomography showed a well-defined semilunar-shaped radiolucency demarcated by a fine radiopaque line. The cyst was enucleated. The histopathologic analisys revealed the presence of hyperplastic, non-keratinized squamous epithelium with heavy, dense inflammatory cell infiltrate in the epitelium and connective tissue wall. This analysis associated with macroscopic, clinical and radiografic examination confirmed the diagnosis of paradental cyst. A clinic-pathologic correlation, incorporating the surgical, radiographic and histologic findings, is required to obtain the final diagnosis of paradental cyst. Today, the treatment of choice is simple enucleation and thorough curettage of the cyst without extraction of the involved tooth, but if CT demonstrates erosions in the buccal or lingual cortices, marsupialization should be the treatment of choice.

  11. Nursing students' response to a case study in ethics. (United States)

    Davis, A J; Ota, K; Suzuki, M; Maeda, J


    This paper describes the responses of undergraduate nursing students to an ethical clinical case study. Students in a baccalaureate program were given a case study before a lecture on ethical principles and the same case study after this lecture. These responses raise questions about the content of nursing ethics classes in Japan. The place of individual patient rights and the role of the family in a situation of non-disclosure about diagnosis and prognosis were major issues for the students. The responses reveal the problem of the 'nurse-in-the-middle' between the patient and others whose values differ. Students' post-lecture responses emphasized communication among the people involved.

  12. Interactive verification of Markov chains: Two distributed protocol case studies

    Directory of Open Access Journals (Sweden)

    Johannes Hölzl


    Full Text Available Probabilistic model checkers like PRISM only check probabilistic systems of a fixed size. To guarantee the desired properties for an arbitrary size, mathematical analysis is necessary. We show for two case studies how this can be done in the interactive proof assistant Isabelle/HOL. The first case study is a detailed description of how we verified properties of the ZeroConf protocol, a decentral address allocation protocol. The second case study shows the more involved verification of anonymity properties of the Crowds protocol, an anonymizing protocol.

  13. Prevalence of myocarditis in pediatric intensive care unit cases presenting with other system involvement

    Directory of Open Access Journals (Sweden)

    Hanaa Ibrahim Rady


    Full Text Available OBJECTIVE: To assess children with myocarditis, the frequency of various presenting symptoms, and the accuracy of different investigations in the diagnosis. METHODS: This was an observational study of 63 patients admitted to PICU with non-cardiac diagnosis. Cardiac enzymes, chest-X ray, echocardiography, and electrocardiogram were performed to diagnose myocarditis among those patients. RESULTS: There were 16 cases of definite myocarditis. The age distribution was non-normal, with median of 5.5 months (3.25-21. Of the 16 patients who were diagnosed with myocarditis, 62.5% were originally diagnosed as having respiratory problems, and there were more females than males. Among the present cases, the accuracy of cardiac enzymes (cardiac troponin T [cTn] and creatine phosphokinase MB [CKMB] in the diagnosis of myocarditis was only 63.5%, while the accuracy of low fractional shortening and of chest-X ray cardiomegaly was 85.7 and 80.9%; respectively. Cardiac troponin folds 2.02 had positive predictive value of 100%, negative predictive value of 88.7%, specificity of 100%, sensitivity of 62.5%, and accuracy of 90.5%. CONCLUSIONS: Children with myocarditis present with symptoms that can be mistaken for other types of illnesses. When clinical suspicion of myocarditis exists, chest-X ray and echocardiography are sufficient as screening tests. Cardiac troponins confirm the diagnosis in screened cases, with specificity of 100%.

  14. Cochlear implantation in patients with inner ear bone malformations with posterior labyrinth involvement: an exploratory study. (United States)

    Palomeque Vera, Juan Miguel; Platero Sánchez-Escribano, María; Gómez Hervás, Javier; Fernández Prada, María; González Ramírez, Amanda Rocío; Sainz Quevedo, Manuel


    Inner ear bone malformations are one cause of profound sensorineural hearing loss. This investigation focused on those affecting the posterior labyrinth, especially enlarged vestibular aqueduct syndrome, which is associated with fluctuating and progressive hearing loss. The objectives of this study were to analyze the behavior of the electrical stimulation, auditory functionality and linguistic development in patients with inner ear malformations involving the posterior labyrinth. The study included ten patients undergoing cochlear implantation (cases: five with enlarged vestibular aqueduct, two with vestibular aqueduct stenosis/aplasia, and three with semicircular canal disorders). Post-implantation, data were gathered on the electrical stimulation threshold and maximum comfort levels and on the number of functioning electrodes. Evaluation of Auditory Responses to Speech (EARS) subtests were used to assess auditory functionality and language acquisition at 6, 12, and 24 months post-implantation. Results were compared with findings in a control group of 28 cochlear implantation patients without these malformations. No significant differences were found between case and control groups in electrical stimulation parameters; auditory functionality subtest scores were lower in cases than controls, although the difference was only statistically significant for some subtests. In conclusion, cochlear implantation patients with posterior labyrinth bone malformations and profound hearing loss, including those with enlarged vestibular aqueduct syndrome, showed no significant difference in electrical stimulation threshold with controls. Although some auditory functionality test results were lower in cases than in controls, cochlear implantation appears to be beneficial for all patients with these malformations.

  15. Background: GIS Applications and Case Studies


    01, CCTP; Albert, Don


    This unit presents (1) a case study and (2) a bibliographic resource for GIS in the medical field. The case study illustrates the use of a GIS to monitor and analyze spatial patterns of physicians' multiple locations. This case highlights data location, acquisition and assessment, join and relational operators, geocoding and distance calculations, and standard query language.

  16. Evaluation of brachial plexus fascicles involvement on infraclavicular block: unfixed cadaver study

    Directory of Open Access Journals (Sweden)

    Luiz Carlos Buarque de Gusmão


    Full Text Available BACKGROUND AND OBJECTIVES: This study shows how the diffusion of the anesthetic into the sheath occurs through the axillary infraclavicular space and hence proves the efficacy of the anesthetic block of the brachial plexus, and may thereby allow a consolidation of this pathway, with fewer complications, previously attached to the anesthesia. MATERIALS AND METHODS: 33 armpits of adult cadavers were analyzed and unfixed. We injected a solution of neoprene with latex dye in the infraclavicular space, based on the technique advocated by Gusmão et al., and put the corpses in refrigerators for three weeks. Subsequently, the specimens were thawed and dissected, exposing the axillary sheath along its entire length. RESULTS AND DISCUSSION: Was demonstrated involvement of all fasciculus of the plexus in 51.46%. In partial involvement was 30.30%, 18.24% of cases the acrylic was located outside the auxiliary sheath involving no issue. CONCLUSIONS: The results allow us to establish the infraclavicular as an effective and easy way to access plexus brachial, because the solution involved the fascicles in 81.76% partially or totally, when it was injected inside the axillary sheath. We believe that only the use of this pathway access in practice it may demonstrate the efficiency.

  17. Asymptomatic cerebral involvement in Sjoegren's syndrome: MRI findings of 15 cases

    Energy Technology Data Exchange (ETDEWEB)

    Pierot, L. (Service de Neuroradiologie Charcot, G.H. Pitie-Salpetriere, Paris (France)); Sauve, C. (Service de Neurologie, G.H. Pitie-Salpetriere, Paris (France)); Leger, J.M. (Service de Neurologie, G.H. Pitie-Salpetriere, Paris (France)); Martin, N. (Service de Neuroradiologie Charcot, G.H. Pitie-Salpetriere, Paris (France)); Koeger, A.C. (Service de Rhumatologie, G.H. Pitie-Salpetriere, Paris (France)); Wechsler, B. (Service de Medecine Interne, G.H. Pitie-Salpetriere, Paris (France)); Chiras, J. (Service de Neuroradiologie Charcot, G.H. Pitie-Salpetriere, Paris (France))


    Fifteen patients with Sjoegren's syndrome without clinical evidence of central nervous system disease were studied by MRI. Signal abnormalities were observed in 9 (60%). They were always visible on T2-weighted images as small punctale areas of high signal in the basal ganglia and the white mater of the cerebral hemispheres. Abnormalities were less frequently seen on T1-weighted images. Enlargement of cerebral sulci was observed in 6 cases. The specificity and significance of these abnormalities are discussed. (orig.)

  18. Environmental injustice: case studies from the South

    Energy Technology Data Exchange (ETDEWEB)

    Cifuentes, Enrique [Pediatric Environmental Health Specialty Unit, National Institute of Public Health, Mexico Environmental Sciences, Av Universidad 655, Cuernavaca CP 62508 (Mexico); Frumkin, Howard [National Centre Environmental Health, Agency for Toxic Substances and Disease Registry, Centers for Disease Control and Prevention, 1600 Clifton Road MS E-28, Atlanta, GA 30333 (United States)


    We selected three case studies to illustrate environmental injustice issues in the South. These examples relate to migrant agricultural workers, the maquiladora industry and artisanal mining, while reviewing some of the major mechanisms involved, e.g. multinational corporations, the development of free trade zones, multilateral free trade agreements and the export of hazards. A series of strategies are discussed in order to address environmental injustice and health disparities that exist on a global scale. Some of the recommendations involve policy initiatives; others, such as research and mentorship, fall within the traditional domain of public health practice. In this paper, special attention is given to concerned environmental and occupational health professionals using evidence-based data for advocacy. For lasting changes to be made, however, stronger institutions and legislation are required. Those who have the 'right to know' about environmental injustice issues include communities of concern, workers' representatives and lawyers. Government officials and company officials may eventually work on the basis of conflict resolution, compensation and remediation, to quote some examples. Systematic approaches to protect both the environment and public health must be updated.

  19. Environmental injustice: case studies from the South (United States)

    Cifuentes, Enrique; Frumkin, Howard


    We selected three case studies to illustrate environmental injustice issues in the South. These examples relate to migrant agricultural workers, the maquiladora industry and artisanal mining, while reviewing some of the major mechanisms involved, e.g. multinational corporations, the development of free trade zones, multilateral free trade agreements and the export of hazards. A series of strategies are discussed in order to address environmental injustice and health disparities that exist on a global scale. Some of the recommendations involve policy initiatives; others, such as research and mentorship, fall within the traditional domain of public health practice. In this paper, special attention is given to concerned environmental and occupational health professionals using evidence-based data for advocacy. For lasting changes to be made, however, stronger institutions and legislation are required. Those who have the 'right to know' about environmental injustice issues include communities of concern, workers' representatives and lawyers. Government officials and company officials may eventually work on the basis of conflict resolution, compensation and remediation, to quote some examples. Systematic approaches to protect both the environment and public health must be updated.

  20. Stafne’s bone cavity: An unusual case with involvement of the buccal and lingual mandibular plates (United States)

    Figueiredo, Rui; Gay-Escoda, Cosme


    Lingual mandibular bone defects, also known as Stafne bone cavity (SC), are unilateral asymptomatic radiolucencies, generally seen in the mandibular angle, below the inferior alveolar canal. Although panoramic radiographies normally offer enough information to make a correct diagnosis, additional studies are often required, especially in atypical cases. The present report describes an atypical presentation of a Stafne’s bone cavity in a 78 years-old male patient. In this particular case, an asymptomatic and radiolucid lesion was observed during a routine dental examination. The computed tomography (CT) showed an involvement of both lingual and buccal mandibular plates producing a tunnel-like lesion. No history of mandibular trauma or surgery was refered. An additional magnetic resonance imaging (MRI) was made to discard submandibular gland pathology and to confirm the diagnosis. Since SC is asymptomatic and nonprogressive, a conservative approach based in clinical and radiological follow-ups was considered to be the most suitable treatment option. Key words:Stafne bone cavity, lingual mandibular bone defect, case report. PMID:24596643


    Directory of Open Access Journals (Sweden)

    Patrícia Freire Ferreira Oliveira


    Full Text Available Means of accommodation involve a wide range of social actors and agents, as well as different business models. Management strategies in this sector have been increasingly important for long-term sustainability and competitiveness of business organizations. This study aims to analyze the interactions between apart-hotels and their stakeholders to foster an improvement of services provided, aligning the interface of strategic management from the point of view of managers and their key stakeholders. It is an exploratory study, with qualitative chacter, along with multiple case studies of the following establishments: Travel Inn, Hotels Slaviero and Etoile george v. Brazilian enterprises, which manage lodging facilities with apart-hotel concepts, combining features that enable comparative analysis of the study. For conceptual understanding, this study was based on literature about stakeholders, taking the work of Freeman (1984 and Freeman et al (2010 as main references. The research was conducted through semi-structured interviews with managers of lodging facilities and their key stakeholders and through direct observation and documentation. We found that not all groups of influence are considered in the planning of service flats. However, the organizations surveyed indicated that the market has realized the importance of the groups that exert influence and are influenced by their goals, and are therefore increasingly alert for integration of such groups in their strategic planning.

  2. Transanal rectopexy - twelve case studies

    Directory of Open Access Journals (Sweden)

    Rubens Henrique Oleques Fernandes


    Full Text Available OBJECTIVES: This study analyzed the results of transanal rectopexy and showed the benefits of this surgical technique. METHOD: Twelve patients were submitted to rectopexy between 1997 and 2011. The surgical technique used was transanal rectopexy, where the mesorectum was fixed to the sacrum with nonabsorbable suture. Three patients had been submitted to previous surgery, two by the Delorme technique and one by the Thiersch technique. RESULTS: Postoperative hospital stay ranged from 1 to 4 days. One patient (8.3% had intraoperative hematoma, which was treated with local compression and antibiotics. One patient (8.3% had residual mucosal prolapse, which was resected. Prolapse recurrence was seen in one case (8.3%. Improved incontinence occurred in 75% of patients and one patient reported obstructed evacuation in the first month after surgery. No death occurred. CONCLUSION: Transanal rectopexy is a simple, low cost technique, which has shown good efficacy in rectal prolapse control.OBJETIVO: O presente estudo analisou os resultados da retopexia pela via transanal e expôs os benefícios desta técnica cirúrgica. MÉTODO: Doze pacientes com prolapso foram operados no período de 1997 a 2011. A técnica cirúrgica usada foi a retopexia transanal, onde o mesorreto foi fixado ao sacro com fio inabsorvível. Três pacientes tinham cirurgia prévia, dois pela técnica de Delorme e um pela técnica de Thiersch. RESULTADOS: A permanência hospitalar pós-operatória variou de 1- 4 dias. Uma paciente (8,3% apresentou hematoma transoperatório que foi tratado com compressão local e antibioticoterapia. Um paciente apresentou prolapso mucoso residual (8,3%, que foi ressecado. Houve recidiva da procidência em um caso (8,3%. A melhora da incontinência ocorreu em 75% dos pacientes e uma paciente apresentou bloqueio evacuatório no primeiro mês após a cirurgia. Não houve mortalidade entre os pacientes operados. CONCLUSÃO: A retopexia transanal é uma t

  3. Penile Involvement and Henoch-Schönlein Purpura: A Case Report

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    Önder YAVAŞCAN


    Full Text Available Henoch-Schönlein purpura (HSP, characterized by non-thrombocytopenic purpura accompanied by arthritis/arthralgia, gastrointestinal and genitourinary system involvement is the most common vasculitis in childhood. Associated penile involvement is very rare in patients with genitourinary system involvement. We report a 4.5 year-old boy with penile involvement and arthritis after a shortduration remission of HSP. Prednisolone (1mg/kg/day, orally and conservative measures resulted in complete recovery within five days. In conclusion, steroid treatment could be administered in HSP children with penile involvement although controversial.

  4. Reevaluation of RAPD markers involved in a case of stingray misidentification (Dasyatidae: Dasyatis). (United States)

    Faria, V V; Rolim, L S; Vaz, L A L; Furtado-Neto, M A A


    We investigated a reported case of stingray Dasyatis americana misidentification not detected in a published study using the random amplified polymorphic DNA (RAPD) technique. If the referred specimen (landed by fisheries in Ceará, northeastern Brazil) was misidentified (as Dasyatis centroura) in the field, why did its RAPD data fail to clarify the mistake? Was it due to limitations of RAPD markers or perhaps to a taxonomic issue? Contrary to our initial expectations, neither of these hindered the detection of the misidentification. After reanalyzing the primary genetic data associated with the misidentified specimen (PCR gel photographs and/or matrices of presence/absence of markers for six RAPD primers), we found that the RAPD markers were sufficient to correctly assign the misidentified specimen to its proper species identity. In the original study, the specimen misidentification was neither noticed by the authors nor apparent in the published article due to how their results were interpreted and presented.

  5. Drive Electric Vermont Case Study

    Energy Technology Data Exchange (ETDEWEB)

    Wagner, Fred [Energetics Incorporated, Columbia, MD (United States); Roberts, Dave [Vermont Energy Investment Corporation (VEIC), Burlington, VT (United States); Francfort, Jim [Idaho National Lab. (INL), Idaho Falls, ID (United States); White, Sera [Idaho National Lab. (INL), Idaho Falls, ID (United States)


    Currently in the United States, the heavy majority of plug-in electric vehicle (PEV) sales have been in highly conducive, selected, metropolitan areas; opposed to more broad distribution across the country. The U.S. Department of Energy’s EV Everywhere Grand Challenge is looking carefully at the barriers and opportunities that exist to enable small and midsize communities to partake in the PEV market and benefit from the economic and environmental advantages of PEVs. In order to gain insight into these challenges and barriers, DOE selected a success story (i.e., Drive Electric Vermont) as the subject of this case study, as the state of Vermont is tied with Detroit, Michigan in having the highest percentage of 2014 (most recent complete data) PEV registrations for cold weather U.S. cities and has seen more than a sixfold increase in charging stations over the last three years. The overall objective of this case study was to use the lessons learned from Drive Electric Vermont to determine what activities are most effective at encouraging acquisitions of PEVs and deployment of charging infrastructure in small to midsize communities, prioritizing and sequencing their implementation, identifying robust means for extrapolation, and applying this understanding to other small to midsize communities across the nation. The Drive Electric Vermont Program was formed in 2012 with a goal of increasing the use of electrified transportation in Vermont through policy development, education and outreach, and infrastructure development. The Drive Electric Vermont Program can be broadly broken into four components: (1) strategic planning/leadership, (2) stakeholder/partnership development, (3) education and outreach, and (4) incentives. The early phases of the program focused heavily on strategic planning, and stakeholder and partnership development, followed by a transition to education and outreach activities, charging infrastructure development, and grant and incentive programs

  6. Drive Electric Vermont Case Study

    Energy Technology Data Exchange (ETDEWEB)

    Wagner, Fred [Energetics Incorporated, Columbia, MD (United States); Roberts, Dave [Vermont Energy Investment Corporation (VEIC), Burlington, VT (United States); Francfort, Jim [Idaho National Lab. (INL), Idaho Falls, ID (United States); White, Sera [Idaho National Lab. (INL), Idaho Falls, ID (United States)


    Currently in the United States, the heavy majority of plug-in electric vehicle (PEV) sales have been in highly conducive, selected, metropolitan areas; opposed to more broad distribution across the country. The U.S. Department of Energy’s EV Everywhere Grand Challenge is looking carefully at the barriers and opportunities that exist to enable small and midsize communities to partake in the PEV market and benefit from the economic and environmental advantages of PEVs. In order to gain insight into these challenges and barriers, DOE selected a success story (i.e., Drive Electric Vermont) as the subject of this case study, as the state of Vermont is tied with Detroit, Michigan in having the highest percentage of 2014 (most recent complete data) PEV registrations for cold weather U.S. cities and has seen more than a sixfold increase in charging stations over the last three years. The overall objective of this case study was to use the lessons learned from Drive Electric Vermont to determine what activities are most effective at encouraging acquisitions of PEVs and deployment of charging infrastructure in small to midsize communities, prioritizing and sequencing their implementation, identifying robust means for extrapolation, and applying this understanding to other small to midsize communities across the nation. The Drive Electric Vermont Program was formed in 2012 with a goal of increasing the use of electrified transportation in Vermont through policy development, education and outreach, and infrastructure development. The Drive Electric Vermont Program can be broadly broken into four components: (1) strategic planning/leadership, (2) stakeholder/partnership development, (3) education and outreach, and (4) incentives. The early phases of the program focused heavily on strategic planning, and stakeholder and partnership development, followed by a transition to education and outreach activities, charging infrastructure development, and grant and incentive programs

  7. Pattern of chromosome involvement in childhood hyperdiploid pre-B-cell acute lymhoblastic leukemia cases from India

    Directory of Open Access Journals (Sweden)

    Lily S. Kerketta


    Conclusion: In this study, the pattern of chromosome involvement in hyperdiploid karyotype of ALL patients is same as other studies except some chromosomes like 1, 6, 11, 12, 19 and 22 have some more frequent involvement than other studies. This study also showed the occurrence of TEL/AML1 fusion is more (19.8% than other reports from India.

  8. Exacerbation of hypereosinophilic syndrome with pulmonary involvement in two consecutive pregnancies: a case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Itai Ghersin


    Full Text Available Hypereosinophilic syndrome represents a heterogeneous group of disorders with the common feature of prolonged eosinophilia of unknown cause and organ system dysfunction including the pulmonary system. Hypereosinophilic syndrome, with and without pulmonary involvement, in association with pregnancy is very rare, and to the best of our knowledge only one case of hypereosinophilic syndrome with pulmonary involvement during pregnancy has been previously reported in the medical literature. We describe a case of a patient with previously symptomatic hypereosinophilic syndrome with pulmonary involvement who experienced exacerbations of her disease during two consecutive pregnancies. To the best of our knowledge this is the first report which demonstrates a worsening effect of pregnancy on both eosinophil count and end organ involvement in a patient with previous diagnosis of hypereosinophilic syndrome. [Int J Res Med Sci 2014; 2(4.000: 1774-1776

  9. Roadmaster Roading Contractors Case Study

    Directory of Open Access Journals (Sweden)

    Hazel Taylor


    Full Text Available Systems analysis students seldom experience the practical difficulties of the initial investigation into a client’s requirements. They get little chance to practice the skills they need to investigate complex and confused problem situations, or to appreciate the wider organizational issues that can impact on a situation. This teaching case is designed to give students the opportunity to practice and apply investigation skills and to challenge them to consider the wider work environment when considering possible solutions to a problem situation. The case is conducted as a role-play, with students acting as systems analysts and teaching staff role-playing the clients. The students develop a report analyzing the client’s situation based on the issues that arise during the interviews. Feed-back sessions focus on discussing how well the students applied various interviewing strategies previously covered in lectures, and on the wider organizational problems that could impact proposed information system solutions.

  10. Study on Case Teaching of Financial Management (United States)

    Che, Zhenghong; Che, Zhengmei


    Case teaching is an efficient teaching method of management. It plays an important role to enhance the students' ability to practice the theory. However, case teaching of financial management has not achieved the expected results. The paper aims to study the importance, characteristics and corresponding methods of case teaching method of financial…

  11. A case of adult Pompe disease presenting with severe fatigue and selective involvement of type 1 muscle fibers. (United States)

    van den Berg, Linda E M; de Vries, Juna M; Verdijk, Robert M; van der Ploeg, Ans T; Reuser, Arnold J J; van Doorn, Pieter A


    We present a case of adult Pompe disease (acid maltase deficiency) with an uncommon clinical presentation characterized by severe fatigue and myalgia prior to the onset of limb girdle weakness. Remarkably, the muscle biopsy demonstrated selective involvement of type 1 muscle fibers. The cause and clinical effects of fiber type specific involvement are currently unknown, but the phenomenon might contribute to the clinical heterogeneity in Pompe disease and the variable response to enzyme replacement therapy.

  12. A New Lean Paradigm in Higher Education: A Case Study (United States)

    Doman, Mark S.


    Purpose: This case study aims to demonstrate that lean principles and practices utilized in industry can be successfully applied to improve higher education administrative processes through an innovative and engaging learning experience involving undergraduate students. Design/methodology/approach: This is a first-hand account by the instructor of…

  13. On adaptive optimal input design: A bioreactor case study

    NARCIS (Netherlands)

    Stigter, J.D.; Vries, D.; Keesman, K.J.


    The problem of optimal input design (OID) for a fed-batch bioreactor case study is solved recursively. Here an adaptive receding horizon optimal control problem, involving the so-called E-criterion, is solved on-line, using the current estimate of the parameter vector at each sample instant {tk, k =

  14. Managing Communication during a School Crisis: A Case Study (United States)

    Gentilucci, James L.


    Crisis communication training of school principals is problematic because it overemphasizes media relations and underemphasizes the critical importance of immediate and personal communication with students, staff, and parents--those most affected by school crises. A case study involving the death of a student in a small rural school explains why…

  15. Metastatic lesions involving the sella: Report of three cases and review of the literature

    Directory of Open Access Journals (Sweden)

    Weilbaecher Christina


    Full Text Available Metastatic cancer must be considered as a possibility for intrasellar masses. Newer treatment modalities, such as gamma knife radiosurgery needs to be explored for these lesions. Three cases of intrasellar metastatic lesions were retrospectively reviewed. Presenting complaints, radiographic studies, operative procedure, and histopathological confirmation were recorded for each patient. All had an unknown primary malignancy prior to the presentation with the intrasellar lesion detected by magnetic resonance imaging (MRI. Presenting symptoms were diplopia with extraocular movement deficits in all patients. Transsphenoidal resection or biopsy was performed. Histopathological analysis revealed small cell carcinoma in two patients and plasmacytoma in one. All patients received postoperative radiation and/or chemotherapy. Survival following initial presentation was 2 months and 6 months for two of the patients; the third patient is alive at 2-month follow-up.

  16. Complex Variant of Philadelphia Translocation Involving Chromosomes 9, 12, and 22 in a Case with Chronic Myeloid Leukaemia (United States)

    Malvestiti, F.; Agrati, C.; Chinetti, S.; Di Meco, A.; Cirrincione, S.; Oggionni, M.; Grimi, B.; Maggi, F.; Simoni, G.; Grati, F. R.


    Chronic myeloid leukemia (CML) is a hematopoietic stem cell disorder included in the broader diagnostic category of myeloproliferative neoplasms, associated with fusion by BCR gene at chromosome 22q11 to ABL1 gene at chromosome 9q34 with the formation of the Philadelphia (Ph) chromosome. In 2–10% of CML cases, the fusion gene arises in connection with a variant translocation, involving chromosomes 9, 22, and one or more different chromosomes; consequently, the Ph chromosome could be masked within a complex chromosome rearrangement. In cases with variant Ph translocation a deletion on der(9) may be more frequently observed than in cases with the classical one. Herein we describe a novel case of CML with complex variant Ph translocation involving chromosomes 9, 12, and 22. We present the hematologic response and cytogenetic response after Imatinib treatment. We also speculated the mechanism which had originated the chromosome rearrangement. PMID:25045550

  17. Complex Variant of Philadelphia Translocation Involving Chromosomes 9, 12, and 22 in a Case with Chronic Myeloid Leukaemia

    Directory of Open Access Journals (Sweden)

    F. Malvestiti


    Full Text Available Chronic myeloid leukemia (CML is a hematopoietic stem cell disorder included in the broader diagnostic category of myeloproliferative neoplasms, associated with fusion by BCR gene at chromosome 22q11 to ABL1 gene at chromosome 9q34 with the formation of the Philadelphia (Ph chromosome. In 2–10% of CML cases, the fusion gene arises in connection with a variant translocation, involving chromosomes 9, 22, and one or more different chromosomes; consequently, the Ph chromosome could be masked within a complex chromosome rearrangement. In cases with variant Ph translocation a deletion on der(9 may be more frequently observed than in cases with the classical one. Herein we describe a novel case of CML with complex variant Ph translocation involving chromosomes 9, 12, and 22. We present the hematologic response and cytogenetic response after Imatinib treatment. We also speculated the mechanism which had originated the chromosome rearrangement.

  18. Acute calcific tendinitis of the rectus femoris associated with intraosseous involvement: a case report with serial CT and MRI findings. (United States)

    Kim, Young Sung; Lee, Ho Min; Kim, Jong Pil


    Acute calcific tendinitis of the shoulder is a well-known condition, but it is rare in the rectus femoris origin. Mostly reported cases were occurred in the reflected head of the rectus femoris, and only few cases were in the direct head of the rectus femoris. Intraosseous marrow involvement of calcific tendinitis is a more rare condition; it often goes misdiagnosed as an infection or a neoplasm. We report a rare, unusual case of acute calcific tendinitis of the direct head of the rectus femoris associated with intraosseous marrow involvement of calcification in anterior inferior iliac spine with serial CT and MRI findings. Aggressive osseous change may occur in acute calcific tendinitis of the rectus femoris as in this case which should be made an appropriate diagnosis to avoid unnecessary investigation and overtreatment like a surgery.

  19. Syntheses and Structural Studies of Schiff Bases Involving Hydrogen Bonds


    José Elguero; Rosa M. Claramunt; Dionisia Sanz; Almudena Perona


    New Schiff bases have been prepared by reacting 3-hydroxy-4-pyridine- carboxaldehyde with various amines. NMR spectroscopic methods provided clear evidence that the Schiff bases exist in the solid state and in solution as hydroxyimino tautomers with the E-configuration. A study of the stabilities of the tautomeric forms and the different conformers has been carried out using density functional calculations at the B3LYP/6-31G** level. © 2006 by MDPI.

  20. The use of full spectrum digital photography for evidence collection and preservation in cases involving forensic odontology. (United States)

    Wright, Franklin D; Golden, Gregory S


    Photography often represents the best method to collect and preserve evidence in forensic cases. This is especially true in forensic odontology with cases involving dental identification, human abuse and, perhaps most significantly, bitemark cases. Basic visible light photography is adequate in most dental identification cases; however, full spectrum digital photography is best utilized to collect all available evidence in cases of human abuse and bitemarks. This paper will discuss the types of photographic evidence that should be collected with various forensic odontological cases and the specific techniques utilized in full spectrum forensic digital photography. The use of full spectrum photography captures the forensic injuries using special techniques recording the injuries in each of the four resultant events that occur when light strikes skin.

  1. Liverpool Telecare Pilot: case studies

    Directory of Open Access Journals (Sweden)

    Nigel Barnes


    Full Text Available Telecare services use information and communications technology (ICT to support the provision of care to people in their own homes. This paper describes a pilot telecare service employed by Liverpool (UK City Council to support a sample of their frail and elderly social services users. The pilot has been running for over two years and has been deployed for 21 individuals in Liverpool. In this paper we present the pilot system and provide real example cases which help to illustrate the benefits of such a system.

  2. Benign monomelic amyotrophy in a 7-year-old girl with proximal upper limb involvement: case report. (United States)

    Yilmaz, Oznur; Alemdaroğlu, Ipek; Karaduman, Ayşe; Haliloğlu, Göknur; Topaloğlu, Haluk


    Monomelic amyotrophy (MMA) is a benign motor neuron disease characterized by neurogenic amyotrophy, which usually affects one of the upper or lower extremities. Progression is slow and symptoms are clinically stable. Symptoms are seen in the second or third decades of life. In this study, we present a seven-year-old girl who was diagnosed and directed to the Physiotherapy Department at the age of 5 years and had unilateral proximal upper limb involvement. Family history of the case was recorded. Neurologic evaluation was performed. Range of joint motion, muscle shortness and strength, posture, extremity lengths, gait, timed performance, arm function, and motor and mental maturation were assessed. The physiotherapy program was designed progressively as strengthening and resistive exercises. Motor and mental developmental milestones were normal. There was no limitation in active or passive motion of all joints. She had more flexible joints, scapula alata, asymmetry between shoulder levels, and weakness on proximal muscles of the right upper extremity. In the follow-up assessment at eight months, there was no asymmetry between shoulder levels and scapular symmetry began to improve. Female gender and involvement restricted to one proximal upper limb are rare in the literature. This patient demonstrates the positive effects of physical therapy with early diagnosis of MMA. The rapid recovery of muscle weakness shows the importance of strengthening and resistive exercises applied to specific muscles in the treatment.

  3. Study of the mechanisms involved in reactive silica

    Energy Technology Data Exchange (ETDEWEB)

    Boinski, Frederic [Univ Lille Nord of France, Ecole des Mines, 941, rue Charles Bourseul, BP 838, 59508 Douai (France); Khouchaf, Lahcen, E-mail: [Univ Lille Nord of France, Ecole des Mines, 941, rue Charles Bourseul, BP 838, 59508 Douai (France); Tuilier, Marie-Helene [Universite de Haute-Alsace, LPMT (EA CNRS 4365), Universite de Haute Alsace, 61 rue Albert Camus, F-68093 Mulhouse (France)


    The microstructure of a heterogeneous SiO{sub 2} submitted to a depolymerisation process is studied using Transmission Electron Microscope (TEM), Environmental SEM (ESEM), and X-ray diffraction (XRD). With ESEM the formation of micro domain induced by the dissolution phenomena is shown. XRD shows the formation of a halo that is associated with the formation of amorphous phase. The parameters 'position and FWHM' of the halo, enabled us to show the evolution of the disorderly phase when the reaction progresses. The hypothesis of formation of nanoparticles with different structural states was confirmed by the TEM.

  4. PUREX transition project case study

    Energy Technology Data Exchange (ETDEWEB)

    Jasen, W.G.


    In December 1992, the US Department of Energy (DOE) directed that the Plutonium-Uranium Extraction (PUREX) Plant be shut down and deactivated because it was no longer needed to support the nation`s production of weapons-grade plutonium. The PUREX/UO{sub 2} Deactivation Project will establish a safe and environmentally secure configuration for the facility and preserve that configuration for 10 years. The 10-year span is used to predict future maintenance requirements and represents the estimated time needed to define, authorize, and initiate the follow-on decontamination and decommissioning activities. Accomplishing the deactivation project involves many activities. Removing major hazards, such as excess chemicals, spent fuel, and residual plutonium are major goals of the project. The scope of the PUREX Transition Project is described within.

  5. A Case Report: The Diagnosis and Therapeutic Evaluation for a Rare Disease of Langerhans Cell Histiocytosis Involving Thyroid (United States)

    Cai, Ye-Feng; Wang, Qing-Xuan; Ni, Chun-Jue; Dong, Si-Yang; Lv, Lin; Li, Quan; Chen, En-Dong; Zhang, Xiao-Hua


    Abstract Langerhans cell histiocytosis (LCH) involving the thyroid gland is extremely rare. Currently, the diagnosis and therapeutic evaluation for LCH involving thyroid is a challenge. We reported a rare case of LCH involving thyroid, presenting as painless thyroid goiters, and successfully performed positron emission tomography/computed tomography (PET/CT) to make an accurate diagnosis and therapeutic evaluation for LCH. Although the histology or cytology is the golden standard for the diagnosis of LCH involving thyroid, the PET/CT should be keep in mind when LCH involving thyroid with inconclusive cytologic results. During the treatment of LCH, PET/CT can be performed to assess the therapeutic effect and select the most effective and reliable treatment for LCH. PMID:26554785

  6. Isotretinoin-induced acute severe myopathy involving pelvic girdle muscles: A case report (United States)

    Sameem, Farah; Semira


    Oral isotretinoin has been in widespread use for more than three decades. It causes numerous side effects; skin and mucous membrane being commonly involved. Musculoskeletal adverse effects are also known to occur, but pelvic girdle myopathy is rarely reported. We report myopathy involving pelvic girdle muscles in a young male who received oral isotretinoin for folliculitis decalvans.

  7. Isotretinoin-induced acute severe myopathy involving pelvic girdle muscles: A case report

    Directory of Open Access Journals (Sweden)

    Farah Sameem


    Full Text Available Oral isotretinoin has been in widespread use for more than three decades. It causes numerous side effects; skin and mucous membrane being commonly involved. Musculoskeletal adverse effects are also known to occur, but pelvic girdle myopathy is rarely reported. We report myopathy involving pelvic girdle muscles in a young male who received oral isotretinoin for folliculitis decalvans.

  8. Prospective randomized clinical studies involving reirradiation. Lessons learned

    Energy Technology Data Exchange (ETDEWEB)

    Nieder, Carsten [Nordland Hospital, Department of Oncology and Palliative Medicine, Bodoe (Norway); University of Tromsoe, Department of Clinical Medicine, Faculty of Health Sciences, Tromsoe (Norway); Langendijk, Johannes A. [University Medical Centre Groningen, Department of Radiation Oncology, Groningen (Netherlands); Guckenberger, Matthias [University Hospital Zuerich, Department of Radiation Oncology, Zuerich (Switzerland); Grosu, Anca L. [University Hospital Freiburg, Department of Radiation Oncology, Freiburg (Germany)


    Reirradiation is a potentially useful option for many patients with recurrent cancer. The purpose of this study was to review all recently published randomized trials in order to identify methodological strengths and weaknesses, comment on the results, clinical implications and open questions, and give advice for the planning of future trials. Systematic review of trials published between 2000 and 2015 (databases searched were PubMed, Scopus and Web of Science). We reviewed 9 trials, most of which addressed reirradiation of head and neck tumours. The median number of patients was 69. Trial design, primary endpoint and statistical hypotheses varied widely. The results contribute mainly to decision making for reirradiation of nasopharynx cancer and bone metastases. The trials with relatively long median follow-up confirm that serious toxicity remains a concern after high cumulative total doses. Multi-institutional collaboration is encouraged to complete sufficiently large trials. Despite a paucity of large randomized studies, reirradiation has been adopted in different clinical scenarios by many institutions. Typically, the patients have been assessed by multidisciplinary tumour boards and advanced technologies are used to create highly conformal dose distributions. (orig.) [German] Eine Rebestrahlung kann fuer viele Patienten mit rezidivierenden Malignomen eine nuetzliche Option bieten. Der Zweck dieser Studie bestand darin, alle in der juengeren Vergangenheit publizierten randomisierten Studien zu beurteilen, da deren methodische Staerken und Schwaechen, Ergebnisse und resultierende Implikationen bzw. offene Fragen die Planung kuenftiger Studien wesentlich beeinflussen koennen. Systematische Uebersicht aller zwischen 2000 und 2015 veroeffentlichten Studien (Literatursuche ueber PubMed, Scopus und Web of Science). Ausgewertet wurden 9 Studien, in die vor allem Patienten mit Kopf-Hals-Tumoren eingeschlossen waren. Im Median hatten 69 Patienten teilgenommen. Das

  9. Tactile Astronomy - a Portuguese case study (United States)

    Canas, L.; Alves, F.; Correia, A.


    Although astronomy plays an important role in the most various outreach initiatives, as well as school science curricula, due to its strong visual component in knowledge acquisition, astronomy subjects are not entirely well addressed and accessed by visually impaired students and/or general public. This stresses the need of more tactile material production, still very scarce in an educational context whether formal or informal. This is a case study activity developed based on different schematic tactile images of several objects present in our solar system. These images in relief, highlight, through touch, several relevant features present in the different astronomical objects studied. The scientific knowledge is apprehended through the use of a tactile key, complemented with additional information. Through proper hands-on activities implementation and careful analysis of the outcome, the adapted images associated with an explanatory key prove to be a valuable resource in tactile astronomy domain. Here we describe the process of implementing such initiative near visually impaired students. The struggles and challenges perceived by all involved and the enrichment experience of engaging astronomy with visually impaired audiences, broadening horizons in an overall experience accessible to all.

  10. Case studies in conservation science (United States)

    Bisulca, Christina

    The research presented in this dissertation covers three separate topics of conservation as defined by the National Science Foundation: 1) Materials Stabilization, Strengthening, Monitoring, and Repair; 2. Understanding Material Degradation and Aging; and 3) Materials and Structural Characterization of Cultural Heritage Objects (the 'technical study'). The first topic is addressed through a study to assess the consolidant tetraethoxysilane for the stabilization of alum treated wood. Falling under materials degradation studies is a study published in American Museum Novitates to understand how environmental conditions affect the aging of fossil resins from five different deposits. Two separate studies are included in technical study of cultural heritage objects which comprises the third research area of materials characterization. The first is a survey of red dyes used in Chinese paintings from the Ming Dynasty to the Early Republic (1364-1911). The second is a study of the pigments, dyes and binders used in Hawaiian barkcloth (kapa) from the 19th century.

  11. Chronic lymphocytic leukaemia: case control epidemiological study in Yorkshire. (United States)

    Cartwright, R A; Bernard, S M; Bird, C C; Darwin, C M; O'Brien, C; Richards, I D; Roberts, B; McKinney, P A


    This is the second report of a large case control study of lymphoma/leukaemia occurring in Yorkshire during 1979-84, and deals with chronic lymphocytic leukaemia presenting either in its haematological (CLL) or more solid lymphomatous (malignant lymphoma-lymphocytic or MLL) forms. In all, 330 cases and 561 controls were interviewed. The results support the concept that CLL/MLL is a condition of multiple aetiologies with evidence for genetic predisposition through an excess of family cases, immune perturbation demonstrated by excessive previous skin diseases and phenylbutazone use, and viral involvement shown by links with infectious diseases and multiple sclerosis.

  12. A case story, involving the use of maltitol, a sugar alcohol, as a cutting agent in amphetamine and cocaine powders

    DEFF Research Database (Denmark)

    Reitzel, Lotte Ask; Holm, Niels Bjerre; Linnet, Kristian


    . The work described covers the part of the case involving the department of forensic chemistry, and not the whole police investigation, but everything was done within the frames given by the police. To the best of our knowledge, this is the first report of a disaccharide polyol being used as a cutting agent...

  13. 78 FR 17744 - Social Security Ruling, SSR 13-2p; Titles II and XVI: Evaluating Cases Involving Drug Addiction... (United States)


    ... From the Federal Register Online via the Government Publishing Office SOCIAL SECURITY ADMINISTRATION Social Security Ruling, SSR 13-2p; Titles II and XVI: Evaluating Cases Involving Drug Addiction and Alcoholism (DAA); Correction AGENCY: Social Security Administration. ACTION: Notice of...

  14. The Relationship between Faculty Involvement in Governance and Faculty Vitality: The Case of North Carolina Community Colleges (United States)

    Madray, Van


    This study examines the effects of governance involvement on the vitality of community college faculty members. This study explores the degree to which involvement in the governance of a college through a faculty senate fosters the vitality of elected faculty members. While faculty vitality is a difficult concept to measure directly, faculty…

  15. Structuring an integrated care system: interpreted through the enacted diversity of the actors involved – the case of a French healthcare network

    Directory of Open Access Journals (Sweden)

    Corinne Grenier


    Full Text Available Research question: We are looking at the process of structuring an integrated care system as an innovative process that swings back and forth between the diversity of the actors involved, local aspirations and national and regional regulations. We believe that innovation is enriched by the variety of the actors involved, but may also be blocked or disrupted by that diversity. Our research aims to add to other research, which, when questioning these integrated systems, analyses how the actors involved deal with diversity without really questioning it. Case study: The empirical basis of the paper is provided by case study analysis. The studied integrated care system is a French healthcare network that brings together healthcare professionals and various organisations in order to improve the way in which interventions are coordinated and formalised, in order to promote better detection and diagnosis procedures and the implementation of a care protocol. We consider this case as instrumental in developing theoretical proposals for structuring an integrated care system in light of the diversity of the actors involved. Results and discussion: We are proposing a model for structuring an integrated care system in light of the enacted diversity of the actors involved. This model is based on three factors: the diversity enacted by the leaders, three stances for considering the contribution made by diversity in the structuring process and the specific leading role played by those in charge of the structuring process.  Through this process, they determined how the actors involved in the project were differentiated, and on what basis those actors were involved. By mobilizing enacted diversity, the leaders are seeking to channel the emergence of a network in light of their own representation of that network. This model adds to published research on the structuring of integrated care systems.

  16. Structuring an integrated care system: interpreted through the enacted diversity of the actors involved – the case of a French healthcare network

    Directory of Open Access Journals (Sweden)

    Corinne Grenier


    Full Text Available Research question: We are looking at the process of structuring an integrated care system as an innovative process that swings back and forth between the diversity of the actors involved, local aspirations and national and regional regulations. We believe that innovation is enriched by the variety of the actors involved, but may also be blocked or disrupted by that diversity. Our research aims to add to other research, which, when questioning these integrated systems, analyses how the actors involved deal with diversity without really questioning it.Case study: The empirical basis of the paper is provided by case study analysis. The studied integrated care system is a French healthcare network that brings together healthcare professionals and various organisations in order to improve the way in which interventions are coordinated and formalised, in order to promote better detection and diagnosis procedures and the implementation of a care protocol. We consider this case as instrumental in developing theoretical proposals for structuring an integrated care system in light of the diversity of the actors involved.Results and discussion: We are proposing a model for structuring an integrated care system in light of the enacted diversity of the actors involved. This model is based on three factors: the diversity enacted by the leaders, three stances for considering the contribution made by diversity in the structuring process and the specific leading role played by those in charge of the structuring process.  Through this process, they determined how the actors involved in the project were differentiated, and on what basis those actors were involved. By mobilizing enacted diversity, the leaders are seeking to channel the emergence of a network in light of their own representation of that network. This model adds to published research on the structuring of integrated care systems.

  17. Case Studies in L2 Teacher Education. (United States)

    Reichelt, Melinda


    Reports on the use of student-generated case studies in an English-as-a-Second-Language teacher education course, including the context, participants classroom procedures and case studies written, as well as students' responses to their use. (Author/VWL)

  18. A Case Study of "Empathetic Teaching Artistry" (United States)

    Risner, Doug


    This case study is one of twenty cases derived from Anderson and Risner's international study of teaching artists in dance, and theatre, which investigated participants' (n=172) artistic and academic preparation in dance, and theatre, initial entry into the teaching artist field, rewards, challenges, and obstacles in participants' work, artists'…

  19. Case Studies in Middle Management Supervision (United States)

    White, Lori S.


    This chapter presents a series of supervision-related case studies of situations that midlevel managers might face. Individuals enrolled in a midlevel management professional development course recommended the topics selected for this chapter. Drawing upon her experience teaching the course, the author selected four case studies that individuals…

  20. Five Misunderstandings About Case-Study Research

    DEFF Research Database (Denmark)

    Flyvbjerg, Bent


    useful for generating hypotheses, whereas other methods are more suitable for hypotheses testing and theory building; (d) the case study contains a bias toward verification; and (e) it is often difficult to summarize specific case studies. This article explains and corrects these misunderstandings one...

  1. Case studies--ergonomics in projects. (United States)

    Pikaar, Ruud N


    The aim of a series of sessions on Company Case Studies, is to learn from practical experiences, to give feed back to researchers on applicability of theories, methods and techniques, and last but not least, to market ergonomics. In order to learn from case material, reports need to be easy accessible and well structured. System ergonomics provides such a structure. Usually a project is not done twice, i.e. with and without ergonomics. Therefore, it is not possible to make comparisons and determine the impact of ergonomics directly. A different approach is needed. It has been suggested at the IEA2006 World Congress, to compile a database of published case studies, each case to be reported in a fixed report format and critically reviewed to enable generalizing the outcomes. This paper proposes such a format. At the IEA2012 World Congress 40 case studies have been accepted, representing applied ergonomics cases in manufacturing, process industries, aviation and logistic systems.

  2. Leishmaniasis in dogs: Case study

    Directory of Open Access Journals (Sweden)

    Aleksić Jelena


    Full Text Available The paper presents a case of leishmaniasis in a 2.5-month-old dog imported from France. The clinical examination established a generally poor state of health, expressed cachexia, atrophy of the temporal musculature, weakness of movement, as well as abnormally long and brittle nails. There was also hyperkeratosis of the nose tip and paws. A histological examination of biopsy sections of the altered skin parts showed inflammatory changes in the area of the dermis, together with infiltration of macrophages and a smaller number of lymphocytes, plasmocytes and neutrophil granulocytes in the area around the sebaceous glands and hair follicles. The determined changes correspond to superficial dermatitis. Edema followed by partial degeneration of connective-tissue fibers is observed in connective tissue. A smaller number of intracellular parasitic forms was established in mononuclear cells. A smaller number of oval amastigotes with round dark red nucleis were observed in sections stained using the Gimza method in the cytoplasm of macrophages located in the dermis, but also extracellularly. It was concluded that the dog was diseased with leishmaniasis on the grounds of the clinical picture and the microscopic findings.

  3. Regional case studies--Africa. (United States)

    Prentice, Andrew M


    Africa is the final continent to be affected by the nutrition transition and, as elsewhere, is characterized by the paradoxical coexistence of malnutrition and obesity. Several features of the obesity epidemic in Africa mirror those in other emerging nations: it penetrates the richer nations and urban areas first with a strong urban- rural gradient; initially it affects the wealthy, but later there is a demographic switch as obesity becomes a condition more associated with poverty, and it shares many of the same drivers related to the increasing affordability of highly refined oils and carbohydrates, and a move away from subsistence farm work and towards sedentary lifestyles. Africa also has some characteristics of the obesity epidemic that stand out from other regions such as: (1) excepting some areas of the Pacific, Africa is probably the only region in which obesity (especially among women) is viewed culturally as a positive and desirable trait, leading to major gender differences in obesity rates in many countries; (2) most of Africa has very low rates of obesity in children, and to date African obesity is mostly an adult syndrome; (3) Africans seem genetically prone to higher rates of diabetes and hypertension in association with obesity than Caucasians, but seem to be relatively protected from dislipidemias; (4) the case-specific deaths and disabilities from diabetes and hypertension in Africa are very high due to the paucity of health services and the strain that the 'double burden' of disease places on health systems.

  4. Rearrangements involving 12p12 in two cases of cardiac myxoma

    NARCIS (Netherlands)

    Dijkhuizen, T; Berg, E van den; Molenaar, W M; Meuzelaar, J J; de Jong, Bauke


    Recently, we reported on the cytogenetic analysis of a case of cardiac myxoma, revealing a 46,XY,der(7)t(7;17)(p21;p11), add (10) (q22), add (12) (p12), del(17)(p11) chromosomal pattern. In this article we present the cytogenetic analysis of another case of cardiac myxoma, in which we found several

  5. Testicular Involvement in Wegener Granulomatosis: Case Report and Review of the literature

    Directory of Open Access Journals (Sweden)

    Mehmet Nuri TURAN


    Full Text Available Wegener granulomatosis (WG is a type of necrotising vasculitis that affects mainly the respiratory tract, paranasal sinuses and the kidneys. Urogenital involvement is rare; mainly affecting the prostate gland. Testicular involvement in WG is exceptional. We report a 50-year-old male patient with hematuria, proteinuria and testicular pain and renal failure diagnosed as WG by testicular and kidney biopsy. We also provide a review of the literature.

  6. From single-case studies to practice-based knowledge: aggregating and synthesizing case studies. (United States)

    Iwakabe, Shigeru; Gazzola, Nicola


    Recent developments in case study methodology reflect a rising interest that clinicians and researchers share in building a clinically useful and empirically sound knowledge base from single-case studies. The present article describes three types of single-case studies (clinical, experimental, systematic) and examines their potential contributions to psychotherapy research. It then lays out three ways in which single-case studies can be aggregated and synthesized to enhance clinical understanding: (a) a case database that allows clinicians to efficiently search for relevant cases, (b) a metasynthesis of single-case studies that integrates common themes across similar cases, and (c) an individual case comparison method in which closely matched cases are compared to identify both therapeutic and hindering processes.

  7. 10 years of 1:1 taping in Belgium - A selection of murder cases involving fibre examination. (United States)

    De Wael, K; Lepot, L; Lunstroot, K; Gason, F


    Since 2002, the 1:1 tape lifting technique on murder victims has been introduced in Belgium. Thirty-six murder cases for which a fibre examination was carried out in our laboratory between 2002 and 2012 are reviewed. These cases all involved the collection of microtraces on 39 victims using a 1:1 taping or similar technique, called semi 1:1 taping. The degree of "positive outcomes" for investigative and comparative fibre cases is high. Especially in cases where the modus operandi of suspects had to be verified, the examination of the 1:1 tape lifting led to very useful fibre results. The findings from some of these fibre cases are used to illustrate the advantages, drawbacks and points of interest of the two collection techniques. These are also compared with the zonal taping technique, another microtrace collection technique applied on victims at the crime scene.

  8. Summary of case studies for cooperation mechanisms

    DEFF Research Database (Denmark)

    Longa, Francesco Dalla; Klinge Jacobsen, Henrik; Hansen, Lise-Lotte Pade;


    This document is a summary report highlighting the main aspect analyzed in the RES4LESS case studies. The document starts with an introductory chapter where the background that led to the selection of the case studies is outlined. In the following three chapters the case studies are presented......, highlighting the most relevant results. A brief chapter concludes the document, giving an outlook on the follow-up activities of the RES4LESS project. This summary is intended not only as an introduction to the RES4LESS cases studies, but also as a guideline to read and interpret the in-depth analysis carried...... out in the final documents that describe the case studies in detail. These documents will be published in September 2012 on the RES4LESS website,

  9. Making a case for case studies in psychotherapy training

    DEFF Research Database (Denmark)

    Mackrill, Thomas Edward; Iwakabe, Shigeru


    The evidence debate in psychotherapy pays little attention to developing an evidence base for training practices. Understanding effective training requires an examination of what makes training work. This article examines the role of case studies in psychotherapy training. This has not been...... articulated explicitly or researched systematically in spite of its cardinal importance. An analysis of the role of case studies in psychotherapy training is presented. Reading, watching, or hearing about cases can offer novice psychotherapists access to a closed world; access to psychological theory...... in action; access to whole courses of therapy; access to different approaches; access to significant moments; access to the therapeutic relationship; access to a wide range of client types; access to working in different contexts; and the opportunity of identifying with therapists and clients. Writing...

  10. Theoretical pluralism in psychoanalytic case studies. (United States)

    Willemsen, Jochem; Cornelis, Shana; Geerardyn, Filip M; Desmet, Mattias; Meganck, Reitske; Inslegers, Ruth; Cauwe, Joachim M B D


    The aim of this study is to provide an overview of the scientific activity of different psychoanalytic schools of thought in terms of the content and production of case studies published on ISI Web of Knowledge. Between March 2013 and November 2013, we contacted all case study authors included in the online archive of psychoanalytic and psychodynamic case studies ( to inquire about their psychoanalytic orientation during their work with the patient. The response rate for this study was 45%. It appears that the two oldest psychoanalytic schools, Object-relations psychoanalysis and Ego psychology or "Classical psychoanalysis" dominate the literature of published case studies. However, most authors stated that they feel attached to two or more psychoanalytic schools of thought. This confirms that the theoretical pluralism in psychoanalysis stretches to the field of single case studies. The single case studies of each psychoanalytic school are described separately in terms of methodology, patient, therapist, or treatment features. We conclude that published case studies features are fairly similar across different psychoanalytic schools. The results of this study are not representative of all psychoanalytic schools, as some do not publish their work in ISI ranked journals.

  11. Forty-six Cases of the Nerve Root-Involved Cervical Spondylopathy Treated by Needling the "Sitian" Points

    Institute of Scientific and Technical Information of China (English)

    Dong Hongying; Wang Xiuyun; Meng Xiangwen; Liu Gongwang; Chen Zhenqiu


    In order to investigate the analgesic effect of needling at "Sitian" points for the nerve root-involved cervical spondylopathy, 68 cases of the nerve root-involved cervical spondylopathy were randomly divided into a treatment group of 46 cases treated by needling at "Sitian" points, and a control group of 22 cases treated by needling at cervical Jiaji points. After 2 therapeutic courses, the therapeutic effects were evaluated by using the visual analogue scale (VAS) and the semeiographic format. The results showed that the markedly effective rate was 78.3% and 54.5%, respectively in the treatment group and the control group, and the difference between the two groups was of significance (P<0.05). It can be concluded that needling at "Sitian" points can bring about a better therapeutic effect on the improvement of clinical symptoms, physical signs and pain than that of the needling at the cervical Jiaji points.

  12. [Ergotamine poisoning: a case study]. (United States)

    Zapalska-Pozarowska, Karolina; Szponar, Jarosław; Górska, Agnieszka; Niewiedzioł, Marek


    Ergotamine is a well known pharmacological remedy applied in neurology (treatment of vascular headache) and in obstetrics (abortive remedy, uterus atony). But today it is rarely used, because of new safer anti-migraine medicine (triptanes) which cause fewer side effects. According to obstetrical indications ergotamine is applied only in hospital treatment. For that reason, cases of intoxication by this class of drugs are rarely observed. Ergotamine causes constriction of the blood vessels through the blockade of alpha-receptors and stimulation of the serotonin-receptors on the walls of blood vessels both in the central nervous system and in peripheral circulation. Intoxication/overdose symptoms may appear on application of therapeutic dose by sensitive patients, mostly by patients with migraine headache using ergotamine preparation for relief of migraine attacks. In the Regional Centre of Clinical Toxicology, a 21-year-old patient was hospitalized. She took about 20 tablets of Cafergot (complex preparation containing 1mg ergotamine tartare and 100mg caffeine). During her stay on the ward, typical symptoms of severe poisoning were observed: nausea, severe vomiting, dizziness, decreased blood pressure without perceptible pulse, narrowing of the blood vessels in the extremities of the body (peripheral vasoconstriction) - paresthesia, digital cyanosis, refrigeration of legs, angina. Due to taking once of a great dose of the drug by the patient, violent process of intoxication, possibility of dangerous complication and also the unavailability of specific antidotes and lack of efficient methods of extracorporeal elimination of the drug, the patient was intensively controlled and symptomatic treatments according to the law of intensive therapy was applied.

  13. Hybrid Risk Management Methodology: A Case Study

    Directory of Open Access Journals (Sweden)

    Jacky Siu-Lun Ting


    Full Text Available Risk management is a decision-making process involving considerations of political, social, economic and engineering factors with relevant risk assessments relating to a potential hazard. In the last decade, a number of risk management tools are introduced and employed to manage and minimize the uncertainty and threats realization to the organizations. However, the focus of these methodologies are different; in which companies need to adopt various risk management principles to visualize a full picture of the organizational risk level. Regarding to this, this paper presents a new approach of risk management that integrates Hierarchical Holographic Modeling (HHM, Enterprise Risk Management (ERM and Business Recovery Planning (BCP for identifying and assessing risks as well as managing the consequences of realized residual risks. To illustrate the procedures of the proposed methodology, a logistic company ABC Limited is chosen to serve as a case study Through applying HHM and ERM to investigate and assess the risk, ABC Limited can be better evaluated the potential risks and then took the responsive actions (e.g. BCP to handle the risks and crisis in near future.

  14. Involvement of larder beetles (Coleoptera: Dermestidae) on human cadavers: a review of 81 forensic cases. (United States)

    Charabidze, Damien; Colard, Thomas; Vincent, Benoit; Pasquerault, Thierry; Hedouin, Valery


    From 1994 to 2013, French forensic entomology laboratories investigated 1,093 cases. Larder beetles (Coleoptera: Dermestidae) were observed in 81 (7.5%) of these cases. To describe and analyze these 81 cases, eight parameters were used: city, location (indoor or outdoor), decay stage (fresh, decay, or dry), dermestid species and instar (adults and/or larvae), presence of living calliphorid larvae, presence of calliphorid pupae or adults, and presence of other necrophagous species. Eight Dermestidae species were observed: Dermestes frischii (42% of cases), Dermestes undulatus (35.8%), Dermestes peruvianus (12.3%), Dermestes lardarius (9.9%), Dermestes haemorrhoidalis (8.6%), Dermestes maculatus (7.4%), Dermestes bicolor (3.7%), and Dermestes ater (1.2%). Larder beetles primarily developed on human cadavers in outdoor locations in areas with a dry climate and were never reported in oceanic areas (which are characterized by frequent rainfall and high ambient humidity). The number of dermestid species on a single corpse never exceeded three. Typically, one species was found per corpse. Species differed between indoor and outdoor cases, with D. frischii and D. undulatus dominant in outdoor cases, while D. peruvianus dominant in indoor cases. Calliphoridae was found in 88% of the cases, while Hydrotaea and Piophilidae were observed 40% of the time. Regarding Coleoptera, Necrobia spp. (Coleoptera: Cleridae) was observed in 46% of the cases. Lastly, we observed a typical decomposition pattern, with preferential feeding areas on the face, hands, and feet (i.e., the extremities). Pupation chambers on or inside the bones were not observed.

  15. Nursing student medication errors involving tubing and catheters: a descriptive study. (United States)

    Wolf, Zane Robinson; Hicks, Rodney W; Altmiller, Geralyn; Bicknell, Patricia


    This retrospective case study examined reports (N=27) of medication errors made by nursing students involving tubing and catheter misconnections. Characteristics of misconnection errors included attributes of events recorded on MEDMARX error reports of the United States Pharmacopeia. Two near miss errors or Category B errors (medication error occurred, did not reach patient) were identified, with 21 Category C medication errors (occurred, with no resulting patient harm), and four Category D errors (need for increased patient monitoring, no patient harm) reported. Reported intravenous tubing errors were more frequent than other type of tubing errors and problems with clamps were present in 12 error reports. Registered nurses discovered most of the errors; some were implicated in the mistakes along with the students.

  16. Case Study Methodology and Homelessness Research

    Directory of Open Access Journals (Sweden)

    Jill Pable


    Full Text Available This paper describes the potential suitability of case study methodology for inquiry with the homeless population. It references a research study that uses case study research method to build theory. This study's topic is the lived experience of destitute individuals who reside in homeless shelters, and explores the homeless shelter built environment's potential influence on resident satisfaction and recovery. Case study methodology may be appropriate because it explores real-life contextual issues that characterize homelessness and can also accommodate the wide range of homeless person demographics that make this group difficult to study in a generalized fashion. Further, case study method accommodates the need within research in this area to understand individualized treatments as a potential solution for homelessness.

  17. Comparative Study of the Critical Chain and PERT Planning Methods: No Bad Human Behaviors Involved

    Directory of Open Access Journals (Sweden)

    Chia-Ling Huang


    Full Text Available Since 1997, Critical Chain Project Management (CCPM method has received a lot of attention and hundreds of successful cases have also been reported and all claims that it is possible to rapidly achieve highly reliable on-time delivery (OTD with short project lead time (PLT in multi-project environment. The main reason that CCPM can achieve highly reliable OTD and short PLT in multi-project environment can be contributed to that CCPM makes good use of safety time imbedded in tasks by two changes: logistical change and bad human behaviors change. However, if no bad human behaviors involved, does the mere emphasis on logistical change contributed to the success of project time reduction and OTD improvement? This is the key question still remained. A comparative study of the critical chain and Program Evaluation and Review Technique (PERT planning methods, no bad human behaviors involved, was performed in this study. The simulation results showed that in terms of mean project time, CCPM is no significantly better than PERT. However, in terms of plan reliability, CCPM achieve higher reliable than PERT did and this is the contribution of CCPM logistical change.

  18. Case Study on Quality Education (United States)

    Habib, Zahida


    Quality of Education, especially at Primary level, is an important issue to be discussed at the International Forum. This study highlights the quality of primary education through a comparison of the quality of Community Model Schools and Govt. Girls Primary Schools in Pakistan. Community Model Schools were established under Girls Primary…

  19. A Multidimensional Study of School-Family-Community Partnership Involvement: School, School Counselor, and Training Factors (United States)

    Bryan, Julia A.; Griffin, Dana


    A multidimensional study examines both the dimensions of school counselors' involvement in school-family-community partnerships and the factors related to their involvement in partnerships. The School Counselor Involvement in Partnerships Survey was revised and its factor structure examined. Principal factor analyses revealed three dimensions of…

  20. [Clostridium difficile and cytomegalovirus involved in a case of pseudomembranous colitis]. (United States)

    García, Coralith; Velarde, Juan; Cedron, Hugo; Ferrufino, Juan Carlos; Seas, Carlos; Bussalleu, Alejandro; Gotuzzo, E; Gotuzzo, Eduardo


    We report an unusual case of pseudomembranous colitis with fatal outcome where C. difficile and cytomegalovirus coexistense in a Peruvian patient with AIDS and gastrointestinal compromise by a mycobacterium.

  1. Arctic bioremediation -- A case study

    Energy Technology Data Exchange (ETDEWEB)

    Smallbeck, D.R.; Ramert, P.C. (Harding Lawson Associates, Novato, CA (United States)); Liddell, B.V.


    This paper discusses the use of bioremediation as an effective method to clean up diesel-range hydrocarbon spills in northern latitudes. The results of a laboratory study of microbial degradation of hydrocarbons under simulated arctic conditions showed that bioremediation can be effective in cold climates and led to the implementation of a large-scale field program. The results of 3 years of field testing have led to a significant reduction in diesel-range hydrocarbon concentrations in the contaminated area.


    Directory of Open Access Journals (Sweden)

    Praffulla Chandra


    Full Text Available BACKGROUND Primary carcinoma of vagina is a rare entity in Gynaecological oncology. A tumour should be considered as a primary vaginal carcinoma when cervix is uninvolved. Here we are reporting a case of primary vaginal adenocarcinoma with a rare uterine malformation, right renal agenesis and enlarged left kidney. This case was confirmed by meticulous physical examination, histopathology and relevant radiological investigations which excluded the possibility of carcinoma cervix, endometrium and ovary. This patient was treated solely by chemotherapy

  3. [Recklinghausen disease with tumor involving the vulva. Presentation of a case]. (United States)

    Goméz-Bravo Topete, E; Martínez Martínez, M; Hendrichs Troeglen, B


    A case of one patient is reported. A 19 year old woman who came to the Hospital with a genital mass located on the right greater lip that was 11 inches and weighted 6.8 pounds approximately. Brown spots were not found, but it was suspected to be a neurofibromatosis; a Von Recklinghausen case. A surgical resection was performed which confirmed the diagnosis. The woman got out after five days of stay, asymptomatic at the moment.

  4. A case of Erdheim Chester disease with central nervous system involvement

    Directory of Open Access Journals (Sweden)

    Anil Kumar Patil


    Full Text Available Erdheim Chester disease (ECD is a rare non-Langerhans cell histiocytosis, commonly involving the musculoskeletal system. Other tissue can also be involved, including the central nervous system with wide spectrum of clinical features, at times being nonspecific. This can cause diagnostic dilemmas with delay in diagnosis and initiation of therapy. Here we describe a 63-year-old man who had presented with ataxia and behavioral changes, bony pains, weight loss, and fatigue. His computed tomography (CT, 99Tc scintigraphy and histopathological features on bone biopsy were consistent with ECD. Thus, ECD should be considered as a differential diagnosis in patients presenting with bony pain and nonspecific features of multiorgan involvement.

  5. Team building in an Elementary School: A Descriptive Case Study


    Holleran, David J.


    TEAM BUILDING IN AN ELEMENTARY SCHOOL: A DESCRIPTIVE CASE STUDY David J. Holleran (ABSTRACT) The purpose of this study was to examine the team-building process implemented in an elementary school. Research questions were developed on what team-building activities took place, when the activities took place, what expenses were involved, what the outcomes were, and what the reactions of the staff were towards team building activities implemented at the school. Twen...

  6. Case Study: A Strategic Research Methodology

    Directory of Open Access Journals (Sweden)

    Khairul B.M. Noor


    Full Text Available This research reviews the literature on case study as a strategic qualitative research methodology. Although case studies have been criticised by some authors as lacking scientific rigour and do not address generalizability, this research, however, reiterated its appropriateness when dealing with a process or a complex real-life activities in great-depth. Case study has been commonly used in social science fields like sociology, industrial relations and anthropology eventhough generally was considered an underutilized strategy. Hence, this research explained the general concept of a case study, strengths and weaknesses of using this method knowing that theoretically case is exciting and data rich. Based on a study of four organizations and the researcher’s own experience, this article described matters on how case study was undertaken, gaining excess to those organizations and the systematic process of data collection and triangulation (multiple techniques. It was noted that combining multiple techniques for elicitng data in case study research actually strengthens and confirmed results.

  7. Selection of controls in case-control studies. I. Principles. (United States)

    Wacholder, S; McLaughlin, J K; Silverman, D T; Mandel, J S


    A synthesis of classical and recent thinking on the issues involved in selecting controls for case-control studies is presented in this and two companion papers (S. Wacholder et al. Am J Epidemiol 1992;135:1029-50). In this paper, a theoretical framework for selecting controls in case-control studies is developed. Three principles of comparability are described: 1) study base, that all comparisons be made within the study base; 2) deconfounding, that comparisons of the effects of the levels of exposure on disease risk not be distorted by the effects of other factors; and 3) comparable accuracy, that any errors in measurement of exposure be nondifferential between cases and controls. These principles, if adhered to in a study, can reduce selection, confounding, and information bias, respectively. The principles, however, are constrained by an additional efficiency principle regarding resources and time. Most problems and controversies in control selection reflect trade-offs among these four principles.


    Directory of Open Access Journals (Sweden)

    George Leal Jamil


    Full Text Available Although Information Systems' literature contains more ERP success cases, it is not rare to notice unsuccessful ERP deployments that extend over years and consume much more financial and human resources than expected. One of the reasons for that is related to the fact that ERP implementation is a social-technical multifaceted and complex process. The key success factors for ERP deployment comprises varied features such as strategic planning, project management, consulting team performance, user involvement, and top management support. This paper intends to investigate an ERP deployment case that is considered unsuccessful due to the low level of user satisfaction. The ERP's key success factors presented in literature were compared to the characteristics of this actual ERP implementation. The case study was performed in a medium-size aluminium and copper recycling industry located in the Belo Horizonte metropolitan area, the capital of Minas Gerais state, in Brazil. The research results provided evidence that the unsuccessful ERP project was partially generated by the insufficient presence of critical success factors suggested in the ERP literature. Embora a literatura contenha mais casos de sucesso de ERP, não é raro constatar implantações mal sucedidas que se estendem por vários anos e consomem muito mais recursos humanos e financeiros do que o esperado. Um dos motivos pelos quais isso ocorre é o fato de que a implantação de um ERP é um processo sócio-técnico complexo e multifacetado. Os fatores-chave de sucesso na implantação de sistemas ERP contemplam variados aspectos tais como planejamento estratégico, gerência do projeto, atuação da equipe de consultoria externa, envolvimento de usuários, apoio da alta administração, entre outros. O presente trabalho se propõe a investigar uma implantação de ERP percebida como razoavelmente mal sucedida em função do baixo grau de satisfação dos seus usuários. Os fatores-chave de

  9. Case study on printed matter

    DEFF Research Database (Denmark)

    Introduction Existing product Life Cycle Assessments (LCA’s) on offset printed matter all point at paper as the overall dominating contributor to the impacts from the life-cycle of this category of products. This dominating role of paper is primarily founded in the energy-related impact categories...... include these chemical-related impact categories by making use of some of the newest knowledge about emissions from the production at the printing industry combined with knowledge about the composition of the printing materials used during the production of offset printed matter. This paper is based...... on the dissertation “Assessment of chemical emissions in life cycle impact assessment” (Larsen 2004) and the paper “Life-cycle assessment of offset printed matter with EDIP97 – how important are emissions of chemicals? “ (Larsen et al. 2009). Goal and scope The goal of the study is to identify the distribution...

  10. Case Study of above Average Elementary School (United States)

    Mendez-Morse, Sylvia; Klinker, JoAnn Franklin


    This case study explores the duty of midmanagement administrators to enforce district policies with which they do not necessarily agree. The case addresses the issues of moral leadership, distribution of power, emotional responses that impact decision making, class differences, and equity. It also examines the role conflict that many married…

  11. Abbreviated Case Studies in Organizational Communication (United States)

    Wanguri, Deloris McGee


    The cases contained within organizational communication texts are generally two to three pages, often followed by questions. These case studies are certainly useful. They generally describe events in the present, provide some type of organizational context, include first-hand data, include a record of what people say and think, develop a…

  12. Case Study Report about Gender Impact Assessment

    DEFF Research Database (Denmark)

    Faber, Stine Thidemann; Agustin, Lise Rolandsen


    The aim of this national case study report is to take a closer look at the use of Gender Impact Assessments in Denmark in order to describe the Danish implementation of this specific Gender Mainstreaming method. By way of analyzing two selected cases (two law proposals put forward by The Danish...

  13. Music in context : Four case studies

    NARCIS (Netherlands)

    Randwijck, R.J.C. van


    In his thesis entitled “Music in Context. Four Case Studies”, R.J.C. van Randwijck investigates the context in which music has been created. It is a search in Four Case Studies, approaching four pieces of music from the context in which they were written in order to understand their meaning. The inv

  14. Case studies of steel structure failures

    Directory of Open Access Journals (Sweden)

    P. Bernasovský


    Full Text Available The contribution deals with some case studies of steel structure failures, which happened in Slovakia a few years ago. Features of cracking are illustrated on real cases of breakdowns in the transmission gas pipelines, at the cement works and in the petrochemical indus-try. All failures were caused by an incorrect technical approach. Possible remedial measures are proposed.

  15. An adult case of chronic myelogenous leukemia with myeloblastic involvement of the central nervous system.

    Directory of Open Access Journals (Sweden)



    Full Text Available A 31-year-old female with chronic myelogenous leukemia, who developed myeloblastic involvement of the central nervous system during acute myeloblastic transformation of the disease, was treated with methotrexate intrathecally. The therapy produced prompt clinical response and complete reversal of abnormal cerebrospinal fluid findings. However, the patient expired 10 months following the acute blastic crisis.

  16. School Engagement and Parental Involvement: The Case of Cross-Border Students in Singapore (United States)

    Yuen, Celeste Y. M.; Cheung, Alan C. K.


    The primary purpose of this paper is to examine the mutual relationship between school engagement of cross-border students (CBS) from Malaysia in Singapore and parental involvement in education. Focus-group interviews were conducted with school personnel, CBS and their non-local counterparts to provide a comprehensive understanding of the…

  17. A case of localized Castleman's disease with systemic involvement : Treatment and pathogenetic aspects

    NARCIS (Netherlands)

    Veldhuis, GJ; vanderLeest, AHD; deWolf, JTM; deVries, EGE; Vellenga, E


    A patient is presented who had Castleman's disease with constitutional symptoms, a palpable supra-clavicular/axillar mass, and a microcytic anemia, among other laboratory abnormalities, including elevated levels of interleukin-6. Treatment consisted of irradiation of the involved area, with subseque

  18. The involvement of citizens evaluating public security policies: Baja California’s case

    Directory of Open Access Journals (Sweden)

    Pablo Jesús González Reyes


    Full Text Available This paper emphasizes the importance of citizen involvement in the evaluation processes of public security policy in Baja California, as a revealing need of establishing new options for public management, through which relationships of mutual responsibility between society and government are enacted.

  19. Implementing Product Platforms: A Case Study

    DEFF Research Database (Denmark)

    Nielsen, Ole Fiil; Mortensen, Niels Henrik


    The paper describes a case study dealing with the process of creating and implementing a product platform. The paper espessially deals with the fact that to obtain the benefits of platforms a permanent change in behaviour in product development must be ensured. This change in behaviour requires...... acceptance and approval from the organisation in general and the commitment from management to enforce agreed-upon decisions. The case study itself was performed in the Danish company LEGO Group. The case study had two objectives: To create a technical architecture and align this architecture...

  20. Case study in professionally-oriented training

    Directory of Open Access Journals (Sweden)

    Valitov Shamil M.


    Full Text Available Modern educational technologies are based on competence approach and focus on the future professional activity. Case study is one of the most significant technologies in modern higher education. The basic concepts used in the case study method are a “situation” and an “analysis”, as well as their derivative - “analysis of the situation”. The case study method of is one of the best tools for gaining experience, as it investigates practical situations that occur in managerial job. It combines theoretical knowledge with the analysis of the actual practical experience in accordance with a major. Doing case studies students read the description of the situation and offer divergent projects of managerial decisions that could be used by real managers dealing with the problem posed by the case study author. Answers to the questions posed in the case description are not given, as a rule, since the main purpose in the case analysis is to organize a discussion in the classroom or provoke speculations of those who do the self-study.

  1. A Death Involving a Fired and Deflected Bullet: A Case Report from Lyon University Institute of Forensic Science, France. (United States)

    Maujean, Géraldine; Guinet, Tiphaine; Malicier, Daniel


    In case of gunshot deaths, atypical wounds can make the distinction between entrance and exit wounds harder. They may be due either to anatomical reasons or to diverse cogent ballistic arguments. The reported case pertains to a fatal hunting accident involving an expanded conical point bullet against the neck with both atypical entrance and exit wounds. Ballistic analyses including test firings allowed a better understanding of the external and internal findings. Upon premature impact with an intermediary target, the bullet experienced expansion in the formation of sharp brass petals responsible for a star-shaped entry wound. The trajectory of the deformed high energy projectile through the victim's body was then deviated by the cervical column, causing it to be tangential to the skin when exiting the body. The description of such atypical cases may benefit other experts and may assist in their investigation into similar cases.

  2. An Unusual Case of Ascending Pancreatitis with Mediastinal Involvement: A Case Report with CT and MRI Findings

    Directory of Open Access Journals (Sweden)

    Ernesto Di Cesare


    Full Text Available Fluid collections are common findings of pancreatitis and spread, more often, along preferential drainage pathways in the abdomen. In some rare cases, fluid collections may spread towards extra-abdominal sites like the mediastinum leading to the formation of mediastinal collections. We present the case of a 52-years-old man with pain in the right upper quadrant of the abdomen and mid-epigastrium lasting for some hours. Laboratory tests suggested a diagnosis of pancreatitis. CT and subsequent MRI revealed changes consistent with acute exacerbation on chronic pancreatitis spreading to the mediastinum and to the greater omentum. The patient received medical treatment and reported gradual improvement in his laboratory results and CT findings.

  3. Case report 390: Tuberculous pseudotumor of the proximal end of the right tibia without obvious synovial involvement

    Energy Technology Data Exchange (ETDEWEB)

    Abdelwahab, I.F.; Present, D.A.; Klein, M.J.


    A case of osseous tuberculosis has been presented in a young black man who was known to be an addict to cocaine. An osteolytic lesion involved the proximal end of the tibia, being eccentric and subarticular in location. The knee joint spaces were intact, suggesting that no obvious involvement of the cartilages was present. Thus, neoplastic lesions such as chondroblastoma and giant cell tumor were considered in the differential diagnosis of the lesion which appeared to be benign radiologically. The lesion proved to be tuberculous in nature, with intact knee joint cartilages. A diagnosis of tuberculous 'pseudotumor' might be used aptly. (orig./SHA).

  4. Primary NK/T cell lymphoma nasal type of the stomach with skin involvement: a case report

    Directory of Open Access Journals (Sweden)

    Sebastian Kobold


    Full Text Available Since nasal NK/T cell lymphoma and NK/T cell lymphoma nasal type are rare diseases, gastric involvement has seldom been seen. We report a unique case of a patient with a primary NK/T cell lymphoma nasal type of the stomach with skin involvement. The patient had no history of malignant diseases and was diagnosed with hematemesis and intense bleeding from his gastric primary site. Shortly after this event, exanthemic skin lesions appeared with concordant histology to the primary site. Despite chemotherapy, the patient died one month after the first symptomatic appearance of disease.

  5. Central Nervous System Involvement of T-cell Prolymphocytic Leukemia Diagnosed with Stereotactic Brain Biopsy: Case Report

    Directory of Open Access Journals (Sweden)

    Selçuk Göçmen


    Full Text Available Prolymphocytic leukemia (PLL is a generalized malignancy of the lymphoid tissue characterized by the accumulation of monoclonal lymphocytes, usually of B cell type. Involvement of the central nervous system (CNS is an extremely rare complication of T-cell prolymphocytic leukemia (T-PLL. We describe a case of T-PLL presenting with symptomatic infiltration of the brain that was histopathologically proven by stereotactic brain biopsy. We emphasize the importance of rapid diagnosis and immediate treatment for patients presenting with CNS involvement and a history of leukemia or lymphoma.

  6. Optic nerve involvement in childhood onset systemic lupus erythematosus: Three cases and a review of the literature. (United States)

    Suri, D; Abujam, B; Gupta, A; Rawat, A; Saikia, B; Walker Minz, R; Gupta, V; Bansal, R; Kaushik, S; Singh, S


    The ocular system can be affected in systemic lupus erythematosus (SLE) in one third of patients. However, optic nerve involvement is relatively uncommon, but is more so in pediatric SLE patients, where it can occur in 1% of cases. We report three children with SLE who presented with optic nerve involvement. Two children had optic neuritis, with optic neuritis being the first manifestation in one child. The third child had ischaemic optic neuropathy secondary to antiphospholipid syndrome. A careful work up for SLE should be performed in every child with optic nerve disease. Prompt diagnosis and early treatment results in a better prognosis.

  7. Antiphospholipid syndrome: A case study

    Energy Technology Data Exchange (ETDEWEB)

    Davies, T. [Royal Adelaide Hospital, Adelaide, SA (Australia). Department of Nuclear Medicine


    Full text: A forty-two-year-old male presented to the Royal Adelaide Hospital with symptoms of increasing shortness of breath, swelling in both ankles, petechial rash and blood in his sputum. Initial investigations showed cardiomegaly, right ventricular hypertrophy, patchy lung infiltrates, a platelet count of 1500 and a clotting time of 60 seconds. A V/Q scan indicated a high probability of pulmonary embolism. Further investigations showed that the patient was positive for lupus anticoagulant and cardiolipin antibodies. A diagnosis of primary antiphospholipid syndrome was made. The patient``s high risk of strokes and hemorrhaging prompted investigation by a {sup 99}mTc-HMPAO brain scan. Further V/Q scans were performed to follow up the initial finding of multiple pulmonary embolism and a R-L shunt study was performed to investigate a left subclavian murmur. The patient was admitted for four weeks and began treatment which included cyclaphosphamide, corticosteroids and plasmaphoresis and was discharged when stable. Over the next six months he was re admitted three times for relapse of antiphospholipid syndrome. On his fourth admission he collapsed and died five hours after admission. Cause of death was due to cardiac arrhythmia secondary to severe right ventricular hypertrophy and dilation. The effects of antiphospholipid syndrome was believed to be responsible for this outcome.

  8. Energy Audit: A Case Study

    Directory of Open Access Journals (Sweden)

    Sanjay Kumar


    Full Text Available This India is the Fifth largest producer of Electricalenergy in the world. Despite such achievements the gapbetween demand and supply of electrical energy is increasingevery year and power sector is highly capital – intensive. Thusthe deficit in installed capacity was nearly 10000MWper year.So the gap between demand and supply is continuouslyincreasing day by day. An energy audit is a study of a plant orfacility to determine how and where energy is used and toidentify methods for energy savings. The opportunities lie inthe use of existing renewable energy technologies, greaterefforts at energy efficiency and the dissemination of thesetechnologies and options. This thesis provides an overview of ageneral energy conservation measures (ECMs that can becommonly recommended for NIT Hamirpur. It should be notedthat the Energy auidut presented in this paper does not pretendto be exhaustive nor comprehensive. It provides merely toindicate some of the options that energy auditor can considerwhen performing an analysis of this institute. Energyconservation and exploration of new energy avenues are thewell accepted solution to fulfil the demand in future. The totalcost of energy plays a vital role in determining the product costof a commodity. Therefore the identification of potential energysavings and implementation for a given institutional facility isunimportant to ensure its competitive advantage over otherinstitute. This paper work presents such energy saving methodsin a methodological approach, experienced during a detailedenergy audit of NIT Hamirpur.

  9. A Rare Case Report of Spindle Cell Ameloblastic Carcinoma Involving the Mandible (United States)

    Kunche, Arunodaya; Ananthaneni, Anuradha; Bagalad, Bhavana S; Kuberappa, Puneeth Horatti


    Ameloblastic Carcinoma (AC) is uncommon malignant epithelial odontogenic tumour of jaw, with characteristic histologic features and behavior. Clinically, it has aggressive, infiltrative growth pattern with a distinct predilection for mandible. It exhibits histologic features of ameloblastoma and gets dedifferentiated overtime to culminate in carcinoma. Majority of the cases arise denovo (primary) and only few cases arise from a pre-existing ameloblastoma (secondary). Spindle-cell differentiation in ameloblastic carcinoma is rare; Salter described it as a separate entity “low-grade spindle cell ameloblastic carcinoma. Here we report a case of 32-year-old female patient who presented with a swelling present for past six months. It was diagnosed as Spindle cell Ameloblastic Carcinoma (SpAC), after the hemimandibulectomy the patient was under regular follow up for 14 months, no sign of recurrence was seen. PMID:28274070

  10. Idiopathic retroperitoneal fibrosis involving a unilateral renal sinus: A case report and literature review

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Seul Bi; Yoon, Jung Hee; Kim, Seung Ho; Lee, Ye Daum; Kim, Suk Jung; Lim, Yun Jung; Jung, Hyun Kyung; Lee, Jin Soo [Dept. of Radiology, Haeundae Paik Hospital, Inje University College of Medicine, Busan (Korea, Republic of)


    Idiopathic retroperitoneal fibrosis (RPF) is a rare disease entity and its etiology is uncertain. We report two similar cases which showed an uncommon presentation of idiopathic RPF. A 66-year-old woman and an 80-year-old man presented with incidental findings of left renal pelvic mass-like lesions. Computed tomography revealed a soft tissue density mass replacing the left renal pelvis, which was suspicious for renal pelvic cancer, and the diagnosis of idiopathic RPF was surgically confirmed. To the best of our knowledge, a few cases of idiopathic RPF presenting with features of a localized unilateral renal pelvic mass mimicking renal pelvic cancer have been reported.

  11. Effect of personal involvement in traumatic events on memory: the case of the Dolphinarium explosion. (United States)

    Nachson, Israel; Slavutskay-Tsukerman, Irena


    The association between memories of the terrorist explosion at the Dolphinarium discotheque in Tel Aviv and the level of personal involvement in the explosion was investigated. Memories of injured victims, uninjured eyewitnesses, and uninvolved controls who learned about the explosion from the mass media were compared. It was expected that memory of the explosion would be most and least detailed and accurate among the victims and the controls, respectively. The participants responded to an open-ended question about the explosion, as well as to specific and multiple-choice questions. Data analyses showed that the victims and the eyewitnesses remembered more details than the controls, and that the victims remembered both central and peripheral details more accurately than the other participants. Degree of involvement in the same traumatic experience was thus shown to be differentially associated with memory accuracy.

  12. Heterotopic neuroglial tissue: two cases involving the tongue and the buccal region

    DEFF Research Database (Denmark)

    Aanaes, Kasper; Hasselby, Jane Preuss; Bilde, Anders


    We report two rare cases of extranasal heterotopic neuroglial tissue and review the literature on the topic. The clinical, histological, and immunohistochemical features are presented. Both patients had lesions extranasally, even though the sinonasal region is the predominant site for these heter...

  13. Involving citizens in public decision making: the case of participatory budgeting in Lithuania


    Liucija Birskyte


    In times of increasing public distrust in government and its institutions, engaging the public in decision making may strengthen democracy as well as result in a more effective allocation of scarce public resources. Participatory budgeting has started in Brazil and spread around the world but is a new concept in some countries. The objective of this paper is to reveal the current situation of attempts to involve the public in making decisions on budget allocations in Lithuanian municipalities...

  14. Case Study Orientation for New Teachers. (United States)

    Richardson, James M.


    This article describes Oldfields School's systematic orientation program for beginning teachers. They meet as a group and discuss case studies, which give substance to the regulations and policies listed in the school handbooks. (SJL)

  15. Towards More Case Study Research in Entrepreneurship

    Directory of Open Access Journals (Sweden)

    Tom Duxbury


    Full Text Available Entrepreneurship as an emerging discipline has made good strides, but according to some, has fallen short of bringing its theory and literature up to the standards of others in the management sciences. Rich with the descriptive detail needed for insightful theory building in entrepreneurship, scholars have called for more case study research, particularly those incorporating non-retrospective and longitudinal observations. At the same time however, it has become rare to find such research published in A-level journals dedicated to entrepreneurship. A survey presented here of major entrepreneurship journals over the past six years revealed a publication rate of only 3% using the case study method. This presents a major impediment for developing fresh research in this field based upon the study of real cases. The author explores how the case study method has been applied to entrepreneurship research and provides recommendations for improved publication rates.

  16. Safety cases for medical devices and health information technology: involving health-care organisations in the assurance of safety. (United States)

    Sujan, Mark A; Koornneef, Floor; Chozos, Nick; Pozzi, Simone; Kelly, Tim


    In the United Kingdom, there are more than 9000 reports of adverse events involving medical devices annually. The regulatory processes in Europe and in the United States have been challenged as to their ability to protect patients effectively from unreasonable risk and harm. Two of the major shortcomings of current practice include the lack of transparency in the safety certification process and the lack of involvement of service providers. We reviewed recent international standardisation activities in this area, and we reviewed regulatory practices in other safety-critical industries. The review showed that the use of safety cases is an accepted practice in UK safety-critical industries, but at present, there is little awareness of this concept in health care. Safety cases have the potential to provide greater transparency and confidence in safety certification and to act as a communication tool between manufacturers, service providers, regulators and patients.

  17. A case story, involving the use of maltitol, a sugar alcohol, as a cutting agent in amphetamine and cocaine powders

    DEFF Research Database (Denmark)

    Reitzel, Lotte Ask; Holm, Niels Bjerre; Linnet, Kristian;


    In a criminal case involving cutting and resale of amphetamine and cocaine in the Copenhagen area of Denmark, maltitol was used as a cutting agent. The analysis of maltitol in seizures of pure diluents as well as in amphetamine and cocaine powders was carried out using reversed-phase high...... performance liquid chromatography (HPLC) with high-resolution (HR) mass spectrometric detection. Maltitol was identified in four out of nine amphetamine samples and in five out of six cocaine samples from the case in question. The use of maltitol as a cutting agent was considered by the police as a specific...... marker of the particular criminal group under investigation. To support or reject this hypothesis, cocaine and amphetamine samples from a four month period after the involved persons had been arrested were evaluated, also as part of the police investigation. None of these samples contained maltitol...

  18. Outcomes of Botulinum Toxin Type A Injection Followed by Rehabilitation in Cases of Cerebral Palsy With Upper Extremity Involvement. (United States)

    Karaca, Burcu; Ünlü, Ece; Köse, Gülşen; Gönen, Emel; Çakcı, Aytül


    We evaluated the efficiency of botulinum toxin type A injection followed by a rehabilitation program including individual therapy, group therapy, and occupational therapy in cases of cerebral palsy with upper extremity involvement. A total of 29 injections were performed on 25 patients, and the patients were placed on rehabilitation program. At 3-month and 6-month assessments, there was a significant improvement in lateral grip strength, 9 Hole Peg test, Upper Limb Physician's Rating Scale and pediatric functional independence measure total scores. There were significant decreases in active range of motion in elbow extension, supination, and wrist extension, and Modified Ashworth Scale in elbow flexion, elbow pronation, and wrist flexion at 6-week, 3-month, and 6-month assessments. Combination of group therapy with traditional therapy methods after injection is effective in cases of cerebral palsy with upper extremity involvement.

  19. [Systemic vasculitis: study of 27 cases in Senegal]. (United States)

    Ndongo, S; Diallo, S; Tiendrebeogo, J; Diop, I B; Tall, A; Pouye, A; Ka, M M; Diop, T M


    Studies on vasculitis in black Africa are rare. The purpose of this report is to describe a retrospective study of systemic vasculitis managed in the internal medicine, ORL and cardiolology departments of the Aristide le Dantec University Hospital in Dakar, Senegal from 1995 to 2007. A series of 27 cases involving 7 men and 20 women with a mean age of 49 years was compiled. Primary vasculitis included Horton disease in 3 cases, Wegener disease in 2, Takayasu disease in 1, and Buerger disease in 1. Secondary vasculitis included mixed cryoglobulinemia with Gougerot Sjögren syndrome in 7 cases, primary Goujeröt syndrome in 4, rheumatoid arthritis in 3, nodosa periarteritis with hepatitis B in 2, SHARP syndrome in 1, and polymyositis in 1. The remaining two cases involved abdominal periaortitis including one associated with retrosperitoneal fibrosis and tuberculosis and the other with spondylarthropathy. Corticotherapy in combination with anticoagulants, immunosuppressive therapy, and surgery, when necessary, allowed effective management in 24 cases. The findings of this study show that systemic vasculitis can have numerous etiologies and indicate that secondary forms are the most common. Appropriate care modalities are needed to prevent severe outcome in Senegalese hospitals.



    Isadora Gracia; Harum Sasanti


    A case of chronic bullous type mucocutaneous disease involving oral mucosa was reported from a 56 years old man with never healing oral ulcers and wound on the perianal skin for three years. There were also red and black spots on the limb and back skin and a lesion on nail. Painful oral lesion consisted of mucous erosion, desquamative gingivitis, and sloughing area on palate and tongue. The patient is diabetic. The first perianal skin diagnosis was granulomatous candidasis with differential d...

  1. Incomplete Horner syndrome: Report of a case and description of the sympathetic nervous system anatomy involved in Horner syndrome. (United States)

    Garbo, Grant M; Harmatz, Alexander J; Isaacson, Glenn


    Horner syndrome, in which ptosis, miosis, and anhidrosis occur concomitantly, can arise from injury to the sympathetic nerve pathways anywhere from the brain to the end organs. Incomplete Horner syndrome lacks the sign of anhidrosis. We present a case of incomplete Horner syndrome caused by internal carotid artery dissection and provide a road map of the cervical sympathetic nerves involved in Horner syndrome to explain its etiology. We also discuss the imaging of and therapy for internal carotid artery dissections.

  2. Brain regions involved in swallowing: Evidence from stroke patients in a cross-sectional study

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    Shiva Ebrahimian Dehaghani


    Full Text Available Background: Limited data available about the mechanisms of dysphagia and areas involving swallow after brain damage; accordingly it is hard to predict which cases are more likely to develop swallowing dysfunction based on the neuroimaging. The aim of this study was to investigate the relationship between brain lesions and dysphagia in a sample of acute conscious stroke patients.Materials and Methods: In a cross-sectional study, 113 acute conscious stroke patients (69 male mean [standard deviation (SD] age 64.37 [15.1], participated in this study. Two neurologists and one radiologist localized brain lesions according to neuroimaging of the patients. Swallowing functions were assessed clinically by an expert speech pathologist with the Mann Assessment of Swallowing Ability (MASA. The association of brain region and swallowing problem was statistically evaluated using Chi-square test. Results: Mean (SD MASA score for the dysphagic patients was 139.61 (29.77. Swallowing problem was significantly more prevalent in the right primary sensory (P = 0.03, right insula (P = 0.005, and right internal capsule (P = 0.05. Conclusion: It may be concluded from these findings that the right hemisphere lesions associated with occurring dysphagia. Further studies using more advanced diagnostic tools on big samples particularly in a perspective structure are needed.

  3. Study of Myocardial Involvement and Lactic Acid Production in Perinatal Asphyxia

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    Asutosh P Chauhan


    Full Text Available Purpose: A Study of newborn infants to evaluate extent of hypoxia from Apgar score and correlate it with biochemistry parameters & to evaluate the presence and extent of cardiac involvement in asphyxiated new born infants along with estimation of the extent of lactic acidosis in asphyxiated new born infants. Methods: A Study of 52 newborn infants, free from congenital heart diseases were included in the study. After their through clinical examination, they were subdivided into three groups according to their Apgar score. Blood was collected from a stasis free vein in plain bulb. Serum separated after centrifugation was used for estimation of CK-MB and LDH activity. Results: serum CK-MB levels in group II as compared to group I was significantly raised (P< 0.0001. Similarly the comparison of CK-MB between group II and group III and also between group I and group III was highly significant with a p value of <0.0001. Serum lactate levels were also significantly elevated in cases as compared with controls with a p value of <0.0001. Conclusions: Our study shows a clear relationship between clinical pattern of asphyxiated newborn infants and alterations of serum cardiac enzymes (CK-MB and LDH and lactic acid production. [Natl J of Med Res 2013; 3(1.000: 76-79

  4. A case story, involving the use of maltitol, a sugar alcohol, as a cutting agent in amphetamine and cocaine powders

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    Reitzel Lotte Ask


    Full Text Available In a criminal case involving cutting and resale of amphetamine and cocaine in the Copenhagen area of Denmark, maltitol was used as a cutting agent. The analysis of maltitol in seizures of pure diluents as well as in amphetamine and cocaine powders was carried out using reversed-phase high performance liquid chromatography (HPLC with high-resolution (HR mass spectrometric detection. Maltitol was identified in four out of nine amphetamine samples and in five out of six cocaine samples from the case in question. The use of maltitol as a cutting agent was considered by the police as a specific marker of the particular criminal group under investigation. To support or reject this hypothesis, cocaine and amphetamine samples from a four month period after the involved persons had been arrested were evaluated, also as part of the police investigation. None of these samples contained maltitol. The work described covers the part of the case involving the department of forensic chemistry, and not the whole police investigation, but everything was done within the frames given by the police. To the best of our knowledge, this is the first report of a disaccharide polyol being used as a cutting agent for illicit drugs.

  5. Collecting Duct Renal Cell Carcinoma Found to Involve the Collecting System During Partial Nephrectomy: A Case Report

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    Andrew C Harbin


    Full Text Available Collecting duct carcinoma (CDC is a rare and aggressive form of renal cell carcinoma (RCC arising from the principal cells of the collecting duct.  One third of cases present with metastatic disease, but many present in a manner similar to conventional RCC or urothelial carcinoma (UC.  We discuss a case of CDC which presented as a small mass at the cortico-medullary junction, and was discovered at robotic partial nephrectomy (RPN to be grossly involving the collecting system. A 62-year-old man presented with a small renal mass suspicious for RCC, which was found on computed tomography (CT after an episode of gross hematuria.  After thorough workup, RPN was attempted; however, intraoperatively the mass was found to be involving the collecting system.  Radical nephroureterectomy was performed, and the pathology report revealed CDC.  CDC is a rare and aggressive form of RCC.  While many cases are metastatic at diagnosis, most patients present with the incidental finding of a small renal mass.  There are no reports of a CDC involving the collecting system at RPN after negative ureteroscopy preoperatively.  The adjuvant therapeutic options for CDC are limited, and long term survival is poor.    

  6. Temporomandibular Joint Herniation Into the External Auditory Canal: Two Cases Involving a Persistent Foramen Tympanicum. (United States)

    Shin, Jung Eun; Jeong, Kyung-Hwa; Ahn, Sung Hwan; Kim, Chang-Hee


    A congenital bony defect of the external auditory canal (EAC) may cause temporomandibular joint (TMJ) herniation into the EAC. This rare condition is known as persistent foramen tympanicum. We report 2 cases of symptomatic TMJ herniation through a patent foramen tympanicum. The patients complained of mastication-induced tinnitus. Otoscopic examination revealed that a whitish protruding mass at the anterior wall of the EAC bulged when the patients closed their mouths. After conservative managements such as avoidance of chewing foods on the affected side for 2 months, mastication-induced tinnitus disappeared and the size of protruding mass was decreased in one of the patients. Surgical repair of the bony defect has been the treatment of choice. In cases when symptoms are trivial and patients do not want surgical treatment, however, conservative management would be a sound alternative.

  7. Two Cases of Solitary Fibrous Tumor Involving Urinary Bladder and a Review of the Literature (United States)

    Buonfiglio, Vitor Bonadia; Manzano, Joao Padua; Filippi, Renée Zon; Sadi, Marcus Vinicius


    Solitary fibrous tumor (SFT) is a rare neoplasia of mesenchymal origin, initially described in visceral pleura and lately discovered to have ubiquitous distribution. SFT of the urogenital tract is uncommon and appears to have similar morphologic features and biologic behaviors as SFTs found elsewhere. We present two new cases of SFT of the bladder and review 22 similar cases published in the literature. Due to the general indolent behavior of these lesions, a complete but organ sparing surgical excision should be considered when technically feasible. Therefore, proper identification and characterization of SFT through morphological and immunohistochemical criteria on biopsy specimens are mandatory in the differential diagnosis from other more aggressive spindle-cell tumors, thus avoiding unnecessary radical surgery.

  8. Minimally invasive post-mortem CT-angiography in a case involving a gunshot wound. (United States)

    Ruder, Thomas D; Ross, Steffen; Preiss, Ulrich; Thali, Michael J


    Non-contrast post-mortem computed tomography (pm-CT) is useful in the evaluation of bony pathologies, whereas minimally invasive pm-CT-angiography allows for the detection of subtle vascular lesions. We present a case of an accidentally self-inflicted fatal bullet wound to the chest where pm-CT-angiography revealed a small laceration of the anterior interventricular branch of the left coronary artery and a tiny disruption of the right ventricle with pericardial and pleural effusion. Subsequent autopsy confirmed our radiological findings. Post-mortem CT-angiography has a great potential for the detection of vascular lesions and can be considered equivalent to autopsy for selected cases in forensic medicine.

  9. Cerebellar involvement that occurred during treatment of Legionella pneumonia: A case report

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    Ozlem Alici


    Full Text Available Legionnaires’ disease can appear with different levels of severity. A case of a previously healthy lady with communityacquiredpneumonia who progressed to severe acute respiratory distress syndrome and developed cerebellar dysfunctionis reported. In patients presenting with neurological symptoms after an episode of pneumonia, Legionella infectionshould be considered. J Microbiol Infect Dis 2013; 3(2: 83-85Key words: Legionella, cerebellar dysfunction, dysarthria, ataxia

  10. Cases of Review and Adjudication and Lawsuit Involving Trademark Composed of Combination of Colours

    Institute of Scientific and Technical Information of China (English)


    Case 1 The English applicant, the Standard Chartered PLC, filed, on 18 April 2002, an application with the Trademark Office for registration of a device trademark (See Fig. 1 below; hereinafter referred to as the trademark in point) in goods of class 16 of the International Classification, such as "paper, card board, book, magazine, and stationery". The applicant stated in the application that the trademark in point was one composed of combination of colours. Upon examination, the Trademark Office issued...

  11. Possible vitreous involvement in a case with rapidly progressing choroidal neovascularization

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    Masayuki Hata


    Full Text Available A 65-year-old man with subfoveal choroidal neovascularization (CNV underwent photodynamic therapy (PDT. Despite the sequential treatments, the CNV grew larger and finally penetrated the retina. Vitreous adhesion was observed at the edge of the supraretinal fibrotic tissue. The case highlighted the possible unexpected side-effect of PDT. The upregulation of the vascular endothelial growth factor or the enhanced vitreous traction was considered to be responsible for the event.

  12. Anencephaly: A pathological study of 41 cases

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    C Panduranga


    Full Text Available Background : Anencephaly is a lethal neural tube defect which is due to the defective closure of rostral pore of neural tube. In more than 50% of cases it is associated with other systemic anomalies. Hence this study was undertaken to assess pathological parameters associated with anencephaly in particular attention to associated systemic anomalies. Materials and Methods: It is a study on 41 anencephaly fetuses conducted in the Department of Pathology. The period of study is from January 2001 to December 2011. Results: Out of 41 cases, 30 (73% cases showed presence of systemic anomalies, 48.5% of the cases were observed in primigravida. Most common associated anomaly was spina bifida followed by gastrointestinal anomalies. Conclusion: Pathological examination of the abortus is essential to document the associated anomalies.

  13. Cardiac involvement and its complications about three cases of severe scorpion envenomation. (United States)

    Aboumaâd, B; Tiger, A; Khattabi, A; Soulaymani, R; Lahssaini, M; Benhassain, S M; Iba, N


    For several decades, Morocco is confronted to medico-social problem of scorpion stings and envenomations. In 2009, epidemiological data established by the Poison Control Center recorded 29,816 stung patients, with an incidence of 1.1‰ and a fatality rate of 0.18%. The neurotoxins from scorpion venom are potent activators of the autonomic nervous system resulting a physiopathological disorder of vital systems. The most serious clinical manifestations are neurotoxic effects, pulmonary edema and cardiovascular distress. This present work reports the cases of three children (4 years and 6 months, 8 months and 15 days, 4 years), hospitalized in intensive care for an envenomation by Androctonus mauritanicus (the most fatal scorpion specie). The children presented cardiac dysfunction where pulmonary edema and state of shock were complications resultants. Two cases survived after supportive and symptomatic treatment based on dobutamine as primordial treatment in cardiovascular and pulmonary correction and other drugs. The third case died. The objective of this work was to detect the limit of the effectiveness of symptomatic treatment during a severe scorpion envenomation.

  14. Recurrent malignant otitis externa with multiple cranial nerve involvement: A case report

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    Đerić Dragoslava


    Full Text Available Introduction. Necrotizing otitis externa is a rare but conditionally fatal infection of external auditory canal with extension to deep soft tissue and bones, resulting in necrosis and osteomyelitis of the temporal bone and scull base. This condition is also known as malignant otitis due to an aggressive behavior and poor treatment response. Early diagnosis of malignant otitis is a difficult challenge. We present an illustrative case of necrotizing otitis externa and suggest some strategies to avoid diagnostic and treatment pitfalls. Case Outline. A 70-year-old patient presented with signs of malignant otitis externa, complicated by peripheral facial palsy. Adequate diagnostic and treatment procedures were performed with clinical signs of resolution. The recurrence of malignant infection had presented three months after previous infection with multiple cranial nerve neuropathies and signs of jugular vein and lateral sinus thrombosis. An aggressive antibiotic treatment and surgery were carried out, followed by substantial recovery of the patient and complete restoration of cranial nerves’ functions. Conclusion. Necrotizing otitis externa is a serious condition with uncertain prognosis. The suspicion of malignant external otitis should be raised in cases of resistance to topical treatment, especially in patient with predisposing factors. Evidence-based guideline for necrotizing otitis externa still doesn’t exist and treatment protocol should be adjusted to individual presentation of each patient.

  15. The "Commitment Model" for Clinical Ethics Consultations: Society's Involvement in the Solution of Individual Cases. (United States)

    Fournier, Véronique; Spranzi, Marta; Foureur, Nicolas; Brunet, Laurence


    Several approaches to clinical ethics consultation (CEC) exist in medical practice and are widely discussed in the clinical ethics literature; different models of CECs are classified according to their methods, goals, and consultant's attitude. Although the "facilitation" model has been endorsed by the American Society for Bioethics and Humanities (ASBH) and is described in an influential manual, alternative approaches, such as advocacy, moral expertise, mediation, and engagement are practiced and defended in the clinical ethics field. Our Clinical Ethics Center in Paris was founded in 2002 in the wake of the Patients' Rights Act, and to date it is the largest center that provides consultation services in France. In this article we shall describe and defend our own approach to clinical ethics consultation, which we call the "Commitment Model," in comparison with other existing models. Indeed commitment implies, among other meanings, continuity through time, a series of coherent actions, and the realization of important social goals. By drawing on a recent consultation case, we shall describe the main steps of our consultation procedure: interviews with major stakeholders, including patients and proxies; case conferences; and follow up. We shall show why we have chosen the term "commitment" to represent our approach at three different but interrelated levels: commitment towards patients, within the case conference group, and towards society as a whole.

  16. Explaining governmental involvement in home care across Europe: an international comparative study.

    NARCIS (Netherlands)

    Genet, N.; Kroneman, M.; Boerma, W.G.W.


    The involvement of governments in the home care sector strongly varies across Europe. This study aims to explain the differences through the conditions for the involvement of informal care and governments in society; wealth and the demographic structure. As this study could combine qualitative data

  17. A 3-Year Study of a School-Based Parental Involvement Program in Early Literacy (United States)

    Crosby, Susan Ann; Rasinski, Timothy; Padak, Nancy; Yildirim, Kasim


    Although parental involvement in children's literacy development has been recognized for its potential in helping children develop early literacy achievement, studies of the effectiveness and sustainability of school-based parent involvement programs are not numerous. This study examines the effectiveness and durability of a school-based…

  18. Hodgkin's disease with leptomeningeal involvement. Report of a case with long survival

    Energy Technology Data Exchange (ETDEWEB)

    Orlowski, E.P.; Hansen, R.M.; Anderson, T.; Hanson, G.A.; Kun, L.E.; Pisciotta, A.V.


    A 30-year-old white man with Stage IV B Hodgkin's disease, mixed cellularity type, developed leptomeningeal involvement shortly after relapsing on nitrogen mustard, Oncovin (vincristine), procarbazine, and prednisone (MOPP), and while receiving Adriamycin (doxorubicin), bleomycin, Velban (vinblastine), and dacarbazine (ABVD). Whole brain irradiation and intrathecal methotrexate were successfully incorporated into his treatment program. The patient has now been in complete remission for more than 40 months. A review of this rare complication of Hodgkin's disease is presented.

  19. Cardiac involvement in diphtheria: Study from a tertiary referral infectious disease hospital

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    Alakes Kumar Kole


    Full Text Available Background: Diphtheria is still a fatal disease even in the era of universal immunization. Diphtheria myocarditis, one of the serious complications of respiratory diphtheria may cause death if not recognized and treated properly. Aims and Objectives: To determine the outcomes of cardiac involvement in respiratory diphtheria. Materials and Methods: One hundred (n = 100 patients with respiratory tract diphtheria were evaluated in respect to cardiac involvement. All patients were closely monitored for a minimum period of 4-6 weeks from the onset of respiratory symptoms. Continuous ECG monitoring including blood biochemistry (SGOT, CPK-MB, and Troponin-T were done in each case. Results : The most common symptoms were throat pain seen in 94 cases, palpitation in 56 cases, bull neck in 40 cases, shortness of breath in 12 cases, fever in 9 cases, and nasal regurgitation in 8 cases. Most common complication observed was myocarditis seen in 70 patients and majority of patients (60 were asymptomatic. The ECG changes were T wave inversion in 54 patients, inappropriate sinus tachycardia in 38 patients, ST segment depression in precordial leads in 8 patients, Mobitz type II block in 6 patients, Mobitz type I block in 4 patients, RBBB in 4 patients, multiple atrial ectopics in 4 patients, and sinus bradycardia in 2 patients. A total number of five patients died. Conclusions: Myocarditis was commonest and serious complication of respiratory diphtheria. Increase in vaccination coverage and improvement of socioeconomic status are all effective preventive measures to reduce the incidence of diphtheria.

  20. Case studies of nurseries in Malawi

    DEFF Research Database (Denmark)

    Namoto, M.; Likoswe, M.G.

    This study of 42 case studies of nurseries was made as part of a major sample survey of 360 nurseries in 6 districts in Malawi. The purpose of the study was to let the small nurseries in the country explain in their own words how they source seed, how and for whom they produce seedlings...

  1. Predicting Students Drop Out: A Case Study (United States)

    Dekker, Gerben W.; Pechenizkiy, Mykola; Vleeshouwers, Jan M.


    The monitoring and support of university freshmen is considered very important at many educational institutions. In this paper we describe the results of the educational data mining case study aimed at predicting the Electrical Engineering (EE) students drop out after the first semester of their studies or even before they enter the study program…

  2. Software war stories case studies in software management

    CERN Document Server

    Reifer, Donald J


    This book provides readers with practical advice on how to handle the many issues that can arise as a software project unfolds. The book uses twelve case studies to communicate lessons learned addressing such issues as they occur in government, industrial and academic settings. These cases focus on addressing the things that can be done to establish and meet reasonable expectations.  Such corrective actions often involve more than just dealing with project issues.  For example, software practitioners may have to address obstacles placed in their way by procurement, organizational procedures an

  3. Service Innovation Involved by Employees and Customers:From Conceptual Model to an IT Service Case

    Institute of Scientific and Technical Information of China (English)

    LIU De-wen; LU Ruo-yu


    With the service industry and information technology developing, Service innovation occurs continually in business today. It is important for service firms to understand the service's business and process;customer knowledge including needs, expectations and experiences.However, employees are key factor to collect the customer's advice. At the same time, employees may organize customers for the new service. So, the integration of employees and customers will help service firm in the way of developing a new service and upgrading a service. The paper describes some models to explain the relation based on some literatures and give some advices for service firms. At last, we introduce an IT service case

  4. Emerging acute Chagas Disease in Amazonian Brazil: case reports with serious cardiac involvement

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    Ana Yecê das Neves Pinto


    Full Text Available Four cases of serious cardiac attacks by autochthonous Trypanosoma cruzi infection from the Brazilian Amazon are reported; three of them occurred in micro-epidemic episodes. The manifestations included sudden fever, myalgia, dyspnea and signs of heart failure. Diagnosis was confirmed by specific exams, especially QBC (Quantitative Buffy Coat and natural xenodiagnosis. Despite treatment with benznidazol, three patients died with serious myocarditis, renal failure and cardiac tamponade. The authors call attention to the emergence of this disease and reveal a previously unknown pathogenicity of T. cruzi strains in this area, added to a non-usual transmission form.

  5. Thyroid Eye Disease With Significant Levator Involvement and Ptosis: A Case Report. (United States)

    Scruggs, Ryan T; Black, Evan H


    A case of an 87-year-old woman with a history of Graves disease presenting with a 5-year history of severe ptosis and very poor levator function of the left side is presented. MRI revealed marked enlargement of all extraocular muscles and significant enlargement of the left levator muscle. Given the patient's age and atypical presentation of thyroid eye disease (TED), she was taken to the operating room for biopsy and ptosis repair with frontalis suspension. Histopathological analysis revealed chronic inflammation and fibrosis consistent with Graves disease.

  6. Pediatric fibromatosis involving mandible: case reportand a five-year post-operative follow-up

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    Vilson Lacerda Brasileiro Junior


    Full Text Available Extra-abdominal fibromatosis is a benign fibrous neoplasm of locally aggressive behavior. Surgical excision with a wide margin is the treatment of choice. The aim of the present work is to report the case of fibromatosis in an 11-year-old melanodermic patient, who showed swelling in the area of the right mandible. Conservative surgery was performed based on the initial histopathological diagnosis of benign lesion suggestive of neural origin. The new anatomopathological examination of the surgical specimen was compatible with fibromatosis. The patient is still under periodic observation as part of the five-year surgical follow-up, showing no signs of recurrence.

  7. Synovial membrane involvement in osteoarthritic temporomandibular joints - A light microscopic study

    NARCIS (Netherlands)

    Dijkgraaf, LC; Liem, RSB; deBont, LGM


    Objective. To study the light microscopic characteristics of the synovial membrane of osteoarthritic temporomandibular joints to evaluate synovial membrane involvement in the osteoarthritic process. Study design. Synovial membrane biopsies were obtained during unilateral arthroscopy in 40 patients.

  8. A Case of Swyer Syndrome Associated with Advanced Gonadal Dysgerminoma Involving Long Survival

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    Salete Da Silva Rios


    Full Text Available Swyer syndrome is caused by abnormal sex differentiation during the embryonic period, resulting in incomplete intrauterine masculinization and undifferentiated gonads. The current case report describes a patient with Swyer syndrome associated with stage 3 gonadal dysgerminoma who has survived for 23 years. At age 18, this patient sought assistance for primary amenorrhea from the Gynecological Services Department of the University of Brasília Hospital. A physical examination revealed that the patient was at Tanner stage 4 with respect to axillary hair, breasts, and pubic hair; she presented with a eutrophic vagina and a small cervix. She was treated with a combination of estrogens and progestogens to induce cycling. Approximately 4 years later, a complex tumor was found and resected; a histopathological analysis revealed that this tumor was a right adnexal dysgerminoma with peritoneal affection. The patient was also subjected to chemotherapy. Her follow-up has continued to the present time, with no signs of tumor recurrence. In conclusion, this report describes an extremely rare case in which Swyer syndrome was associated with ovarian dysgerminoma; relative to similar patients, the described patient has survived for an unusually prolonged time.

  9. Subdural hemorrhage: A unique case involving secondary vitamin K deficiency bleeding due to biliary atresia. (United States)

    Miyao, Masashi; Abiru, Hitoshi; Ozeki, Munetaka; Kotani, Hirokazu; Tsuruyama, Tatsuaki; Kobayashi, Naho; Omae, Tadaki; Osamura, Toshio; Tamaki, Keiji


    Extrahepatic biliary atresia (EHBA) is a rare disease characterized by progressive and obliterative cholangiopathy in infants and is one of the major causes of secondary vitamin K deficiency bleeding (VKDB) due to cholestasis-induced fat malabsorption. Breast feeding increases the tendency of bleeding in EHBA patients because breast milk contains low amounts of vitamin K. A 2-month-old female infant unexpectedly died, with symptoms of vomiting and jaundice prior to death. She had been born by uncomplicated vaginal delivery and exhibited normal growth and development with breastfeeding. There was no history of trauma. She received vitamin K prophylaxis orally. In an emergency hospital, a CT scan showed a right intracranial hematoma and mass effect with midline shift to the left. In the postmortem examination, severe atresia was observed in the whole extrahepatic bile duct. Histologically, cholestasis, periductal fibrosis, and distorted bile ductules were noted. The gallbladder was not identified. A subdural hematoma and cerebellar tonsillar herniation were found; however, no traumatic injury in any part of the body was observed. Together, these findings suggest that the subdural hemorrhage was caused by secondary vitamin K deficiency resulting from a combination of cholestasis-induced fat malabsorption and breastfeeding. Subdural hemorrhage by secondary VKDB sometimes occurs even when vitamin K prophylaxis is continued. This case demonstrated that intrinsic factors, such as secondary VKDB (e.g., EHBA, neonatal hepatitis, chronic diarrhea), should also be considered in infant autopsy cases presenting with subdural hemorrhage.

  10. Pontine extension of a tentorial schwannoma without cranial nerve involvement: a case report

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    D'Urso Pietro


    Full Text Available Abstract Introduction Intracranial schwannomas unrelated to the cranial nerves are uncommon. We report a new case of tentorial schwannoma unrelated to the cranial nerves, with extension into the pons. A literature review with discussion of the most relevant pathogenetic aspects is also performed. Case presentation A 42-year-old Caucasian man was admitted with right-sided paresthesias and weakness of his upper and lower extremities. The neurological examination revealed right hemiparesis and hemi-hypoesthesia. A brain magnetic resonance imaging scan revealed a cerebellopontine lesion, arising from the left free edge of the tentorium, and extending into his pons. A piecemeal removal was performed through a retrosigmoid approach. The lesion was not found to be associated with any cranial nerves. The histological examination revealed a schwannoma Antoni type A. His postoperative course was uneventful. At one year follow-up, the patient was neurologically intact and the magnetic resonance imaging of his brain performed at that time showed complete removal without signs of recurrence. Conclusion Tentorial schwannomas are rare clinical entities. Knowledge of their clinical, radiological and anatomical characteristics is very important for the correct diagnosis and management.

  11. Case Study Research Methodology in Nursing Research. (United States)

    Cope, Diane G


    Through data collection methods using a holistic approach that focuses on variables in a natural setting, qualitative research methods seek to understand participants' perceptions and interpretations. Common qualitative research methods include ethnography, phenomenology, grounded theory, and historic research. Another type of methodology that has a similar qualitative approach is case study research, which seeks to understand a phenomenon or case from multiple perspectives within a given real-world context.

  12. Gigantic Suprapubic Lymphedema: A Case Study (United States)

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


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

  13. [Asteroid hyalopathy. Ultrastructural study of 3 cases]. (United States)

    Adenis, J P; Leboutet, M J; Loubet, R


    The vitreous of three patients with asteroïd hyalosis (average age: 57 years) was obtained by a two-hand closed pars plana vitrectomy. Asteroïd hyalosis was associated with alcoholic neuropathy in the first case, long standing retinal detachment in the second case, and diabetes mellitus in the third case. The visual acuity before and after the surgical procedure improved from 1.2/6 to 6/6 in the first case, from light perception to 0.3/6 in the second case, from 0.6/6 to 4.8/6 in the third case. The vitreous was studied by different ultrastructural technics : transmission electron microscopy (T.E.M.) scanning electron microscopy (S.E.M.) and electron diffraction X ray analysis (E.D.A.X.). By S.E.M. the asteroïd bodies appeared as rounded structures with an irregular surface connected to each other by fibrous strands among sodium chloride crystals. No cellular remnants were observed. By T.E.M. the asteroïd bodies were composed of interwinned ribbons of multilaminar membranes with a periodicity (10 to 60 A) characteristic of complex lipids, especially phospholipids. At the edge of the ribbons there were dots and sometimes clumps of opaque material that tended to crack out of the specimen with the heat of the electron beam. T.E.M. study disclosed the irregular disposition of the calcific bodies. By E.D.A.X. the calcific composition of the rounded structures could be determined : calcium and phosphorus were the main elements detectable in asteroïd bodies of all sizes for all three patients. The average calcium counts for the three successive cases were : 18, 30, 43 and for phosphorus : 9, 14, 26. Potassium was found in the first case, and sulfur in the third case.(ABSTRACT TRUNCATED AT 250 WORDS)

  14. Role of Brachytherapy in the Boost Management of Anal Carcinoma With Node Involvement (CORS-03 Study)

    Energy Technology Data Exchange (ETDEWEB)

    Moureau-Zabotto, Laurence, E-mail: [Department of Radiation Therapy, Institut Paoli Calmettes, Marseille (France); Ortholan, Cecile [Department of Radiation Therapy, Monaco (France); Hannoun-Levi, Jean-Michel [Department of Radiation Therapy, Antoine Lacassagne Cancer Center, Nice (France); Teissier, Eric [Azurean Cancer Center, Mougins (France); Cowen, Didier [Department of Radiation Therapy, Timone Academic Hospital and North Academic Hospital, Marseille (France); Department of Radiation Therapy, Val d' Aurelle Cancer Center, Montpellier (France); Salem, Nagi [Department of Radiation Therapy, Institut Paoli Calmettes, Marseille (France); Lemanski, Claire [Catalan Oncology Center, Perpignan (France); Ellis, Steve [French Red Cross Center, Toulon (France); Resbeut, Michel [Department of Radiation Therapy, Institut Paoli Calmettes, Marseille (France); French Red Cross Center, Toulon (France)


    Purpose: To assess retrospectively the clinical outcome in anal cancer patients, with lymph node involvement, treated with split-course radiation therapy and receiving a boost through external beam radiation therapy (EBRT) or brachytherapy (BCT). Methods and Materials: From 2000 to 2005, among 229 patients with invasive nonmetastatic anal squamous cell carcinoma, a selected group of 99 patients, with lymph node involvement, was studied. Tumor staging reported was T1 in 4 patients, T2 in 16 patients, T3 in 49 patients, T4 in 16 patients, and T unknown in 14 patients and as N1 in 67 patients and N2/N3 in 32 patients. Patients underwent a first course of EBRT (mean dose, 45.1 Gy) followed by a boost (mean dose, 18 Gy) using EBRT (50 patients) or BCT (49 patients). All characteristics of patients and tumors were well balanced between the BCT and EBRT groups. Prognostic factors of cumulative rate of local recurrence (CRLR), cumulative rate of distant (including nodal) recurrence (CRDR), colostomy-free survival (CFS) rate, and overall survival (OS) rate were analyzed for the overall population and according to the nodal status classification. Results: The median follow-up was 71.5 months. The 5-year CRLR, CRDR, CFS rate, and OS rate were 21%, 19%, 63%, and 74.4%, respectively. In the overall population, the type of node involvement (N1 vs N2/N3) was the unique independent prognostic factor for CRLR. In N1 patients, by use of multivariate analysis, BCT boost was the unique prognostic factor for CRLR (4% for BCT vs 31% for EBRT; hazard ratio, 0.08; P=.042). No studied factors were significantly associated with CRDR, CFS, and OS. No difference with regard to boost technique and any other factor studied was observed in N2/N3 patients for any kind of recurrence. Conclusion: In anal cancer, even in the case of initial perirectal node invasion, BCT boost is superior to EBRT boost for CRLR, without an influence on OS, suggesting that N1 status should not be a contraindication to


    Directory of Open Access Journals (Sweden)



    Full Text Available India experienced very rapid population growth from 48 million to 1.2 billion in a span of decades. In India rapid urbanization, industrialization, population explosion and migration of people in past two decades r esults in enormous growth in the field of road transportation. This resulted in increasing amount of the road traffic leading to increased risk for occurrence of road traffic accidents. In India road traffic injuries will be third leading cause of death by 2020 with the increase in the use of two wheelers and congestion and environmental pollution this mortality rate will continue to rise. Considering the preciousness of human lives, this study has been undertaken to analyse the pattern of injuries in Road Traffic Accidents Involving Two Wheelers to create awareness among the law enforcing authorities, transport authorities and public regarding two wheeler fatalities. A sincere attempt has been made in this study to analyse the distribution of the pattern of injuries sustained by two wheeler travellers, so that appropriate interventional strategies can be evolved at various levels and by different agencies. 147 Two wheeler Accident victims were randomly selected from 1063 road traffic accident cases brought t o the Institute of Forensic Medicine, Madras Medical College Chennai - 3 for routine medico legal examination. Preliminary data were collected from the medico legal documents such as history of the case, Inquest form, First Information Report, Accident Regis ter, Death Report, Clinical data submitted by the investigating officer at the time of medico legal examination. During autopsy, on external exami nation, nature of injury, size, number were measured in all cases. Internal organ injuries were recorded. Caus e of death was arrived at based on the findings made out during autopsy. Totally 147 motorcyclist victims were included in this study in which demographic factors such as age, sex, time of accident, manner of collision

  16. Nanomaterial Case Study: A Comparison of Multiwalled ... (United States)

    The draft document is intended to be used as part of a process to identify what is known and, more importantly, what is not yet known that could be of value in assessing the broad implications of specific nanomaterials. Like previous case studies (see History/ Chronology below), this draft case study on multiwalled carbon nanotubes (MWCNTs) is based on the comprehensive environmental assessment (CEA) approach, which consists of both a framework and a process. Unlike previous case studies this case study incorporates information about a traditional (i.e., “non-nano-enabled”) product, against which the MWCNT flame-retardant coating applied to upholstery textiles (i.e., the “nano-enabled” product) can be compared. The comparative element serves dual-purposes: 1) to provide a more robust database that facilitates identification of data gaps related to the nano-enabled product and 2) to provide a context for identifying key factors and data gaps for future efforts to evaluate risk-related trade-offs between a nano-enabled and non-nano-enabled product. This draft case study does not represent a completed or even a preliminary assessment of MWCNTs; rather, it uses the CEA framework to structure information from available literature and other resources (e.g., government reports) on the product life cycle, fate and transport processes in various environmental media, exposure-dose characterization, and impacts in human, ecological, and environmental receptors.

  17. [Osteo-neuro-meningeal-lumbosacral involvement in Marfan syndrome. Report of a case]. (United States)

    Boyer, A; Marie, I; Primard, E; Cailleux, N; Lévesque, H; Courtois, H


    Marfan syndrome is an hereditary condition which primarily affects conjunctive tissue with predominant vascular lesions, aortic insufficiency and aortic dissection which condition vital prognosis. Until further progress is made in the genetic determination of the disease, the diagnosis is currently based on the association of clinical criteria, which enables multidisciplinary management. This approach should lead to specific medical and surgical treatment--which may reduce Marfan morbidity and mortality. We report the case of a 45 year-old patient with suspected Marfan syndrome during adolescence. The presence of a cardiovascular lesion and a recently reported abnormality i.e. a sacral erosion by a dural ectasia, enabled us to confirm the diagnosis. We reviewed the current criteria in Marfan diagnosis and their specific management.

  18. Cases of violence involving transvestites and transsexuals in a northeastern Brazilian city. (United States)

    Silva, Glauber Weder Dos Santos; Souza, Emanoel Fhilipe Leite; Sena, Romeika Carla Ferreira de; Moura, Izabella Bezerra de Lima; Sobreira, Maura Vanessa Silva; Miranda, Francisco Arnoldo Nunes de


    Objective To analyze cases of violence against transvestites and transsexuals based on their sociodemographic profile. Method Cross-sectional, descriptive research performed in Cajazeiras / Paraíba, consisting of 16 transvestites and transsexuals. Data collection took place in April 2014 and was analyzed descriptively. Results The typology of violence that victimized transvestites and transsexuals were: verbal (91.96%), psychological (58.33%) and physical (33.33%), often between 24 hours and six months preceding the survey. Regarding the spatiality: the street, school and health services were all scenarios of aggression. With respect to the offending agent, the findings point towards neighbors, family members and health professionals. All forms of violence happened between agents and spaces of aggression. Conclusions Violence among this population, silence around the situations of abuse became more pronounced as did its invisibility in the social and institutional context, reflecting the inhibition of human rights and concealment of reality.

  19. Atlas occipitalization in a supersonic fighter pilot involved in a midair collision: a case report. (United States)

    Gips, Hadas; Hiss, Jehuda; Davidson, Benjamin


    We report a case of a midair collision between two F16 fighter aircraft, in which one pilot survived and the other was ejected upon impact and his remains recovered from sea. In autopsy, no patholgy was detected, other than the expected evidence of mechanical trauma. No defects in the aircraft or faults in the parachute or ejection mechanism were found. Reconstruction of the shattered skull base and the cervical vertebrae revealed fusion of the atlanto-occipital joint (occipitalization) and a left paracondylar process. The effective diameter of the spinal canal was decreased by the abnormal articulation. Such malformations can cause a wide range of neurologic deficits. Considering the skill and alertness needed to operate a supersonic fighter aircraft, with the pressure applied by the heavy protective head gear and various G forces endured by the spinal column during flight, we postulate that the collision was related to the pilot's sudden incapacitation.

  20. Blood concentrations of clobazam and norclobazam in a lethal case involving clobazam, meprobamate and clorazepate. (United States)

    Pok, Phak-Rop Pos; Mauras, Michel; De Saint Léger, Marie-Noëlle; Kuhlmann, Erika; Charpenel-Durat, Catherine; Navarette, Claudie; Duval, Marie-Laure; De Meo, Pierre


    Clobazam is a benzodiazepine with anti-anxiety and anticonvulsant properties marketed in several countries. Norclobazam, a metabolite of clobazam, has similar pharmacological activity but weaker sedative and tranquilizing effect. The two drugs were detected by GC-MS and determined by HPLC-DAD in the samples from a postmortem case. The femoral blood concentrations of clobazam and norclobazam were 0.72 and 36 μg/mL, respectively. The concentration of the active norclobazam was very high. The sum of both clobazam and norclobazam blood concentration (36.72 μg/mL) was clearly toxic, but was not necessarily fatal. Other associated drugs concentrations were within their therapeutic ranges. Interactions due to drug association were discussed.

  1. Ethics and Computer-Assisted Assessment: Three Case Studies. (United States)

    Jacob, Susan; Brantley, John C.


    Three ethical-legal case incidents involving computer-assisted psychodiagnostic assessment in the schools are presented. Each case is analyzed in terms of applicable laws, ethical codes, and standards for professional practice. (Author)

  2. The Glioma International Case-Control Study

    DEFF Research Database (Denmark)

    Amirian, E Susan; Armstrong, Georgina N; Zhou, Renke


    describe the Glioma International Case-Control (GICC) Study (recruitment, 2010-2013), a study being conducted by the Genetic Epidemiology of Glioma International Consortium that integrates data from multiple data collection sites, uses a common protocol and questionnaire, and includes biospecimen...

  3. Connecting Reading and Writing: A Case Study (United States)

    Li, Zhanfang


    Connecting reading and writing, proposed by many scholars, is realized in this case study. The 30 participants in this study are the English majors of the third year in one School of Foreign Languages in Beijing. They are encouraged to write journals every week, based on the source text materials in their Intensive Reading class, with the final…

  4. A Multiple Case Study of Innovation (United States)

    Zheng, Wei; Khoury, Anne E.


    This study aims to explore how leadership and contextual factors influence innovation in R&D teams in national laboratories, using the approach of multiple case studies. This paper provides some preliminary findings from two highly innovative teams residing in two national laboratories in the US. The preliminary results suggested several common…

  5. Prader-Willi Disease: A Case Study. (United States)

    Forbus, William R., III

    A case study focuses on the characteristics and physical management of a 15-year-old with Prader-Willi Syndrome, a birth defect associated with hypotonia, insatiable appetite, hypogonadism, central nervous system dysfunction, and abnormal growth and development . A literature review addresses studies dealing with behavior modification of obesity…

  6. Measuring marketing performance - A case study


    Laakso, Vesa-Pekka


    PURPOSE OF THE STUDY The purpose of this study is to develop a marketing dashboard for a Finnish company that operates in the financial industry. The identification of suitable metrics for assessing marketing performance is considered central. This study proposes a new construct (a dashboard) that aims to providing management relevant information on marketing performance from decision-making perspective. METHODOLOGY AND DATA The methodology is a constructive case study. In the...

  7. Epigenetic Case Studies in Agricultural Animals (United States)

    In many biological processes, the regulation of gene expression involves epigenetic mechanisms. An altered pattern of epigenetic modification is central to many animal diseases. Using animal disease models, we have studied one of the major epigenetic components: DNA methylation. We characterized the...

  8. Dental trauma involving root fracture and periodontal ligament injury: a 10-year retrospective study

    Directory of Open Access Journals (Sweden)

    Sônia Regina Panzarini


    Full Text Available The purpose of this retrospective study was to analyze the cases of traumatic dental injuries involving root fracture and/or periodontal ligament injury (except avulsion treated at the Discipline of Integrated Clinic, School of Dentistry of Araçatuba, São Paulo State University (UNESP, Brazil, from January 1992 to December 2002. Clinical and radiographic records from 161 patients with 287 traumatized teeth that had sustained root fracture and/or injuries to the periodontal ligament were examined. The results of this survey revealed that subluxation (25.09% was the most common type of periodontal ligament injury, followed by extrusive luxation (19.86%. There was a predominance of young male patients and most of them did not present systemic alterations. Among the etiologic factors, the most frequent causes were falls and bicycle accidents. Injuries on extraoral soft tissues were mostly laceration and abrasion, while gingival and lip mucosa lacerations prevailed on intraoral soft tissues injuries. Radiographically, the most common finding was an increase of the periodontal ligament space. The most commonly performed treatment was root canal therapy. Within the limits of this study, it can be concluded that traumatic dental injuries occur more frequently in young male individuals, due to falls and bicycle accidents. Subluxation was the most common type of periodontal ligament injury. Root canal therapy was the type of treatment most commonly planned and performed.


    Directory of Open Access Journals (Sweden)

    Silvia eGiovedi


    Full Text Available Autism spectrum disorders (ASDs are heterogeneous neurodevelopmental disorders characterized by deficits in social interaction and social communication, restricted interests and repetitive behaviors. Many synaptic protein genes are linked to the pathogenesis of ASDs, making them prototypical synaptopathies. An array of mutations in the synapsin (Syn genes in humans have been recently associated with ASD and epilepsy, diseases that display a frequent comorbidity. Synapsins are presynaptic proteins regulating synaptic vesicle traffic, neurotransmitter release and short-term synaptic plasticity. In doing so, Syn isoforms control the tone of activity of neural circuits and the balance between excitation and inhibition. As ASD pathogenesis is believed to result from dysfunctions in the balance between excitatory and inhibitory transmissions in neocortical areas, Syns are novel ASD candidate genes. Accordingly, deletion of single Syn genes in mice, in addition to epilepsy, causes core symptoms of ASD by affecting social behavior, social communication and repetitive behaviors. Thus, Syn knockout mice represent a good experimental model to define synaptic alterations involved in the pathogenesis of ASD and epilepsy.

  10. The Future of the Food System: Cases Involving the Private Sector in South Africa

    Directory of Open Access Journals (Sweden)

    Laura M. Pereira


    Full Text Available The food system is facing unprecedented pressure from environmental change exacerbated by the expansion of agri-food corporations that are consolidating their power in the global food chain. Although Africa missed the Green Revolution and the wave of supermarket expansion that hit the West and then spread to Asia and Latin America, this is unlikely to continue. With a large proportion of sub-Saharan African countries’ GDP still heavily reliant on agriculture, global trends in agri-food business are having an increasing impact on African countries. South Africa, a leader in agribusiness on the continent, has a well-established agri-food sector that is facing increasing pressure from various social and environmental sources. This paper uses interview data with corporate executives from South African food businesses to explore how they are adapting to the dual pressures of environmental change and globalisation. It shows that companies now have to adapt to macro-trends both within and outside the formal food sector and how this in turn has repercussions for building sustainable farming systems—both small and large-scale. It concludes with the recognition that building a sustainable food system is a complex process involving a diversity of actors, however changes are already being seen. Businesses have strategically recognised the need to align the economic bottom line with social and environmental factors, but real sustainability will only happen when all stakeholders are included in food governance.

  11. Granulomatous pachymeningitis around the sella turcica (Tolosa-Hunt syndrome) involving the hypophysis--case report. (United States)

    Kita, Daisuke; Tachibana, Osamu; Nagai, Yukihiro; Sano, Hiroki; Yamashita, Junkoh


    A 50-year-old female presented with right painful abducens nerve palsy persisting for 4 months and mild panhypopituitarism with diabetes insipidus for 6 months. T(1)-weighted magnetic resonance (MR) imaging of the sellar region showed a homogeneously enhanced mass lesion in the right cavernous sinus which seemed to extend from the swollen pituitary gland. T(2)-weighted MR imaging clearly showed the mass in the right cavernous sinus and the thickened dura mater of the sellar floor as hypointense, and the enlarged pituitary gland as isointense. Biopsy of the thickened dura mater and swollen pituitary gland was performed via the transsphenoidal approach. Histological examination revealed inflammation and collagen fiber formation in these regions. The diagnosis was secondary panhypophysitis resulting from granulomatous pachymeningitis involving the cavernous sinus (Tolosa-Hunt syndrome). Corticosteroid therapy was begun after the biopsy. Her periorbital pain and diplopia were relieved, but diabetes insipidus persisted. Follow-up MR imaging showed a decrease in the volumes of the pituitary gland and the mass in the cavernous sinus.

  12. A Prospective Longitudinal Study of Children's Theory of Mind and Adolescent Involvement in Bullying (United States)

    Shakoor, Sania; Jaffee, Sara R.; Bowes, Lucy; Ouellet-Morin, Isabelle; Andreou, Penelope; Happe, Francesca; Moffitt, Terrie E.; Arseneault, Louise


    Background: Theory of mind (ToM) allows the understanding and prediction of other people's behaviours based on their mental states (e.g. beliefs). It is important for healthy social relationships and thus may contribute towards children's involvement in bullying. The present study investigated whether children involved in bullying during early…

  13. School, Neighborhood, and Family Factors Are Associated with Children's Bullying Involvement: A Nationally Representative Longitudinal Study (United States)

    Bowes, Lucy; Arseneault, Louise; Maughan, Barbara; Taylor, Alan; Caspi, Ashalom; Moffitt, Terrie E.


    School size and problems with neighbors is associated with a greater risk of being a bullying victim while family factors such as maltreatment and domestic violence are associated with involvement in bullying. The findings are based on the Environmental Risk Longitudinal Twin Study that involves 2,232 children.

  14. Integrating Ethics into Case Study Assignments

    Directory of Open Access Journals (Sweden)

    Pamela A. Marshall


    Full Text Available I teach an upper-level writing course, Genes, Race, Gender, and Society, designed for Life Science majors, in which I utilize a case study to expose students to ethical ways of thinking.  Students first work through the topical case study and then are challenged to rethink their responses through the lenses of ethics, taking into account different ethical frameworks.  Students then develop their own case study, integrating ethical components.  I want to expose my students to this way of thinking because I see technology being driven by the Jurassic Park phenomenon, "Your scientists were so preoccupied with whether or not they could, they didn't stop to think if they should." and want future physicians grounded in a sense of how their actions relate to the greater good.

  15. Shuttle Case Study Collection Website Development (United States)

    Ransom, Khadijah S.; Johnson, Grace K.


    As a continuation from summer 2012, the Shuttle Case Study Collection has been developed using lessons learned documented by NASA engineers, analysts, and contractors. Decades of information related to processing and launching the Space Shuttle is gathered into a single database to provide educators with an alternative means to teach real-world engineering processes. The goal is to provide additional engineering materials that enhance critical thinking, decision making, and problem solving skills. During this second phase of the project, the Shuttle Case Study Collection website was developed. Extensive HTML coding to link downloadable documents, videos, and images was required, as was training to learn NASA's Content Management System (CMS) for website design. As the final stage of the collection development, the website is designed to allow for distribution of information to the public as well as for case study report submissions from other educators online.

  16. Trends in Dissertations Involving Technology-Assisted Mathematics Instruction: The Case of Turkey (United States)

    Tatar, Enver; Akkaya, Adnan; Kagizmanli, Türkan Berrin


    The purpose of this study is to examine thesis studies on technology-supported mathematics education in Turkey in terms of the keywords, mathematical areas, technologies and methodology used and results obtained. Data were obtained from 105 graduate theses. At the end of the analysis of the data, it was determined that most used keywords were from…

  17. University Response to Crisis Events Involving International Populations: The Case of Seven Directors of International Offices (United States)

    Andrews, James P.


    This qualitative research study focuses on crisis events affecting university international populations. It explores how seven directors of university international offices at seven different geographical locations in Texas respond to those events. The study findings shed light on the current state of crisis preparedness in higher education from…

  18. Lingual schwannoma involving the posterior lateral border of the tongue in a young individual: case report. (United States)

    Pereira, Luciano José; Pereira, Patrícia Peres Iucif; dos Santos, João de Paula; Reis Filho, Viator Ferreira; Dominguete, Paulo Roberto; Pereira, Alessandro A Costa


    A schwannoma, also called neurilemmoma, is a benign, encapsulated, slow growing tumor arising from the neural sheath's Schwann cells of the peripheral, cranial or autonomic nerves. The etiology is unknown, there is no gender preference and the tumors occur most commonly between the ages of 20 and 50 years. Approximately 25-48% of these tumors occur in the head and neck region, with only 1% occurring in the mouth. The current case reports a schwannoma of the tongue, found in a 12 year-old boy. The lesion was present for 6 months. The clinical examination revealed a 1.5x1.0 cm, sessile, rubbery, non-tender non-ulcerated mass on the right posterior lateral border of the tongue. An excisional biopsy was performed under local anesthesia. The histological sections showed a circumscribed submucosal nodule composed of spindle cells with thin wavy nuclei arranged as typical Antoni A (with Verocay bodies) and Antoni B areas. Nuclear palisading distribution (typical of a schwannoma) was readily identifiable. The patient was recurrence free after one year.

  19. Wind farm repowering: A case study

    Energy Technology Data Exchange (ETDEWEB)

    Selva, L. [Renewable Energy Eng. (Spain); Canas, M.; Gomez, E.; Pujante, A [Renewable Energy Research Inst., Dept. of Electrical, Electronic and Control Eng. (Spain)


    Wind farm repowering involves the replacement of smaller and middle sized wind turbines, with state-of-the-art multi-megawatt turbines. In this paper, a detailed study of the repowering of a wind farm is presented, by computing the generated active power from existing wind turbines and the new ones. The active power generated with the wind turbines are totalized to obtain the yearly generated energy and analyzed, thus economic studies take the repowering cost into account too. (au)

  20. Repurposing legacy data innovative case studies

    CERN Document Server

    Berman, Jules J


    Repurposing Legacy Data: Innovative Case Studies takes a look at how data scientists have re-purposed legacy data, whether their own, or legacy data that has been donated to the public domain. Most of the data stored worldwide is legacy data-data created some time in the past, for a particular purpose, and left in obsolete formats. As with keepsakes in an attic, we retain this information thinking it may have value in the future, though we have no current use for it. The case studies in this book, from such diverse fields as cosmology, quantum physics, high-energy physics, microbiology,

  1. Presenting Software Metrics Indicators- A Case Study

    DEFF Research Database (Denmark)

    Pantazos, Kostas; Shollo, Arisa; Staron, Miroslaw;


    decisions based on indicators. In essence, visualizing indicators and their dependencies can communicate the information to the stakeholders efficiently if done correctly, or mislead them if not done properly. In this paper we present results of a case study conducted in a unit of Ericsson. During the case...... study we identified the main requirements for methods for visualizing the indicators, developed these visualizations and conducted a series of interviews evaluating them. The results show that the dashboard presentation is the best solution, but that the simple, tabular visualizations are next best...


    Directory of Open Access Journals (Sweden)

    Rebecca Clift


    Full Text Available This paper discusses what the methods of conversation analysis (CA might have to offer the study of linguistic synonymy. It takes as a case study two items commonly held to be synonyms -'actually' and 'in fact'- and shows considerable differences between the two in their interactional implementation: they are implicated in the prosecution of differing courses of action. Such cases argue that it is analytically more profitable to consider what a lexical item does in the context of talk than what it means.

  3. A Comparative Comment on the Case Studies

    DEFF Research Database (Denmark)

    Kjeldsen, Christian Christrup; Ley, Thomas; Jensen, Niels Rosendal;


    Denne konklusion sammenfatter hovedtrækkene af de gennemførte case studies i WorkAble-projektet. Vigtige pointer er, at unge på tværs af de forskellige case studies har vanskeligt ved at blive hørt og taget alvorligt. I stedet spises de af med "realistisk vejledning" eller dårlige uddannelses- og...... arbejdstilbud. Konklusionen foreslår at give unge mere tid til at træffe de alvorlige valg vedr. deres fremtid ved at indføre et refugium, som i tankegang minder om Eriksons ungdomsmoratorium....

  4. Estudo da utilização de materiais de referência nas análises de água por laboratórios envolvidos no sistema de acreditação Case study on the usage of reference materials in water analysis by laboratories involved in the accreditation system

    Directory of Open Access Journals (Sweden)

    Suzana Saboia de Moura


    Full Text Available O presente estudo propõe-se discutir o uso de materiais de referência (MR pelos laboratórios de ensaios de águas, sob o ponto de vista da aquisição dos materiais conforme o item "Aquisição de serviços e suprimentos" (4.6 da norma ABNT NBR ISO/IEC 17025. O papel dos MR nas análises químicas é fornecer referências metrológicas visando assegurar a rastreabilidade das medições. A rastreabilidade é um aspecto essencial da garantia da qualidade para se obter aceitação de dados analíticos nos mercados nacional e internacional. Neste estudo de caso, de caráter exploratório e qualitativo, uma pesquisa foi realizada junto a todos os laboratórios de ensaios prestadores de serviços analíticos para a Agência Nacional de Águas (ANA e envolvidos no sistema de acreditação pela Coordenação Geral de Acreditação do Inmetro (Cgcre/Inmetro, utilizando-se questionário estruturado e com 50% de retorno. Os resultados mostraram que são muito poucos os certificados de MR com reconhecimento de terceira parte, ou seja, por organismos de acreditação, segundo normas consagradas que tratam efetivamente da rastreabilidade metrológica. Propõe-se, finalmente, uma política para garantir, sempre que possível, a rastreabilidade dos resultados de ensaios dos laboratórios, na ausência de MR certificados.This paper aims at discussing the use of reference materials (RM by water testing laboratories, on the context of RM purchase, based on the requirements of the standard ABNT NBR ISO/IEC 17025, section "Purchasing services and supplies" (4.6. The role of RM in chemical analysis is to provide metrological reference to assure measurement traceability. This is an essential aspect of quality assurance in order to have analytical results accepted in the international market. In this case study, based on the methodological exploratory and qualitative approach, a questionnaire was sent to testing laboratories which provide analytical services to the

  5. Reduction of Stereotypical Hand Movements in Girls with Rett Syndrome: Two Case Studies. (United States)

    Lotan, Meir; Roth, Dana

    This study explains the characteristics and treatment of individuals with Rett Syndrome and presents two case studies that investigated the use of interventions in reducing stereotypical hand movements (SHM). The case studies involve two girls (ages 5 and 7) with Rett Syndrome who were enrolled in a special education school. Information was…

  6. Solitary axillary lymph node metastasis without breast involvement from ovarian Cancer: Case report and brief literature review

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Ji In; Kim, Soo Jin; Park, Sung Hee; Kim, Hee Sung [Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul (Korea, Republic of)


    Axillary lymph node metastasis without breast involvement from ovarian cancer is rare. We report a case of a 68-year-old woman proven as ovarian serous papillary carcinoma and metastatic papillary carcinoma of the omentum on surgical diagnostic laparoscopy. In addition, a hypermetabolic lymph node was detected in left axilla and was considered a reactive benign lesion. Mammography and ultrasonography showed no focal lesion in both breasts, but ultrasonography-guided core needle biopsy for the lymph node revealed metastatic serous papillary carcinoma from ovarian origin. Even with a low incidence of axillary lymph node metastasis without breast involvement from ovarian cancer and only marginally elevated standardized uptake value in positron emission tomography, the possibility of metastasis at axillary lymph node in patients with known primary ovarian cancer must be considered.

  7. Erosive oral lichen planus with cutaneous involvement in a 7-year-old girl: a rare case report. (United States)

    Moger, Ganapathi; Thippanna, Chandrashekar K; Kenchappa, Mallikarjun; Puttalingaiah, Vinuth D


    Lichen planus is a chronic autoimmune, mucocutaneous disease, which can affect the oral mucosa, skin, genital mucosa, scalp and nails, and commonly seen in adults. Childhood lichen planus is a rare entity, which is characterized by skin lesions with the oral involvement being extremely uncommon. There are only a few reports on this subject in the literature. Early and correct diagnosis with adequate management is very important to avoid further complications as it is a pre-malignant condition. Herewith, we report a seven-year-old girl having erosive oral lichen planus with cutaneous involvement, which responded well to the treatment. This is to add another case of lichen planus in a child and to emphasize its consideration in the differential diagnosis of oral mucosal red and white lesions in children.

  8. Case studies continue to illuminate the cognitive neuroscience of memory. (United States)

    Rosenbaum, R Shayna; Gilboa, Asaf; Moscovitch, Morris


    The current ubiquity of functional neuroimaging studies, and the importance they have had in elucidating brain function, obscures the fact that much of what we know about brain-behavior relationships derives largely from the study of single- and multiple-patient cases. A major goal of the present review is to describe how single cases continue to uniquely and critically contribute to cognitive neuroscience theory. With several recent examples from the literature, we demonstrate that single cases can both challenge accepted dogma and generate hypotheses and theories that steer the field in new directions. We discuss recent findings from case studies that specify critical functions of the hippocampus in episodic memory and recollection, and clarify its role in nonmnemonic abilities. Although we focus on the hippocampus, we discuss other regions and the occurrence of new associative learning, as well as the involvement of the ventromedial prefrontal and parietal cortices in memory encoding and retrieval. We also describe ways of dealing with the shortcomings of case studies, and emphasize the partnership of patient and neuroimaging methods in constraining neurocognitive models of memory.

  9. Non-infringement Suit Involving Dispute over Trademark Infringement--Comments on the Case of Peter Rabbit Trademarks infringement

    Institute of Scientific and Technical Information of China (English)

    Jiang Ying


    @@ The Case in Brief The plaintiff: the China Social Sciences Press (CSSP) The defendant: Frederick Warne & Co., Ltd. (FW) Cause of action: Dispute involving establishment of non-infringement of the exclusive right to use registered trademarks In April,2003, the CSSP published a series of books entitled the Peter Rabbit Series, which comprises four separate volumes of books: the Tale of Peter Rabbit,the Tale of Mrs Tittlemouse, the Tale of Tom Kitten, and the Tale of Pigling Bland.This series, published in Chinese and English, had collected 19 fairy tales written by the woman English writer Beatrix Potter, who passed away over 50 years ago.

  10. Cervical Spondylopathy Involving the Vertebral Arteries Treated by Body-Acupuncture Combined with Scalp-Acupuncture in 72 Cases

    Institute of Scientific and Technical Information of China (English)

    李保民; 柴富明; 高洪明


    @@ Among various types of cervical spondylopathy, the one involving the vertebral arteries is frequently encountered in the middle-aged and the old people. It is often accompanied with arteriosclerosis and high blood viscosity, and clinically it is difficult to be treated. From March 1996 to December 2000, the authors hadtreated 72 cases of cervical spondylopathy of this type and achieved satisfactory therapeutic effects shown by clinical symptoms and indicated by the trans-cranial Doppler ultrasonic examination (TCD). This is reported as follows.

  11. Intra-Arterial Angiolymphoid Hyperplasia with Eosinophilia: A Rare Case Report of Peripheral Medium Sized Muscular Artery Involvement. (United States)

    Amin, Ashima; Umashankar, T; Dsouza, Chryselle Olive


    Angiolymphoid hyperplasia with eosinophilia (ALHE) is an uncommon benign vasoproliferative disease with distinct clinical and histopathological features. The most common clinical presentation is dermal and subcutaneous painless nodules in the head and neck region. The involvement of medium sized peripheral muscular artery is uncommon. It predominantly affects Caucasian adults during the third and fourth decades, but is also known to occur in Asians and it very rarely occurs in children. We here by present a case of intravascular ALHE in a 46-year-old female presenting with subcutaneous forearm nodule clinically diagnosed as ulnar artery thrombosis.

  12. Beliefs and Recommendations Regarding Child Custody and Visitation in Cases Involving Domestic Violence: A Comparison of Professionals in Different Roles. (United States)

    Saunders, Daniel G; Faller, Kathleen C; Tolman, Richard M


    Research is lacking on differing perspectives regarding custody cases involving domestic violence (DV). In a survey of judges, legal aid attorneys, private attorneys, DV program workers, and child custody evaluators (n = 1,187), judges, private attorneys, and evaluators were more likely to believe that mothers make false DV allegations and alienate their children. In response to a vignette, evaluators and private attorneys were most likely to recommend joint custody and least likely to recommend sole custody to the survivor. Legal aid attorneys and DV workers were similar on many variables. Gender, DV knowledge, and knowing victims explained many group differences.

  13.  Transient Osteoporosis of the Hip/Bone Marrow Edema Syndrome with Soft Tissue Involvement: A Case Report

    Directory of Open Access Journals (Sweden)

    Mohamad A. Al-Tanni


    Full Text Available  Transient osteoporosis of the hip (TOH is a rare condition mainly affecting pregnant women in their third trimester and middle aged men. We report a case of TOH/Bone marrow edema syndrome in pregnancy with involvement of the surrounding soft tissues on magnetic resonance image, which has not been previously reported. The presence of such edema in the soft tissues may help to differentiate this condition from early avascular necrosis of the hip, and may also provide an insight into the pathogenesis of the condition. The reported patient was treated conservatively and fully recovered.

  14. The Danish National Case Study Report

    DEFF Research Database (Denmark)

    Brodersen, Søsser; Jørgensen, Michael Søgaard

    and science through co-operation with Science Shops as a mediator between universities and civil society. The Danish national case study report analyses three projects carried out through the Science Shops at DTU and RUC. One case is a co-operation between two DTU students and an NGO, whom is working towards...... that all three NGO’s have used the results and findings to try influencing the societal discourses, and that the results and findings have helped two of the NGOs to gain influence. The analysis further shows that this influence seems to depend on the ability of the NGOs to build alliances with other actors......This report is the Danish case study report in the EU-financed project INTERACTS, which analyses experience and expectations to the interaction between NGOs, Science Shops and universities. The report analyses potentials and barriers to NGO’s and similar civil society groups’ use of research...

  15. Microbial study of meningitis and encephalitis cases. (United States)

    Selim, Heba S; El-Barrawy, Mohamed A; Rakha, Magda E; Yingst, Samuel L; Baskharoun, Magda F


    Meningitis and/or encephalitis can pose a serious public health problem especially during outbreaks. A rapid and accurate diagnosis is important for effective earlier treatment. This study aimed to identify the possible microbial causes of meningitis and/or encephalitis cases. CSF and serum samples were collected from 322 patients who had signs and symptoms suggestive of meningitis and/or encephalitis. Out of 250 cases with confirmed clinical diagnosis, 83 (33.2%) were definitely diagnosed as bacterial meningitis and/or encephalitis cases (by using CSF culture, biochemical tests, latex agglutination test, and CSF stain), 17 (6.8%) were definitely diagnosed as having viral causes ( by viral isolation on tissue culture, PCR and ELISA), and one (0.4%) was diagnosed as fungal meningitis case (by India ink stain, culture, and biochemical tests). Also, there was one encephalitis case with positive serum ELISA IgM antibodies against Sandfly scilian virus. N. meningitidis, S. pneumonia and M. tuberculosis were the most frequently detected bacterial agents, while Enteroviruses, herpes simplex viruses and varicella zoster viruses were the most common viral agents encountered. Further studies are needed to assess the role of different microbial agents in CNS infections and their effective methods of diagnosis.


    Directory of Open Access Journals (Sweden)

    Ramakrishna R


    Full Text Available BACKGROUND We have studied 200 patients of pleural fluid presenting to our tertiary care centre. Presence of cases of pleural fluid is a common presentation both in pulmonary and extrapulmonary diseases. We analysed the patients having both exudates and transudates and studied the results. MATERIALS AND METHODS We selected patients above 20 years of age and classified the patients with pleural fluid as having transudates and exudates. We studied the causes of transudates and exudates. A total of 200 patients are studied in this prospective study. Diagnosis of pleural exudates is made on the basis of Light’s criteria, chest x-ray, pleural fluid analysis, CT scan in selected patients, sputum examination, bronchoscopy and bronchial washings. Moribund and non-cooperative patients and HIV positives were excluded from the study. RESULTS Among the 200 patients, 91% have exudates. 9% have transudates by Light’s criteria. Tuberculosis is the commonest cause of effusions (64.83% followed by malignancy (13.73% and sympneumonic or parapneumonic effusions (9.89%. Pleural effusions occurred predominantly in males. Prevalence of diabetes Mellitus among cases of tuberculous pleural effusions is 13.56%. Tuberculous effusions are predominantly right-sided. CONCLUSION Predominant cases of pleural fluid are exudates. Commonest cause of pleural effusion is Tuberculosis followed by malignancy both pulmonary and extrapulmonary and sym. and parapneumonic effusions. Prevalence of Diabetes among Tuberculous pleural effusion cases is more or less same as in general population. Cough, expectoration fever, chest pain and breathlessness are the common symptoms occurring in three fourths of the patients of tuberculous pleural effusion. Most of the cases of Tuberculous effusion are above 30 years of age. In the diagnosis of tuberculous pleural effusion, Pleural fluid ADA is very important. Pleural fluid cytology, pleural biopsy, bronchoscopy, bronchial washings and sputum

  17. Evaluation of Cardiac Involvement in Children with Dengue by Serial Echocardiographic Studies.

    Directory of Open Access Journals (Sweden)

    Tawatchai Kirawittaya

    Full Text Available Infection with dengue virus results in a wide range of clinical manifestations from dengue fever (DF, a self-limited febrile illness, to dengue hemorrhagic fever (DHF which is characterized by plasma leakage and bleeding tendency. Although cardiac involvement has been reported in dengue, the incidence and the extent of cardiac involvement are not well defined.We characterized the incidence and changes in cardiac function in a prospective in-patient cohort of suspected dengue cases by serial echocardiography. Plasma leakage was detected by serial chest and abdominal ultrasonography. Daily cardiac troponin-T levels were measured. One hundred and eighty one dengue cases were enrolled. On the day of enrollment, dengue cases that already developed plasma leakage had lower cardiac index (2695 (127 vs 3188 (75 (L/min/m2, p = .003 and higher left ventricular myocardial performance index (.413 (.021 vs .328 (.026, p = .021 and systemic vascular resistance (2478 (184 vs 1820 (133 (dynes·s/cm5, p = .005 compared to those without plasma leakage. Early diastolic wall motion of the left ventricle was decreased in dengue cases with plasma leakage compared to those without. Decreased left ventricular wall motility was more common in dengue patients compared to non-dengue cases particularly in cases with plasma leakage. Differences in cardiac function between DF and DHF were most pronounced around the time of plasma leakage. Cardiac dysfunction was transient and did not require treatment. Transient elevated troponin-T levels were more common in DHF cases compared to DF (14.5% vs 5%, p = 0.028.Transient left ventricular systolic and diastolic dysfunction was common in children hospitalized with dengue and related to severity of plasma leakage. The functional abnormality spontaneously resolved without specific treatment. Cardiac structural changes including myocarditis were uncommon.

  18. Aerospace Mechanisms and Tribology Technology: Case Study (United States)

    Miyoshi, K.


    This paper focuses attention on tribology technology practice related to vacuum tribology. A case study describes an aspect of a real problem in sufficient detail for the engineer and scientist to understand the tribological situation and the failure. The nature of the problem is analyzed and the tribological properties are examined.

  19. Aerospace Mechanisms and Tribology Technology: Case Studies (United States)

    Miyoshi, Kazuhisa


    This chapter focuses attention on tribology technology practice related to vacuum tribology and space tribology. Two case studies describe aspects of real problems in sufficient detail for the engineer and the scientist to understand the tribological situations and the failures. The nature of the problems is analyzed and the range of potential solutions is evaluated. Courses of action are recommended.

  20. Case Study of Home-School Visits (United States)

    Aguerrebere, Yolanda


    This case study evaluated one site of a California teacher home visit program. Home visits have been an important means of connecting families and schooling. In 1999, California inaugurated a statewide home visit program to promote effective partnership between home and school for low-achieving schools. At this site, families in 3 kindergarten…