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Sample records for charakter udajov ich

  1. Patient survey (ICH CAHPS)

    Data.gov (United States)

    U.S. Department of Health & Human Services — In-Center Hemodialysis Facilites Patient evaluations from the In-Center Hemodialysis Consumer Assessment of Healthcare Providers and Systems (ICH-CAHPS) Survey. The...

  2. J. Randvere Ruth ja Otto Weiningeri Geschlecht und Charakter / Mirjam Hinrikus

    Index Scriptorium Estoniae

    Hinrikus, Mirjam, 1972-

    2004-01-01

    Naise kirjeldus J. Randvere "Ruthis" ja Otto Weiningeri "Geschlecht und Charakter'is". Andmed autori kohta lk. 202. Ilmunud ka kogumikus: J. Randvere "Ruth" 19.-20. sajandi vahetuse kultuuris / koost. Mirjam Hinrikus. Tallinn : Underi ja Tuglase Kirjanduskeskus, 2006, lk. 145-169

  3. Ich spreche Deutsch: A User's Report

    Science.gov (United States)

    Glassar, Sheila

    1969-01-01

    The textbook under discussion, "Ich spreche Deutsch" by Heinz Griesbach and Dora Schulz (London-Harlow: Longmans-Hueber, 1966), is intended to be a one-year introduction to German, particularly for less academic pupils and students. (FWB)

  4. ICH/FWCD system design for KSTAR

    Energy Technology Data Exchange (ETDEWEB)

    Bae, Young Dug; Kwak, J. G.; Han, J. M.; Ju, M. H.; Hong, B. G.

    1997-07-01

    The ICH/FWCD system for KSTAR shall initially be configured to provide 6 MW power to the plasma with one antenna. The system can be upgraded to provide 12 MW of power to the plasma with the addition of a second system that is duplicate of the first. The initial KSTAR ion cyclotron system consist of one port-mounted antenna that have four current straps. Each strap, using appropriate tuning, matching, and decoupling circuitry will be driven by an independent rf power source. The goal of this ICH/FWCD system is to deliver up to 6 MW of power to the plasma under a variety of plasma conditions. In this report, the plasma loading for various plasma conditions is computed by RANT3D code; electric property of antenna, i.e. inductance, capacitance and mutual coupling are examined; and then a brief description of the overall ICH/FWCD system is given. (author). 3 refs., 4 tabs., 25 figs.

  5. ICH/FWCD system design for KSTAR

    International Nuclear Information System (INIS)

    Bae, Young Dug; Kwak, J. G.; Han, J. M.; Ju, M. H.; Hong, B. G.

    1997-07-01

    The ICH/FWCD system for KSTAR shall initially be configured to provide 6 MW power to the plasma with one antenna. The system can be upgraded to provide 12 MW of power to the plasma with the addition of a second system that is duplicate of the first. The initial KSTAR ion cyclotron system consist of one port-mounted antenna that have four current straps. Each strap, using appropriate tuning, matching, and decoupling circuitry will be driven by an independent rf power source. The goal of this ICH/FWCD system is to deliver up to 6 MW of power to the plasma under a variety of plasma conditions. In this report, the plasma loading for various plasma conditions is computed by RANT3D code; electric property of antenna, i.e. inductance, capacitance and mutual coupling are examined; and then a brief description of the overall ICH/FWCD system is given. (author). 3 refs., 4 tabs., 25 figs

  6. Enabling ICH Q10 Implementation--Part 1. Striving for Excellence by Embracing ICH Q8 and ICH Q9.

    Science.gov (United States)

    Calnan, Nuala; O'Donnell, Kevin; Greene, Anne

    2013-01-01

    This article is the first in a series of articles that will focus on understanding the implementation essentials necessary to deliver operational excellence through a International Conference on Harmonisation of Technical Requirements for Registration of Pharmaceuticals for Human Use (ICH) Q10-based pharmaceutical quality system (PQS). The authors examine why, despite the fact that the ICH Q10 guideline has been with us since 2008, the transformation of the traditional Quality Management Systems QMS in use within the pharmaceutical industry is a work in progress for only a few forward-thinking organisations. Unfortunately, this transformation remains a mere aspiration for the majority of organisations. We explore the apparent lack of progress by the pharmaceutical sector in adopting six sigma and related quality management techniques to ensure the availability of high-quality medicines worldwide. The authors propose that the desired progress can be delivered through two key shifts in our current practices; by embodying the principles of operational excellence in every aspect of our business and by learning how to unlock the scientific and tacit knowledge within our organisations. It has been ten years since The Wall Street Journal revealed the pharmaceutical industry's "little secret" comparing the perceived level of manufacturing expertise in the industry as lagging far behind those of potato-chip and laundry-soap makers. Would you consider the quality and manufacturing strategies in place today in your organisation to be more efficient and scientifically based than those of 2003? If so, what evidence exists for you to draw any conclusion regarding enhanced performance? Do your current practices drive innovation and facilitate continual improvement and if so, how? Ultimately, can you confidently affirm that patient-related risks associated with the product(s) manufactured by your organisation have been reduced due to the quality assurance program now applied

  7. Idiopathic Chondrolysis of the Hip ( ICH: Report of three Cases

    Directory of Open Access Journals (Sweden)

    C Dechosilpa

    2014-11-01

    Full Text Available Idiopathic Chondrolysis of the Hip (ICH is a rare condition, occurring mostly in black female adolescence. It is characterized by the rapidly progressive destruction of articular cartilage in the hip joint resulting in premature degeneration and subsequent joint arthrosis. We report three cases of ICH: a 13-year old boy presented with left knee pain, an 11-year old girl with right hip pain and a 12-year old girl with right thigh pain. All of them had the same characteristic radiographic findings. The initial treatment was started conservatively. Surgical treatment was performed in one patient in order to confirm diagnosis and correct deformity.

  8. The Focus Antipassive in K'iche' Mayan.

    Science.gov (United States)

    Pye, Clifton

    1989-01-01

    This analysis shows how the Government and Binding (GB) framework of Chomsky may be extended to the focus antipassive construction in K'iche', a Mayan language spoken in the central highland region of Guatemala. The GB model previously has been successfully extended to a number of Romance languages and has shown that a wide range of differences…

  9. Tuning and matching of the BPX ICH system

    International Nuclear Information System (INIS)

    Swain, D.W.

    1991-01-01

    Two methods of tuning and matching the ion cyclotron heating (ICH) antennas for the Burning Plasma Experiment (BPX) to the BPX plasma have been analyzed. Both appear to provide adequate tuning and matching capabilities. However, there are trade-offs between the frequency range that can be covered and the compactness of the high-voltage region of the transmission lines that makes up of the matching network. 4 refs., 5 figs

  10. Evidence that cyclophosphamide can to induce exchanges in the sister chromatids (ICH) through secondary injuries

    International Nuclear Information System (INIS)

    Morales R, P.; Rodriguez R, R.

    1997-01-01

    By means of the use of destination protocol of ICH inductive injuries (DLI-ICH), it was studied if interchanges in the sister chromatids (ICH) induced by cyclophosphamide (CP), in the second post-treatment division (ICH-2) are produced by secondary injuries or by fresh injuries. For discard between these possibilities it was administered CP at different periods before of the first post-treatment division, taking as reference the administered time for high dose of bromodeoxyuridine (BrdU ) which was approximately at the beginning of this division. The ICH frequencies that occur in the first, the second and the third synthesis stages (S) were determined. It was observed that when the administered CP was four hours before BrdU , the ICH frequencies of the second and the third S were reduced. The frequency of the first ICH increased lightly in relation to those of the normal protocol (0.5 h before BrdU ) and that the supplying of CP six hours before caused almost a total reduction of ICH of second and third S and an important increment of ICH of first S.This was interpreted as evidence that the ICH-2 are product of secondary injuries. (Author)

  11. Engineering design and fabrication of ICH antenna on KSTAR

    Energy Technology Data Exchange (ETDEWEB)

    Bae, Y.D.; Hong, B.G.; Hwang, C.K. [Korea Atomic Energy Research Institute, Taejon (Korea)

    1999-08-01

    Engineering design of 6MW ICH(Ion Cyclotron Heating) system for the plasma heating and current drive in KSTAR (Korea Superconducting Tokamak Advanced Research) tokamak is carried out and a proto-type antenna is domestically fabricated. The proto-type antenna is installed on RF test chamber, and its mutual coupling and vacuum impedance will be measured. Furthermore, high voltage and current behavior under no-plasma load conditions will be studied using 100 kW of 30 MHz RF power. A vacuum feedthrough is designed and fabricated using two ceramic cylinder, which has power rating of 1.5 MW and pulse length of 300 sec. Its RF characteristics will be tested using 100 kW RF transmitter. 19 refs., 46 figs., 8 tabs. (Author)

  12. Hydrogen inhalation ameliorated mast cell mediated brain injury after ICH in mice

    Science.gov (United States)

    Manaenko, Anatol; Lekic, Tim; Ma, Qingyi; Zhang, John H.; Tang, Jiping

    2012-01-01

    OBJECTIVE Hydrogen inhalation was neuroprotective in several brain injury models. Its mechanisms are believed to be related to anti-oxidative stress. We investigated the potential neurovascular protective effect of hydrogen inhalation especially effect on mast cell activation in a mouse model of intracerebral hemorrhage (ICH). DESIGN Controlled in vivo laboratory study. SETTING Animal research laboratory SUBJECTS 171, 8 weeks old male CD-1 mice were used. INTERVENTIONS Collagenase-induced ICH model in 8 weeks old, male, CD-1 mice was used. Hydrogen was administrated via spontaneous inhalation. The blood-brain barrier (BBB) permeability and neurological deficits were investigated at 24 and 72 hours after ICH. Mast cell activation was evaluated by Western blot and immuno-staining. The effects of hydrogen inhalation on mast cell activation were confirmed in an autologous blood injection model ICH. MEASURMENT AND MAIN RESULTS At 24 and 72 hours post-ICH, animals showed BBB disruption, brain edema, neurological deficits, accompanied with phosphorylation of Lyn kinase and release of tryptase, indicating mast cell activation. Hydrogen treatment diminished phosphorylation of Lyn kinase and release of tryptase, decreased accumulation and degranulation of mast cells, attenuated BBB disruption and improved neurobehavioral function. CONCLUSION Activation of mast cells following ICH contributed to increase of BBB permeability and brain edema. Hydrogen inhalation preserved BBB disruption by prevention of mast cell activation after ICH. PMID:23388512

  13. Safety assessment of biotechnology-derived pharmaceuticals: ICH and beyond.

    Science.gov (United States)

    Serabian, M A; Pilaro, A M

    1999-01-01

    Many scientific discussions, especially in the past 8 yr, have focused on definition of criteria for the optimal assessment of the preclinical toxicity of pharmaceuticals. With the current overlap of responsibility among centers within the Food and Drug Administration (FDA), uniformity of testing standards, when appropriate, would be desirable. These discussions have extended beyond the boundaries of the FDA and have culminated in the acceptance of formalized, internationally recognized guidances. The work of the International Committee on Harmonisation (ICH) and the initiatives developed by the FDA are important because they (a) represent a consensus scientific opinion, (b) promote consistency, (c) improve the quality of the studies performed, (d) assist the public sector in determining what may be generally acceptable to prepare product development plans, and (e) provide guidance for the sponsors in the design of preclinical toxicity studies. Disadvantages associated with such initiatives include (a) the establishment of a historical database that is difficult to relinquish, (b) the promotion of a check-the-box approach, i.e., a tendancy to perform only the minimum evaluation required by the guidelines, (c) the creation of a disincentive for industry to develop and validate new models, and (d) the creation of state-of-the-art guidances that may not allow for appropriate evaluation of novel therapies. The introduction of biotechnology-derived pharmaceuticals for clinical use has often required the application of unique approaches to assessing their safety in preclinical studies. There is much diversity among these products, which include the gene and cellular therapies, monoclonal antibodies, human-derived recombinant regulatory proteins, blood products, and vaccines. For many of the biological therapies, there will be unique product issues that may require specific modifications to protocol design and may raise additional safety concerns (e.g., immunogenicity

  14. Evidence that cyclophosphamide can to induce exchanges in the sister chromatids (ICH) through secondary injuries; Evidencia de que la ciclofosfamida puede inducir intercambios en las cromatidas hermanas (ICH) a traves de lesiones secundarias

    Energy Technology Data Exchange (ETDEWEB)

    Morales R, P.; Rodriguez R, R. [Instituto Nacional de Investigaciones nucleares, A.P. 18-1027, 11801 Mexico D.F. (Mexico)

    1997-07-01

    By means of the use of destination protocol of ICH inductive injuries (DLI-ICH), it was studied if interchanges in the sister chromatids (ICH) induced by cyclophosphamide (CP), in the second post-treatment division (ICH-2) are produced by secondary injuries or by fresh injuries. For discard between these possibilities it was administered CP at different periods before of the first post-treatment division, taking as reference the administered time for high dose of bromodeoxyuridine (BrdU ) which was approximately at the beginning of this division. The ICH frequencies that occur in the first, the second and the third synthesis stages (S) were determined. It was observed that when the administered CP was four hours before BrdU , the ICH frequencies of the second and the third S were reduced. The frequency of the first ICH increased lightly in relation to those of the normal protocol (0.5 h before BrdU ) and that the supplying of CP six hours before caused almost a total reduction of ICH of second and third S and an important increment of ICH of first S.This was interpreted as evidence that the ICH-2 are product of secondary injuries. (Author)

  15. ICH guidelines--implementation of the 3Rs (refinement, reduction, and replacement): incorporating best scientific practices into the regulatory process.

    Science.gov (United States)

    Ohno, Yasuo

    2002-01-01

    An overview of the International Conference on Harmonization of Technical Requirements for Registration of Pharmaceuticals for Human Use (ICH) is described. ICH was established through cooperation of the regulatory agencies and industrial parties of three main regions involved in pharmaceuticals: the European Union, the United States, and Japan. The purpose of the ICH is to make recommendations to achieve greater harmonization regarding interpretation and application of technical guidelines and requirements for product registration in an effort to reduce or obviate the need to duplicate the testing carried out during the research and development of new medicines. The main purpose of ICH was not to foster the 3Rs per se; however, harmonization of guidelines has eliminated duplications of similar tests to satisfy the specific requirements of each region. The ICH process has contributed to mutual understanding of the regulatory requirements and has decreased the number of unnecessary animal experiments. Specific examples of the contributions of ICH harmonization to the 3Rs are described.

  16. Revision of the ICH guideline on detection of toxicity to reproduction for medicinal products: SWOT analysis.

    Science.gov (United States)

    Barrow, Paul

    2016-09-01

    SWOT analysis was used to gain insights and perspectives into the revision of the ICH S5(R2) guideline on detection of toxicity to reproduction for medicinal products. The current ICH guideline was rapidly adopted worldwide and has an excellent safety record for more than 20 years. The revised guideline should aim to further improve reproductive and developmental (DART) safety testing for new drugs. Alternative methods to animal experiments should be used whenever possible. Modern technology should be used to obtain high quality data from fewer animals. Additions to the guideline should include considerations on the following: limit dose setting, maternal toxicity, biopharmaceuticals, vaccines, testing strategies by indication, developmental immunotoxicity, and male-mediated developmental toxicity. Emerging issues, such as epigenetics and the microbiome, will most likely pose challenges to DART testing in the future. It is hoped that the new guideline will be adopted even outside the ICH regions. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. O obrazech a snech: Jindřich Štyrský (1899 – 1942)

    Czech Academy of Sciences Publication Activity Database

    Winter, Tomáš

    2007-01-01

    Roč. 3, č. 29 (2007), s. 8-9 ISSN 1801-4542 Institutional research plan: CEZ:AV0Z80330511 Keywords : Jindřich Štyrský * surrealism * Czech art of 20th century Subject RIV: AL - Art, Architecture, Cultural Heritage

  18. Prediction and prognostication of neurological deterioration in patients with acute ICH

    DEFF Research Database (Denmark)

    Ovesen, Christian; Christensen, Anders Fogh; Havsteen, Inger

    2015-01-01

    OBJECTIVE: Patients with intracerebral haemorrhage (ICH) are at high risk of neurological deterioration (ND). We aimed at establishing predictors of early ND (END) as well as late ND (LND) and at exploring the impact of neurological stability during the first week on long-term prognosis. DESIGN: ...

  19. Managing Ich infections of walleye cultured in a surface water supply with copper sulfate

    Science.gov (United States)

    Ichthyophthirius multifiliis infests walleye during growout at Rathbun Fish Hatchery (RFH). Daily flow-through formalin treatments (45-50 ppm for 9 h) were applied to prevent Ich outbreaks, and this contributed to 25% ($35,000) of fish production costs during the grow-out period. Research to decre...

  20. Charakter Marias. - Darbringung Jesu im Tempel. II. Dogmatik. - Demut Mariens. I. Dogmatik. - Ehe. III. Dogmatik. - Engel/Erzengel. II. Dogmatik. - Erlösungsordnung. - Eschatologie. - Evangelisation. - Gericht. - Gnadenthron. - Gotteskind. - Gottesschau. - Häresie. - Heilsplan Gottes. - Himmelfahrt Mariae. I. Dogmatik. - Hingabe Marias. - Hoffnung. - Inkulturation. - Jesus Christus. - Josephsehe. - Jungfräulichkeit. II. Dogmatik. - Jungfräulichkeitsgelübde. - Jungfrau und Mutter. - Menschwerdung. II. Dogmatik. - Mitwirken Mariens. - Münzen. - Nachfolge Marias. - Nächstenliebe Marias. - Ohnmacht Mariens. I. Dogmatik

    OpenAIRE

    Ziegenaus, Anton

    1992-01-01

    Charakter Marias. - Darbringung Jesu im Tempel. II. Dogmatik. - Demut Mariens. I. Dogmatik. - Ehe. III. Dogmatik. - Engel/Erzengel. II. Dogmatik. - Erlösungsordnung. - Eschatologie. - Evangelisation. - Gericht. - Gnadenthron. - Gotteskind. - Gottesschau. - Häresie. - Heilsplan Gottes. - Himmelfahrt Mariae. I. Dogmatik. - Hingabe Marias. - Hoffnung. - Inkulturation. - Jesus Christus. - Josephsehe. - Jungfräulichkeit. II. Dogmatik. - Jungfräulichkeitsgelübde. - Jungfrau und Mutter. - Menschwerd...

  1. Classification of Different Degrees of Disability Following Intracerebral Hemorrhage: A Decision Tree Analysis from VISTA-ICH Collaboration.

    Science.gov (United States)

    Phan, Thanh G; Chen, Jian; Beare, Richard; Ma, Henry; Clissold, Benjamin; Van Ly, John; Srikanth, Velandai

    2017-01-01

    Prognostication following intracerebral hemorrhage (ICH) has focused on poor outcome at the expense of lumping together mild and moderate disability. We aimed to develop a novel approach at classifying a range of disability following ICH. The Virtual International Stroke Trial Archive collaboration database was searched for patients with ICH and known volume of ICH on baseline CT scans. Disability was partitioned into mild [modified Rankin Scale (mRS) at 90 days of 0-2], moderate (mRS = 3-4), and severe disabilities (mRS = 5-6). We used binary and trichotomy decision tree methodology. The data were randomly divided into training (2/3 of data) and validation (1/3 data) datasets. The area under the receiver operating characteristic curve (AUC) was used to calculate the accuracy of the decision tree model. We identified 957 patients, age 65.9 ± 12.3 years, 63.7% males, and ICH volume 22.6 ± 22.1 ml. The binary tree showed that lower ICH volume (27.9 ml), older age (>69.5 years), and low Glasgow Coma Scale (tree showed that ICH volume, age, and serum glucose can separate mild, moderate, and severe disability groups with AUC 0.79 (95% CI 0.71-0.87). Both the binary and trichotomy methods provide equivalent discrimination of disability outcome after ICH. The trichotomy method can classify three categories at once, whereas this action was not possible with the binary method. The trichotomy method may be of use to clinicians and trialists for classifying a range of disability in ICH.

  2. Riziko ICHS v české populaci hodnocené podle projektu SCORE

    Czech Academy of Sciences Publication Activity Database

    Tomečková, Marie; Grünfeldová, H.; Peleška, Jan; Hanuš, P.; Marušiaková, Miriam

    2006-01-01

    Roč. 52, č. 12 (2006), s. 1231-1231 ISSN 0042-773X. [Kongres o ateroskleróze /10./. 07.12.2006-09.12.2006, Špindlerův Mlýn] R&D Projects: GA AV ČR 1ET200300413 Institutional research plan: CEZ:AV0Z10300504 Keywords : riziko ICHS * SCORE Subject RIV: FA - Cardiovascular Disease s incl. Cardiotharic Surgery

  3. ESRD QIP - In- Center Hemodialysis Consumer Assessment Of Healthcare Providers And Services Systems ( ICH CAHPS) Survey - Payment Year 2018

    Data.gov (United States)

    U.S. Department of Health & Human Services — This dataset include facility details, performance rate, measure score, and the state and national average scores for each of the ICH CAHPS survey metrics that are...

  4. I-Ching, dyadic groups of binary numbers and the geno-logic coding in living bodies.

    Science.gov (United States)

    Hu, Zhengbing; Petoukhov, Sergey V; Petukhova, Elena S

    2017-12-01

    The ancient Chinese book I-Ching was written a few thousand years ago. It introduces the system of symbols Yin and Yang (equivalents of 0 and 1). It had a powerful impact on culture, medicine and science of ancient China and several other countries. From the modern standpoint, I-Ching declares the importance of dyadic groups of binary numbers for the Nature. The system of I-Ching is represented by the tables with dyadic groups of 4 bigrams, 8 trigrams and 64 hexagrams, which were declared as fundamental archetypes of the Nature. The ancient Chinese did not know about the genetic code of protein sequences of amino acids but this code is organized in accordance with the I-Ching: in particularly, the genetic code is constructed on DNA molecules using 4 nitrogenous bases, 16 doublets, and 64 triplets. The article also describes the usage of dyadic groups as a foundation of the bio-mathematical doctrine of the geno-logic code, which exists in parallel with the known genetic code of amino acids but serves for a different goal: to code the inherited algorithmic processes using the logical holography and the spectral logic of systems of genetic Boolean functions. Some relations of this doctrine with the I-Ching are discussed. In addition, the ratios of musical harmony that can be revealed in the parameters of DNA structure are also represented in the I-Ching book. Copyright © 2017 Elsevier Ltd. All rights reserved.

  5. Shielding optimisation of the ITER ICH&CD antenna for shutdown dose rate

    International Nuclear Information System (INIS)

    Turner, Andrew; Leichtle, Dieter; Lamalle, Philippe; Levesy, Bruno; Meunier, Lionel; Polunovskiy, Eduard; Sartori, Roberta; Shannon, Mark

    2015-01-01

    Highlights: • Neutronics analysis on the ITER ICH&CD system conducted to reduce shutdown dose rate. • Several designs for shielding the port plug gaps were modelled. • Shielding significantly reduced interspace dose rate but still exceed project requirements. • Design optimisation of the ICH port is continuing. • Significant contributions from other ports require an integrated modelling approach. - Abstract: The Ion Cyclotron Heating and Current Drive (ICH&CD) system will reside in ITER equatorial port plugs 13 and 15. Shutdown dose rates (SDDR) within the port interspace are required to be less than 100 μSv/h at 10 6 s cooling. A significant contribution to the SDDR results from neutrons streaming down gaps around the port frame, and the mitigation of this streaming is the main subject of these analyses. An updated MCNP model of the antenna was created and integrated into an ITER reference model. Shielding plates were defined in the port gaps, and scoping studies conducted to assess their effectiveness in several configurations, based on which a front dog-leg arrangement was selected for high resolution 3-D activation analysis using MCR2S. It was concluded that the selected configuration reduced the SDDR from ∼500 μSv/h to 220 μSv/h but were still in excess of dose rate requirements. Approximately 30% of this was due to cross-talk from neighbouring ports. In addition, increased dose rates were observed in the port interspace along the lines of sight of the removable vacuum transmission lines. Design optimisation is continuing, however an integrated approach is needed with regard to ITER port plug design and the shielding of surrounding systems.

  6. Shielding optimisation of the ITER ICH&CD antenna for shutdown dose rate

    Energy Technology Data Exchange (ETDEWEB)

    Turner, Andrew, E-mail: andrew.turner@ccfe.ac.uk [CCFE, Culham Science Centre, Abingdon, Oxon OX14 3DB (United Kingdom); Leichtle, Dieter [Fusion for Energy, Josep Pla 2, Torres Diagonal Litoral B3, 08019 Barcelona (Spain); Lamalle, Philippe; Levesy, Bruno [ITER Organization, Route de Vinon-sur-Verdon, CS 90 046, 13067 St., Paul-lez-Durance (France); Meunier, Lionel [Fusion for Energy, Josep Pla 2, Torres Diagonal Litoral B3, 08019 Barcelona (Spain); Polunovskiy, Eduard [ITER Organization, Route de Vinon-sur-Verdon, CS 90 046, 13067 St., Paul-lez-Durance (France); Sartori, Roberta [Fusion for Energy, Josep Pla 2, Torres Diagonal Litoral B3, 08019 Barcelona (Spain); Shannon, Mark [CCFE, Culham Science Centre, Abingdon, Oxon OX14 3DB (United Kingdom)

    2015-10-15

    Highlights: • Neutronics analysis on the ITER ICH&CD system conducted to reduce shutdown dose rate. • Several designs for shielding the port plug gaps were modelled. • Shielding significantly reduced interspace dose rate but still exceed project requirements. • Design optimisation of the ICH port is continuing. • Significant contributions from other ports require an integrated modelling approach. - Abstract: The Ion Cyclotron Heating and Current Drive (ICH&CD) system will reside in ITER equatorial port plugs 13 and 15. Shutdown dose rates (SDDR) within the port interspace are required to be less than 100 μSv/h at 10{sup 6} s cooling. A significant contribution to the SDDR results from neutrons streaming down gaps around the port frame, and the mitigation of this streaming is the main subject of these analyses. An updated MCNP model of the antenna was created and integrated into an ITER reference model. Shielding plates were defined in the port gaps, and scoping studies conducted to assess their effectiveness in several configurations, based on which a front dog-leg arrangement was selected for high resolution 3-D activation analysis using MCR2S. It was concluded that the selected configuration reduced the SDDR from ∼500 μSv/h to 220 μSv/h but were still in excess of dose rate requirements. Approximately 30% of this was due to cross-talk from neighbouring ports. In addition, increased dose rates were observed in the port interspace along the lines of sight of the removable vacuum transmission lines. Design optimisation is continuing, however an integrated approach is needed with regard to ITER port plug design and the shielding of surrounding systems.

  7. "Ich soll nicht zu mir selbst kommen" : Werther, Goethe und die Formung des Subjekts in der Moderne

    OpenAIRE

    Petersdorff, Dirk von (Prof. Dr.)

    2012-01-01

    Die Leiden des jungen Werther: Sie gehen aus einem neuen Reflexions- uns Ausgleichungsbedürfnis hervor, aus der Suche nach einem konsistenten Ich. Werther erlebt die kognitiven und affektiven Veränderungen, die die Moderne heraufführt, und aus diesen Erfahrungen geht sein Verlangen nach Einheit hervor (...). Die Suche nach dem einheitlichen, festen, verläßlichen Ich hält den Briefroman zusammen, und die Gattungswahl korrespondiert mit der Fragestellung, denn das Medium des Briefes hat im 18. ...

  8. Workshop on High Power ICH Antenna Designs for High Density Tokamaks

    Science.gov (United States)

    Aamodt, R. E.

    1990-02-01

    A workshop in high power ICH antenna designs for high density tokamaks was held to: (1) review the data base relevant to the high power heating of high density tokamaks; (2) identify the important issues which need to be addressed in order to ensure the success of the ICRF programs on CIT and Alcator C-MOD; and (3) recommend approaches for resolving the issues in a timely realistic manner. Some specific performance goals for the antenna system define a successful design effort. Simply stated these goals are: couple the specified power per antenna into the desired ion species; produce no more than an acceptable level of RF auxiliary power induced impurities; and have a mechanical structure which safely survives the thermal, mechanical and radiation stresses in the relevant environment. These goals are intimately coupled and difficult tradeoffs between scientific and engineering constraints have to be made.

  9. Workshop on high power ICH antenna designs for high density tokamaks

    International Nuclear Information System (INIS)

    Aamodt, R.E.

    1990-01-01

    A workshop in high power ICH antenna designs for high density tokamaks was held in Boulder, Colorado on January 31 through February 2, 1990. The purposes of the workshop were to: (1) review the data base relevant to the high power heating of high density tokamaks; (2) identify the important issues which need to be addressed in order to ensure the success of the ICRF programs on CIT and Alcator C-MOD; and (3) recommend approaches for resolving the issues in a timely realistic manner. Some specific performance goals for the antenna system define a successful design effort. Simply stated these goals are: couple the specified power per antenna into the desired ion species; produce no more than an acceptable level of rf auxiliary power induced impurities; and have a mechanical structure which safely survives the thermal, mechanical and radiation stresses in the relevant environment. These goals are intimately coupled and difficult tradeoffs between scientific and engineering constraints have to be made

  10. Duration of Acute and Chronic Toxicity Testing in Animals (ICH S4A and S4B)

    DEFF Research Database (Denmark)

    Spindler, Per; Van Cauteren, Herman

    2013-01-01

    regions in 1991; whereas the process of harmonising the duration of non-rodent studies was initiated. The US FDA originally required studies of at least 12 months duration, whereas in Japan and EU studies of 6 months duration were considered acceptable as an ICH objective. In this chapter, the background...

  11. Hematoma shape, hematoma size, Glasgow coma scale score and ICH score: which predicts the 30-day mortality better for intracerebral hematoma?

    Directory of Open Access Journals (Sweden)

    Chih-Wei Wang

    Full Text Available To investigate the performance of hematoma shape, hematoma size, Glasgow coma scale (GCS score, and intracerebral hematoma (ICH score in predicting the 30-day mortality for ICH patients. To examine the influence of the estimation error of hematoma size on the prediction of 30-day mortality.This retrospective study, approved by a local institutional review board with written informed consent waived, recruited 106 patients diagnosed as ICH by non-enhanced computed tomography study. The hemorrhagic shape, hematoma size measured by computer-assisted volumetric analysis (CAVA and estimated by ABC/2 formula, ICH score and GCS score was examined. The predicting performance of 30-day mortality of the aforementioned variables was evaluated. Statistical analysis was performed using Kolmogorov-Smirnov tests, paired t test, nonparametric test, linear regression analysis, and binary logistic regression. The receiver operating characteristics curves were plotted and areas under curve (AUC were calculated for 30-day mortality. A P value less than 0.05 was considered as statistically significant.The overall 30-day mortality rate was 15.1% of ICH patients. The hematoma shape, hematoma size, ICH score, and GCS score all significantly predict the 30-day mortality for ICH patients, with an AUC of 0.692 (P = 0.0018, 0.715 (P = 0.0008 (by ABC/2 to 0.738 (P = 0.0002 (by CAVA, 0.877 (P<0.0001 (by ABC/2 to 0.882 (P<0.0001 (by CAVA, and 0.912 (P<0.0001, respectively.Our study shows that hematoma shape, hematoma size, ICH scores and GCS score all significantly predict the 30-day mortality in an increasing order of AUC. The effect of overestimation of hematoma size by ABC/2 formula in predicting the 30-day mortality could be remedied by using ICH score.

  12. Hematoma Shape, Hematoma Size, Glasgow Coma Scale Score and ICH Score: Which Predicts the 30-Day Mortality Better for Intracerebral Hematoma?

    Science.gov (United States)

    Wang, Chih-Wei; Liu, Yi-Jui; Lee, Yi-Hsiung; Hueng, Dueng-Yuan; Fan, Hueng-Chuen; Yang, Fu-Chi; Hsueh, Chun-Jen; Kao, Hung-Wen; Juan, Chun-Jung; Hsu, Hsian-He

    2014-01-01

    Purpose To investigate the performance of hematoma shape, hematoma size, Glasgow coma scale (GCS) score, and intracerebral hematoma (ICH) score in predicting the 30-day mortality for ICH patients. To examine the influence of the estimation error of hematoma size on the prediction of 30-day mortality. Materials and Methods This retrospective study, approved by a local institutional review board with written informed consent waived, recruited 106 patients diagnosed as ICH by non-enhanced computed tomography study. The hemorrhagic shape, hematoma size measured by computer-assisted volumetric analysis (CAVA) and estimated by ABC/2 formula, ICH score and GCS score was examined. The predicting performance of 30-day mortality of the aforementioned variables was evaluated. Statistical analysis was performed using Kolmogorov-Smirnov tests, paired t test, nonparametric test, linear regression analysis, and binary logistic regression. The receiver operating characteristics curves were plotted and areas under curve (AUC) were calculated for 30-day mortality. A P value less than 0.05 was considered as statistically significant. Results The overall 30-day mortality rate was 15.1% of ICH patients. The hematoma shape, hematoma size, ICH score, and GCS score all significantly predict the 30-day mortality for ICH patients, with an AUC of 0.692 (P = 0.0018), 0.715 (P = 0.0008) (by ABC/2) to 0.738 (P = 0.0002) (by CAVA), 0.877 (Phematoma shape, hematoma size, ICH scores and GCS score all significantly predict the 30-day mortality in an increasing order of AUC. The effect of overestimation of hematoma size by ABC/2 formula in predicting the 30-day mortality could be remedied by using ICH score. PMID:25029592

  13. Intracerebral hemorrhage (ICH) evaluation with a novel magnetic induction sensor: a preliminary study using the Chinese head model.

    Science.gov (United States)

    Zhang, Ziyi; Liu, Peiguo; Zhou, Dongming; Zhang, Liang; Lei, Hengdong

    2014-01-01

    Biomedical magnetic induction measurement is a promising method for the detection of intracerebral hemorrhage (ICH), especially in China. Aiming at overcoming the problem of low sensitivity, a magnetic induction sensor is chosen to replace the conventional sensors. It uses a two-arm Archimedean spiral coil as the exciter and a circular coil as the receiver. In order to carry out high-fidelity simulations, the Chinese head model with real anatomical structure is introduced into this novel sensor for the first time. Simulations have been carried out upon early stage ICH measurements. By calculating the state sensitivity and time sensitivity of the perturbation phase of two types of sensors using the electromagnetic software, we conclude that the primary signal received can be largely reduced using the novel sensor, which could effectively increase the time and state sensitivity simultaneously.

  14. β -carotene effect the induction of the sister chromatid exchanges (ICH) by gamma radiation in mouse radiosensibilized osseous marrow cells In vivo

    International Nuclear Information System (INIS)

    Morales R, P.; Cruz V, V.L.

    1997-01-01

    The effect of β- carotene over the ICH radioinduction in radiosensibilized with BrdU osseous marrow cells of mouse was determined In vivo. The treatment with 50 μg β carotene per se induces a significant increment in the ICH frequency and the pre or post-treatment with the same dose causes an additive effect in the ICH frequency produced by 0.62 Gy of gamma radiation. This implies that β- carotene does not have radioprotective activity, under conditions which was developed this experiment. (Author)

  15. Influence of I-ching (Yijing, or The Book Of Changes) on Chinese medicine, philosophy and science.

    Science.gov (United States)

    Lu, Dominic P

    2013-01-01

    I-Ching or Yi-Jing ([see text] also known as The Book of Changes) is the earliest classic in China. It simply explained the formation of the universe and the relationship of man to the universe. Most, if not all, branches of various knowledge, including traditional Chinese medicine, can be traced back its origin to this Book in which Fu Shi ([see text] 2852 B.C.) theorized how the universe was formed, through his keen observation of environment and orbits of sun, moon and stars. He used symbols to represent his views. The essence of I-Ching is basically the expression and function of Yang symbolized as "--" (from ) and Yin symbolized "- -" (from --><--), and [see text] Yin and Yang as interaction and circulation of Yang and Yin. Both Yin and Yang were derived from the same origin, Tai-Chi. Fu Shi believed Yin and Yang were the two opposite background force and energy that make the universe as what it is. Yang and Yin manifest in great variety of phenomena such as mind and body, masculine and feminine, sun and moon, hot and cold, heaven and earth, positive and negative electricity etc. The entire theory of Chinese medicine is based on the theories of Yin and Yang as well as that of 5 Element Cycles which are also related to the orderly arrangement of 8 trigrams ([see text]) by King Wen ([see text]1099-1050 B.C.). The 5 Elements Theory explains the "check and balance" mechanism created by the background force of Yin and Yang Qi and illustrated the relationships that are either strengthened or weakened by "acting and controlling" among the 5 elements. I-Ching has exerted profound influences on some well- known European philosophers and scientists, notably Leibnitz and Hegel. Between I-Ching and modern cosmology and the physics of sub-atomic particles, there are some basic theories in common.

  16. Accelerated Stability Testing of a Clobetasol Propionate-Loaded Nanoemulsion as per ICH Guidelines.

    Science.gov (United States)

    Ali, Mohammad Sajid; Alam, Mohammad Sarfaraz; Alam, Nawazish; Anwer, Tarique; Safhi, Mohammed Mohsen A

    2013-01-01

    The physical and chemical degradation of drugs may result in altered therapeutic efficacy and even toxic effects. Therefore, the objective of this work was to study the stability of clobetasol propionate (CP) in a nanoemulsion. The nanoemulsion formulation containing CP was prepared by the spontaneous emulsification method. For the formulation of the nanoemulsion, Safsol, Tween 20, ethanol, and distilled water were used. The drug was incorporated into an oil phase in 0.05% w/v. The lipophilic nature of the drug led to the O/W nanoemulsion formulation. This was characterized by droplet size, pH, viscosity, conductivity, and refractive index. Stability studies were performed as per ICH guidelines for a period of three months. The shelf life of the nanoemulsion formulation was also determined after performing accelerated stability testing (40°C ± 2°C and 75% ± 5% RH). We also performed an intermediate stability study (30°C ± 2°C/65% RH ± 5% RH). It was found that the droplet size, conductivity, and refractive index were slightly increased, while the viscosity and pH slightly decreased at all storage conditions during the 3-month period. However, the changes in these parameters were not statistically significant (p≥0.05). The degradation (%) of the optimized nanoemulsion of CP was determined and the shelf life was found to be 2.18 years at room temperature. These studies confirmed that the physical and chemical stability of CP were enhanced in the nanoemulsion formulation.

  17. [Pediatric drug development: ICH harmonized tripartite guideline E11 within the United States of America, the European Union, and Japan].

    Science.gov (United States)

    Pflieger, M; Bertram, D

    2014-10-01

    To address the lack of appropriate pediatric drugs available on the global market, in 2000 the International Conference on Harmonization of Technical Requirements for Registration of Pharmaceuticals for Human Use (ICH) issued the ICH E11 guideline regarding the Clinical Investigation of Medicinal Products in the Pediatric Population. This guideline considerably changes the environment of drug development for children. It has been written specifically to harmonize, promote, and facilitate high-quality and ethical clinical research for children within the ICH regions, i.e., the United States of America (USA), the European Union (EU), and Japan. This article details the various regulations applicable in each ICH region following the publication of the guideline. The framework of rewards, incentives, and obligations for pharmaceutical companies established for the development of pediatric drugs are compared. It appears that the USA and the EU have both developed specific regulations for pediatric drug development while Japan has not. However, in Japan, pharmaceutical companies (PCs) are encouraged to develop pediatric drugs voluntarily, and they may be granted additional months of market exclusivity or the postponement of the drug re-examination deadline. In both the USA and the EU, regulations aimed to increase the number of clinical studies conducted in children, in order to ensure that the necessary data are generated, determining the conditions in which a drug may be authorized to treat the pediatric population. PCs are encouraged to develop pediatric assessment, including pediatric clinical trials, which is described in a pediatric plan submitted to the relevant authorities. A system of rewards for PCs submitting an application for marketing authorization containing pediatric use information has been put in place to cover the additional investment for testing drugs in children. Subject to conditions, these rewards consist in a 6-month extension of the patent or

  18. Manuscritos freudianos inéditos: das ich und das es

    Directory of Open Access Journals (Sweden)

    Juan Carlos Cosentino

    2013-04-01

    Full Text Available Apresentamos aqui uma leitura crítica e comparada entre o rascunho e a forma final de O ego e o id, no momento em que nasce uma dissimetria entre o inconsciente reprimido e o material inconsciente que permanece não reconhecido. Partimos do capítulo "Os dois tipos de pulsão". O próprio Freud nos lembra que as questões aí levantadas retomam pensamentos iniciados em 1920. A partir da redefinição do Inconsciente e, mais tarde, com a reformulação da ideia de pulsão de morte, tais considerações permanecem mais perto da psicanálise que do texto Além.... Não obstante, o que denomina "nossa especulação" retorna nas conclusões do capítulo IV sobre o pressuposto da pulsão de morte. Com a irrupção do não-ligado, quais são os propósitos da pulsão de morte, em 1923, quando esta tem as mãos livres? Em 1924, constata que não-toda a pulsão está inscrita na representação. Intervém o silêncio da pulsão: essa fronteira, onde o id fala, o id goza e nada sabe.Freudian unpublished manuscripts: das Ich und das Es. This is a critical and comparative reading of the manuscripts of The Ego and the Id. We can read in this work a dissymmetry between the repressed unconscious and the material that remains unknown. We depart from chapter IV, "The two kinds of Drives". As Freud announces, the matters he displays resume thoughts from his writings of 1920. So, starting with the redefinition of Ucs and afterwards, with the reformulation of the idea of Todestrieb, they remain much closer to psychoanalysis than Beyond the pleasure principle. But what he calls, "our speculation" returns in the conclusions of chapter IV about the assumption of the Todestrieb. With the breaking through of the not bound: what are the purposes the Todestrieb serves, when, as he says in 1923, it has its hands free? In 1924 he confirms that not-all the drive is inscribed in the representation. The silence of the drive intervenes: this border, where id speaks, id enjoys

  19. Combination of Intra-Hematomal Hypodensity on CT and BRAIN Scoring Improves Prediction of Hemorrhage Expansion in ICH.

    Science.gov (United States)

    VanDerWerf, Joshua; Kurowski, Donna; Siegler, James; Ganguly, Taneeta; Cucchiara, Brett

    2018-02-06

    Hematoma expansion (HE) occurs in 1/3 of ICH patients and is associated with poor outcome. Intra-hematomal hypodensity (IHH) on CT has been reported to predict HE, as has the "BRAIN" score. We sought to assess the predictive value of these markers alone and in combination. We performed a retrospective single-center study of ICH patients with CT IHH on initial CT. Two HE definitions were examined: > 6 ml and > 6 ml or > 33%. Multivariable logistic regression was used to determine the relationship between IHH and HE. Predictive value of the BRAIN score alone and integrated with IHH was assessed. In 122 included patients, median ICH volume was 13 ml, median time to CT 2.0 h; HE > 6 ml occurred in 31% and > 6 ml/> 33% in 43% of subjects. IHH were identified in 61% of patients with moderate inter-rater agreement (κ = 0.59). In multivariable analysis, IHH was associated with HE using > 6 ml definition (OR 8.3, 95% CI, 2.6-32.8, P  6 ml/> 33% definition (OR 1.9, 95% CI 0.84-4.3, P = 0.12). Rate of HE (> 6 ml) increased across increasing BRAIN score quartiles (Q1:11%, Q2:23%, Q3:43%, Q4:57%, P for trend  6 ml in patients with BRAIN score ≥ 10 and IHH was 55%, with either alone was 33%, and with neither was 3%. Combining IHH on non-contrast CT and a simple clinical BRAIN score is a potentially powerful way to predict those patients at very high and very low risk of HE.

  20. {beta} -carotene effect the induction of the sister chromatid exchanges (ICH) by gamma radiation in mouse radiosensibilized osseous marrow cells In vivo; Efecto del {beta}- caroteno la induccion de intercambios en las cromatidas hermanas (ICH) por radiacion gamma en celulas radiosensibilizadas de la medula osea de raton In vivo

    Energy Technology Data Exchange (ETDEWEB)

    Morales R, P.; Cruz V, V.L. [Instituto Nacional de Investigaciones Nucleares, A.P. 18-1027, 11801 Mexico D.F. (Mexico). Dept. de Biologia

    1997-07-01

    The effect of {beta}- carotene over the ICH radioinduction in radiosensibilized with BrdU osseous marrow cells of mouse was determined In vivo. The treatment with 50 {mu}g {beta} carotene per se induces a significant increment in the ICH frequency and the pre or post-treatment with the same dose causes an additive effect in the ICH frequency produced by 0.62 Gy of gamma radiation. This implies that {beta}- carotene does not have radioprotective activity, under conditions which was developed this experiment. (Author)

  1. Koncepcje Édouarda Séguina i ich znaczenie dla rozwoju pedagogiki osób niepełnosprawnych intelektualnie

    OpenAIRE

    Fetzki, Tomasz

    2011-01-01

    Wydział Studiów Edukacyjnych: Zakład Historii Wychowania Praca ma charakter interdyscyplinarny, historyczno – pedagogiczny. Jej celem była próba stworzenia pierwszej w języku polskim monografii Édouarda Séguina – twórcy pedagogiki osób niepełnosprawnych intelektualnie, zawierającej w miarę pełną biografię Édouarda Séguina, ukazującą jego postać wielowymiarowo, na tle różnych prądów naukowych i społecznych epoki, w której żył, jak też prezentującej w sposób w miarę całościowy oryginalność j...

  2. Significance of the expression of matrix metalloproteinase-9 (MMP-9) in brain tissue of rat models of experimental intracerebral haemorrhage (ICH)

    International Nuclear Information System (INIS)

    Wu Jiami; Liu Shengda

    2005-01-01

    Objective: To study the relationship between the brain tissue expression of MMP-9 and brain water content in rat models of experimental ICH. Methods: Rat models of ICH were prepared with intracerebral (caudate nuclei) injection of autologous noncoagulated blood (50 μl). Animals were sacrificed at 6h, 12h, 24h, 48h, 72h, 120h, lw, 2w and the MMP-9 expressions at the periphery of intracerebral hematoma were examined with immunohisto chemistry. The brain water content was also determined at the same time. Control models were prepared with intracerebral sham injection of normal saline. Results: (1) In the ICH models, the number of MMP-9 positive capillaries at the periphery of hematoma began to rise at 6h (vs that of sham group, P < 0.01 ) with peak at 48h, then gradually dropped. At lwk, the number was still significantly higher than that in the sham group (P <0.01 ). However, there were no expression at 2wk. (2) The brain water content in the ICH group was significantly increased at 12h (vs sham group, P < 0.05) with peak at 72h. At lwk, the brain water content was still significantly higher in the ICH group (P <0.01 ) but at 2wk, the brain water content was about the same in both groups. (3) Animals injected with different amounts of blood (30 μl, 50 μl, 100 μl) showed increased expression of MMP-9 along with the increase of dose (P<0.01). (4) The MMP-9 expression was positively correlated with the brain water content (r=0.8291, P<0.05). Conclusion: In the rat models, MMP-9 expression was activated after ICH. The increase paralleled that of the amount of haemorrhage and brain water content. It was postulated that MMP-9 enhanced development of brain edema through degrading of the blood brain barrier component substances. (authors)

  3. Czechoznawstwo polskie – charakter i sens jednego kierunku badawczego

    Czech Academy of Sciences Publication Activity Database

    Pánek, Jaroslav

    2017-01-01

    Roč. 7, č. 1 (2017), s. 99-113 ISSN 2084-1213 Institutional support: RVO:67985963 Keywords : Czech Studies * Poland * Humanities Subject RIV: AB - History OBOR OECD: History (history of science and technology to be 6.3, history of specific sciences to be under the respective headings)

  4. Wie viel muss ich wissen, um global handeln zu können? Verantwortung für Weltarmut und das Problem der epistemischen Überforderung

    Directory of Open Access Journals (Sweden)

    Weber-Guskar Eva

    2015-12-01

    Full Text Available Was heißt es, sich in unserer globalisierten Welt als eine vollverantwortliche Person zu verstehen und zu verhalten? Einerseits scheint es richtig, dass wir global verantwortlich sind, d.h. dass wir auch gegen entferntes Leid etwas tun sollten; andererseits aber ist wegen vielfacher Überforderungsproblemen unklar ist, wie man diese Verantwortung tatsächlich übernehmen können soll – was wiederum dagegen spricht, dass wir diese Verantwortung berechtigtermaßen zuschreiben können. Um einen Aspekt dieses großen Themas zu behandeln, konzentriere ich mich in diesem Aufsatz auf den Anwendungsbereich von extremer Armut und argumentiere in folgenden Schritten. Zuerst spitze ich das Thema zu auf ein Problem, das Samuel Scheffler in diesem Zusammenhang konstatiert hat, nämlich einen Widerstreit zwischen dem, was Verantwortung unter den Bedingungen der Globalisierung bedeutet und dem, wie wir uns grundsätzlich als Handelnde zu verstehen gewohnt sind. Dann zeige ich erstens, dass dem Thema einer epistemischen Überforderung dabei entscheidendes Gewicht zugesprochen wird, zweitens jedoch, dass sich, genauer besehen, dieses Problem gar nicht in dieser Art stellt. Dafür schlage ich eine Analyse des Verantwortungsbegriffs vor, die es ermöglicht, Kriterien zu identifizieren, anhand derer gewisse Grenzen gezogen werden können, so dass die Zuschreibung der Verantwortung gerechtfertigt werden kann.

  5. The clinical epidemiology of spontaneous ICH in a sub-Sahara African country in the CT scan era: a neurosurgical in-hospital cross-sectional survey

    Directory of Open Access Journals (Sweden)

    Amos Olufemi Adeleye

    2015-08-01

    Full Text Available Background There is paucity of data-driven scientific reports from sub-Saharan Africa on the burden of spontaneous intracerebral haemorrhage (sICH. We have maintained a prospective consecutive in-hospital data base of cases of sICH referred for neurosurgical intervention over a 5-year period. Methods This is a cross-sectional descriptive study of the clinical epidemiology and brain-CT characterization of sICH from the data base in this region in the current era. Results There were 63 subjects, 38 (60.3% males, aged 28 to 85 years, mean 55.7 (SD, 12.7, the modal age distribution being the sixth decade. Uncontrolled hypertension was the main predisposition in the study: present, premorbid, in 79% but uncontrolled in 88% of these known cases, and exhibited malignant derangements of blood pressure in more than half. The clinical ictus to in-hospital presentation was delayed, median 72 hours; was in severe clinical state in 70%; 57% was comatose, and was complicated with fever in 57% and respiratory morbidity also in 55.6%. The main clinical symptomatology was hemiparesis, headache, vomiting and aphasia. The sICH was supratentorial on brain CT in 85.7%, ganglionic in 50.8% and thalamic in 58.3% of the latter. The bleed had CT evidence of mass effect and intraventricular extension in more than half. Twenty three patients (36.5% underwent operative interventionsConclusions In this patient population, sICH is mainly ganglionic and thalamic in location with significant rate of associated IVH. In-hospital clinical presentation is delayed and in critical state, and, the bleeding is uncontrolled hypertension related in >95%.

  6. Dynamics of electron solvation in I(-)(CH3OH)n clusters (4 ≤ n ≤ 11).

    Science.gov (United States)

    Young, Ryan M; Yandell, Margaret A; Neumark, Daniel M

    2011-03-28

    The dynamics of electron solvation following excitation of the charge-transfer-to-solvent precursor state in iodide-doped methanol clusters, I(-)(CH(3)OH)(n = 4-11), are studied with time-resolved photoelectron imaging. This excitation produces a I···(CH(3)OH)(n)(-) cluster that is unstable with respect to electron autodetachment and whose autodetachment lifetime increases monotonically from ~800 fs to 85 ps as n increases from 4 to 11. The vertical detachment energy (VDE) and width of the excited state feature in the photoelectron spectrum show complex time dependence during the lifetime of this state. The VDE decreases over the first 100-400 fs, then rises exponentially to a maximum with a ~1 ps time constant, and finally decreases by as much as 180 meV with timescales of 3-20 ps. The early dynamics are associated with electron transfer from the iodide to the methanol cluster, while the longer-time changes in VDE are attributed to solvent reordering, possibly in conjunction with ejection of neutral iodine from the cluster. Changes in the observed width of the spectrum largely follow those of the VDEs; the dynamics of both are attributed to the major rearrangement of the solvent cluster during relaxation. The relaxation dynamics are interpreted as a reorientation of at least one methanol molecule and the disruption and formation of the solvent network in order to accommodate the excess charge.

  7. High heat flux testing of ITER ICH&CD antenna beryllium faraday screen bars mock-ups

    International Nuclear Information System (INIS)

    Courtois, X.; Meunier, L.; Kuznetsov, V.; Beaumont, B.; Lamalle, P.; Conchon, D.; Languille, P.

    2016-01-01

    Highlights: • ITER ICH&CD antenna beryllium faraday screen bars mock-ups were manufactured. • The mock-ups are submitted to high heat loads to test their heat exhaust capabilities. • The mock-ups withstand without damage the design limit load. • Lifetime is gradually reduced when the heat load is augmented beyond the design limit. • Thermal and mechanical behavior are reproducible, and coherent with the calculation. - Abstract: The Faraday Screen (FS) is the plasma facing component of ITER ion cyclotron heating antennas shielding. The requirement for the high heat exhaust, and the limitation of the temperatures to minimize strain and thus offer sufficient resistance to fatigue, imply the need for high conductivity materials and a high cooling flow rate. The FS bars are constructed by a hipping process involving beryllium tiles, a pure copper layer, a copper chrome zirconium alloy for the cooling channel and a stainless steel backing strip. Two FS bars small scale mock-ups were manufactured and tested under high heat flux. They endured 15,000 heating cycles without degradation under nominal heat flux, and revealed growing flaws when the heat flux was progressively augmented beyond. In this case, the ultrasonic test confirms a strong delamination of the Be tiles.

  8. Adherence of non-pharmaceutically sponsored oncology trial protocols to the International Conference on Harmonization (ICH) guidelines in an academic institution outside the ICH jurisdictions and the impact of IRB implementation on this adherence

    International Nuclear Information System (INIS)

    Zeeneldin, A.A.

    2013-01-01

    Purpose: To assess adherence of non-pharmaceutically sponsored trials (non-PSTs) to ICH protocol structure guidelines and to estimate the effect of implementing Institutional Review Boards (IRB) review on this adherence. Methods: This is a retrospective exploratory study where 60 non-PST clinical trial protocols (CTPs) were reviewed and halved to IRB-reviewed CTPs (IRCTPs) and non-lRB-reviewed CTPs (non-lRCTPs). Adherence score (AS) was calculated as the number of fulfilled items or sub-items divided by their total number. Results: Three adherence patterns were encountered: (1) items consistently present in both groups e.g. general and background information, objectives, inclusion criteria and intervention details, (2) items consistently absent in both groups and included contact information of investigators and trial sites, product accountability, randomization codes management, interim analyses and many other statistical aspects, and (3) items variably present in both groups where the effect of IRB was verifiable. Trial site details, potential benefits, discontinuation and exclusion criteria, and follow up for adverse events were more encountered in IRCTPs than non-IRCTPs. Withdrawal criteria monitoring of treatment compliance showed a reverse pattern (p < 0.05 for all). The total AS, administrative AS and ethics AS for IRCTPs was 43%, 22% and 70% compared to 38%, 16% and 33% for non-IRCTPs (p < 0.003, <0.001, 0.004), respectively. The scientific AS was 54% for both groups (p = 0.87). Conclusions: IRB-implementation at NCl-Egypt improved ethical and administrative sections of academic protocols. However, this improvement is modest and needs further actions including adoption of protocol templates. Scientific sections were as good after IRB-implementation as they were before that

  9. Marketingová situační analýza BK Lions Jindřichův Hradec

    OpenAIRE

    Hron, Patrik

    2014-01-01

    The aim of this bachelor thesis is to carry out an analysis of each part of marketing mix and the environment in which the BK Lions Jindřichův Hradec basketball club is situated. Suitable and applicable recommendations are suggested to make the marketing mix more effective based on analysis of marketing situation. The first part is focused on describing the marketing mix and marketing situational analysis at a theoretical level. The practical part describes particular marketing tools which ar...

  10. Do I still want to take this? Soll ich das wirklich schlucken? Uncertainty avoidance in English and German PILs - a contrastive study

    OpenAIRE

    Verplaetse, Heidi; Wermuth, Cornelia

    2013-01-01

    Do I still want to take this? Soll ich das wirklich schlucken? Uncertainty avoidance in English and German PILs - a contrastive study Aim and focus The current study aims to compare the linguistic means used in German and English patient information leaflets (PILs) for patients’ understanding and behaviour concerning medicine intake. We focus on the expression of uncertainty avoidance. Background Three studies and a European guideline lie at the basis of the current study. ...

  11. Kein Mensch ist ein Ich-Land [No man is an island]. The metaphorof an island in reflections on friendship

    Directory of Open Access Journals (Sweden)

    Joanna Roszak

    2010-01-01

    Full Text Available In her essay, the author recalls literary contexts (including John Donne, Michel Houellebecq and Ernest Hemingway and philosophical and anthropological contexts (including Aristotle, Thomas Merton, Maurice Blanchot, Jean-Paul Sartre and Gilles Deleuze presenting the poetic “I’s” various ways of approaching friendship. The quotation from a German translation of John Donne’s poem used in the title of the article is in itself a meaningful phonetic wordplay: “Kein Mensch ist ein Ich-Land” (no man is an “I” land, no man is an island. The main part of the essay includes an interpretation of the television series Lost — Joanna Roszak investigates philosophical references in the series and indicates biblical contexts (“Am I my brother’s keeper?”. A very apt comment to many episodes in the series is, according to the author, the formula told by Z. Herbert’s Fortinbras: Ani nam witać się ani żegnać żyjemy na archipelagach/ A ta woda te słowa cóż mogą cóż mogą” [It is not for us to greet each other or bid farewell we live on archipelagos/ and that water these words what can they do what can they do prince]. It is a similar defencelessness in which the main characters of Lost try to struggle the reality, even if they live together, and die all alone. Collective memory has become a safeguard for the community in the world, which is to be destined for homelessness and forlornness. The other person though becomes a reference point — it is him or her that makes it possible to find the way home.

  12. A comparative study of ICH validated novel spectrophotometric techniques for resolving completely overlapping spectra of quaternary mixtures

    Science.gov (United States)

    Ali, Nouruddin W.; Abdelwahab, Nada S.; Abdelkawy, M.; Emam, Aml A.

    2016-02-01

    A pharmaceutically marketed mixture of Yohimbine, Alpha-tocopheryl acetate, Niacin, and Caffeine co-formulated as a promising therapy for erectile dysfunction. Simultaneous determination of the aforementioned pharmaceutical formulation without prior separation steps was applied using mean centering of ratio spectra and triple divisor spectrophotometric methods. Mean centering of ratio spectra method depended on using the mean centered ratio spectra in three successive steps which eliminated the derivative steps and so the signal to noise ratio was improved. The absorption spectra of the prepared solutions were measured in the wavelength range of 215-300 nm in the concentration ranges of 1-15, 3-15, 1-20, and 3-15 μg mL- 1 for Yohimbine, Alpha-tocopheryl acetate, Niacin, and Caffeine, respectively. The amplitudes of the mean centered third ratio spectra were measured at 250 nm and 268 nm for Yohimbine and Alpha-tocopheryl acetate, respectively and at peak to peak 272-273 and 262-263 nm for Niacin and Caffeine, respectively. In triple divisor method each drug in the quaternary mixture was determined by dividing the spectrum of the quaternary mixture by a standard spectrum of a mixture containing equal concentrations of the other three drugs. First derivative of these ratio spectra was obtained where determination could be achieved without any interference from the other three drugs. Amplitudes of 1-15, 3-15, 1-15, and 3-15 μg mL- 1 were used for selective determination of Yohimbine, Alpha-tocopheryl acetate, Niacin, and Caffeine, respectively. Laboratory prepared mixtures were analyzed by the developed novel methods to investigate their selectivity also, Super Act® capsules were successfully analyzed to ensure absence of interference from additives. The developed methods were validated according to the ICH guidelines. The proposed methods were statistically compared with each other and with the reported methods; using student t-test, F-test, and one way ANOVA

  13. A multi-site comparison of in vivo safety pharmacology studies conducted to support ICH S7A & B regulatory submissions.

    Science.gov (United States)

    Ewart, Lorna; Milne, Aileen; Adkins, Debbie; Benjamin, Amanda; Bialecki, Russell; Chen, Yafei; Ericsson, Ann-Christin; Gardner, Stacey; Grant, Claire; Lengel, David; Lindgren, Silvana; Lowing, Sarah; Marks, Louise; Moors, Jackie; Oldman, Karen; Pietras, Mark; Prior, Helen; Punton, James; Redfern, Will S; Salmond, Ross; Skinner, Matt; Some, Margareta; Stanton, Andrea; Swedberg, Michael; Finch, John; Valentin, Jean-Pierre

    2013-01-01

    Parts A and B of the ICH S7 guidelines on safety pharmacology describe the in vivo studies that must be conducted prior to first time in man administration of any new pharmaceutical. ICH S7A requires a consideration of the sensitivity and reproducibility of the test systems used. This could encompass maintaining a dataset of historical pre-dose values, power analyses, as well as a demonstration of acceptable model sensitivity and robust pharmacological validation. During the process of outsourcing safety pharmacology studies to Charles River Laboratories, AstraZeneca set out to ensure that models were performed identically in each facility and saw this as an opportunity to review the inter-laboratory variability of these essential models. The five in vivo studies outsourced were the conscious dog telemetry model for cardiovascular assessment, the rat whole body plethysmography model for respiratory assessment, the rat modified Irwin screen for central nervous system assessment, the rat charcoal meal study for gastrointestinal assessment and the rat metabolic cage study for assessment of renal function. Each study was validated with known reference compounds and data were compared across facilities. Statistical power was also calculated for each model. The results obtained indicated that each of the studies could be performed with comparable statistical power and could achieve a similar outcome, independent of facility. The consistency of results obtained from these models across multiple facilities was high thus providing confidence that the models can be run in different facilities and maintain compliance with ICH S7A and B. Copyright © 2013 Elsevier Inc. All rights reserved.

  14. Patient Experience Assessment is a Requisite for Quality Evaluation: A Discussion of the In-Center Hemodialysis Consumer Assessment of Health Care Providers and Systems (ICH CAHPS) Survey.

    Science.gov (United States)

    Cavanaugh, Kerri L

    2016-01-01

    Patient experience surveys provide a critical and unique perspective on the quality of patient-centered healthcare delivery. These surveys provide a mechanism to systematically express patients' voice on topics valued by patients to make decisions about choices in care. They also provide an assessment to healthcare organizations about their service that cannot be obtained from any other source. Regulatory agencies have mandated the assessment of patients' experience as part of healthcare value based purchasing programs and weighted the results to account for up to 30% of the total scoring. This is a testimony to the accepted importance of this metric as a fundamental assessment of quality. After more than a decade of rigorous research, there is a significant body of growing evidence supporting specifically the validity and use of the Consumer Assessment of Healthcare Providers and Systems (CAHPS) surveys, including a version specific to in-center hemodialysis (ICH CAHPS). This review will focus on the ICH CAHPS survey including a review of its development, content, administration, and also a discussion of common criticisms. Although it is suggested that the survey assesses activities and experiences that are not modifiable by the healthcare organization (or the dialysis facility in our case) emerging evidence suggests otherwise. Dialysis providers have an exclusive opportunity to lead the advancement of understanding the implications and serviceability of the evaluation of the patient experience in health care. © 2016 Wiley Periodicals, Inc.

  15. Ocena stanu zachowania gazet i czasopism wielkopolskich z lat 1800-1939 przechowywanych w Bibliotece Uniwersyteckiej w Poznaniu pod kątem ich zakwaszenia

    Directory of Open Access Journals (Sweden)

    Katarzyna Kubiś

    2009-01-01

    Full Text Available W latach 2007-2008 w Bibliotece Uniwersyteckiej w Poznaniu przeprowadzono badania mające określić stan zachowania przechowywanych w jej magazynach gazet i czasopism wielkopolskich z lat 1800-1939 pod kątem ich zakwaszenia. W tym celu zastosowano metodę stanfordzką, połączoną z badaniem pH papieru. Wytypowana do analiz kolekcja obejmowała 7014 woluminów, z których wyodrębniono 384 egzemplarze stanowiące próbę reprezentatywną. W wyniku badań ustalono, że 40% kolekcji jest w bardzo złym stanie, a dalsze 45% to egzemplarze zniszczone i wymagające naprawy. Wszystkie przebadane obiekty wydrukowane zostały na kwaśnym papierze, co więcej – dla 96% kolekcji odnotowano pH poniżej 5. W świetle przeprowadzonych badań należy stwierdzić, że 85% kolekcji powinna zostać przeniesiona na nośniki analogowe i cyfrowe, a następnie, o ile pozwoli na to ich obecny stan zachowania, poddana procesowi odkwaszania.

  16. Debata o památkové péči v 60. letech 20. století. Ivo Loos, Jindřich Malátek a Transgas

    Czech Academy of Sciences Publication Activity Database

    Švácha, Rostislav

    2017-01-01

    Roč. 77, č. 4 (2017), s. 361-372 ISSN 1210-5538 Institutional support: RVO:68378033 Keywords : Jindřich Malátek * Ivo Loos * postwar architecture * theory of architecture and heritage care * Transgas Subject RIV: AL - Art, Architecture, Cultural Heritage

  17. Karel Kramář a Jindřich G. Maštálka. "Tys' nebyl přítelem heroických rozhodnutí..."

    Czech Academy of Sciences Publication Activity Database

    Bílek, Jan

    2009-01-01

    Roč. 17, Suppl. 2 (2009), s. 177-199 ISSN 1210-6860. [Karel Kramář (1860-1937). Praha, 31.10.2007-02.11.2007] Institutional research plan: CEZ:AV0Z70900502 Keywords : Kramář, Karel * Maštálka, Jindřich Gustav Subject RIV: AB - History

  18. Study and ICH validation of a reverse-phase liquid chromatographic method for the quantification of the intact monoclonal antibody cetuximab

    Directory of Open Access Journals (Sweden)

    Antonio Martínez-Ortega

    2016-04-01

    Full Text Available Cetuximab (CTX is a potent chimeric mouse/human monoclonal antibody (mAb approved worldwide for treatment of metastatic colorectal cancer. Among the various biological and physical analyses performed for full study on this biopharmaceutic, the determination of the concentration preparations throughout manufacturing and subsequent handling in hospital is particularly relevant. In the present work, the study and validation of a method for quantifying intact CTX by reverse-phase high-performance liquid chromatography with diode array detection ((RPHPLC/DAD is presented. With that end, we checked the performance of a chromatographic method for quantifying CTX and conducted a study to validate the method as stability-indicating in accordance with the International Conference on Harmonization guidelines (ICH for biotechnological drugs; therefore, we evaluated linearity, accuracy, precision, detection and quantification limits, robustness and system suitability. The specificity of the method and the robustness of the mAb formulation against external stress factors were estimated by comprehensive chromatographic analysis by subjecting CTX to several informative stress conditions. As demonstrated, the method is rapid, accurate, and reproducible for CTX quantification. It was also successfully used to quantify CTX in a long-term stability study performed under hospital conditions.

  19. Calcite raft geochemistry as a hydrological proxy for Holocene aquifer conditions in Hoyo Negro and Ich Balam (Sac Actun Cave System), Quintana Roo, Mexico

    Science.gov (United States)

    Kovacs, Shawn E.; Reinhardt, Eduard G.; Chatters, James C.; Rissolo, Dominique; Schwarcz, Henry P.; Collins, Shawn V.; Kim, Sang-Tae; Nava Blank, Alberto; Luna Erreguerena, Pilar

    2017-11-01

    Two cores from calcite rafts deposits located in Cenote Ich Balam and Hoyo Negro were dated and analyzed for 87Sr/86Sr, δ18O, δ13C, Sr/Ca and Cl/Ca. The geochemical records show changing aquifer salinity spanning the last ∼ 8.5 cal kyrs BP and interrelationships with Holocene climate trends (wet and dry periods). During the wet mid-Holocene, the salinity of the meteoric Water Mass (WM; at 7.8-8.3 cal kyrs BP) was relatively high at 1.5-2.7 ppt and then became less saline (1.0-1.5 ppt) during the last ∼ 7000 yrs as climate became progressively drier. High salinity of the meteoric WM during the wet mid-Holocene is attributed to increased turbulent mixing between the meteoric and underlying marine WM. Increased precipitation, in terms of amount, frequency, and intensity (e.g. hurricanes) causes higher flow of meteoric water towards the coast and mixing at the halocline, a phenomenon recorded with recent instrumental monitoring of the aquifer. Conversely, during dry periods reduced precipitation and flow in the meteoric WM would result in lower salinity. Karst properties and Holocene sea-level rise also seem to have an effect on the aquifer. When the regionally extensive network of shallow cave passages (∼ 10-12 m water depth) are flooded at ∼ 8000 cal yrs BP, there is a rapid shift in salinity. This study demonstrates that calcite raft deposits can be used as paleo-environmental recorders documenting the effects of sea level and climate change on aquifer condition.

  20. Der 'Religiöse' Charakter von Heideggers philosohischer Methode: Relegere, Re-elegere, Relinquere

    NARCIS (Netherlands)

    Blok, V.

    2011-01-01

    The question addressed in this article is to what extent a destructed concept of religion can be said to characterize the philosophical method of Martin Heidegger. In order to approach this question, we first characterize his method as "Vollzug der Fraglichkeit": philosophy in its deepest sense does

  1. Impact of globalization under the ICH guidelines on the conduct of reproductive toxicity studies--report on current status in Japan, Europe and the U.S. by questionnaire survey.

    Science.gov (United States)

    Mineshima, Hiroshi; Endo, Yoshihiko; Ogasawara, Hiroyuki; Nishigaki, Keiji; Numa, Toshiaki; Hirano, Fumiya; Matsuzawa, Toshiaki

    2004-08-01

    We surveyed interpretation of the ICH guidelines concerning reproductive toxicology. Valid responses were obtained from Japan (JPN), Europe (EUR) and the U.S. The results obtained were compared to those at the time of a previous survey targeted at JPN facilities in 1995-1996 as well as compared among all three regions. Compared to the previous survey in Japan, the number of facilities performing toxicokinetics (TK) in rats has slightly increased. This result was considered to represent changes of attitude toward TK in reproductive toxicity studies. Differences in interpretation of the guidelines between JPN, EUR and the US were widely seen. Clear differences were noted in sperm examinations, postnatal tests, fetal examinations, some examinations for F1 animals after culling and TK. Researchers in the West seemed to be interpreting the ICH guidelines more flexibly from the scientific point of view. JPN researchers appeared to interpret the guidelines, including notes, as rigid requirements. Most of the parts which produced different interpretations were the notes in the guidelines. The force of mention in the notes should be defined in the future. In addition, there were doubts about some parts, including notes, which had been found to have become unsuitable for the implementation of studies because of scientific progress or from long experience in using the guidelines. Therefore, updates of the guidelines may be needed in the future as well as the remedy of interpretation by JPN researchers. In JPN, the number of reproductive toxicity studies has decreased. The scanty experience in JPN therefore raises apprehension of appropriate selection and stagnating development of methodology, and might hinder the maintenance of the guidelines. In the future, the cooperation of CROs as well as global collaboration will be essential not only to scientific developments of reproductive toxicology but also updates of the guidelines.

  2. Motywy wędrówki dusz i dybuka w kulturze żydowskiej i ich współczesna realizacja w twórczości Jony Wolach

    Directory of Open Access Journals (Sweden)

    Anna Piątek

    2016-06-01

    Full Text Available Motifs of transmigration of souls and dybbuk in Jewish culture and their contemporary implementation in the works by Yona Wollach This article describes two concepts important for Jewish mysticism – dybbuk and the transmigration of soul, and goes on to present their contemporary usage in the works by Yona Wollach. The concept of the transmigration of souls (in Hebrew: gilgul neshamot describes a situation whereby the soul of a dead person returns to the this world and occupies a new body. In the case of the dybbuk (in Hebrew: dibuk, on the other hand, the body of a living person, who has his or her own soul, is possessed by the spirit of a dead person. The concepts of reincarnation and dybbuk played an important role not only in religious tradition but also in folklore and popular and high culture. Both became the focus of a number of artworks. The article presents fragments of the poems of the Israeli poet Yona Wollach (1944–1985, in which she describes psychological states similar to transmigration of souls and being captured by a dybbuk. The article aims to show that these poetic images are in close connection with Wollach`s concept of the human psyche.   Motywy wędrówki dusz i dybuka w kulturze żydowskiej i ich współczesna realizacja w twórczości Jony Wolach Artykuł przybliża dwa ważne pojęcia mistyki żydowskiej – dybuka i wędrówki dusz, a następnie ukazuje współczesne nawiązanie do nich w twórczości Jony Wolach. Pod pojęciem wędrówki dusz (hebr. gilgul neszamot rozumie się sytuację, w której dusza zmarłego wraca do świata doczesnego i zamieszkuje w nowym ciele. Natomiast w przypadku dybuka (hebr. dibuk dochodzi do zawładnięcia ciałem żywego człowieka, posiadającego już jedną duszę, przez ducha zmarłej wcześniej osoby. Pojęcia wędrówki dusz i dybuka odgrywały istotną rolę nie tylko w tradycji religijnej, ale i w folklorze oraz kulturze popularnej i wysokiej, stając się tematem wielu dzie

  3. Rezension von: Thomas Martinec, Claudia Nitschke (Hg.: Familie und Identität in der deutschen Literatur. Frankfurt am Main u.a.: Peter Lang Verlag 2009. — Ariane Eichenberg: Familie – Ich – Nation. Göttingen: V&R unipress 2009.

    Directory of Open Access Journals (Sweden)

    Christine Kanz

    2010-06-01

    Full Text Available Die Themen Generation und Familie gehören zu den wichtigsten Sujets literarischer Texte, insbesondere wenn diese die Herausbildung oder die Zerstörung von Identität problematisieren. Ein neuer, von Claudia Nitschke und Thomas Martinec herausgegebener Tagungsband ist der literatur- und kulturwissenschaftlichen Auseinandersetzung mit diesen Themen gewidmet. Sechs Jahrzehnte nach dem Ende des Zweiten Weltkrieges hat vor allem das Genre des Generationenromans Hochkonjunktur, insbesondere Texte der dritten Generation zum Umgang der Großeltern-Generation mit dem Nationalsozialismus. Den Verfasser/-innen dieses neuen, in sich heterogenen Genres wird in der Studie von Ariane Eichenberg allerdings keine allzu große Wirkmächtigkeit bescheinigt. Im Gegenteil nährten die modischen Texte mit den Funden aus der Vergangenheit vor allem das Ich der Erzähler/-innen, deren eigene Gefühle und Selbstvergewisserung in einer von Unsicherheiten geprägten Gegenwart.

  4. Sposób prowadzenia badań archeologiczno-architektonicznych, a możliwości wykorzystania ich wyników w procesie projektowym na przykładzie byłego Szpitala im. Babińskiego we Wrocławiu.

    Directory of Open Access Journals (Sweden)

    Justyna Kleszcz

    2018-04-01

    Full Text Available Niniejszy artykuł stanowi omówienie zagadnienia trybu i sposobu prowadzenia badań archeologiczno-architektonicznych ze szczególnym uwzględnieniem możliwości prawnych oraz analizę skutków (pozytywnych i negatywnych wyboru poszczególnych form na sposób, w jaki prowadzone są prace projektowe oraz możliwości ekspozycji odsłoniętych reliktów. Zagadnienia te zostaną omówione głównie na przykładzie prac prowadzonych od 2015 roku na obszarze byłego szpitala im. Babińskiego przy placu Jana Pawła II we Wrocławiu przez zespół badawczy pod kierunkiem dr inż. arch. Piotra Kmiecika oraz dr Roberta Szweda, przy współudziale dr Czesława Lasoty. Teren byłego Szpitala był zdecydowanie jednym z najciekawszych pod względem archeologiczno – architektonicznym we Wrocławiu, jednocześnie jednak również jednym z najbardziej skomplikowanych. Na stopień skomplikowania miało wpływ nie tyle nagromadzenie warstw kulturowych i spodziewanych odkryć, a samo położenie oraz nawarstwienie ciągłych przekształceń obszaru, skutkujące gęstą zabudową, a także nagromadzeniem czynnych magistrali sieciowych o znaczeniu tranzytowym, ukształtowaniem powiązań komunikacyjnych w obrębie rozległego obszaru i ukształtowaniem zieleni objętej ochroną prawną. Jednoczesne wystąpienie tylu czynników spowodowało niemożliwość oszacowania zakresu i wielkości prowadzonych prac przed ich rozpoczęciem, wymusiło elastyczność oraz konieczność zaaranżowania badań z uwzględnieniem udziału ekip budowlanych w ich trakcie. Poziom komplikacji wymuszał także pewne modyfikacje w trybie prowadzonych prac, co ukazuje konieczność weryfikacji podejścia do restrykcyjnego podziału, oraz ukazuje szereg możliwości, jakie daje ściślejsza współpraca na linii architekt-archeolog-urząd konserwatora zabytków-budowa.

  5. Il’ich’s Native Land Today,

    Science.gov (United States)

    1982-09-28

    riil t". r1*1e.re taft fat 2vv**,cvq 4 t"~ ~J1 of labor by 22 April 1970. for industrial enterprises to inerease the profit in 1970 in camparios with...two minuts another vehicle moves out to carry out the exerolte. The tank which was driven n the route by a third course student, Acosoal wsaer Turly...should we meet the great date with new successes in labor , but also with serious deeds in the communist upbringing of the youth. We are living in the

  6. Design of fast tuning elements for the ITER ICH system

    International Nuclear Information System (INIS)

    Swain, D.W.; Goulding, R.H.

    1996-05-01

    The coupling between the ion cyclotron (IC) antenna and the ITER plasma (as expressed by the load resistance the antenna sees) will experience relatively fast variations due to plasma edge profile modifications. If uncompensated, these will cause an increase in the amount of power reflected back to the transmitter and ultimately a decrease in the amount of radio frequency (rf) power to the plasma caused by protective suppression of the amount of rf power generated by the transmitter. The goals of this task were to study several alternate designs for a tuning and matching (T ampersand M) system and to recommend some research and development (R ampersand D) tasks that could be carried out to test some of the most promising concepts. Analyses of five different T ampersand M configurations are presented in this report. They each have different advantages and disadvantages, and the choice among them must be made depending on the requirements for the IC system. Several general conclusions emerge from our study: The use of a hybrid splitter as a passive reflected-power dump [''edge localized mode (ELM)-dump''] appears very promising; this configuration will protect the rf power sources from reflected power during changes in plasma loading due to plasma motion or profile changes (e.g., ELM- induced changes in the plasma scrape-off region) and requires no active control of the rf system. Trade-offs between simplicity of design and capability of the system must be made. Simple system designs with few components near the antenna either have high voltages over considerable distances of transmission lines, or they are not easily tuned to operate at different frequencies. Designs using frequency shifts and/or fast tuning elements can provide fast matching over a wide range of plasma loading; however, the designs studied here require components near the antenna, complicating assembly and maintenance. Capacitor-tuned resonant systems may offer a good compromise

  7. Ich glaube nicht an übersinnliche Kraft hinter Naturgesetzen

    CERN Document Server

    2005-01-01

    The European Organisation for Nuclear Research CERN in Geneva is the leader in research sector of the elementary particles. And a sud-tyrolean has an essential interest in it. Südtirol Online speaks with this physicist about Universe, the smallest components in nature, and about the question: "What is behind?"

  8. ICH Guidelines-compliant HPLC-UV Method for Pharmaceutical ...

    African Journals Online (AJOL)

    NICOLAAS

    samples; (2) the method devoted to analysis of plasma samples is relying on intensive and costly ... by Saudi Food & Drug Authority Laboratories (Riyadh, Saudi. Arabia). .... The ruggedness of the method was evaluated by altering the .... PDGFRb+ perivascular progenitor cells in tumours regulate pericyte differentiation and ...

  9. Wissensmanagementsysteme in Schulen oder: wie bringe ich Ordnung ins Chaos?

    Directory of Open Access Journals (Sweden)

    Andreas Breiter

    2002-11-01

    Full Text Available Die zunehmende Ausstattung von Schulen mit digitalen Medien wird zu einer Herausforderung für die Organisationsentwicklung. Digitale Materialien der Lehrkräfte sowie Schülerarbeiten in digitalisierter Form wachsen tagtäglich an. Bisher fehlen geeignete organisatorische und technische Möglichkeiten zur Archivierung, Verteilung und Nutzung. In Unternehmen hat sich mit dem Begriff Wissensmanagement ein organsatorisches Konzept etabliert, das die Nutzung der Ressource Wissen optimieren will. Um diese Prozesse zu unterstützen, wurden und werden informations- und kommunikationstechnische Werkzeuge entwickelt, deren Übertragung auf den Schulbereich aufgrund dessen organisatorischer Komplexität aber scheitern muss. In diesem Beitrag werden diese Besonderheiten herausgestellt und die Erfahrungen mit der Entwicklung eines webbasierten Wissensmanagementsystems in Zusammenarbeit mit Schulen skizziert.

  10. ICH antenna development on the ORNL RF Test Facility

    International Nuclear Information System (INIS)

    Gardner, W.L.; Bigelow, T.S.; Haste, G.R.; Hoffman, D.J.; Livesey, R.L.

    1987-01-01

    A compact resonant loop antenna is installed on the ORNL Radio Frequency Test Facility (RFTF). Facility characteristics include a steady-state magnetic field of ∼ 0.5 T at the antenna, microwave-generated plasmas with n e ∼ 10 12 cm -3 and T e ∼ 8 eV, and 100 kW of 25-MHz rf power. The antenna is tunable from ∼22--75 MHz, is designed to handle ≥1 MW of rf power, and can be moved 5 cm with respect to the port flange. Antenna characteristics reported and discussed include the effect of magnetic field on rf voltage breakdown at the capacitor, the effects of magnetic field and plasma on rf voltage breakdown between the radiating element and the Faraday shield, the effects of graphite on Faraday shield losses, and the efficiency of coupling to the plasma. 2 refs., 4 figs

  11. Ocena stopnia uzależnienia społeczeństwa od smartfonów oraz zdrowotnych i psychospołecznych skutków ich używania = Assessment of the degree of dependence of society from smartphones, and health and psychosocial effects of their use

    Directory of Open Access Journals (Sweden)

    Sandra Ćwikła

    2016-09-01

      Ocena stopnia uzależnienia społeczeństwa od smartfonów oraz zdrowotnych i psychospołecznych skutków ich używania Assessment of the degree of dependence of society from smartphones, and health and psychosocial effects of their use   Sandra Ćwikła1, Dominik Olejniczak2   1 Absolwentka kierunku Zdrowie Publiczne Wydział Nauki o Zdrowiu Warszawski Uniwersytet Medyczny   2 Warszawski Uniwersytet Medyczny Zakład Zdrowia Publicznego ul. Banacha 1a, 02-097 Warszawa     Słowa kluczowe: smartfon, zachowania zdrowotne, uzależnienie, internet Key words: Smartphone, Health Behavior, Addiction, Internet     Streszczenie Wprowadzenie: Badania pokazują, że smartfon staje się nieodłącznym elementem życia współczesnego człowieka. Powodem, dla którego ludzie chętnie kupują i użytkują smartfony jest ich wielozadaniowość. Zadaniem aplikacji mobilnej jest niezależne od czasu i miejsca umożliwienie użytkownikom dostępu do informacji, komunikacji oraz rozrywki. Celem głównym badania własnego było określenie stopnia uzależnienia respondentów od smartfonów. Materiał i metoda: Badanie przeprowadzone zostało za pomocą metody sondażu diagnostycznego. Za narzędzie badawcze posłużył autorski kwestionariusz w wersji papierowej oraz elektronicznej. Kwestionariusz został wypełniony anonimowo przez 319 osób. Wyniki: Ponad 2/3 badanych deklaruje, że używa telefonu przez cały dzień bądź kilkanaście razy dziennie. Badanie własne pokazuje, że ponad połowa respondentów używa smartfony do celów służbowych (30% lub służbowych I prywatnych (41%. Ponad połowa (58% respondentów nie wyobraża sobie spędzenia tygodnia bez telefonu. Spośród wszystkich respondentów, aż 65% zaliczyłoby samych siebie do osób zależnych od smartfona. Wnioski: Praca biurowa jest często związana z używaniem telefonu komórkowego, co może być również powodem uzależnienia. Smartfony stały się nieodłącznym i niezastąpionym

  12. The Application of Modern Techniques and Measurement Devices for Identification of Copper Ore Types and Their Properties / Wykorzystanie nowoczesnych technik i urządzeń pomiarowych do identyfikacji typów rud miedzi i ich właściwości

    Science.gov (United States)

    Krawczykowska, Aldona; Trybalski, Kazimierz; Krawczykowski, Damian

    2013-06-01

    minerałów miedzionośnych oraz rodzajem ich skupień i wpryśnięć. Niezwykle istotne jest właściwe rozpoznanie rudy pod względem petrograficzno-mineralogicznym. Znajomość właściwości przerabianej rudy pozwala na pełniejsze jej wykorzystanie poprzez właściwe prowadzenie i sterowanie procesami, dobór ich parametrów takich m.in. jak: czas mielenia, parametry klasyfikacji, rodzaj odczynników flotacyjnych, czas flotacji. W artykule przedstawiono wyniki przeprowadzonych analiz mikroskopowych, analizy obrazów zdjęć skaningowych oraz procedury wykorzystania otrzymanych informacji do identyfikacji typów rud (zastosowanie sieci neuronowych do rozpoznawania składów litologicznych). W badaniach wykorzystano rudę miedzi, pochodzącą z jednego z zakładów górniczych KGHM Polska Miedź S.A. Pobrane próbki rudy reprezentowały każdy z trzech typów litologicznych występujących w krajowych złożach: węglanową, łupkową oraz piaskowcową. Przeprowadzono ilościową analizę mineralogiczno-petrograficzną przy pomocy mikroskopu optycznego w świetle odbitym, a wyniki przedstawiono w tabelach 1 i 2. Wyniki te określają ilościowo stopień uwolnienia i zrosty dla jednego rodzaju minerału. Pokazano także przykładowe zdjęcia mikroskopowe zgładów poszczególnych typów litologicznych rud oraz próbek proszkowych tych typów (rys. 1 i 2). W kolejnym etapie badań wykorzystano skaningowy mikroskop elektronowy. Zdjęcia morfologii próbek uzyskane z mikroskopu elektronowego (obrazy SEM) były przedmiotem komputerowej analizy obrazu, umożliwiającej mikrostrukturalną klasyfikację ilościową typów rud. Analizowano wszystkie próbki poszczególnych typów litologicznych rudy miedzi: węglanowej, łupkowej i piaskowcowej oraz mieszanki tych typów w trzech klasach ziarnowych: 0÷45 μm, 45÷71 μm i 71÷100 μm. Celem przekształceń wykorzystanych w procedurze komputerowej analizy obrazu jest otrzymanie poprawnie posegmentowanego obrazu binarnego, kt

  13. Ocena zdolność do pracy zawodowej pielęgniarek oraz analiza zagrożeń psychospołecznych występujących na ich stanowiskach pracy – badania pilotażowe = Assessment of work ability of nurses and analysis of psychosocial risks occurring at their workplaces – pilot study

    Directory of Open Access Journals (Sweden)

    Kinga Dorota Kulczycka

    2016-10-01

      Słowa kluczowe: zdolność do pracy zawodowej, obciążenie psychospołeczne, pielęgniarstwo. Key words: work ability, psychosocial load, nursing.       Streszczenie Wstęp. Każdego roku wśród Polaków zwiększa się odsetek osób starszych. Starzenie się społeczeństwa sprawia, że w kraju rośnie zapotrzebowanie na opiekę pielęgniarską. Tymczasem wskaźnik zatrudnienia pielęgniarek w bezpośredniej opiece nad pacjentem w Polsce należy do najniższych w Europie. Niedobór kadr wymusza na pracujących wykonywanie większej liczby zadań w tym samym czasie, obciążając ich organizm zarówno w wymiarze fizycznym jaki i psychologicznym. Cel pracy. Celem niniejszej pracy jest ocena zdolności do pracy zawodowej i zagrożeń psychospołecznych wśród personelu pielęgniarskiego .Materiał i metody. Badanie przeprowadzono w grudniu 2015 roku wśród aktywnych zawodowo pielęgniarek. Badania prowadzono przy użyciu: Indeksu zdolności do pracy zawodowej (WAI, części D Skali Ryzyka Psychospołecznego oraz autorskiej ankiety. Wyniki. Zdolność do pracy zawodowej pielęgniarek oceniono na umiarkowaną (44,4% oraz dobrą (44,4%. Uzyskano silną korelację ujemną pomiędzy wynikiem wskaźnika WAI a wiekiem (r=-0,68; p=0,002 oraz stażem pracy ogółem(r=-0,55; p=0,02. Istotną korelację zdolności do pracy zawodowej, tym razem dodatnią, otrzymano w zestawieniu z oceną satysfakcji zawodowej (r=0,61, p=0,007. Wnioski. Zdolność do pracy zawodowej wśród badanych pielęgniarek znajduje się na poziomie umiarkowanym oraz dobrym. Jej poziom obniża się wraz z wiekiem, stażem pracy oraz spadkiem satysfakcji zawodowej. Na stanowisku pracy pielęgniarki wykazano występowanie wielu zagrożeń psychospołecznych.   Summary Introduction. Every year an increase is observed in the percentage of the elderly Polish population. Due to the ageing of society there is a growing demand for nursing care.  However, the employment rate of nurses in direct patient

  14. Stanisław Bułak-Bałachowicz. Postać, która mogła połączyć narody byłego Wielkiego Księstwa Litewskiego, a jednak ich nie połączyła

    Directory of Open Access Journals (Sweden)

    Joanna Gierowska-Kałłaur

    2017-12-01

    ęstwa Litewskiego, a jednak ich nie połączyła Darzony powszechnym szacunkiem przez sobie współczesnych, posługujący się wszystkimi kresowymi językami, świetny żołnierz – Stanisław Bułak-Bałachowicz jeszcze jako podkomendny Mikołaja Judenicza, starał się o przemianowanie dowodzonego przez siebie oddziału na „Armię Ludową”, inaczej ujmując, Armię Terytorialną lub Krajową. Terytorialnym rozumieniem „białoruskości”, powiązanym z atawistycznym antybolszewizmem Bałachowicza, posłużył się Józef Piłsudski w swojej nowej kombinacji politycznej. Piłsudski postanowił wykorzystać nadarzające się romantyczne marzenie Sawinkowa o Trzeciej Rosji dla własnego celu. Rosyjski Komitet Polityczny, szable Bałachowicza i oświadczenia Wiaczesława Adamowicza ojca (Mozyrz, listopad 1920 r. miały posłużyć do budowy – Białorusi dla Białorusinów. Nie „kowieńsko-berlińskiej” i nie „sowieckiej”. „Trzeciej Białorusi”. Białorusi przyjaznej Polsce. W wyniku rozmów z Sawinkowem, budowniczym „Trzeciej Rosji”, po 6 marca 1920 r. (tzw. Nota Milleranda Piłsudski zaangażował się we wspieranie (również finansowe Rosyjskiego Komitetu Politycznego. Na podstawie umowy Polskiego Naczelnego Dowództwa z B. W. Sawinkowem wszystkie formacje rosyjskie na terytorium Rzeczypospolitej Polskiej zostały podporządkowane politycznie B. Sawinkowowi. 27 sierpnia 1920 r. z rozkazu Naczelnego Dowództwa Bałachowicz zawarł z Sawinkowem tajną umowę. Obaj z Sawinkowem dążyć mieli do zwołania w przyszłości Zgromadzenia Ustawodawczego, ziemi dla ludu, demokracji i utworzenia Związku Narodów (federacji. W przypadku posunięcia się oddziału Bułak-Bałachowicza „w głąb terytorium rosyjskiego” miały być przy nim zorganizowane samorząd lokalny i zarząd administracyjny. Właśnie w ten sposób Bułak-Bałachowicz miał być wykonawcą kolejnego „pomysłu” J. Piłsudskiego „na Białoruś”.

  15. Properties of Waste from Coal Gasification in Entrained Flow Reactors in the Aspect of Their Use in Mining Technology / Właściwości odpadów ze zgazowania węgla w reaktorach dyspersyjnych w aspekcie ich wykorzystania w technologiach górniczych

    Science.gov (United States)

    Pomykała, Radosław

    2013-06-01

    przedstawiono analizę możliwości wykorzystania ubocznych produktów zgazowania, jako materiałów do podsadzki hydrauliczne (wg normy PN-93/G-11010), podsadzki zestalanej oraz mieszaniny do doszczelniania zrobów (wg normy PN-G-11011:1998) - technologii stosowanych w polskim górnictwie węgla kamiennego. Podstawowe badania ubocznych produktów zgazowania obejmowały takie właściwości jak gęstość, wilgotność, skład ziarnowy, wymywalność zanieczyszczeń chemicznych oraz zawartość radionuklidów. Wybrane właściwości fizyczne ubocznych produktów zgazowania oraz ich oznaczenie zestawiono w tabeli 1. Składy ziarnowe żużli ze zgazowania, analizowanych pod kątem zastosowania w podsadzce hydraulicznej przedstawiono na rys. 1, a materiałów dla technologii zawiesinowej, czyli popiołu lotnego A2 oraz zmielonych żużli oznaczonych, jako S1m, S2m oraz S3m - na rys. 2. Żużle ze zgazowania zawierają nie więcej niż 6% ziaren mniejszych niż 0,1 mm, co odpowiada wymaganiom dla materiałów podsadzkowych I klasy. Analiza wymywalności zanieczyszczeń chemicznych wykazała przekroczenia wymagań jednej lub obu przywołanych norm w zakresie pH i/lub niklu dla próbek żużli S1 i S2 oraz popiołu A2 (tab. 2). Zwraca uwagę bardzo niska wartość pH oraz bardzo wysoka zawartość niklu dla żużla S1. Jest to rzecz nietypowa dla krajowych odpadów energetycznych powstających ze spalania węgla kamiennego. W zakresie zawartości radionuklidów wszystkie materiały spełniają nie tylko wymagania norm podsadzkowych, ale również wymagania stawiane materiałom budowlanym (tab. 3). Ściśliwość żużli ze zgazowania kształtuje się na poziomie 11÷14%, co pozwala zakwalifikować je do materiałów podsadzkowych III klasy. Aby uzyskać materiał wyższej klasy, konieczne jest zmieszanie żużli z piaskiem podsadzkowych. W zakresie wodoprzepuszczalności wszystkie żużle kwalifikują się, jako materiał podsadzkowy klasy I (rys. 5, tab. 4). W normie PN-G-11011

  16. Wasale, trybutariusze, sojusznicy. ­Charakter relacji państw bałkańskich z Turcją osmańską w XIV wieku

    Directory of Open Access Journals (Sweden)

    Ilona Czamańska

    2015-08-01

    4. Entry into close, family relations with the ruling sultan meant usually a close political and military cooperation. Greek, Bulgarian and Serbian wives of the sultans had the right to remain in the Christian faith and often exerted a strong political influence. The support and protection of the closest relatives of the wife was fulfilled by the Turkish rulers. Thanks to it, for example Serbia of Stefan Lazarević was essentially strengthened, becoming at the same time the most serious support of Bajezid I in the Balkans.

  17. Charakter centrálních částí městské zástavby dotvářen pomocí zelené infrastruktury

    Czech Academy of Sciences Publication Activity Database

    Šerá, Božena

    2013-01-01

    Roč. 42, č. 1 (2013), s. 105-109 ISSN 0044-4863 Institutional support: RVO:67179843 Keywords : city greenery * tree * town * street * urban planning Subject RIV: AP - Urban, Regional and Transport Planning

  18. Proces nabycia przedsiębiorstwa na przykładzie transakcji Adidas-Salomon Group i Reebok Ltd.

    OpenAIRE

    Poparda, Katarzyna

    2011-01-01

    Fuzje i przejęcia przedsiębiorstw stały się popularnym sposobem na poszerzenie pozycji konkurencyjnej przedsiębiorstw w branży producentów strojów, obuwia i sprzętu sportowego. Cel pracy obejmuje przedstawienie istoty fuzji i przejęć oraz metod ich analizy i oceny, a także analizę i ocenę przesłanek, elementów procesu integracji i rezultatów nabycia Reebok Ltd. przez Adidas-Salomon Group. W części empirycznej posłużono się metodyką SWOT i Pięciu Sił M.E. Portera. Źródła danych miały charakter...

  19. Ankündigung und Projektbeschreibung: Ich zeig es Dir - HOCH 2

    Directory of Open Access Journals (Sweden)

    Sandra Schön

    2012-12-01

    Full Text Available Haben Sie schon mal mit einem Kurzvideo gelernt? Die Praxis zeigt, dass sich kurze Videos ideal für das Lehren und Lernen in Peer-to-Peer-Kontexten eignen. Seit Mitte Oktober 2012 produzieren Jugendliche zwischen 9 und 13 Jahren Unterrichtsvideos. Dieser Beitrag gibt einen kurzen Einblick in das laufende Projekt.Did you ever use short videos for teaching and learning? The project that is presented in this paper shows how young people from 9 to 13 years are producing short videos for teaching and learning in peer-to-peer contexts.

  20. Technology and language: Learning to say mouse in K'iche' | CRDI ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Students are learning that their indigenous language and culture are a vital part of ... until the late 1990s, actively discouraged the use of Indigenous languages in the ... quality computer and Internet training for rural Indigenous communities.

  1. Numerical versus analytical Ic(H) patterns in Josephson junctions with periodically alternating critical current density

    International Nuclear Information System (INIS)

    Lazarides, N

    2004-01-01

    An analytical expression for the magnetic-field-dependent critical current I c (H) of Josephson junctions with periodically alternating critical current density J c (x) is derived within the uniform field approximation. Comparison with numerically calculated I c (H) patterns for junctions with identical, thick, periodically arranged defects with the corresponding analytical expression reveals fair agreement for a wide range of parameters, due to increased characteristic length. Based on qualitative arguments, we give the dependence of the new characteristic length on the geometrical parameters of the junction, which is in agreement with self-consistent calculations with the static sine-Gordon equation. The analytical expression captures the observed qualitative features of the I c (H) patterns, while it is practically exact for short junctions or high fields. It also produces the shift of the major peak from the zero-field position of the standard Fraunhofer pattern to another position related to the periodicity of the critical current density in φ-junctions

  2. Konvertibilné obligácie a špecifiká ich hodnocovania

    Directory of Open Access Journals (Sweden)

    Božena Hrvoľová

    2013-11-01

    Full Text Available Convertible bonds belong to the group of innovations, which are connected with common features of more securities that are named hybrid or synthetic securities. This article will discuss advantages of these securities for investors and companies’ (issuers, specifics of convertible bonds valuation, conversion premium and premium for option, which are connected with convertible bonds valuation and with investors´ decision making, whether they will remain in the position of holder or whether they will convert convertible bonds into the shares of company.

  3. Die heiligen Propheten, eure Apostel und ich. Metatextuelle Studien zum zweiten Petrusbrief

    NARCIS (Netherlands)

    Ruf, M.G.

    2010-01-01

    Of all New Testament writings, the Second Letter of Peter bears the most explicit witness to the varied literary activity of Early Christianity and most expressly reflects on its use of Scripture as prophecy. The present dissertation applies itself to this metatextual character of the Second Letter

  4. Zmarli mówią - dialogi elizejskie, najwybitniejsi twórcy i ich utwory

    OpenAIRE

    Urbańska, Monika

    2005-01-01

    The study deals with the history of development of the genre dialogues of the dead. Most authors of the dialogues drew inspiration from creation of a poet Lukian from Samosat. The genre especially flourished in XVIIIth century France. The greatest French authors of dialogues were: Boileau, Fontenelle and Fénelon. Boileau was the author of the first significiant dialogues U's Heros de roman, dialogue á la maniere de iMcien which was published in 1773. Fontenclle made his débu...

  5. OBLICZENIE PRZEPŁYWÓW MAKSYMALNYCH I ICH REDUKCJI W ZLEWNI ZURBANIZOWANEJ

    Directory of Open Access Journals (Sweden)

    Mariusz BARSZCZ

    2016-03-01

    Full Text Available W pracy przedstawiono wyniki zastosowania modelu SWMM do obliczenia przepływów o prawdopodobieństwach 50, 10, 2 i 1% w 8. przekrojach Potoku Służewieckiego na odcinku od km 0+000 do 6+576 oraz w 2. przekrojach Rowu Wolica. Zlewnia Potoku Służewieckiego jest zlokalizowana w południowej części Warszawy. Największe zagrożenie powodziowe występuje na odcinku Potoku Służewieckiego od km 0+000 do 3+875. Przepustowość koryta Potoku na tym odcinku kształtuje się na poziomie przepływu maksymalnego o prawdopodobieństwie 50%. Największe wartości przepływów w Potoku Służewieckim prognozowano w przekroju obliczeniowym numer V (km 4+267: Q50% = 13,863, Q10% = 23,019, Q2% = 28,825 i Q1% = 30,500 m3·s-1. Jedną z przyczyn występowania zagrożenia powodziowego w dolnym biegu Potoku Służewieckiego jest dopływ dużej ilości wód opadowych Rowem Wolica. Wartości przepływów w górnym odcinku Rowu Wolica (w przekroju VI zawierały się w granicach od 8,005 do 12,402 m3·s-1, w zależności od prawdopodobieństwa wystąpienia opadu obliczeniowego. W celu określenia możliwości redukcji przepływów w Rowie Wolica, przeprowadzono obliczenia w których uwzględniono zastosowanie kryzy na odcinku ujściowym kolektora do kanału otwartego. Zastosowanie kryzy w kolektorze pozwoli zredukować przepływy o prawdopodobieństwach 50, 10 i 2% odpowiednio o 61,0; 46,0 i 36,6%. Zastosowanie kryzy o stałej średnicy ϕ1,08 m, ustalonej dla przepływu o prawdopodobieństwie 2%, spowoduje znacznie mniejszą redukcję przepływów maksymalnych o prawdopodobieństwach 50 i 10%.

  6. ICH rf system data acquisition and real time control using a microcomputer system

    International Nuclear Information System (INIS)

    Cary, W.P.; Allen, J.A.; Pinsker, R.I.; Petty, C.C.

    1993-10-01

    On the basis of the rapidly increasing power, speed, and decreasing cost of the personal computer (microcomputer) it was felt that a real time data acquisition and control system could be configured quickly and very cost effectively. It was further felt that by using a high level or object-oriented programming language that considerable time and expense could be saved and at the same time increase system flexibility. This paper will attempt to address the desired system requirements and performance for both the control of the high power transmitters and for the data acquisition and presentation of the information

  7. "Ich war nicht der allmächtige Autor" / Simon Stephens ; intervjueerinud Jacqueline Bolton

    Index Scriptorium Estoniae

    Stephens, Simon, 1971-

    2012-01-01

    NO99 teatris esietendunud kolme teatri - NO99, Münchner Kammerspiele, Lyric Hammersmith Theatre - koostöös valminud lavastuse "Three Kingdoms" ("Kolm kuningriiki") teksti autor Simon Stephens räägib

  8. Slavjane na territorii Čechii i ich kontakty v VI-VII vv

    Czech Academy of Sciences Publication Activity Database

    Profantová, Naďa

    2015-01-01

    Roč. 2015, č. 5 (2015), s. 97-116 ISSN 1608-9057 Institutional support: RVO:67985912 Keywords : Prague-type pottery culture * contacts * archaeology and identity * palmate fibulae * Byzantine buckles Subject RIV: AC - Archeology, Anthropology, Ethnology

  9. Skutki nowych form organizacyjnych dla pracy mistrzów w ich ocenie

    OpenAIRE

    Paul, Jadwiga

    1987-01-01

    Digitalizacja i udostępnienie w Cyfrowym Repozytorium Uniwersytetu Łódzkiego kolekcji czasopism naukowych wydawanych przez Uniwersytet Łódzki nr 885/P-DUN/2014 zostało dofinansowane ze środków MNiSW w ramach działalności upowszechniającej naukę.

  10. "Ich kam unter die Schweizer": Teaching Switzerland as a Multi-Ethnic Society

    Science.gov (United States)

    Baumgartner, Karin

    2012-01-01

    This article describes a five-week module on "Switzerland as a multi-ethnic society" intended to counteract the popular image of Switzerland as a homogenous country concerned mostly with tourism, chocolate, and watches. Instead, the module treats Switzerland through topics such as the definition of identity in a multi-ethnic society, the…

  11. Development of data acquisition and control system for ICH & CD transmission line components test facility

    Energy Technology Data Exchange (ETDEWEB)

    Patel, Manoj, E-mail: manoj.patel@iter-india.org [ITER-India, Institute for Plasma Research, Bhat, Gandhinagar 382428, Gujarat (India); Jha, Akhil [ITER-India, Institute for Plasma Research, Bhat, Gandhinagar 382428, Gujarat (India); Patel, Nidhi [Department of Instrumentation & Control Engineering, Dharmsinh Desai University, Nadiad 387001, Gujarat (India); Krishna, J.V.S. Hari; Rajnish, Kumar; Soni, Dipal; Verma, Sriprakash; Patel, Hriday; Trivedi, Rajesh; Mukherjee, Aparajita [ITER-India, Institute for Plasma Research, Bhat, Gandhinagar 382428, Gujarat (India)

    2016-11-15

    Highlights: • Traveling Wave Resonator (TWR) gain achieved is 13.58 dB using 10 dB coupler. • Software module for Automatic calibration for power detector is developed and integrated. • Application module is developed using LabVIEW™ for high power RF operation of TWR. - Abstarct: India is developing a very high power test bed (∼MW level) based on concept of Travelling Wave Resonator (TWR) for testing of passive transmission line components [3]. Data acquisition and control system is required for safe and reliable operation of TWR. It includes online monitoring of input power and circulating ring power. Acquired RF signal provides information about forward and reflected RF power. For MW power level testing, system is protected against arc and thermal effect during CW operation. National Instrument make hardware and software have been used to acquire signals from RF detector, Arc detectors, IR camera and thermocouples etc. LabVIEW™ based software has been developed for calculation of RF parameters. Graphical user interface is developed for better visualization. Initial testing of the TWR setup with 10 dB coupler provides a power gain of 13.58 dB (22X). For future 3 MW TWR test bed the required power gain is ∼20 dB (100X) since the available source is ∼40 kW. This paper describes the detail design and integrated test results for data acquisition and control system for TWR test bed.

  12. Technology and language: Learning to say mouse in K'iche' | IDRC ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    2011-02-08

    Feb 8, 2011 ... Students are learning that their indigenous language and culture are a ... Evolving from project to organizational status, Enlace Quiché is part of a ... The department of Quiché, where Enlace Quiché is based, was one of the ...

  13. Związki polifenolowe i ich suplementacja u kobiet po menopauzie

    Directory of Open Access Journals (Sweden)

    Ireneusz Połać

    2011-04-01

    Full Text Available Polyphenolic compounds are a broad group of organic compounds of plant secondary metabolites, whichhave in their structure one or more aromatic rings and from one to several hydroxyl groups with acidic character.Due to their heterogeneous construction polyphenolic compounds have been classified into several groups:simple phenols, phenolic acids, coumarins, xanthones, stilbenes, lignans, anthraquinones and the largest group– flavonoids. Polyphenols are characterized by a variety of biological activity. As natural antioxidants, they mayprotect against reactive oxygen species (ROS and reactive nitrogen species (RNS. Moreover, they have theability to seal blood vessels and of vasodilatation. Polyphenolic compounds also have anti allergic, antibiotic,antibacterial, antiviral, antifungal, anti-inflammatory and anticoagulation effects. Many recent studies haveshown that a diet rich in polyphenolic compounds modulates several biomarkers of cardiovascular diseaseand cancer. Thanks to their pro-health properties, an increasing number of dietary supplements based on plantextracts are introduced for commercial use. Clinical studies confirm the effectiveness of supplementation withproducts containing polyphenolic compounds in the prevention of cardiovascular disease in postmenopausalwomen. Polyphenols also have the ability of aromatase inhibition, which means that they can be used in theprevention of breast cancer. This article describes the characteristics and biological properties of polyphenoliccompounds, as well as clinical studies conducted in postmenopausal women taking polyphenols.

  14. Filtration track membranes and their biomedical applications; Trekowe membrany filtracyjne oraz ich zastosowania biomedyczne

    Energy Technology Data Exchange (ETDEWEB)

    Buczkowski, M; Wawszczak, D; Starosta, W [Institute of Nuclear Chemistry and Technology, Warsaw (Poland)

    1997-10-01

    The characteristics of track filtration membranes has been performed. The investigation of radiation resistance has been carried out for different types of polymer foil used as a membrane material. Biomedical applications of track filtration membranes have been presented and discussed. 10 refs, 10 figs.

  15. Přechylování jmen živočichů

    Czech Academy of Sciences Publication Activity Database

    Albrechtová, Barbora

    2016-01-01

    Roč. 99, č. 5 (2016), s. 243-255 ISSN 0027-8203 R&D Projects: GA MŠk(CZ) LM2010013 Institutional support: RVO:68378092 Keywords : animal names * derivation of gender opposite forms * markedness * word -formation Subject RIV: AI - Linguistics

  16. O škalach ekvivalentnych uslovij, charakterizujuščich vesovoje neravenstvo Stiltjesa

    Czech Academy of Sciences Publication Activity Database

    Gogatishvili, Amiran; Persson, L. E.; Stepanov, V.D.; Wall, P.

    2012-01-01

    Roč. 447, č. 1 (2012), s. 13-14 ISSN 0869-5652 R&D Projects: GA ČR GA201/08/0383 Institutional support: RVO:67985840 Keywords : integral inequalities * Stieltjes inequality * Stieltjes transform * scales of equivalents conditions Subject RIV: BA - General Mathematics http://www.maikonline.com/maik/showArticle.do?auid=VAH8R2F8ME

  17. Fotbaloví fanoušci - hooligans na našich stadionech

    OpenAIRE

    KROČÁK, Pavel

    2010-01-01

    Bachelor paper is about radical football fans (hooligans). The theory describes football hooliganism and its progress in Europe. Practical part answers the hypothesis: Number 1. most of czech people is afraid of radical football fans. Number 2. most of public depend on activity of state organs to protect againts fans criminality. The research verifies this hyphothesis in the region of South Bohemia and with a view to reality, that most of informations about hooligans are from media.

  18. Uczelnia na zagranicznym rynku edukacyjnym – strategia internacjonalizacji szkoły wyższej

    Directory of Open Access Journals (Sweden)

    Andrzej Szromnik

    2014-03-01

    Full Text Available Cel: Wyjaśnienie założeń i warunków realizacyjnych internacjonalizacji uczelni jako strategicznego kierunku jej rozwoju, a ponadto przedstawienie uniwersalnych scenariuszy strategicznych ekspansji uniwersytetu za granicą oraz determinantów sukcesu. Metodologia: Artykuł ma charakter koncepcyjny i opiera się na diagnozie oraz analizie na rynku usług edukacji uniwersyteckiej w Polsce. W wyniku studiów literatury specjalistycznej wyodrębniono główne zjawiska warunkujące funkcjonowanie i kierunki zmian szkolnictwa wyższego stanowiące ogólne tło rozważań i projektów szczegółowych. Wnioski: Autor wskazuje strategie uwarunkowania i procedury decyzyjne ekspansji uniwersytetu na zagraniczne rynki edukacji na poziomie wyższym. Akcentuje główne szanse i zagrożenia z tytułu działalności uczelni za granicą. Propozycje mają nie tylko charakter poznawczy, ale także mogą być podstawą ich aplikacji w realiach polskich uczelni. Oryginalność: Działalność uczelni zagranicznych na rodzimym rynku edukacyjnym jest zjawiskiem występujących w wielu krajach. W artykule zaproponowano koncepcję strategii internacjonalizacji uniwersytetu w jej wariancie ogólnym wraz ze szczegółową procedurą analityczno-decyzyjną. W piśmiennictwie fachowym ten aspekt rozwoju uczelni nie został rozwinięty zgodnie z założeniami marketingu międzynarodowego.

  19. Ab initio NMR parameters of BrCH3 and ICH3 with relativistic and vibrational corrections

    Science.gov (United States)

    Uhlíková, Tereza; Urban, Štěpán

    2018-05-01

    This study is focused on two effects identified when NMR parameters are calculated based on first principles. These effects are 1. vibrational correction of properties when using ab initio optimized equilibrium geometry; 2. relativistic effects and limits of using the Flygare equation. These effects have been investigated and determined for nuclear spin-rotation constants and nuclear magnetic shieldings for the CH3Br and CH3I molecules. The most significant result is the difference between chemical shieldings determined based on the ab initio relativistic four-component Dirac-Coulomb Hamiltonian and chemical shieldings calculated using experimental values and the Flygare equation. This difference is approximately 320 ppm and 1290 ppm for 79Br and 127I in the CH3X molecule, respectively.

  20. Samoocena pracowników w instytucjach edukacyjnych i pomocowych a ich działalność zawodowa

    OpenAIRE

    Krakowiak, Piotr; Łukaszewska, Barbara

    2016-01-01

    Self-esteem plays an important role in every activity associated with interpersonal interaction. It is one of the most important components of the personalities of employees working in helping professions include educational and pedagogical activities. The self-esteem of the educator is a significant starting point that builds relationship teaching or assistance. Formation of self-esteem is the recognition and acceptance of an individual human personality. Self-esteem is one of many structure...

  1. Application of ICH Q9 Quality Risk Management Tools for Advanced Development of Hot Melt Coated Multiparticulate Systems.

    Science.gov (United States)

    Stocker, Elena; Becker, Karin; Hate, Siddhi; Hohl, Roland; Schiemenz, Wolfgang; Sacher, Stephan; Zimmer, Andreas; Salar-Behzadi, Sharareh

    2017-01-01

    This study aimed to apply quality risk management based on the The International Conference on Harmonisation guideline Q9 for the early development stage of hot melt coated multiparticulate systems for oral administration. N-acetylcysteine crystals were coated with a formulation composing tripalmitin and polysorbate 65. The critical quality attributes (CQAs) were initially prioritized using failure mode and effects analysis. The CQAs of the coated material were defined as particle size, taste-masking efficiency, and immediate release profile. The hot melt coated process was characterized via a flowchart, based on the identified potential critical process parameters (CPPs) and their impact on the CQAs. These CPPs were prioritized using a process failure mode, effects, and criticality analysis and their critical impact on the CQAs was experimentally confirmed using a statistical design of experiments. Spray rate, atomization air pressure, and air flow rate were identified as CPPs. Coating amount and content of polysorbate 65 in the coating formulation were identified as critical material attributes. A hazard and critical control points analysis was applied to define control strategies at the critical process points. A fault tree analysis evaluated causes for potential process failures. We successfully demonstrated that a standardized quality risk management approach optimizes the product development sustainability and supports the regulatory aspects. Copyright © 2016 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

  2. Teórie vrodenosti a ich vzťah k vede (Innateness Theories and their Relation to Science

    Directory of Open Access Journals (Sweden)

    Katarína Hrnčiarová

    2013-03-01

    Full Text Available The aim of my contribution will be to describe how the contemporary philosophy of mind and philosophy of language are connected with the knowledge of modern science while meeting the problem of innateness. However strong their relation is, we can still call these approaches philosophical, not scientific in essence. The relation between philosophy and science of those problems is not only the issue of contemporary philosophy, but it has been developing since Modern times when the innateness theories were connected to the contemporary physics and optics. Nowadays, this relation is transferred to relation with other sciences, such as neurobiology. The contemporary philosophy is inconceivable without the cooperation with science regarding the problem of innateness.

  3. Sociálne benefity v nezamestnanosti vo vybraných krajinách EU a ich porovnanie

    OpenAIRE

    Pastírik, Tomáš

    2013-01-01

    The main aim of this thesis is to compare particular systems of social benefits in selected counties of European union and uncover the potencial connection between different european social models. In other words, if countries which belongs to a concrete social model have also similar systems of social benefits. The work is divided into two parts. The theoretical part is focused on theoretical knowledge related to unemployment and social policies that are fundamental for understanding this is...

  4. Die häufigsten Fehler bei der FMEA-Anwendung und wie ich sie vermeiden kann

    OpenAIRE

    Schloske, Alexander

    2010-01-01

    Die FMEA stellt heutzutage eines der wichtigsten Werkzeuge des präventiven Risikomanagements dar. Die universell anwendbare Vorgehensweise des VDA hat sich dabei in der Industrie etabliert. Der Beitrag beschreibt aus der Sicht von 20 Jahren FMEA-Erfahrung, wie die FMEA zielführend erstellt wird und mit welchen Tipps und Tricks eine effiziente und effektive FMEA-Erstellung ermöglicht wird.

  5. Wenn ich nur wüsste, ob…: Der beamtenrechtliche Aufstieg im deutschen Bibliothekswesen am Beispiel des Freistaates Bayern

    Directory of Open Access Journals (Sweden)

    Kathrin Schwärzel

    2015-12-01

    Full Text Available Mit dem Gesetz zum Neuen Dienstrecht in Bayern hat der bayerische Gesetzgeber im Jahre 2010 das Laufbahnrecht grundlegend reformiert. Als Kernstück der Reform gilt der Regelungskomplex zum beamtenrechtlichen Aufstieg, insbesondere zur sogenannten modularen Qualifizierung, mit dem der Landesgesetzgeber einen modernen Weg im Personalmanagement einschlägt. Der Beitrag ordnet die Regelungen in ihren laufbahnrechtlichen Kontext ein und stellt das neue Instrument der Personalentwicklung näher vor. In 2010, the Bavarian legislator introduced a fundamental public employment law reform. Emphasis was put on professional advancement through modular training as a new approach to human resource management in public administration. This article takes a closer look at this new personnel development instrument and its regulation.

  6. Chřástal polní - a jeho tajemný hlas našich luk

    Czech Academy of Sciences Publication Activity Database

    Brlík, V.; Koleček, Jaroslav

    2014-01-01

    Roč. 2014, č. 3 (2014), s. 14-15 ISSN 1803-0092 R&D Projects: GA MŠk EE2.3.35.0026 Institutional support: RVO:68081766 Keywords : agri-environmental schemes * conservation management * intensification * succession Subject RIV: EG - Zoology

  7. "Über Ihre Bewerbung habe ich mich gefreut!" : zu den Emotionen in den deutschen Absageschreiben auf Bewerbungen

    OpenAIRE

    Szczęk, Joanna

    2014-01-01

    The unique situation in which job seekers and employers find themselves results in the necessity to formulate and accept refusal letters. Employers frequently express their emotions in such letters. They are, however, in the form of clichés which apparently do not contain any genuine emotions. The subject of this analysis is genuine German refusal letters collected in the years between 2000 and 2012. Our objective is to indicate the types of emotions verbalized in the analyzed text type and t...

  8. Dynamics of electron solvation in I-(CH3OH)n clusters (4 ≤n≤ 11)

    International Nuclear Information System (INIS)

    Young, Ryan M.; Yandell, Margaret A.; Neumark, Daniel M.

    2011-01-01

    The dynamics of electron solvation following excitation of the charge-transfer-to-solvent precursor state in iodide-doped methanol clusters, I - (CH 3 OH) n=4-11 , are studied with time-resolved photoelectron imaging. This excitation produces a I ... (CH 3 OH) n - cluster that is unstable with respect to electron autodetachment and whose autodetachment lifetime increases monotonically from ∼800 fs to 85 ps as n increases from 4 to 11. The vertical detachment energy (VDE) and width of the excited state feature in the photoelectron spectrum show complex time dependence during the lifetime of this state. The VDE decreases over the first 100-400 fs, then rises exponentially to a maximum with a ∼1 ps time constant, and finally decreases by as much as 180 meV with timescales of 3-20 ps. The early dynamics are associated with electron transfer from the iodide to the methanol cluster, while the longer-time changes in VDE are attributed to solvent reordering, possibly in conjunction with ejection of neutral iodine from the cluster. Changes in the observed width of the spectrum largely follow those of the VDEs; the dynamics of both are attributed to the major rearrangement of the solvent cluster during relaxation. The relaxation dynamics are interpreted as a reorientation of at least one methanol molecule and the disruption and formation of the solvent network in order to accommodate the excess charge.

  9. "in dem moment wo ich es dann erkenne dann ist es auch gleich wieder weg" – Salienzeffekte in der Sprachperzeption

    Directory of Open Access Journals (Sweden)

    Christina Ada Anders

    2014-06-01

    Full Text Available In context of the first study on folk linguistic concepts in the German language area carried out by the Kiel DFG research project "perceptual dialectology", this article looks at how salient features could be surveyed and categorized by a stimulus-response-test. After a definition of salience, the study design including the stimulus-response-test is presented. The test was created and modified during the project as a guessing game by the Institute for German Language (IDS Mannheim. The central question in this article is which linguistic features stimulate the informants to locate a speech sample on a map with predetermined cities and hence which salient features trigger the regional identification. In a second step, the speech samples are analyzed by the variables 'pleasantness' and 'correctness' defined by Dennis R. Preston. The central question here is: Are speech samples with a high pleasure value also automatically considered correct? Finally, an interpretation of metalinguistic comments in the speech examples will give more insight into folk linguistic concepts and the role of salient features in this regard.

  10. Influenceri na sociálnych sieťach a ich využitie v marketingu

    OpenAIRE

    Petrovčíková, Lucia

    2017-01-01

    This diploma thesis called "Influencers in Social media and their Use in Marketing" deals with the new current trend in which, instead of well-known celebrities, star just ordinary people. Despite of this, they managed to conquer the masses through social networks thanks to their unique personality and authenticity. The first chapter focuses on online marketing and explains the basic concept of it, its tools and communication mix, along with data on the structure of the Czech Internet populat...

  11. ‘Wo soll ich hinfliehen vor diesem Mensch?’: Een luisteroefening in Ludwig Hofacker (1797−1828

    Directory of Open Access Journals (Sweden)

    Johan Kommers

    2013-09-01

    Full Text Available De aanwezigheid van de levende God in preken kunnen wij niet terzijde stellen of verontachtzamen. Waar dit wel gebeurt, daar wordt verkondiging een voordracht, zonder de volmacht. Orthodoxie komt in ademnood wanneer exegese en dogmatiek opgaan in een aantal meningen en waarbij het getuigenis van de Bijbel op de achtergrond komt. Ludwig Hofacker (1798–18281 was een prediker die in bijbelonderzoek en prediking zijn oor te luisteren legde aan de Bron. Het Woord van God was voor hem hét homiletisch magazijn. Dat nu nog steeds, in de 21e eeuw, zijn preken gelezen worden, geeft aan dat zijn erfenis een opmerkelijke is. Hij pakte het probleem van de geestelijke dorheid op in een tijd gekenmerkt door het opkomend klimaat van het humanistisch rationalisme. Hofackers prediking geeft weer waar het werkelijk om gaat: Christus alleen. Deze preken laten ook de prediker zelf zien. Zijn stem roept op wat de Reformatie zo na aan het hart lag, en de cadenzen van het sola gratia, sola Scriptura, en het sola fide zijn in elke preek te horen. Het religieuze eigene van Hofacker sluit grote missionaire bewogenheid in. In sermons we cannot disregard the presence of the living God, otherwise preaching will become a performance, without divine authority. Orthodoxy will be gasping for breath when exegesis and dogmatic theology are wholly absorbed in a number of opinions, causing biblical testimony to recede into the background. Ludwig Hofacker (1798–1828, was a preacher who in Bible study and preaching put his ears to the Fountain. The Word of God was his sole homiletic storehouse. Today, in our 21st century, his sermons are still being read. This indicates that he left us a remarkable body of work. He tackled the problem of spiritual dearth in a time of emerging humanistic rationalism. Hofacker’s preaching reflected his core belief: Christ only. His sermons also reflect the preacher himself. His voice clearly recalls what was held so dear in the Reformation, and the cadences of the sola gratia, sola Scriptura and sola fide are heard in every sermon. His religious individuality included a strong motivation for missions.

  12. Básník a lid. Bedřich Václavek mezi literaturou a folklorem

    Czech Academy of Sciences Publication Activity Database

    Feinberg, Joseph Grim

    2017-01-01

    Roč. 65, č. 6 (2017), s. 823-845 ISSN 0009-0468 R&D Projects: GA ČR(CZ) GA17-23955S Institutional support: RVO:67985955 Keywords : Marxism * interwar literary criticism * literary criticism * folklore studies * avant-garde Subject RIV: AJ - Letters, Mass-media, Audiovision OBOR OECD: Literary theory

  13. Die Kritik am transzendentalen Ich: Zu Sartres und Ricœurs Heidegger-Lektüren

    Directory of Open Access Journals (Sweden)

    Yvanka B. Raynova

    2015-08-01

    According Otto Pöggeler Heidegger's main brake with Husserl consists in his rejection of the tran-scendental constitution conceived as the life of an "absolute Cogito," replaced by Heidegger by the "factual life" from which phenomenology should always begin. The author of this paper argues that the problem about the starting point of phenomenology also appears later in the debates between Heidegger and Sartre, as well as in Ricoeur's Heidegger interpretation. Thus, the aim of the article is to analyze to what extent the positions of Heidegger, Sartre, and Ricoeur contradicts or even exclude each other, and to what extent they cross or eventually complement each other. The inquiry shows that Heidegger's accusation of Sartre's forgetting of the question about the sense of being of Dasein is unjustified. Equally untenable is Sartre's critique of Heidegger, that he had bypassed the Cogito as a starting point of the existential analysis, because Sartre's transcendence of the Cogito, which pretends to involve the transphenomenal Being, cannot be derived from it and risks to fall again in the trap of "phenomenalism," which Sartre reproached to Husserl. Ricoeur's Heidegger interpretation brings clarity to this discussion by pulling together the decentration of the subject and the limits of apodicticity of the Cogito. But his elaboration of the hermeneutics of the Self contains the risk of a hyperbolization of the role of language.

  14. SPOŁECZNE BUDOWNICTWO MIESZKANIOWE W ŁODZI – ROZWÓJ, ZASOBY MIESZKANIOWE I ICH UŻYTKOWNICY

    OpenAIRE

    Dzieciuchowicz, Jerzy

    2011-01-01

    Functioning of the public housing industry in Łód is an object of this paper, with special returning the attention to his development and diversifying the housing stock and their users. Conducted examinations showed that the public construction constituted the peculiar form of the housing industry, functioning on distinct legal grounds. Development of this construction, intended for families about lower incomes, took place in Poland only in the period of a systemic transformat...

  15. Polityka rachunkowości w praktyce jednostek gospodarczych w kontekście jej oceny przez biegłych rewidentów

    Directory of Open Access Journals (Sweden)

    Katarzyna Świetla

    2017-07-01

    Full Text Available Ramowy charakter regulacji prawa bilansowego umożliwia jednostkom gospodarczym świadome prowadzenie polityki rachunkowości, które pozwala na kreowanie obrazu przedsiębiorstwa, a tym samym na realizację jego celów i założeń gospodarczych. W artykule, na podstawie analizy literatury przedmiotu i aktów prawnych przedstawiono współczesne problemy związane z tworzeniem polityki rachunkowości i jej dostosowywaniem do indywidualnych potrzeb jednostek gospodarczych. Zaprezentowano także wyniki badań ankietowych przeprowadzonych na grupie polskich biegłych rewidentów. W ich opinii jednostki gospodarcze częściej wykorzystują instrumenty polityki rachunkowości w celu świadomego i celowego kreowania obrazu przedsiębiorstwa, niż w rozmyślnym fałszowaniu sprawozdań finansowych. Autorzy zwracają uwagę na wzrost znaczenia zewnętrznych jednostek konsultingowych w tworzeniu i dostosowywaniu polityki rachunkowości do potrzeb jednostek. Przeprowadzone rozważania skłaniają także do zmiany postrzegania roli biegłego rewidenta w badaniu polityki rachunkowości. W opinii autorów, potwierdzonej wynikami badań, biegły rewident powinien nie tylko sprawdzać zgodność przyjętych rozwiązań z prawem bilansowym, ale też oceniać ich celowość i zasadność w konkretnej sytuacji danej jednostki.

  16. Przypadki obrażeń rąbanych głowy bez skutku śmiertelnego

    Directory of Open Access Journals (Sweden)

    Magdalena Cychowska

    2014-10-01

    Full Text Available Rany rąbane, z uwagi na fakt, że zlokalizowane są najczęściej w obrębie głowy, a do ich powstania dochodzi przy użyciu narzędzia o znacznej masie, prowadzą zazwyczaj do zgonu z powodu rozległego uszkodzenia struktur czaszkowo-mózgowych. Przeżyciowe rany rąbane głowy spotykane są niezwykle rzadko w praktyce sądowo-lekarskiej. W niniejszej pracy przedstawiono trzy przypadki, w których do powstania ran doszło przy użyciu siekiery. W pierwszym przypadku odniesione obrażenia skutkowały chorobą realnie zagrażającą życiu. W drugim przypadku odniesione obrażenia wyczerpywały znamiona narażenia na bezpośrednie niebezpieczeństwo utraty życia i zdrowia w rozumieniu odpowiedniego artykułu kodeksu karnego. Trzeci przypadek uznać można za interesujący, nie tylko z uwagi na charakter doznanych zmian pourazowych, ale również okoliczności zgonu pokrzywdzonej w okresie późniejszym.

  17. Planning and realization of river diversions for the construction of reservoirs and river power stations; Planung und Ausfuehrung von Flussumleitungen im Talsperren- und Flusskraftwerksbau

    Energy Technology Data Exchange (ETDEWEB)

    Patt, M

    1992-03-19

    River diversions are necessary measures in reservoir and river power station construction in order to be able to construct the planned buildings in dry building ground. These diversion measures are only temporary as only in the construction phase of the retaining works the flow is led through the site. As in the recent past large hydraulic engineering plants have reached new dimensions also river diversions have gained importance with regard to the flow to be controlled. With this work the author wants to contribute to an improvement in river diversion with regard to safety, economy and environmental compatibility. (orig.) [Deutsch] Flussumleitungen sind im Talsperren- und Flusskraftwerksbau notwendige Massnahmen, um die projektierten Bauwerke in trockenen Baugruben errichten zu koennen. Diese Umleitungsmassnahmen besitzen einen temporaeren Charakter, da mit ihrer Hilfe der Abfluss ausschliesslich in der Bauphase des Sperrprojekts durch die Baustelle gewaehrleistet wird. Da in juengster Vergangenheit die wasserbaulichen Grossanlagen in neue Dimensionen vorgestossen sind, haben auch die Flussumleitungen hinsichtlich der Abfluesse, die es zu beherrschen gilt, an Bedeutung gewonnen. Mit der vorliegenden Arbeit moechte ich einen Beitrag leisten zur Verbesserung von Flussumleitungen im Hinblick auf Sicherheit, Wirtschaftlichkeit und Umweltvertraeglichkeit. (orig.)

  18. Kierunki zamierzonej modernizacjiCzwartej Dyrektywy UE 

    Directory of Open Access Journals (Sweden)

    Krzysztof Burnos

    2009-06-01

    Full Text Available Czwarta Dyrektywa Rady w sprawie rocznych sprawozdań finansowych niektórych rodzajów spółek liczy sobie już 31 lat. Wprowadzenie do stosowania na terenie UE Międzynarodowych Standardów Sprawozdawczości Finansowej zmieniło charakter unijnych Dyrektyw o rachunkowości. Zakres ich obowiązywania jest dzisiaj ograniczony do jednostek niepublicznych (nienotowanych na giełdach papierów wartościowych, które przede wszystkim są zaliczane do grupy małych i średnich przedsiębiorstw. Najwyższy zatem czas, aby dostosować je do tej grupy przedsiębiorstw, której one dotyczą. Autorzy artykułu przedstawiają kierunki zamierzonej modernizacji Czwartej Dyrektywy zaprezentowane w 2009 r. przez Komisję Europejską w dokumencie Working Document of the Commission Services (DG Internal Market, Consultation Paper on Review of the Accounting Directives i podejmują próbę oceny tych zamierzeń w kontekście wymaganych uproszczeń zasad rachunkowości dla jednostek sektora MŚP oraz ram koncepcyjnych sporządzania sprawozdań finansowych, wydanych przez IASC w 1989 r., a także proponowanych w aktualnie realizowanym wspólnym projekcie IASB i FASB.

  19. Role velikosti buněk ve změnach velikosti těla živočichů

    OpenAIRE

    Hájková, Věra

    2017-01-01

    Animals are very variable in body size. Differences in body size are visible not only at the interspecific level but also within species, whether they are differences in size during ontogeny or among individuals of the same species exposed to different environmental conditions. The size of the organism depends on the size and number of the basic units from which it is built, i.e. the cells. From this perspective body size can be changed only in three ways: by changing the cell size, by changi...

  20. Women’s health behaviors and selected determinants in breast cancer prevention / Zachowania zdrowotne kobiet i wybrane ich determinanty w profilaktyce raka piersi

    Directory of Open Access Journals (Sweden)

    Ślusarska Barbara

    2016-06-01

    Full Text Available Introduction. Breast cancer is the most common malignant cancer in women in Poland. Health behaviors concerning lifestyle and breast self-examination (BSE constitute a significant element of early prevention.

  1. Relacje pomiędzy życiem zawodowym a rodzinnym pracownika i ich wpływ na funkcjonowanie przedsiębiorstwa

    Directory of Open Access Journals (Sweden)

    Sylwia Sysko-Romańczuk

    2011-02-01

    Full Text Available In business there is an increasing conflict between the social role of a family member, who strives for satisfying needs of close relatives, and the role of an employee, who is strongly engaged in accomplishing his professional goals. Only outwardly the problem of work-life balance is not connected with functioning of the companies. The possibility of having a balanced life (work and family is highly assessed by specialist and young talents. The employees are less likely to agree that requirements connected with work are more important than individual and family needs.

  2. „…ich konnte viel über mein Leben lernen“ Soziologieunterricht an der Gymnasialen Oberstufe in Bremen – Eine „Parallelwelt“?

    Directory of Open Access Journals (Sweden)

    Marianne Papke

    2009-12-01

    Full Text Available "Largely unnoticed by both sociology and the German educational institutions and their discourse, Bremen has been offering both Advanced Placement and standard level sociology classes in its schools in grades 11 through 13 for the last 30 years. This paper deals mainly with the relevance of the school subject of sociology as seen by about 100 students recruited from five different classes. The students discuss the difference between the school subject sociology and other social sciences related subjects taught in school. Against this background, the emergence, development and formation of the new Bremen curriculum for sociology will be presented, concluding with a tentative inquiry into the “lack of interrelation” between school and university.In der deutschen Bildungslandschaft und in der Soziologie nahezu nicht wahrgenommen gibt es in Bremen seit 30 Jahren Soziologieleistungs- und -grundkurse in der Gymnasialen Oberstufe. Dieser Aufsatz beschäftigt sich schwerpunktmäßig mit der Bedeutung des Unterrichtsfaches Soziologie aus der Sicht von ca. 100 Schülerinnen und Schülern aus fünf Oberstufenkursen. Die Jugendlichen setzen sich mit dem Unterschied zwischen dem Fach Soziologie und anderen sozialwissenschaftlichen Fächern in der Schule auseinander. Vor diesem Hintergrund werden kurz die Entstehung und die Erarbeitung des neuen Bremer Bildungsplanes Soziologie dargestellt, um am Ende fragend auf die „Beziehungslosigkeit“ zwischen Universität und Schule hinzuweisen.

  3. Pojmowanie emocji i znaczenie działań muzycznych w ich rozwijaniu u dziecka w młodszym wieku szkolnym

    OpenAIRE

    Kłysz-Sokalska, Natalia

    2017-01-01

    Emotional education in Poland is superficial,accidental and at times intuitive. Lack of emotional education classes and the governments’ low support of teachers have a negative effect on the treatment of emotional education as important in the development of a child in an early school age. Teachers, by trial and error, try to solve problems on the basis of their effect rather than cause, which often lies in the student’s emotions. Separating emotions from “rational” thinking is a pedagogical ...

  4. Wäre es Dir lieber, ich würde zu Recht verurteilt? - Sokrates Bund und die Frage der Kontrolle

    Directory of Open Access Journals (Sweden)

    Katharina Kaiser-Müller

    2014-09-01

    Full Text Available Die Ablösung von zweifelhafter menschlicher Kontrolle durch eine zuverlässige Software bietet eindrucksvolle Möglichkeiten. Mit der flächendeckenden Einführung von Sokrates Bund zum Schuljahr 2014/2015 wird endlich die Identifzierung von Pisadurchschnittsverderbern möglich. Die AutorInnen diskutieren die Lage ... Die Situation war dramatisch: Ungerecht angeklagt wegen Verführung der Jugend und Gottlosigkeit, sieht Sokrates dem Tod durch den Schierlingsbecher entgegen und antwortet auf die ob des Fehlurteils durchaus verständliche Klage von Xanthippe mit der titelgebenden Frage. Anschließend verweigert er die Flucht und zieht es vor, sich dem formal korrekt gefällten falschen Urteil zu beugen. Eine legendäre Entscheidung, in der Sokrates die Gesetzestreue mit der Begründung, man müsse schlechte Gesetze ändern, dürfe sie aber nicht übertreten, über das eigene Wohl stellt.

  5. THE RESULTS OF USING OF INDICATORS OF THE HIGH-TEST CAST IRON OF TYPE ICH STRUCTURE IN CONDITIONS OF PRODUCT

    Directory of Open Access Journals (Sweden)

    A. L. Majorov

    2006-01-01

    Full Text Available The results of development of the indicator of highstrength pig-iron are submitted in the report. The indicator using allows to carry out the testing of the pig-iron structure in conditions of manufacture without additional preparation of the casting surface.

  6. Not In-Service Railway Arched Bridges and Their Future/ Nieużytkowane Kolejowe Mosty Sklepione I Ich Przyszłość

    Directory of Open Access Journals (Sweden)

    Juszczyk Artur

    2015-06-01

    Full Text Available Na przełomie XIX i XX wieku na terenie dzisiejszej Polski zachodniej i północnej bardzo intensywnie rozwijana była infrastruktura kolejowa. W efekcie tych działań powstała sieć dróg żelaznych o dużym zagęszczeniu. Pod koniec lat 80-tych ubiegłego stulecia wiele z tych linii było stopniowo zamykanych. Na skutek tych przemian wiele linii oraz obiektów z nimi związanych, w tym obiekty mostowe, zostały pozostawione niekorzystnemu działaniu czasu.

  7. Preparation of TiO{sub 2} nanotubes, study of their morphology and photocatalytic properties; Priprava nanotrubiek TiO{sub 2}, studium ich morfologie a fotokatalytickych vlastnosti

    Energy Technology Data Exchange (ETDEWEB)

    Motola, M.; Plasch, G. [Univerzita Komenskeho, Prirodovedecka fakulta, Katedra anorganickej chemie, 84215 Bratislava (Slovakia); Satrapinskyy, L. [Univerzita Komenskeho, Fakulta matematiky, fyziky a informatiky, Katedra experimentalnej fyziky, 84248 Bratislava (Slovakia)

    2013-04-16

    The present paper deals with the synthesis and characterization of titanium dioxide nanotubes (TNTs) for photocatalytic applications. Nanotubes were prepared by electrochemical anodic oxidation. The samples were heat treated by annealing to become photocatalytically active. Using scanning electron microscopy morphology of the nanotubes was studied. Phase composition of samples was measured by X-ray diffraction (XRD). The photocatalytic activity of nanotubes leads to decrease of the concentration of Rhodamine B during irradiation with UV A light. The photocatalytic activity of nanotubes was compared with the photocatalytic activity of Aeroxide P25 nanocrystalline titania powder. The best photocatalytic active show the samples annealed at 400 grad C. (authors)

  8. Wybrane społeczne wyznaczniki jakości życia 50-letnich Polek w kontekście ich sytuacji zdrowotnej

    Directory of Open Access Journals (Sweden)

    Małgorzata Synowiec-Piłat

    2010-12-01

    Full Text Available Nowadays, the quality of life has become one of the essential issues that come up when the health statusof particular categories or social groups are discussed. It has been empirically proved that not only the biologicalstructure of an organism influences our health, but also that, at a great range, our health is contingent by factorsof psychosocial nature. Objectives: The objective of research, performed in April 2009, was to recognize chosensocial life quality determinants in a group of mature women, in relation to their health status. Materials andMethods: 209 women – citizens of Wroclaw, aged between 50 and 60, were researched. The assessment wasdone by means of a highly standardized survey questionnaire. Results: both material and occupational status ofmost respondents might be regarded as good. It is worth mentioning that, in the opinion of more than half (57%women researched, their occupation has a negative influence on their health, although to a various degree. Generally,women in the examined group tend to relax in a passive way. What seems advantageous, it is the lengthand quality of their night dreaming. Only 1/3 of the researched evaluate their condition positively; 44% of themfeel various disorders, causing discomfort, once a time, and 14% claim to feel so bad that their health conditionmakes their normal functioning hard. As many as 72% of these women do not suffer from any terminal illness.

  9. Das Bin Ich. Ein Buch von mir uber mich (It's Me! A Book By and About Myself). Communicative Activities for German Immersion and Second Language Classes.

    Science.gov (United States)

    Wicke, Mariele; Wicke, Rainer

    This workbook is intended as a text for the learner of German as a foreign language. The workbook is complete with exercises that require students to provide information about themselves. Students provide information by reading questions and filling in the blanks. Questions are asked about families, friends, likes and dislikes, hobbies, and even…

  10. Peniaze ako zdroj šťastia v našich životoch? (Is Money a Source of Happiness in our lives?

    Directory of Open Access Journals (Sweden)

    Otakar Horák

    2013-06-01

    Full Text Available This paper begins by referring to the research which distinguishes two different aspects of subjective well-being, namely 1. experiences of happiness – measured by frequency and intensity of joy, stress, anger, worry and sadness we experience at a certain moment and 2. life satisfaction. Survey shows that beyond an annual household income of $75 000 there is no increase in the experiences of happiness. The paper then refers to the psychological mechanisms and factors – namely hedonic adaptation, social comparison and stress as a result of a raise – that lower the capacity of money to buy us the experiences of happiness. Not only we get quickly used to the things we buy, money also puts us into stressful situations and makes us build barriers between people. The paper then specifies strategies of economic decision-making that contribute to the maximization of happiness, such as purchase of the experiences instead of the things, interrupted and postponed consumption, or prosocial spending. The research indicates that prosocial spending has higher causal impact on promoting happiness than personal spending. As a matter of fact, this phenomenon is not culturally limited to the West. Concluding assertion – expressed only in the form of hypothesis – says that prosocial spending which is a form of prosocial behavior strengthens – through production of happiness – mutual relations in the society (cooperation.

  11. Relacje pomiędzy życiem zawodowym a rodzinnym pracownika i ich wpływ na funkcjonowanie przedsiębiorstwa

    OpenAIRE

    Sylwia Sysko-Romańczuk

    2011-01-01

    In business there is an increasing conflict between the social role of a family member, who strives for satisfying needs of close relatives, and the role of an employee, who is strongly engaged in accomplishing his professional goals. Only outwardly the problem of work-life balance is not connected with functioning of the companies. The possibility of having a balanced life (work and family) is highly assessed by specialist and young talents. The employees are less likely to agree that requir...

  12. "'AchJA,' Dann Kenn Ich Das Auch!" Managing Understanding and Knowledge: On Teaching Response Tokens in the German Language Classroom

    Science.gov (United States)

    Taleghani-Nikazm, Carmen

    2016-01-01

    This paper offers an instructional unit on the response token "achja" in everyday German conversation. The paper first provides a description of "achja" and its distinctive prosodic features based on empirical research in conversation analysis. The goal of the paper is to provide instructors of German with information and…

  13. Składniki odżywcze i ich rola w diecie sportowca = Nutrients and their role in athlete’s diet

    Directory of Open Access Journals (Sweden)

    Zdzisława Kalisz

    2016-08-01

                Dietary nutrients play a significant role in the normal function of the body. Life style focused on physical activity necessitates appropriately balanced diet. The goal of this study was to assess the dietary habits of a selected group of athletes. Participants of the study were 30 male football players from the Olimpia Grudziadz athletic club, who, between March and May of 2016, agreed to fill out a questionnaire pertaining to their diets. Based on the compiled data from the questionnaire, the overall diet can be considered well-balanced with minor deficiencies. Participating athletes consume a meal rich in key nutrients within an hour of their training, the optimal time necessary to replenish muscle glycogen. This study revealed, however, that the number of servings of fruit and vegetables is below the recommended daily norm, and the fruit and vegetables are not consumed daily. To maximize performance and ensure rapid recovery necessitates carefully balanced and appropriately timed diet. It is recommended that the daily dietary regimen consists of five evenly spaced meals rich in nutrients that prepare the athlete for the strenuous physical activity and replenish depleted energy stores during recovery period.

  14. Badania wartości ekonomicznej usług biblioteczno-informacyjnych i ich wpływu na otoczenie

    Directory of Open Access Journals (Sweden)

    Ewa Głowacka

    2011-01-01

    Full Text Available Biblioteki pełnią różnorodne funkcje we współczesnym otoczeniu społecznym. Uczestniczą w tworzeniu kapitału intelektualnego i społecznego, wpływają na wzrost korzyści ekonomicznych użytkowników i całego społeczeństwa. W artykule omówiono główne podejścia i metody badawcze w zakresie oceny korzyści ekonomicznych płynących z funkcjonowania bibliotek. Skupiono się na metodzie analizy kosztów w stosunku do korzyści (ang. CBA – cost-benefit analysis, metodzie analizy warunkowej (ang. CVM – contigent valuation method, określaniu wartości dodanej dla użytkownika (ang. consumer surplus method i metodologii oceny stopy wzrostu z inwestycji (ang. ROI – return of investment. Przeanalizowano również różne projekty badań prowadzone na świecie w tym zakresie.

  15. Síla sukcese. Úloha půdních živočichů v sukcesi

    Czech Academy of Sciences Publication Activity Database

    Rusek, Josef

    2006-01-01

    Roč. 54, č. 4 (2006), s. 174-176 ISSN 0044-4812 R&D Projects: GA AV ČR IAA6066201; GA AV ČR KSK6005114 Institutional research plan: CEZ:AV0Z60660521 Keywords : soil succession * soil organisms Subject RIV: EH - Ecology, Behaviour

  16. “Fremd bin ich eingezogen… ” − An Outsider’s Vision of Ireland in Urszula Antoniak’s Nothing Personal

    Directory of Open Access Journals (Sweden)

    Katharina Schmid

    2013-03-01

    Full Text Available The following essay analyses Urszula Antoniak’s film Nothing Personal with a view to determining how the Irish-Dutch co-production engages with previously defined ways of understanding Ireland. The film acknowledges the long tradition of representing the country as modernity’s other by drawing strongly on romantic myths about Ireland. At the same time, however, it subtly undermines the authenticity of the vision it presents and foregrounds the projections which are at work in its construction. As the film alludes to and eventually disrupts generic conventions, the foreign can be seen to explode any simplistic formula and elude the grasp of myth. Ultimately, Nothing Personal aims to situate the othering of Ireland in a wider context and to draw attention to a recurring pattern in European approaches to foreignness.

  17. How to find technical information. Pt. 2. Wie finde ich technische Informationen. T. 2. Elektrotechnik, Elektronik, Datenverarbeitung, Mess-, Steuerungs- und Reglungstechnik, Bauingenieurwesen, Architektur, Umweltschutz

    Energy Technology Data Exchange (ETDEWEB)

    Joswig, W

    1981-01-01

    This introduction into the finding and ordering of technical literature addresses both students and doctoral candidates as well as engineers which are already practising their profession. The first chapter - library science - gives a basic description of bibliographic research in an average scientific library: reading rooms and their function, structure of catalogues, structure of the reference library as well as lending and interlibrary lending methods. The technical information systems are described in detail. Finally, translation services and technical information and documentation centres are named. The second chapter - bibliographic research - lists the most important aids in finding technical references. Chapter three outlines the topical complex of scientific work. It provides information on how to organize written scientific publications in a formally correct way, how to quote and to list the references. Chapter four contains an index of terms from library and bibliographic science which is to help the beginner to understand the technical terms which cannot completely be excluded from this orientation aid.

  18. Dietoterapia doustna u pacjentów z anoreksją

    Directory of Open Access Journals (Sweden)

    Agata Dutkiewicz

    2016-06-01

    Full Text Available Anorexia nervosa jest polietiologicznym specyficznym zaburzeniem odżywiania, którego objawy i powikłania mają charakter psychologiczny, społeczny i somatyczny. W leczeniu, obok psychoterapii i ewentualnej farmakoterapii, ważną rolę odgrywa prowadzona równolegle terapia żywieniowa. Zdaniem autorytetów w dziedzinie leczenia zaburzeń odżywiania w skład interdyscyplinarnego zespołu terapeutycznego powinien wchodzić wykwalifikowany dietetyk, odpowiedzialny za zaplanowanie, przeprowadzenie i kontrolowanie leczenia żywieniowego oraz reedukacji żywieniowej pacjentów i członków ich rodzin. Przebieg dietoterapii w omawianej jednostce chorobowej jest fazowy i zindywidualizowany, zmienia się wraz z poprawą stanu somatycznego i psychicznego osoby chorej. Prowadzenie dietoterapii wymaga uwzględnienia wielu czynników, takich jak aktualny stan kliniczny pacjenta, jego preferencje i postawy żywieniowe oraz – niezwykle istotna w anoreksji – motywacja chorego do współpracy w procesie terapeutycznym. Celem niniejszego artykułu jest przedstawienie roli i zadań leczenia żywieniowego w jadłowstręcie psychicznym, a także rozmiaru potencjalnych korzyści wynikających z wprowadzenia rzetelnej terapii żywieniowej. W pracy scharakteryzowano dietoterapię z uwzględnieniem etapu planowania diety doustnej, jak również zmian branych pod uwagę podczas przygotowywania jadłospisów na kolejnych etapach leczenia. Podano praktyczne wskazówki dla osób prowadzących dietoterapię, mogące usprawnić leczenie.

  19. Problem agresji pacjentów – próba diagnozy, poszukiwanie rozwiązań

    Directory of Open Access Journals (Sweden)

    Błażej Kmieciak

    2016-09-01

    Full Text Available Relacja między pacjentem a lekarzem ma szczególny charakter, dotyczy bowiem zagadnień bezpośrednio związanych z intymnością i godnością. Pacjent dzieli się informacjami na temat swoich problemów, a lekarz ma wiedzę i umiejętności, które mogą pomóc w ich rozwiązaniu. W omawianej relacji istnieje więc wyraźna dysproporcja: pacjent musi w pewnym momencie zaufać lekarzowi i podjąć proponowane przez niego działania. Dysproporcja ta przyczyniła się do rozwoju idei praw pacjenta. Zwrócono uwagę, że osobę leczoną trzeba traktować z szacunkiem, a jej godności nie wolno naruszać. Dzięki temu coraz popularniejsze stawało się podejście, zgodnie z którym pacjent jest partnerem w procesie terapeutycznym. W ostatnich latach można jednak zaobserwować niepokojące zjawisko: część pacjentów zmieniła stosunek do lekarzy i traktuje ich wyłącznie jako specjalistów od określonych usług. Osoby leczone mają coraz więcej oczekiwań i żądań, którym czasem towarzyszy agresja słowna i fizyczna. Pojawiają się zatem istotne pytania: Czy wystąpienie zachowań agresywnych wynika z konkretnej przyczyny? Czy tylko pewna grupa pacjentów jest skłonna do podejmowania podobnych działań? Czy od agresji można się uzależnić? W jaki sposób lekarz powinien reagować na przemoc werbalną i fizyczną?

  20. A theology of matter. The strong interaction at strong resonance at the meeting point of I and not-I. Conjectures about oscillating strings and fluctuating vacuum energy; Eine Theologie der Materie. Die starke Wechselwirkung bei starker Resonanz am Begegnungs-Ort von Ich und Nicht-Ich. Mutmassungen ueber oszillierende Strings und fluktuierende Vakuum-Energie

    Energy Technology Data Exchange (ETDEWEB)

    Boes, Roderick H.

    2011-07-01

    This book shows that matter and consciousness are intertwined and mutually produce. Quantum vacuum fluctuations ensure that the latent energy of each event is present as zero-point energy simultaneously at all points of the cosmos.

  1. Ich spreche anders, aber das ist auch deutsch: línguas em conflito em uma escola rural localizada em zona de imigração no sul do Brasil Ich spreche anders, aber das ist auch deutsch: languages in conflict in a rural school located in an immigration area in the south of Brazil

    Directory of Open Access Journals (Sweden)

    Maristela Pereira Fritzen

    2008-12-01

    Full Text Available O bilingüismo/multilingüismo como fenômeno social ainda é pouco reconhecido no cenário brasileiro, apesar de o tema ter conquistado espaço na academia. Em termos gerais, considera-se o Brasil um país monolíngüe, onde se fala apenas o português brasileiro. Há, no entanto, vários contextos de línguas minoritárias (grupos indígenas, grupos de imigrantes, zonas de fronteira, comunidades de surdos em que o uso de várias línguas é a regra. Nesses contextos sociolingüisticamente complexos há relações assimétricas e de conflito entre a língua hegemônica e as línguas minoritárias, em geral estigmatizadas. O presente estudo, parte dos resultados de uma pesquisa etnográfica, focaliza o conflito lingüístico presente em uma escola rural localizada numa comunidade bilíngüe/multilíngüe em zona de imigração alemã no sul do país, onde, ainda hoje, as crianças aprendem em casa a língua de herança, empregada em âmbito familiar e social. Com suporte teórico predominantemente vindo do bilingüismo visto de uma perspectiva social e dos Estudos Culturais, o objetivo principal deste artigo é problematizar a situação de contato/conflito lingüístico existente na região alvo da pesquisa e sua interface com questões de identidades construídas nos discursos hegemônicos. Além disso, discute-se como esses conflitos emergem nas relações interacionais entre os professores e entre alunos e professores, dentro da instituição escolar. Os registros sugerem que o bilingüismo da comunidade penetra na escola e que os conflitos lingüísticos e identitários ganham ainda mais força nas interações sociais entre os sujeitos que ali convivem.Bilingualism/multilingualism as a social phenomenon is still little recognized in the Brazilian scenario, despite it has gotten space in the academy. Usually, Brazil is seen as a monolingual country, where the Brazilian Portuguese is the only language spoken. There are, however, contexts of minority languages (indigenous groups, groups of immigrant, border regions, deaf communities in which the use of several languages is the rule. In these sociolinguistically complex contexts there are both asymmetric and conflicting relations between the hegemonic language and minority languages, usually stigmatized. This study develops itself from the results of an ethnographic research, focusing the language conflict that is present in a rural school located in a bilingual/multilingual community in a region of German immigration in the south of the country, where, even nowadays, children learn at home the inherited language, which is used in the familiar and social contexts. With a theoretical basis mostly acquired from bilingualism analyzed from a social perspective and from the perspective of the Cultural Studies, the main aim of this article is to problematize the language contact/conflict situation existing in the target region and its interface with identity questions built in the hegemonic discourses. Moreover, it is discussed the way these conflicts emerge in the interactional relations between teachers and among teachers and students within school. The data suggests that the community's bilingualism gets into school, and that the language and identity conflicts become even stronger within the social interactions among the individuals that live together in that space.

  2. Regelungen im Verkehr mit Lebensmitteln und Bedarfsgegenständen in Deutschland

    Science.gov (United States)

    Thomas, Gundula; Freund, Astrid; Gründig, Friedrich

    Im Zuge der Globalisierung von Produktion und Handel ändert sich auch der Charakter der Vorschriften im Lebensmittelrecht. Zunehmend treten internationale Rechtsbestimmungen, Abkommen, Standards und andere Normen an die Stelle nationaler Regelungen.

  3. Łuszczyca paznokci

    Directory of Open Access Journals (Sweden)

    Hanna Wolska

    2010-09-01

    Full Text Available Łuszczycowe zmiany paznokciowe występują u około 50% pacjentówz łuszczycą zwyczajną i powyżej 80% osób z łuszczycą stawową. Zmianymogą mieć różnorodny charakter, z czego najczęściej występującymii/lub stwarzającymi największe problemy dla pacjentów są: naparstkowanie,hiperkeratoza podpaznokciowa oraz onycholiza. Mogą oneutrudniać wykonywanie nie tylko czynności dnia codziennego, alenawet pracy zawodowej, a tym samym wpływać wybitnie niekorzystniena jakość życia. Istnieją ponadto dane wskazujące na wyraźnyzwiązek między zmianami paznokciowymi i łuszczycą stawową.Związek ten zaznacza się zwłaszcza przy objęciu procesem zapalnymdystalnych stawów międzypaliczkowych. Nasilone zmiany paznokciowewydają się jednym z głównych czynników ryzyka rozwoju łuszczycystawowej. Stopień zajęcia paznokci określa się najczęściej zapomocą tzw. skali NAPSI, która pozwala na obiektywne porównanieskuteczności poszczególnych terapii. Jest to o tyle istotne, że dotychczasnie ma ujednoliconych metod leczenia przy tej lokalizacji łuszczycy.Wszystkie leki podawane ogólnie, zwłaszcza retinoidy, mogąpowodować poprawę stanu paznokci. Badania kontrolowane nowychpreparatów wskazują na znaczną skuteczność infliksymabu, a obserwacjekliniczne – również adalimumabu. Najczęściej jednak stosuje siępreparaty miejscowe, z których najskuteczniejsze wydają się kortykosteroidy,zwłaszcza w iniekcjach domiejscowych, co może jednakłączyć się z istotnymi działaniami niepożądanymi. Bezpieczniejsze jeststosowanie miejscowych pochodnych witaminy D i witaminy A – kalcypotriolui tazarotenu, ale ich skuteczność zależy w dużej mierze odsposobu aplikacji – pod okluzją czy bez okluzji, czy też w skojarzeniuz miejscowymi kortykosteroidami. Postępowanie u pacjentów z łuszczycąpaznokci nadal pozostaje problemem.

  4. Widmo krąży po Europie. Korczulańska Szkoła Letnia jako wyspa wolnego myślenia i przestrzeń dialogu

    Directory of Open Access Journals (Sweden)

    Ewa Wróblewska-Trochimiuk

    2017-10-01

    Full Text Available A spectre is haunting Europe: The Korčula Summer School as a freethinking island and space for dialogue The Korčula Summer School and the journal Praxis associated with it occupy an important place on the map of Yugoslav intellectual history in the nineteen-sixties and seventies. Philosophers, sociologists and representatives of other professions considered the issues of Socialism, revolution, the idea of self-government. These direct contacts with Western intellectuals were not only an important contribution to the Yugoslav philosophical thought, but also constituted an input to the contemporary Western intellectual life. The aim of the article is to present the complex inter-institutional and interpersonal network by which the Yugoslav achievements of the so-called Praxis group became part of the European heritage. In this way, studying wandering ideas shows the Yugoslav culture to be not only receptive, but also creative and innovative.   Widmo krąży po Europie. Korczulańska Szkoła Letnia jako wyspa wolnego myślenia i przestrzeń dialogu Na mapie jugosłowiańskiej historii intelektualnej istotne miejsce zajmują Korczulańska Szkoła Letnia (Korčulanska ljetna škola i związane z nią czasopismo „Praxis”. W ich ramach filozofowie i socjologowie, a także przedstawiciele innych profesji, w latach 60. i 70. XX wieku podejmowali refleksję nad zagadnieniem socjalizmu, rewolucji, idei samorządności. Ożywione kontakty z zachodnimi intelektualistami stanowiły nie tylko istotny wkład w lokalną myśl intelektualną, ale także promieniowały na świat zachodni, gdzie również były dyskutowane i rozwijane. Celem artykułu jest zaprezentowanie licznych i skomplikowanych sieci międzyinstytucjonalnych i międzyludzkich, dzięki którym jugosłowiański dorobek filozoficzny tzw. grupy Praxis, stał się częścią dziedzictwa europejskiego. W ten sposób badanie idei wędrownych pokazuje, że kultura jugosłowiańska miała nie

  5. Znaczenie edukacji w terapii pacjentów z astmą oskrzelową = Importance of education in treatment of patients with asthma

    Directory of Open Access Journals (Sweden)

    Iwona Czerwińska Pawluk

    2015-01-01

      Streszczenie   Edukacja pacjentów z astmą jest jednym z elementów warunkujących osiąganie celów leczenia, a w konsekwencji poprawia jakość życia chorych. Pośród wielu czynników warunkujących skuteczność edukacji prowadzonej wobec pacjentów z chorobą przewlekłą i / lub ich opiekunów na szczególną uwagę zasługują: partnerskie relacje między lekarzem a pacjentem/ jego opiekunem, dostosowanie zakresu wiedzy w zależności do wieku, poziomu wykształcenia oraz oczekiwań pacjentów/ opiekunów.  Istotna też jest ciągłość kształcenia, mająca na celu weryfikację zdobytej wiedzy  i nabytych umiejętności.  Chory na astmę musi zaakceptować chorobę i z pełnym przekonaniem podjąć zadanie współuczestnictwa w jej leczeniu. Edukacja jest podstawą interakcji między pracownikami opieki zdrowotnej a pacjentem. Może mieć charakter edukacji bezpośredniej,  szkoleń w małych grupach, seminariów, sympozjów, konferencji, dystrybucji materiałów edukacyjnych, kampanii medialnych,  portali internetowych.   Abstract   Education of patients with asthma is one of the prerequisites for achieving the goals of treatment and consequently improves the quality of life of patients. Among the many factors determining the effectiveness of education provided to patients with chronic disease and / or their carers deserve special attention: partnerships between doctor and patient / his guardian, adjust the scope of knowledge according to age, educational level and expectations of patients / caregivers. Also important is the continuity of education, in order to verify their knowledge and acquired skills. Suffering from asthma must accept the disease and confidently take on the task of participation in its treatment. Education is the basis of the interaction between health care professionals and patients. It may be of direct education, training in small groups, seminars, symposia, conferences, distribution of educational materials, media

  6. «ICH STEIG’ AN’S LAND, NICHT OHNE FURCHT UND ZAGEN», OVVERO L’ARRIVO A VENEZIA DI AUGUST VON PLATEN E L’INIZIO DEI SONETTI VENEZIANI

    Directory of Open Access Journals (Sweden)

    Serena Spazzarini

    2018-01-01

    Full Text Available In Italy, and in particular in Venice, August von Platen Hallermünde spent long periods and wrote a large number of works. In 1825 he published the Sonette aus Venedig (Sonetti Veneziani in Erlangen. The first part of the paper provides a general introduction to the relations between Platen and Italy and summarizes the «complicated» genesis of this poetical cycle. The second part focuses in more details on a linguistic and rhetorical analysis of the sequence’s first sonnet. Finally, the third part proposes a reflection on possible similarities between the narrative structure of Platen’s sonnets and Thomas Mann’s Death in Venice.

  7. Actual knowledge about some plants with radioprotective effect and about the research of possibilities their use; Aktualne poznatky o niektorych rastlinach s radioprotektivnym ucinkom a o vyskume moznosti ich vyuzitia

    Energy Technology Data Exchange (ETDEWEB)

    Skalka, J [I. Interna klinika, Univerzita veterinarsneho lekarstva, Kosice (Slovakia)

    2004-06-15

    Study was undertaken to refer to me importance of radiological protection of human and animal species, especially. After the crash of nuclear power station in Chernobyl, Ukraine, an enormous natural catastrophe. The world wide research programs are dedicated to vearch for plants with radioprotective effect. Apparently representing sea vegetation, brown algae, were considered to have a radioprotective effect just as a large amount of plants representing terrestrial flora. The direction of research programs in the world continues in identification of other unknown plants having radioprotective effect. We would like to direct our research interests in this direction and use enormous possibilities of our rich and various vegetation. (author)

  8. Analýza implementácie vybraných modulov nástroja ServiceNow s ich predlohou vo forme súboru najlepšej praxe knižnice ITIL

    OpenAIRE

    Vacula, Filip

    2016-01-01

    This thesis is dedicated to the ServiceNow ITSM tool, and its comparison to ITIL. The main goal is to analyze the differences and similarities between implementation of Incident, Problem and Change Management processes in ServiceNow, and their model presented by the best practice recommendations of the ITIL library.

  9. Ich glaube, wir können es uns gar nicht leisten, nichts von Religion zu verstehen.“ Grundkompetenzen für Lehrerinnen und Lehrer im Umgang mit Religion

    Directory of Open Access Journals (Sweden)

    Helga Kohler-Spiegel

    2016-06-01

    Full Text Available Das Recht von Kindern, sich mit Religion auseinanderzusetzen, ist in den Kinderrechten der UN verankert, Friedrich Schweitzer spricht von den „großen Fragen“. Diesen Fragen Raum zu geben beinhaltet ein Begleiten der Kinder, unabhängig ihrer formalen religiösen Zugehörigkeiten. Da sich Religiöses in der Schule auf sehr vielfältige Art zeigt, bedarf es der kurzen Klärung, was darunter verstanden wird, bevor beschrieben wird, welche Grundkompetenzen Lehrpersonen brauchen, um Kinder in der Vielfalt dieser Erfahrungen und Fragen zu begleiten. „I believe we cannot afford to not understand religion.“ Basic competences for teachers in handling religion Children‘s entitlement to deal with religion is constituted in the Human Rights for Children of the UN, Friedrich Schweitzer refers to it as „The big questions“. To create space for these questions implies to shepherd the children, regardless of their formal religious affiliation. Driven by the diversity of religiousness in school, some brief clarification of this topic is required, before characterizing which basic expertise educational personnel need to have in order to guide children through the variety of these experiences and questions.

  10. Verortung des Dichtens in Der Erzählung Meine Sprache und ich von Ilse Aichinger. Kūrybos raiškos vieta Ilzės Aichinger apsakyme Mano kalba ir Aš

    Directory of Open Access Journals (Sweden)

    Inga Bartkuvienė

    2008-01-01

    Full Text Available Straipsnyje analizuojamas kūrybos lokalizacijos klausimas objektu pasirinkus Ilzės Aichinger apsa­kymą Mano kalba ir aš. Susitelkta ties kalbos raiš­kos ženklais autoreferentiniame Aichinger rašyme. Siekis – atskleisti, kaip tekste išsidėsto, kaip veikia ir kokias reikšmes įgauna kalba, rašantysis, rašymas, raštas. Teorines prieigas teikia Martino Heideggerio kalbos filosofija bei Jacques Derrida „gramatologija“.Straipsnio dalyje „Riba kaip kalbos sritis“ apta­riamos kalbos sklaidos kūryboje bei kūrybos kalboje aktualizacijos. Kalba Aichinger tekste steigiasi opo­zicinių savybių sava / svetima sandūroje. Analizė pa­rodo, jog šią opoziciją eliminuoja besiplečiantis kity­bės atverčių laukas. Personifikuotos kalbos „sienos kirtimas“, „apsistojimas prie jūros“ erdviškai žymi ribinę situaciją, kuri yra kalbos būties sąlyga.Dalyje „Kūryba rašte“ gvildenami veikiančių figūrų implikuojami balso ir rašto santykiai: balsas yra kalbančiojo subjekto savybė, antropomorfinį pa­vidalą apsakyme įgijusi kalba prabilti atsisako. Jos būties būdas yra spektriškas, daugialypis, raštiškas. „Sustingęs rašale“ rašantysis praranda subjektyvybę ir išlieka tik kaip signatūros statusas, o „sustingusi rašale kalba“ grąžinama į rašto „būties namus“.

  11. Properties of Artificial Gaseous Mixtures for their Safe Use and Support the Natural Gas Supply Networks / Własności Sztucznych Mieszanin Gazowych do Bezpiecznego ich Użytkowania i Wspomagania Zasilania Sieci Gazu Ziemnego

    Science.gov (United States)

    Łaciak, Mariusz

    2012-11-01

    The increase in natural gas consumption by the general public and industry development, in particular the petrochemical and chemical industries, has made increasing the world interest in using gas replacement for natural gas, both as mixtures of flammable gases and gas mixtures as LPG with air (SNG - Synthetic Natural Gas). Economic analysis in many cases prove that to ensure interchangeability of gas would cost less than the increase in pipeline capacity to deliver the same quantity of natural gas. In addition, SNG systems and installations, could be considered as investments to improve security and flexibility of gas supply. Known existing methods for determining the interchangeability of gases in gas gear based on Wobbe index, which determines the heat input and the burning rate tide, which in turn is related to flame stability. Exceeding the Wobbe index of a value increases the amount of carbon monoxide in the exhaust than the permissible concentration. Methods of determining the interchangeability of gases is characterized by a gas in relation to the above-described phenomena by means of quantitative indicators, or using diagrams interchangeability, where the gas is characterized by the position of a point in a coordinate system. The best known method for determining the interchangeability of gases is Delbourg method, in which the gas is characterized by the revised (expanded) Wobbe Index (Wr), the combustion potential, rate of soot formation (Ic) and the ratio of the formation of yellow ends (I). Universal way to determine the interchangeability of gas is also Weaver accounting method. It does not require determination of the reference gas. It is designed for utensils for household gas and gas pressure p = 1.25 kPa. The criteria and definition of gas interchangeability volatility in practice to the combustion in a gas gear. In the case of gas exchange in industrial furnaces, interchangeability criteria are usually not very useful because of other conditions of combustion and heat exchange. In industrial reheating furnace gas is combusted in a sealed combustion chambers. Air supply is regulated. The exhaust gases are discharged into canals and the chimney to the atmosphere. The temperature difference between load (fuel gas) and the flame is much less than in the case of gas household appliances. In the furnace heat exchange takes place mainly by radiation in 85% to 95%. The value of heat flux flowing from the gas to a heated charge is not proportional to the heat load burners. Interchangeability of gas is linked by adding to natural gas, a certain amount of gas that is a substitute for natural gas in meeting the criteria for substitution in order to ensure certainty of supply of natural gas to customers. Gases that can be used in the processes of blending and used as replacement gases are mainly a mixture of propane and propane - butane (LPG - Liquid Petroleum Gas), landfill gas or biogas (LFG - Landfill Gas) and dimethyl ether (DME). One of the more well-known gas mixtures used in many countries around the world to compensate for peak demands is a mixture containing about 75% of natural gas and approximately 25% propane / air (LPG / air). Also in Poland is prepared to amend the provisions in this regard (at this moment - oxygen in the gas network can not exceed 0.2%). In this paper, the calculations of interchangeability of gas mixtures LFG - LPG and LPG - air (SNG) for natural gas was made. It was determined whether the analyzed mixtures have similar stable flame zones regardless of the quality of LFG fuel and whether they may in whole or in part replace CH4, without any modification of equipment suction air for combustion. The obtained results will determine whether the fuel can be used as a replacement for natural gas used in such household appliances and, possibly, industrial burners. In connection with the possibility of changes in the quality of LFG, depending on such factors as storage time, as pre-treatment, will be determined the degree of interchangeability of LFG as a fuel mixed with regard to its quality.

  12. „Die Bedingungen, die ich als Frau vorfand, haben logischerweise zu meinem Ausstieg geführt“ “The Conditions that I encountered as a women obviously led to me to quit.”

    Directory of Open Access Journals (Sweden)

    Anina Mischau

    2004-03-01

    Full Text Available Warum gibt es, trotz zahlreicher Maßnahmen zur Steigerung des Frauenanteils in ingenieurwissenschaftlichen Studiengängen oder auch zur Integration von Frauen in entsprechende Berufsfelder, nach wie vor so wenige Ingenieurinnen in Deutschland? Warum wird technische Gestaltungs- und Definitionsmacht nahezu ungebrochen mit „Männlichkeit“ oder dem Bild „des Ingenieurs“ verknüpft? Warum zeigt sich die ingenieurwissenschaftliche Fachkultur, wie die Fachkulturforschung im ingenieurwissenschaftlichen Feld selbst, als besonders „resistent“ oder „widerständig“ gegen die Kategorie Geschlecht? Diesen spannenden und politisch provokanten Fragen geht Christiane Erlemann nach. In ihrem Buch rekonstruiert sie die Hinwendung zum, die Auseinandersetzung mit dem und letztlich die Abwendung vom ingenieurwissenschaftlichen Feld anhand biographisch orientierter narrativer Interviews mit Ingenieurinnen, die ihren Beruf „an den Nagel gehängt“ haben.Why, in spite of the numerous measures to increase the number of women studying engineering and their integration into corresponding careers, are there still so few female engineers in Germany? Why is technical prowess still associated with masculinity and the images of the male engineer? Why does the dominant culture in engineering, just like the culture of research in this discipline, prove to be particularly resistant to questions of gender? These are the exciting and politically provocative questions that Christiane Erlemann pursues. Using interviews with female engineers who have left their profession, she re-examines the process of first deciding to become an engineer, pursuing such a career and, finally, deciding to quit.

  13.  Syntetyczne instrumenty finansowe i przykłady ich ujęcia w kontekście stosowania kosztu historycznego i wartości godziwej

    Directory of Open Access Journals (Sweden)

    Paweł Bielawski

    2010-11-01

    Full Text Available Celem niniejszego artykułu jest zaprezentowanie koncepcji konstruowania instrumentów syntetycznych na podstawie parytetu opcji kupna i opcji sprzedaży oraz modelu kosztów posiadania. Koncepcje te zostały wykorzystane do skonstruowania strategii long strangle i long straddle na rzeczywistych i syntetycznych instrumentach. Do wyceny bilansowej strategii zastosowano model mieszany wyceny, oparty na dwóch podstawowych miarach wartości instrumentów finansowych: zasadzie kosztu historycznego i kategorii wartości godziwej.

  14. Dobowe wahania deficytu wodnego i ich zależność od czynników klimatycznych [Diurnal changes of water saturation deficit in leaves and their dependence on the climatic factors

    Directory of Open Access Journals (Sweden)

    J. Czerski

    2015-01-01

    Full Text Available Daily changes in water suction deficit (WSD in different species of Nicotiana, Digitalis, Calendula, Beta and Brassica were studied. Significant water deficit in the middle of the day was demonstrated for all plants studied.

  15. Prorocké gesto Holečkových Našich a jeho reflexe v kulturní paměti jižních Čech

    Czech Academy of Sciences Publication Activity Database

    Hrdina, Martin

    2018-01-01

    Roč. 66, č. 1 (2018), s. 70-92 ISSN 0009-0468 R&D Projects: GA ČR(CZ) GA17-11309S Institutional support: RVO:68378068 Keywords : Josef Holeček * purpose novel * agrarian reform * Petr Chelčický * Jesus Christ * Kubata Subject RIV: AJ - Letters, Mass-media, Audiovision OBOR OECD: Specific literatures

  16. Evaluation of the persistence in the induction of Sister Chromatid Exchanges (SCE) by alkylating agents; Evaluacion de la persistencia en la induccion de Intercambio en las Cromatidas Hermanas (ICH) por agentes alquilantes

    Energy Technology Data Exchange (ETDEWEB)

    Rodriguez R, R.; Huerta V, C.; MOrales R, P.R. [ININ, 52045 Ocoyoacac, Estado de Mexico (Mexico)

    2006-07-01

    The persistence in the induction of sister chromatid exchanges (SCE) by the alkylating agents methyl and ethyl-methanesulfonates (MMS and EMS) was evaluated. For it, to groups of mice its were administered a dose of these agents and later its were analyzed the induced SCE's in two periods: early and late. Both agents caused high increments of SCE in the early period and small in the late one; however, the caused lately by EMS was significantly bigger. This late induction of SCE by EMS possibly is associated with an epigenetic change or with the presence of etiladucts in the phosphodiester bonds of the DNA. (Author)

  17. European guidelines for prevention and management of influenza in hematopoietic stem cell transplantation and leukemia patients: summary of ECIL-4 (2011), on behalf of ECIL, a joint venture of EBMT, EORTC, ICHS, and ELN.

    Science.gov (United States)

    Engelhard, D; Mohty, B; de la Camara, R; Cordonnier, C; Ljungman, P

    2013-06-01

    Influenza may cause severe disease and mortality in leukemia patients and in hematopoietic stem cell transplantation recipients. The 4th European Conference of Infections in Leukemia (ECIL-4) has developed evidence-based guidelines for prevention and management of influenza infections in these patients. Real-time reverse-transcription polymerase chain reaction is the diagnostic test of choice, as it is the most sensitive and specific test for influenza. The risks for severe influenza and fatal outcome include lymphopenia, older age, influenza soon after transplantation or chemotherapy, steroid treatment, and lack of early antiviral therapy. Neuraminidase inhibitors (oral oseltamivir or inhalation of zanamivir) are currently the most effective therapeutic agents for influenza. Main preventive measures include annual vaccination of patients, household contacts, and hospital staff. This review summarizes ECIL-4's main recommendations. © 2013 John Wiley & Sons A/S.

  18. Evaluation of the persistence in the induction of Sister Chromatid Exchanges (SCE) by alkylating agents; Evaluacion de la persistencia en la induccion de Intercambio en las Cromatidas Hermanas (ICH) por agentes alquilantes

    Energy Technology Data Exchange (ETDEWEB)

    Rodriguez R, R; Huerta V, C; MOrales R, P R [ININ, 52045 Ocoyoacac, Estado de Mexico (Mexico)

    2006-07-01

    The persistence in the induction of sister chromatid exchanges (SCE) by the alkylating agents methyl and ethyl-methanesulfonates (MMS and EMS) was evaluated. For it, to groups of mice its were administered a dose of these agents and later its were analyzed the induced SCE's in two periods: early and late. Both agents caused high increments of SCE in the early period and small in the late one; however, the caused lately by EMS was significantly bigger. This late induction of SCE by EMS possibly is associated with an epigenetic change or with the presence of etiladucts in the phosphodiester bonds of the DNA. (Author)

  19. Relationship of the demethylation of the DNA with the induction of the sister chromatid exchanges (SCE) In vivo; Relacion de la desmetilacion del ADN con la induccion de intercambios en las cromatidas hermanas (ICH) In vivo

    Energy Technology Data Exchange (ETDEWEB)

    Toribio E, E

    2005-07-01

    The methylation of the DNA is an epigenetic modification that has an important paper in the regulation of the functionality of the genome of the organisms. It can be altered by demethylation processes, either natural or experimentally induced. The 5-azacytidine (Aza) is a compound that causes the demethylation of the DNA (dm-DNA), inducing with it, expression genic and increase in the frequency of the Sister Chromatid Exchange (SCE). The SCE is a genotoxicity indicator, caused by diverse mutagens and carcinogen. Since the biological meaning and the formation mechanism of this phenomenon has not been totally illustrious, the exploration of the relation between the dm-DNA and the induction of SCE, it could offer new knowledge to explain those queries. The purpose of this work was to study in cells of the mouse bone marrow In vivo, the effect of the Aza on the induction of SCE, based on two aspects: 1) dose answer and 2) the effectiveness of multiple exhibition. To six groups of three to five animals, they are administered Aza to dose of 5, 10, 15 or 20 mg/Kg of weight; in sharp or multiple form, previously to the bromodeoxyuridine supply and 24 h was sacrificed after this; 2 h after an injection with colchicine. Preparations of those metaphases were made, those which were dyed by means of a technique of fluorescence more Giemsa. It was observed that to sharp low dose, the Aza produced an increment in the frequency of SCE that although small it was proportional and statistically significant. To sharp and multiple high doses, the Aza doesn't cause additional increments of SCE, but if toxicity at cellular level and of individuals. It is concluded that a relationship exists between the dm-DNA and the induction of SCE. It is suggested that the total demethylation of the DNA causes 2 SCE/Cell in cells of the mouse bone marrow, or that the cytotoxicity prevents to evidence a bigger induction. (Author)

  20. Zagraniczne kontakty oraz ich rola w podnoszeniu jakości usług i budowaniu wizerunku biblioteki akademickiej. Doświadczenia Biblioteki Głównej Uniwersytetu Pedagogicznego im. KEN w Krakowie w latach 2010-2016

    Directory of Open Access Journals (Sweden)

    Błach Marzena

    2017-06-01

    Full Text Available The aim of the article is to draw attention to the role of contacts with foreign institutions in the process of improving services and building the image of an academic library. Experiences of the Main Library of the Pedagogical University in Cracow show a positive influence of participation in the Erasmus programme on the professional activity (increased number of foreign interlibrary transactions and scientific studies (reports and articles, conference papers, seminars of librarians. The article discusses the cooperation of the PU Main Library with foreign institutions in the years 2010-2016, conducted within the framework of the Erasmus programme and Interlibrary Loan. Statistical data illustrate the intensity of Erasmus and interlibrary contacts. Also, based on the experience of a Main Library employee participating in the International Librarians Network, library networking forms are described.

  1. Relationship of the demethylation of the DNA with the induction of the sister chromatid exchanges (SCE) In vivo; Relacion de la desmetilacion del ADN con la induccion de intercambios en las cromatidas hermanas (ICH) In vivo

    Energy Technology Data Exchange (ETDEWEB)

    Toribio E, E

    2005-07-01

    The methylation of the DNA is an epigenetic modification that has an important paper in the regulation of the functionality of the genome of the organisms. It can be altered by demethylation processes, either natural or experimentally induced. The 5-azacytidine (Aza) is a compound that causes the demethylation of the DNA (dm-DNA), inducing with it, expression genic and increase in the frequency of the Sister Chromatid Exchange (SCE). The SCE is a genotoxicity indicator, caused by diverse mutagens and carcinogen. Since the biological meaning and the formation mechanism of this phenomenon has not been totally illustrious, the exploration of the relation between the dm-DNA and the induction of SCE, it could offer new knowledge to explain those queries. The purpose of this work was to study in cells of the mouse bone marrow In vivo, the effect of the Aza on the induction of SCE, based on two aspects: 1) dose answer and 2) the effectiveness of multiple exhibition. To six groups of three to five animals, they are administered Aza to dose of 5, 10, 15 or 20 mg/Kg of weight; in sharp or multiple form, previously to the bromodeoxyuridine supply and 24 h was sacrificed after this; 2 h after an injection with colchicine. Preparations of those metaphases were made, those which were dyed by means of a technique of fluorescence more Giemsa. It was observed that to sharp low dose, the Aza produced an increment in the frequency of SCE that although small it was proportional and statistically significant. To sharp and multiple high doses, the Aza doesn't cause additional increments of SCE, but if toxicity at cellular level and of individuals. It is concluded that a relationship exists between the dm-DNA and the induction of SCE. It is suggested that the total demethylation of the DNA causes 2 SCE/Cell in cells of the mouse bone marrow, or that the cytotoxicity prevents to evidence a bigger induction. (Author)

  2. „...folglich ich keines Weges einem meiner Mit-Collegen nachtheilig bin...“ Die Deregulierung des habsburgischen Buchhandels unter Joseph II. am Beispiel des Prager Buchdruckers J. N. F. von Schönfeld

    Czech Academy of Sciences Publication Activity Database

    Wögerbauer, Michael

    2009-01-01

    Roč. 34, č. 2 (2009), s. 46-72 ISSN 0340-4528 R&D Projects: GA ČR GA408/08/1545 Institutional research plan: CEZ:AV0Z90560517 Keywords : book studies * Schönfeld, Johann Ferdinand Nepomuk Subject RIV: AJ - Letters, Mass-media, Audiovision

  3. Istočniki aktivnosti mozga, značimyje i neznačimyje dlja klassifikacii patternov EEG, sootvetstvujuščich voobraženiju dviženij

    Czech Academy of Sciences Publication Activity Database

    Bobrov, P.; Húsek, Dušan; Korshakov, A.V.; Frolov, A. A.

    -, č. 12 (2011), s. 3-15 ISSN 1999-8554 R&D Projects: GA ČR GAP202/10/0262; GA ČR GA205/09/1079 Grant - others:GA MŠk(CZ) ED1.1.00/02.0070 Program:ED Institutional research plan: CEZ:AV0Z10300504 Keywords : brain-computer interface * independent component analysis * EEG pattern classifying * motor imagination Subject RIV: IN - Informatics, Computer Science http://www.radiotec.ru/catalog.php?cat=jr7&art=9529

  4. Propuesta de la aplicación de la guía oficial de la ich q10 para el levantamiento de un sistema de calidad en la industria farmacéutica

    OpenAIRE

    Bourne Obando, Carlos Rodolfo; Vega Gordilllo, Maria Veronica

    2010-01-01

    La Industria Farmacéutica es el sector industrial con mayores requerimientos y exigencias tecnológicas y de infraestructura para la producción de sus productos, debido a la estricta regulación con las que son monitoreadas y controladas, tanto localmente como internacionalmente. Este tipo de industria está dedicada a la producción y preparación de productos químicos medicinales y es catalogada entre las industrias más importantes del mundo, por la enorme cantidad de proyectos de investigación,...

  5. Adresát Jindřich Honzl. Dopisy a scénické návrhy Jindřicha Štyrského z Honzlovy pozůstalosti

    Czech Academy of Sciences Publication Activity Database

    Bydžovská, Lenka; Srp, K.

    2008-01-01

    Roč. 56, č. 6 (2008), s. 529-537 ISSN 0049-5123 R&D Projects: GA AV ČR IAA800330603 Institutional research plan: CEZ:AV0Z80330511 Keywords : stage design * artificialism * surrealism Subject RIV: AL - Art, Architecture, Cultural Heritage

  6. "Es ist meine Art, einen und denselben Gegenstand zu verfolgen, bis ich ihn aufgeklärt habe" Äußerungen Alexander von Humboldts über sich selbst

    Directory of Open Access Journals (Sweden)

    Ingo Schwarz

    2000-10-01

    Full Text Available Article in German, Abstracts in English and Spanish. Alexander von Humboldt has been characterized as the second, scientific discoverer of the New World, as the last universal scientist, Aristotle of modern times, etc. However, more or less hidden in his correspondence we find certain self-characterizations which are not that well-known. Some of them are quoted and discussed in the paper. Thus, an attempt is made to answer the question why Humboldt liked to call himself "the old man from the mountains", and whether or not he found it appropriate to be called "Aristotle of our age."

  7. Riziko ICHS určené podle různých indexů aterogenity ovlivňují i další rizikové faktory

    Czech Academy of Sciences Publication Activity Database

    Tomečková, Marie; Marušiaková, M.; Grünfeldová, H.; Peleška, Jan; Hanuš, P.

    2005-01-01

    Roč. 8, 3 Suppl. (2005), s. 43-44 ISSN 1211-9326. [Kongres o ateroskleróze /9./. 01.12.2005-03.12.2005, Špindlerův Mlýn] Institutional research plan: CEZ:AV0Z10300504 Keywords : atherogenetic indexes * risk of coronary heart disease Subject RIV: BB - Applied Statistics, Operational Research

  8. Orestes bojownikiem ruchu oporu, czyli mit Atrydów w filmie "Podróż komediantów" Theo Angelopoulosa

    Directory of Open Access Journals (Sweden)

    Iga Łomanowska

    2016-12-01

    Full Text Available Orestes as a resistance fighter, or the myth of the Atreides in Theo Angelopoulos’s film The travelling players The paper examines the use of the Atreides myth in Theo Angelopoulos’s film The travelling players (1975 in the context of the director’s interpretation of the phenomenon of myth. Angelopoulos treated myth as a set of archetypical situations and patterns of conduct constantly reproduced in the history of the world. He intertwined elements of classical stories with the history of Greece and the Byzantine tradition, thus showing their universal character. In The travelling players, Angelopoulos used the story of betrayed and murdered Agamemnon, who is avenged by his children: Orestes and Electra, but he moved it into modern times, setting the film in Greece of the 1940s and 1950s. The myth is reproduced with modulations: the most important events take place as a result of interventions of History, not fate or decisions of the gods. Moreover, the characters’ conflicts are enriched with a political dimension, as Angelopolous portrays the discord between their ideological stances. But the members of the acting company are as helpless in the face of events as the family of the king of Argos.   Orestes bojownikiem ruchu oporu, czyli mit Atrydów w filmie Podróż komediantów Theo Angelopoulosa Artykuł jest analizą sposobu wykorzystania przez Theo Angelopoulosa mitu Atrydów w filmie Podróż komediantów (1975 w kontekście dokonanej przez niego interpretacji zjawiska mitu. Grecki reżyser traktował mit jako zbiór archetypicznych sytuacji i wzorów postępowania odtwarzanych nieustannie w dziejach świata. Elementy antycznych opowieści splatał w filmach z historią Grecji i tradycją bizantyjską, ujawniając ich uniwersalny charakter. W Podróży komediantów wykorzystał historię zdradzonego i zamordowanego Agamemnona, który zostaje pomszczony przez swoje dzieci: Orestesa i Elektrę, ale przeniósł ją w czasy wsp

  9. Podejście psychologiczne w terapii jąkania

    Directory of Open Access Journals (Sweden)

    Agata Błachnio

    2013-06-01

    Full Text Available Praca omawia różne metody stosowane w terapii jąkania z uwzględnieniem podejścia psychologicznego. Jąkanie jest nie tylko zaburzeniem płynności mówienia, objawy występują bowiem na kilku płaszczyznach: neurofizjologicznej, społecznej i psychologicznej. Terapia jąkania ze względu na złożoność tego zaburzenia wymaga podejścia interdyscy‑ plinarnego, w tym szczególnie koncentracji na radzeniu sobie z emocjami pacjenta i obniżeniu związanych z tym za‑ burzeniem patologicznych reakcji lękowych – logofobii. Celem artykułu jest omówienie metod stosowanych w terapii jąkania oraz ocena ich skuteczności. Główny podział metod zakłada istnienie dwóch podejść: pośrednie i bezpośred‑ nie metody. Metody bezpośrednie oddziałują na akt mowy i mają na celu zmniejszenie niepłynności mowy. Wśród nich można wymienić: rytmizację mówienia, wspomaganie wypowiedzi ruchem ręki czy wydłużenie wypowiedzi. Natomiast metody pośrednie stanowią ich uzupełnienie i koncentrują się na obniżeniu lęku oraz redukcji napięcia po‑ jawiającego się u osoby jąkającej się. Należą do nich różnego rodzaju techniki relaksacyjne, metody oparte na wizu‑ alizacji czy treningi autogenne. Zwracają one uwagę na emocje przeżywane przez osoby jąkające się. Ponadto tech‑ niki takie jak muzykoterapia, psychodrama, hipoterapia, desentyzacja i desensybilizacja są skutecznymi sposobami polepszenia funkcjonowania psychospołecznego osób jąkających się. Prezentowany artykuł ma charakter przeglądo‑ wy, może zatem służyć jako podstawa do opracowania i wdrożenia programów terapeutycznych z udziałem logope‑ dy i psychologa.

  10. Skuteczność montelukastu w ambulatoryjnym leczeniu astmy oskrzelowej u pacjentów powyżej 15. roku życia w warunkach codziennej praktyki lekarskiej (real life study

    Directory of Open Access Journals (Sweden)

    Izabela Kupryś‑Lipińska

    2012-12-01

    Full Text Available Astma oskrzelowa jest chorobą o podłożu zapalnym, dlatego leki o właściwościach przeciwzapalnych stanowią podstawę w terapii tej choroby. Takie działanie wykazują leki antyleukotrienowe. Leki te są rekomendowane przez ekspertów GINA w monoterapii alternatywnie do niskich dawek wGKS w 2. stopniu intensywności terapii lub jako terapia dodana do wGKS w wyższych stopniach intensywności leczenia astmy. Celem obecnego badania obserwacyjnego była ocena skuteczności montelukastu w warunkach codziennej praktyki lekarskiej u pacjentów ambulatoryjnych w wieku 15 lat i więcej, leczonych w Polsce z powodu przewlekłej astmy oskrzelowej. Do bada‑ nia włączono 11 250 pacjentów, u których lekarze z przyczyn medycznych niezależnych od udziału pacjenta w obserwacji włączyli montelukast w ostatnim miesiącu przed rozpoczęciem obserwacji. Dane były zbierane od pacjentów przez ich lekarzy prowadzących w ramach dwóch rutynowych wizyt lekarskich przeprowadzonych średnio w odstępnie 8 tygodni. Zastosowano jednolite, specjalnie przygotowane dla potrzeb badania kwestiona‑ riusze. średnia wieku uczestników badania wyniosła 36,79±15,62 roku (przedział od 15 do 90 lat. Kobiety sta‑ nowiły 52,09% respondentów. W chwili włączenia do obserwacji czas trwania astmy najczęściej wynosił między 2 a 5 lat. W 83,39% przypadków astma miała charakter atopowy. Przyczyną włączenia montelukastu u większo‑ ści pacjentów (58,74% była niedostateczna kontrola choroby, w 47,99% lekarze włączyli lek z powodu objawów astmy prowokowanych wysiłkiem, a w 40,85% wskazywali na istotny wpływ na decyzję współwystępowania aler‑ gicznego nieżytu nosa. W 11,35% przypadków montelukast stosowano w monoterapii, a u 87,6% badanych jako lek dodany do wziewnych glikokortykosteroidów. W ciągu 8 tygodni obserwacji istotnie wzrosła liczba pacjen‑ tów z całkowitą bieżącą kontrolą astmy z 8,22% (695 podczas pierwszej wizyty do

  11. Progress in translational research on intracerebral hemorrhage: Is there an end in sight?

    Science.gov (United States)

    Xi, Guohua; Strahle, Jennifer; Hua, Ya; Keep, Richard F.

    2013-01-01

    Intracerebral hemorrhage (ICH) is a common and often fatal stroke subtype for which specific therapies and treatments remain elusive. To address this, many recent experimental and translational studies of ICH have been conducted, and these have led to several ongoing clinical trials. This review focuses on the progress of translational studies of ICH including those of the underlying causes and natural history of ICH, animal models of the condition, and effects of ICH on the immune and cardiac systems, among others. Current and potential clinical trials also are discussed for both ICH alone and with intraventricular extension. PMID:24139872

  12. Ice cream headache in students and family history of headache: a cross-sectional epidemiological study.

    Science.gov (United States)

    Zierz, Antonia Maria; Mehl, Theresa; Kraya, Torsten; Wienke, Andreas; Zierz, Stephan

    2016-06-01

    Headache attributed to ingestion of a cold stimulus (ICHD-3 beta 4.5.1) is also known as ice cream headache (ICH). This cross-sectional epidemiological study included 283 students (10-14-year-olds) attending a grammar school in Germany, their parents (n = 401), and 41 teachers. A self-administered questionnaire was used to analyze the prevalence and characteristics of ICH based on the ICHD classification. Additionally, the association between ICH and other headaches was investigated in students and parents. Prevalence of ICH in students was 62 % without gender difference. In adults, only 36 % of females and 22 % of males reported ICH. There was an increased risk for ICH in students when mother (OR 10.7) or father (OR 8.4) had ICH. Other headaches in parents had no influence on the prevalence of ICH in students. However, in the groups of students and parents itself there was a highly significant association between ICH and other headaches (students: OR 2.4, mothers: OR 2.9, fathers: OR 6.8). There was a decreased risk for ICH when parents and students had no headache at all (OR < 0.4). ICH in students clearly shows a familial disposition by both father and mother. There was also an association between ICH and other headaches within the student and adult groups. The absence of headache history seems to be a protective factor for ICH.

  13. Ich fordre so viel Freiheit und Musse, als nötig ist, über mich selbst, über meine Bestimmung und meinen Werth als mensch zu denken“ (Moritz, 1962, 17. Zur Kunstund Freiheitskonzeption bei Karl Philipp Moritz. „Ich fordre so viel Freiheit und Musse, als nötig ist, über mich selbst, über meine Bestimmung und meinen Werth als mensch zu denken“ (Moritz, 1962, 17. On Karl Philipp Moritz’s concept of art and freedom

    Directory of Open Access Journals (Sweden)

    Krzysztof Tkaczyk

    2008-01-01

    Full Text Available In 1786 in Rome, Johann Wolfgang Goethe wrote about him: “He is my younger brother; we art cut from the same mould. However, fate was against him, whereas I was fortune’s favourite.” He meant Karl Phillip Moritz (1756-1793, a German writer and art critic, Greek mythology historian, precursor of modern psychology and the author of psychological novel. If we assume that Goethe’s comments concern Moritz’s material and social status only, we would have to admit that Goethe was right. However, if we apply these judgments to the quality of his (Moritz’s works, we would be inclined to saying that in this case the great Goethe was wrong. In his aesthetic, Moritz is far more interesting and progressive than his “elder brother”; in his literary criticism – more consistent than Schiller, and in perceiving society and politics – more radical than Kant. This article is mainly on key concept regarding Moritz’s aesthetic works: the concept of beauty and its functionalism. Definition of “the work of art” as a closed, specified unity enables Moritz to get out of the frame of aesthetics itself and to enter the sphere of politics. Moritz liberates man from the restraints of utility and treats him as a noble individual who possesses the artistic value in himself.

  14. 75 FR 40843 - International Conference on Harmonisation; Draft Guidance on Q4B Evaluation and Recommendation of...

    Science.gov (United States)

    2010-07-14

    .... The six ICH sponsors are the European Commission; the European Federation of Pharmaceutical Industries... Pharmaceutical Research and Manufacturers of America. The ICH Secretariat, which coordinates the preparation of... industry associations to promote international harmonization of regulatory requirements. FDA has...

  15. Resveratrol Attenuates Neurodegeneration and Improves Neurological Outcomes after Intracerebral Hemorrhage in Mice

    Directory of Open Access Journals (Sweden)

    Frederick Bonsack

    2017-08-01

    Full Text Available Intracerebral hemorrhage (ICH is a devastating type of stroke with a substantial public health impact. Currently, there is no effective treatment for ICH. The purpose of the study was to evaluate whether the post-injury administration of Resveratrol confers neuroprotection in a pre-clinical model of ICH. To this end, ICH was induced in adult male CD1 mice by collagenase injection method. Resveratrol (10 mg/kg or vehicle was administered at 30 min post-induction of ICH and the neurobehavioral outcome, neurodegeneration, cerebral edema, hematoma resolution and neuroinflammation were assessed. The Resveratrol treatment significantly attenuated acute neurological deficits, neurodegeneration and cerebral edema after ICH in comparison to vehicle treated controls. Further, Resveratrol treated mice exhibited improved hematoma resolution with a concomitant reduction in the expression of proinflammatory cytokine, IL-1β after ICH. Altogether, the data suggest the efficacy of post-injury administration of Resveratrol in improving acute neurological function after ICH.

  16. Intracerebral hemorrhage in children

    African Journals Online (AJOL)

    Ihab Zidan

    2012-04-01

    Apr 1, 2012 ... Focal abnormality of brain functions from ICH are site .... CT scan (axial view) showing post-traumatic right frontal ICH in a 2 months female child. ... Conventional angiography showing left middle cerebral artery aneurysm.

  17. CD36-Mediated Hematoma Absorption following Intracerebral Hemorrhage: Negative Regulation by TLR4 Signaling

    OpenAIRE

    Fang, Huang; Chen, Jing; Lin, Sen; Wang, PengFei; Wang, YanChun; Xiong, XiaoYi; Yang, QingWu

    2014-01-01

    Promoting hematoma absorption is a novel therapeutic strategy for intracerebral hemorrhage (ICH); however, the mechanism of hematoma absorption is unclear. The present study explored the function and potential mechanism of CD36 in hematoma absorption using in vitro and in vivo ICH models. Hematoma absorption in CD36-deficient ICH patients was examined. Compared with patients with normal CD36 expression, CD36-deficient ICH patients had slower hematoma adsorption and aggravated neurologic defic...

  18. Mehrsprachigkeit - Language Awareness – Sprachbewusstheit. Einführung

    Directory of Open Access Journals (Sweden)

    Monika Angela Budde

    2016-10-01

    Ich bedanke mich bei allen AutorInnen für ihre Beiträge und für die überaus große Kooperationsbereitschaft. Diese habe ich ebenso im Herausgeberteam erfahren und auch diesem möchte ich herzlich danken.

  19. Berichtigung von P. G. Krause

    NARCIS (Netherlands)

    Krause, Paul Gustaf

    1888-01-01

    In meiner Arbeit »Ueber Tertiäre, Cretaceïsche und Aeltere Ablagerungen aus West-Borneo” (Dieser Band, Seite 169 ff.) habe ich eine neue, tertiäre Corbula- Art, Corbula borneensis nov. sp. benannt. Wie ich sogleich nach Beendigung des Druckes bemerke, habe ich übersehen, dass dieser Name bereits für

  20. Hyperbaric oxygen therapy ameliorates acute brain injury after porcine intracerebral hemorrhage at high altitude.

    Science.gov (United States)

    Zhu, Hai-tao; Bian, Chen; Yuan, Ji-chao; Liao, Xiao-jun; Liu, Wei; Zhu, Gang; Feng, Hua; Lin, Jiang-kai

    2015-06-15

    Intracerebral hemorrhage (ICH) at high altitude is not well understood to date. This study investigates the effects of high altitude on ICH, and examines the acute neuroprotection of hyperbaric oxygen (HBO) therapy against high-altitude ICH. Minipigs were placed in a hypobaric chamber for 72 h before the operation. ICH was induced by an infusion of autologous arterial blood (3 ml) into the right basal ganglia. Animals in the high-altitude ICH group received HBO therapy (2.5 ATA for 60 min) 30 min after ICH. Blood gas, blood glucose and brain tissue oxygen partial pressure (PbtO2) were monitored continuously for animals from all groups, as were microdialysis products including glucose, lactate, pyruvate and glutamate in perihematomal tissue from 3 to 12 h post-ICH. High-altitude ICH animals showed significantly lower PbtO2, higher lactate/pyruvate ratio (LPR) and glutamate levels than low-altitude ICH animals. More severe neurological deficits, brain edema and neuronal damage were also observed in high-altitude ICH. After HBO therapy, PbtO2 was significantly increased and LPR and glutamate levels were significantly decreased. Brain edema, neurological deficits and neuronal damage were also ameliorated. The data suggested a more serious disturbance of tissue oxygenation and cerebral metabolism in the acute stage after ICH at high altitude. Early HBO treatment reduced acute brain injury, perhaps through a mechanism involving the amelioration of the derangement of cerebral oxygenation and metabolism following high-altitude ICH.

  1. Parnassiana nova : XII. Kritische Revision der Gattung Parnassius (Fortsetzung 8)

    NARCIS (Netherlands)

    Eisner, C.

    1957-01-01

    Bevor ich mit der Bearbeitung des dritten genus der Parnassiinae beginne, muss ich noch einmal einen Rückblick auf die bereits erfolgte Revision werfen. Ich habe schon früher erwähnt, dass meine Publikationen durch Aufführung aller in meiner Sammlung befindlichen Exemplare einen wissenschaftlichen

  2. Prior antiplatelet therapy and outcome following intracerebral hemorrhage: a systematic review

    DEFF Research Database (Denmark)

    Thompson, B B; Béjot, Y; Caso, V

    2010-01-01

    Antiplatelet therapy (APT) promotes bleeding; therefore, APT might worsen outcome in patients with intracerebral hemorrhage (ICH). We performed a systematic review and meta-analysis to address the hypothesis that pre-ICH APT use is associated with mortality and poor functional outcome following ICH....

  3. Antiparasitic efficacy of curcumin from Curcuma longa against Ichthyophthirius multifiliis in grass carp

    Science.gov (United States)

    Ichthyophthirius multifiliis (Ich) is a ciliated parasite that elicits great economic losses in aquaculture. In the present study, a polyphenol compound, curcumin, was obtained from the rhizome of Curcuma longa by bioassay-guided isolation based on the efficacy of anti-Ich theronts. Anti-Ich efficac...

  4. Clinical characteristics and outcome of intracerebral hemorrhage in young adults

    NARCIS (Netherlands)

    Rutten-Jacobs, L.C.A.; Maaijwee, N.A.M.M.; Arntz, R.M.; Schoonderwaldt, H.C.; Dorresteijn, L.D.A.; Dijk, E.J. van; Leeuw, F.E. de

    2014-01-01

    Data on determinants of prognosis after intracerebral hemorrhage (ICH) in young adults are scarce. Our aim was to identify clinical determinants of prognosis after ICH in adults aged 18-50. We investigated 98 consecutive patients with an ICH, aged 18-50 years, admitted to our hospital between 1980

  5. Pattern and location of intracerebral hemorrhage in Enugu, South ...

    African Journals Online (AJOL)

    Introduction: The incidence rates and location of nontraumatic intracerebral hemorrhage (ICH) have been shown to vary between population and races. Knowledge of ICH patterns may give some insight into the etiology of ICH and help reduce its burden particularly among Africans where health infrastructure is poorly ...

  6. Mechanical properties of steel for construction of gas transfer pipelines and their modification resulting from expanding of gas pipelines during hydraulic pressure testing; Wlasnosci mechaniczne stali do budowy rurociagow przesylowych gazu i ich modyfikacja w wyniku eksploatowania rurociagow gazu w trakcie hydraulicznej proby cisnieniowej

    Energy Technology Data Exchange (ETDEWEB)

    Kopczynski, A [Biuro Studiow i Projektow Gornictwa, Gazoprojekt S.A., Wroclaw (Poland)

    1997-07-01

    There are discussed the mechanical properties of the new generation of steel as per European Standard EN 10208.2: 1996. on the basis of the mechanical parameters of steel the normalized graphs of steel tensioning are presented. Analysis of influence of expanding gas pipelines on changes of steel tensioning graphs were performed. Advantages, resulting from expanding of gas pipelines, were shown. (author)

  7. Intergenerational dialogue of cohabiting adult children and their parents – the socio-economic perspective [Międzypokoleniowy dialog wspólnie zamieszkujących dorosłych dzieci i ich rodziców – perspektywa społeczno-ekonomiczna

    Directory of Open Access Journals (Sweden)

    Magda WIETESKA

    2017-11-01

    Full Text Available One of the developmental tasks imposed by early adulthood is autonomy expressed through residing outside the family home. This feature is more and more often shifted over time, and the phenomenon of the deferment is becoming more common among young adults. Extending the moratorium is confirmed by studies of social reality: more than 40% of people over 30 years old remain dependent on their parents. Young adults do not take on a life consistent with the perception of adulthood prospects in scientific terms: they do not move out of the family home, do not take work or they abandon it because of the unsatisfactory earnings. Among the factors favouring such choices shall be both the psychological and the emotional immaturity of young people and the economic conditions that make it a difficult start in adulthood. Allowing for the return to the childhood situation of biologically adult people involves the whole family. Parents of „immature adults” not only do not part with their children still residing with them in one house, but also increasingly assume the maintenance costs, justifying the need for a common existence by socio-economic conditions, that prevent the financial autonomy of the younger generation. Sometimes the choice is made by the young people themselves. Frustrated by the lack of jobs and prospects to forgo dreams of independence, accepting the role of „not adult adults”. In this article I present the reasons for postponing adulthood included in the conclusions from studies of young adults residing with their parents.

  8. Prosperity of community pharmacy evaluated by gross and net profit and suggested corrective measures. 10 years study / Prosperita verejnej lekárne hodnotená prostredníctvom hrubého a čistého zisku a opatrenia vedúce k ich náprave. 10 ročná štúdia

    Directory of Open Access Journals (Sweden)

    Malovecká I.

    2015-06-01

    Full Text Available Monitoring, calculation and assessment of community pharmacy prosperity with the help of financial analysis indicators for years 2003-2012, using financial statements was conducted, with respect to profitability parameters such as gross and net profit ratios. These ratios reflect various changes that hold between years 2003 and 2012. Under the time of financial crisis, recession and serious socioeconomic changes the profitability parameter gross profit ranged from x2003-2011=14.3-22.8% (average=19.2%, mean=19.8%, σ=2.4, but in 2012 decreased on 14.3%. Net profit ranged x2003-2011 = 2.3-18.3% (average=14.6%, mean =16.6%, σ = 4.9, while in 2012 reached only 2.3%. All changes that have taken place in the society had impact on community pharmacy finance by worsening its profitability. Therefore, the stability of community pharmacy may be threatened and may affect its future performance.

  9. Vnitřní monology a vnitřní dialogy, ich-forma, du-forma a er-forma (ve vztahu k teorii subjektů a perspektivizačních center Aleny Macurové)

    Czech Academy of Sciences Publication Activity Database

    Hoffmannová, Jana

    2017-01-01

    Roč. 8, č. 1 (2017), s. 21-31 ISSN 1804-3240 R&D Projects: GA ČR GA15-01116S Institutional support: RVO:68378092 Keywords : direct/indirect speech/thought * free direct/indirect speech/thought * internal monologue * perspective centre * reported speech/thought * subjectivization of the narrative Subject RIV: AI - Linguistics OBOR OECD: Linguistics

  10. Ocena ryzyka, okoliczności i następstwa upadków oraz ich uwarunkowania wśród mieszkańców domu pomocy społecznej = Risk assessment, circumstances and consequences of falls and their conditioning among social welfare home inhabitants

    Directory of Open Access Journals (Sweden)

    Adrian Bartoszek

    2016-08-01

    • Wysokie ryzyko upadków mieszkańców DPS związane jest istotnie z terapią wielolekową, występowaniem wad  wzroku i słuchu, jednego i więcej  upadków w ciągu ostatniego roku oraz z obawą przed kolejnym upadkiem.   Słowa kluczowe: upadki, czynniki ryzyka, osoby starsze, dom pomocy społecznej.

  11. Ekologický potenciál rybích obsádek našich nádrží: Mohou nám okolní jezera sloužit jako referenční stavy?

    Czech Academy of Sciences Publication Activity Database

    Kubečka, Jan; Peterka, Jiří

    2009-01-01

    Roč. 59, č. 4 (2009), s. 125-126 ISSN 1211-0760 R&D Projects: GA AV ČR(CZ) 1QS600170504; GA ČR(CZ) GA206/07/1392 Institutional research plan: CEZ:AV0Z60170517 Keywords : water framework directive * species composition * ecological status * reservoirs classification * type-indicator species Subject RIV: EH - Ecology, Behaviour

  12. Effect of chlorophyllin on induction of exchanges in sister chromatids by gamma irradiation in mice spermatogonia in vivo; Efecto de la clorofilina sobre la induccion de intercambios en las cromatidas hermanas (ICH) por radiacion gamma en espermatogonias de raton In vivo

    Energy Technology Data Exchange (ETDEWEB)

    Mendiola C, M T

    1994-12-31

    Mouse were exposed to different doses of gamma radiation and the effect on Sister Chromatid Exchange (SCE) frequency in spermatogonias was evaluated. The effect was analyzed before and after Bromodeoxyuridine (BrdU) incorporation to determine the interference of such agent with the cellular response induced by radiation. The capacity of chlorophyllin (sodium and Copper salt derivative from chlorophyll) to reduce SCE induction by radiation in normal and BrdU radio sensitized spermatogonia was also determined. The results indicate that there was a significant increase in SCE frequency by gamma radiation exposure in these cells, such effect was higher irradiating after BrdU incorporation than before. This fact confirms previous observations that BrdU sensitizes some cells to SCE induction. With regard to the chlorophyllin effect, it was determined that this salt acts as a radioprotector reducing gamma-rays induced SCE before or after BrdU incorporation Total protection was obtained with 200 {mu}g of chlorophyllin per g of body weight in both protocols. Under the experimental conditions this study there was no evidence of genotoxicity induced by chlorophyllin itself. The results suggest that this agent may act as a radioprotector by scavenging free radicals produced by gamma-radiation which cause DNA lesions that are involved in SCE formation. (Author).

  13. Interakce rostlin, půdy a půdních živočichů a jejich vliv na sukcesi rostlinných a živočišných společenstev na disturbovaných územích

    Czech Academy of Sciences Publication Activity Database

    Frouz, Jan

    2006-01-01

    Roč. 41, č. 21 (2006), s. 65-71 ISSN 1212-3323 R&D Projects: GA ČR(CZ) GA526/01/1055; GA ČR(CZ) GA526/06/0728; GA AV ČR 1QS600660505 Institutional research plan: CEZ:AV0Z60660521 Keywords : herbivory * nutrient availability * plants Subject RIV: EH - Ecology, Behaviour

  14. Evolution of blood pressure management in acute intracerebral hemorrhage [version 1; referees: 4 approved

    Directory of Open Access Journals (Sweden)

    Stacy Chu

    2017-11-01

    Full Text Available Intracerebral hemorrhage (ICH remains a prevalent and severe cause of death and disability worldwide. Control of the hypertensive response in acute ICH has been a mainstay of ICH management, yet the optimal approaches and the yield of recommended strategies have been difficult to establish despite a large body of literature. Over the years, theoretical and observed risks and benefits of intensive blood pressure reduction in ICH have been studied in the form of animal models, radiographic studies, and two recent large, randomized patient trials. In this article, we review the historical and developing data and discuss remaining questions surrounding blood pressure management in acute ICH.

  15. Prognostic Impact of Health Care-Associated Meningitis in Adults with Intracranial Hemorrhage.

    Science.gov (United States)

    Habib, Onaizah B; Srihawan, Chanunya; Salazar, Lucrecia; Hasbun, Rodrigo

    2017-11-01

    Health care-associated meningitis and ventriculitis (HCAMV) occurs in adults with intracranial hemorrhage (ICH) and is associated with high rates of morbidity and mortality, but the prognostic impact of this infectious complication in a controlled matched study of ICH is unknown. We conducted a case-control study of adult patients with ICH and HCAMV at a large tertiary care hospital in Houston, Texas, from 2003 to 2016. Cases were defined as patients with ICH and HCAMV as documented by a positive cerebrospinal fluid culture. Controls were defined as patients with ICH without evidence of HCAMV. An adverse clinical outcome was defined as a Glasgow Outcome Scale score of ≤4. This study included 120 patients with ICH; 40 patients also had HCAMV, whereas 80 patients had ICH with no evidence of HCAMV. Cases and controls were appropriately matched by age, Glasgow Coma Scale score, and Acute Physiology and Chronic Health Evaluation II score (P > 0.05). Patients with ICH and meningitis had more comorbidities, higher rates of abnormal neurologic examination, hypoglycorrhachia, and elevated cerebrospinal fluid lactate levels (P < 0.05). Adverse clinical outcomes were greater in patients with HCAMV and ICH than in patients with ICH alone (83% vs. 30%; P < 0.001). On logistic regression analysis, independent risk factors associated with an adverse outcome were HCAMV and mechanical ventilation (P < 0.05). HCAMV has a significant prognostic impact in adults with ICH. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. Gastrointestinal bleeding after intracerebral hemorrhage: a retrospective review of 808 cases.

    Science.gov (United States)

    Yang, Tie-Cheng; Li, Jian-Guo; Shi, Hong-Mei; Yu, Dong-Ming; Shan, Kai; Li, Li-Xia; Dong, Xiao-Yan; Ren, Tian-Hua

    2013-10-01

    This study examined the incidence and risk factors for gastrointestinal (GI) bleeding after spontaneous intracerebral hemorrhage (ICH). The available medical records of patients with ICH admitted from June 2008 to December 2009 for any episode of GI bleeding, possible precipitating factors and administration of ulcer prophylaxis were reviewed. The prevalence of GI bleeding was 26.7%, including 3 cases of severe GI bleeding (0.35%). Patients with GI bleeding had significantly longer hospital stay and higher in-hospital mortality compared with patients without GI bleeding. Multivariate logistic regression analyses showed that age, Glasgow Coma Scale scores, sepsis and ICH volume were independent predictors of GI bleeding. About 63.4% of patients with ICH received stress ulcer prophylaxis. GI bleeding occurred frequently after ICH, but severe events were rare. Age, Glasgow Coma Scale score, sepsis and ICH volume were independent predictors of GI bleeding occurring after ICH.

  17. [MRI semiotics features of experimental acute intracerebral hematomas].

    Science.gov (United States)

    Burenchev, D V; Skvortsova, V I; Tvorogova, T V; Guseva, O I; Gubskiĭ, L V; Kupriianov, D A; Pirogov, Iu A

    2009-01-01

    The aim of this study was to assess the possibility of revealing intracerebral hematomas (ICH), using MRI, within the first hours after onset and to determine their MRI semiotics features. Thirty animals with experimental ICH were studied. A method of two-stage introduction of autologous blood was used to develop ICH as human spontaneous intracranial hematomas. Within 3-5h after blood introduction to the rat brain. The control MRI was performed in the 3rd and 7th days after blood injections. ICH were definitely identified in the first MRI scans. The MRI semiotics features of acute ICH and their transformations were assessed. The high sensitivity of MRI to ICH as well as the uniform manifestations in all animals were shown. In conclusion, the method has high specificity for acute ICH detection.

  18. MOVE 2000 - new advertising campaign speeds up modernisation business; MOVE 2000 - die neue Heizungsgemeinschaftswerbung bringt Schwung ins Modernisierungsgeschaeft

    Energy Technology Data Exchange (ETDEWEB)

    Dyas, S. [Zentralverband Sanitaer Heizung Klima, St. Augustin (Germany)

    2001-02-01

    Modernisation of heating systems is a difficult sector. Unfavourable boundary conditions make it even more of a low-interest product, and massive investment barriers are the result. The new advertising campaign of the heating systems industry attempts to counteract this. [German] Heizungsmodernisierung ist ein 'schwieriges' Geschaeft. Zur Zeit gibt es unguenstige Rahmenbedingungen, die den Charakter des Low-interest-Produkts soweit verstaerken, dass es zu massiven Investitionsbarrieren kommt. Diesem entgegen zu wirken ist die Aufgabe der neuen Heizungsgemeinschaftswerbung. (orig.)

  19. Gesamtfahrzeugsimulation betriebsfestigkeitsrelevanter Manöver unter Berücksichtigung von Fahrwerkregelsystemen

    OpenAIRE

    Brandes, Sebastian Jürgen

    2016-01-01

    In der Automobilbranche dient im Bereich der betriebsfesten Bemessung des Fahrwerks die Methode der Mehrkörpersysteme als Analyseverfahren zur Ermittlung von Bewegungen und Schnittgrößen an den Fahrwerksbauteilen. Eine der aktuellen Herausforderungen hierbei ist der zunehmende interdisziplinäre Charakter in Form von mechatronischen Fahrwerkssystemen. In rein virtuellen Entwicklungsphasen kann deren Einfluss auf die Fahrwerksbelastungen einzig anhand von Gesamtfahrzeugsimulationen ermittelt we...

  20. „Aber es gibt keine Antisemiten mehr“: Eine experimentelle Studie zur Kommunikationslatenz antisemitischer Einstellungen

    OpenAIRE

    Beyer, Heiko; Krumpal, Ivar

    2010-01-01

    Die öffentliche Sanktionierung des Antisemitismus nach 1945 hat dazu geführt, dass antisemitische Einstellungen in der bundesdeutschen Öffentlichkeit selten offen geäußert werden, teilweise jedoch im privaten Raum überdauern. Diese Entwicklung wurde von der Antisemitismusforschung zwar theoretisch mit dem Konzept der „Kommunikationslatenz“ aufgearbeitet, methodisch blieben diese Überlegungen jedoch weitgehend folgenlos. Aufgrund des heiklen Charakters antisemitischer Einstellungen ist davon a...

  1. History and development of the tennis equipment

    OpenAIRE

    Horáková, Kateřina

    2007-01-01

    Title: History and development of the tennis equipment. Aim of the work: Process an integral, tabular and synoptic historical development overview of the tennis equipment. This owerview will cover the period since the early beginnings of the game to present days. Methods: Advance work has historical charakter therefore used methods are historiogaphical methods such as chronological method and historical method. Results: Produce tabular description of the tennis equipment by means of reading a...

  2. Sociálně psychologické základy demokracie: Teoretická analýza a empirické sondy

    Czech Academy of Sciences Publication Activity Database

    Klicperová-Baker, Martina

    2016-01-01

    Roč. 60, Supplement 1 (2016), s. 96-109 ISSN 0009-062X R&D Projects: GA ČR GA15-11062S Grant - others:AV ČR(CZ) StrategieAV21/14 Program:StrategieAV Institutional support: RVO:68081740 Keywords : democracy * democratic charakter * post-communist syndrome * psychology of democracy * political psychology Subject RIV: AN - Psychology Impact factor: 0.242, year: 2016

  3. Comparing intracerebral hemorrhages associated with direct oral anticoagulants or warfarin

    Science.gov (United States)

    Kurogi, Ryota; Nishimura, Kunihiro; Nakai, Michikazu; Kada, Akiko; Kamitani, Satoru; Nakagawara, Jyoji; Toyoda, Kazunori; Ogasawara, Kuniaki; Ono, Junichi; Shiokawa, Yoshiaki; Aruga, Toru; Miyachi, Shigeru; Nagata, Izumi; Matsuda, Shinya; Yoshimura, Shinichi; Okuchi, Kazuo; Suzuki, Akifumi; Nakamura, Fumiaki; Onozuka, Daisuke; Ido, Keisuke; Kurogi, Ai; Mukae, Nobutaka; Nishimura, Ataru; Arimura, Koichi; Kitazono, Takanari; Hagihara, Akihito

    2018-01-01

    Objectives This cross-sectional survey explored the characteristics and outcomes of direct oral anticoagulant (DOAC)–associated nontraumatic intracerebral hemorrhages (ICHs) by analyzing a large nationwide Japanese discharge database. Methods We analyzed data from 2,245 patients who experienced ICHs while taking anticoagulants (DOAC: 227; warfarin: 2,018) and were urgently hospitalized at 621 institutions in Japan between April 2010 and March 2015. We compared the DOAC- and warfarin-treated patients based on their backgrounds, ICH severities, antiplatelet therapies at admission, hematoma removal surgeries, reversal agents, mortality rates, and modified Rankin Scale scores at discharge. Results DOAC-associated ICHs were less likely to cause moderately or severely impaired consciousness (DOAC-associated ICHs: 31.3%; warfarin-associated ICHs: 39.4%; p = 0.002) or require surgical removal (DOAC-associated ICHs: 5.3%; warfarin-associated ICHs: 9.9%; p = 0.024) in the univariate analysis. Propensity score analysis revealed that patients with DOAC-associated ICHs also exhibited lower mortality rates within 1 day (odds ratio [OR] 4.96, p = 0.005), within 7 days (OR 2.29, p = 0.037), and during hospitalization (OR 1.96, p = 0.039). Conclusions This nationwide study revealed that DOAC-treated patients had less severe ICHs and lower mortality rates than did warfarin-treated patients, probably due to milder hemorrhages at admission and lower hematoma expansion frequencies. PMID:29490916

  4. Ideal cardiovascular health score at the ELSA-Brasil baseline and its association with sociodemographic characteristics.

    Science.gov (United States)

    Machado, Lucas B M; Silva, Bianca L S; Garcia, Ana P; Oliveira, Renata A M; Barreto, Sandhi M; Fonseca, Maria de Jesus M; Lotufo, Paulo A; Bensenor, Isabela M; Santos, Itamar S

    2018-03-01

    The American Heart Association's ideal cardiovascular health (ICH) define criteria for seven metrics, four classified as lifestyle factors (diet, physical activity, smoking and body-mass index) and four classified as health factors (smoking, blood pressure, fasting plasma glucose and total cholesterol). We aimed to analyze ICH scores at the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) baseline assessment and the associations with sociodemographic characteristics (age, sex, race, educational level, and family income). We analyzed 13,356 ELSA-Brasil participants without cardiovascular disease using quasi-Poisson regression models to study the association between the ICH score and sociodemographic characteristics. Mean ICH scores were 2.5±1.3. Only 1047 (7.8%) participants had 5 or more ICH metrics. In adjusted models, age 65-74years was associated with lower ICH scores (-35.4%; 95% confidence interval [CI]: -37.6% to -33.1%) compared to age 35-44years. Women had higher ICH scores compared to men (+13.8%; 95%CI: +11.8% to +15.7%), mainly due to differences in the health factor ICH metrics. Participants of Black race had lower ICH scores compared to those of White race (-9.4%; 95%CI: -11.8% to -7.0%). Individuals with less than high school education had lower ICH scores than college-educated individuals (-17.2%; 95%CI: -20.0% to -14.2%). Low (<1245 USD) family income was also associated with lower ICH scores compared to those with high (≥3320 USD) family income (-4.4%, 95%CI: -7.2% to -1.6%). We found a low proportion of individuals with 5 or more ICH metrics. Age, sex, race, educational level and income were associated with ICH scores. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

  5. Combining Spot Sign and Intracerebral Hemorrhage Score to Estimate Functional Outcome: Analysis From the PREDICT Cohort.

    Science.gov (United States)

    Schneider, Hauke; Huynh, Thien J; Demchuk, Andrew M; Dowlatshahi, Dar; Rodriguez-Luna, David; Silva, Yolanda; Aviv, Richard; Dzialowski, Imanuel

    2018-06-01

    The intracerebral hemorrhage (ICH) score is the most commonly used grading scale for stratifying functional outcome in patients with acute ICH. We sought to determine whether a combination of the ICH score and the computed tomographic angiography spot sign may improve outcome prediction in the cohort of a prospective multicenter hemorrhage trial. Prospectively collected data from 241 patients from the observational PREDICT study (Prediction of Hematoma Growth and Outcome in Patients With Intracerebral Hemorrhage Using the CT-Angiography Spot Sign) were analyzed. Functional outcome at 3 months was dichotomized using the modified Rankin Scale (0-3 versus 4-6). Performance of (1) the ICH score and (2) the spot sign ICH score-a scoring scale combining ICH score and spot sign number-was tested. Multivariable analysis demonstrated that ICH score (odds ratio, 3.2; 95% confidence interval, 2.2-4.8) and spot sign number (n=1: odds ratio, 2.7; 95% confidence interval, 1.1-7.4; n>1: odds ratio, 3.8; 95% confidence interval, 1.2-17.1) were independently predictive of functional outcome at 3 months with similar odds ratios. Prediction of functional outcome was not significantly different using the spot sign ICH score compared with the ICH score alone (spot sign ICH score area under curve versus ICH score area under curve: P =0.14). In the PREDICT cohort, a prognostic score adding the computed tomographic angiography-based spot sign to the established ICH score did not improve functional outcome prediction compared with the ICH score. © 2018 American Heart Association, Inc.

  6. Retrospective Methods Analysis of Semiautomated Intracerebral Hemorrhage Volume Quantification From a Selection of the STICH II Cohort (Early Surgery Versus Initial Conservative Treatment in Patients With Spontaneous Supratentorial Lobar Intracerebral Haematomas).

    Science.gov (United States)

    Haley, Mark D; Gregson, Barbara A; Mould, W Andrew; Hanley, Daniel F; Mendelow, Alexander David

    2018-02-01

    The ABC/2 method for calculating intracerebral hemorrhage (ICH) volume has been well validated. However, the formula, derived from the volume of an ellipse, assumes the shape of ICH is elliptical. We sought to compare the agreement of the ABC/2 formula with other methods through retrospective analysis of a selection of the STICH II cohort (Early Surgery Versus Initial Conservative Treatment in Patients With Spontaneous Supratentorial Lobar Intracerebral Haematomas). From 390 patients, 739 scans were selected from the STICH II image archive based on the availability of a CT scan compatible with OsiriX DICOM viewer. ICH volumes were calculated by the reference standard semiautomatic segmentation in OsiriX software and compared with calculated arithmetic methods (ABC/2, ABC/2.4, ABC/3, and 2/3SC) volumes. Volumes were compared by difference plots for specific groups: randomization ICH (n=374), 3- to 7-day postsurgical ICH (n=206), antithrombotic-associated ICH (n=79), irregular-shape ICH (n=703) and irregular-density ICH (n=650). Density and shape were measured by the Barras ordinal shape and density groups (1-5). The ABC/2.4 method had the closest agreement to the semiautomatic segmentation volume in all groups, except for the 3- to 7-day postsurgical ICH group where the ABC/3 method was superior. Although the ABC/2 formula for calculating elliptical ICH is well validated, it must be used with caution in ICH scans where the elliptical shape of ICH is a false assumption. We validated the adjustment of the ABC/2.4 method in randomization, antithrombotic-associated, heterogeneous-density, and irregular-shape ICH. URL: http://www.isrctn.com/ISRCTN22153967. Unique identifier: ISRCTN22153967. © 2018 American Heart Association, Inc.

  7. Cohort-Based Identification of Predictors of Symptomatic Intracerebral Hemorrhage After IV Thrombolysis.

    Science.gov (United States)

    Asuzu, David; Nyström, Karin; Amin, Hardik; Schindler, Joseph; Wira, Charles; Greer, David; Chi, Nai Fang; Halliday, Janet; Sheth, Kevin N

    2015-12-01

    Symptomatic intracranial hemorrhage (sICH) is a serious complication of IV rt-PA therapy after acute ischemic stroke. Independent sICH predictors have been previously derived using case-control studies. Here we utilized a novel cohort-based comparison to identify additional independent predictors of sICH. We included 210 patients receiving IV rt-PA therapy from January 2009 through December 2013 at the Yale-New Haven Stroke Center. Clinical parameters were compared using Mann-Whitney tests, two-sample tests of proportions and two-sample t tests. Logistic regression was performed using sICH as the dependent variable. Predictive ability was assessed using areas under the receiver operating characteristic (ROC) curve. sICH rates were lowest from 2010 to 2012 and comprised the low sICH cohort (2.0 % sICH), compared to the high sICH cohort from 2009 to 2013 (9.2 % sICH, P = 0.025). Patients in the low sICH cohort had significantly more visual field deficits (38.6 vs. 24.8 %, P = 0.03) and decreased levels of consciousness (62.4 vs. 39.4 %, P vs. 13.8 %, P = 0.03) and early CT hypodensities (14.9 vs. 29.4 %, P = 0.01). These four parameters together predicted sICH modestly (area under ROC curve 0.66, odds ratio 2.72, P = 0.03) CONCLUSIONS: Using a novel cohort-based approach, we identified two new independent predictors of sICH after IV rt-PA therapy: the presence of the hyperdense MCA sign and early CT hypodensities. Novel methods are needed to reduce the risk of sICH for patients receiving antithrombolytic therapy for ischemic stroke.

  8. Application of the FOUR Score in Intracerebral Hemorrhage Risk Analysis.

    Science.gov (United States)

    Braksick, Sherri A; Hemphill, J Claude; Mandrekar, Jay; Wijdicks, Eelco F M; Fugate, Jennifer E

    2018-06-01

    The Full Outline of Unresponsiveness (FOUR) Score is a validated scale describing the essentials of a coma examination, including motor response, eye opening and eye movements, brainstem reflexes, and respiratory pattern. We incorporated the FOUR Score into the existing ICH Score and evaluated its accuracy of risk assessment in spontaneous intracerebral hemorrhage (ICH). Consecutive patients admitted to our institution from 2009 to 2012 with spontaneous ICH were reviewed. The ICH Score was calculated using patient age, hemorrhage location, hemorrhage volume, evidence of intraventricular extension, and Glasgow Coma Scale (GCS). The FOUR Score was then incorporated into the ICH Score as a substitute for the GCS (ICH Score FS ). The ability of the 2 scores to predict mortality at 1 month was then compared. In total, 274 patients met the inclusion criteria. The median age was 73 years (interquartile range 60-82) and 138 (50.4%) were male. Overall mortality at 1 month was 28.8% (n = 79). The area under the receiver operating characteristic curve was .91 for the ICH Score and .89 for the ICH Score FS . For ICH Scores of 1, 2, 3, 4, and 5, 1-month mortality was 4.2%, 29.9%, 62.5%, 95.0%, and 100%. In the ICH Score FS model, mortality was 10.7%, 26.5%, 64.5%, 88.9%, and 100% for scores of 1, 2, 3, 4, and 5, respectively. The ICH Score and the ICH Score FS predict 1-month mortality with comparable accuracy. As the FOUR Score provides additional clinical information regarding patient status, it may be a reasonable substitute for the GCS into the ICH Score. Copyright © 2018 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  9. A Score for Risk of Thrombolysis-Associated Hemorrhage Including Pretreatment with Statins

    Directory of Open Access Journals (Sweden)

    Hebun Erdur

    2018-02-01

    Full Text Available BackgroundSymptomatic intracranial hemorrhage (sICH after intravenous thrombolysis with recombinant tissue-plasminogen activator (rt-PA for acute ischemic stroke is associated with a poor functional outcome. We aimed to develop a score assessing risk of sICH including novel putative predictors—namely, pretreatment with statins and severe renal impairment.MethodsWe analyzed our local cohort (Berlin of patients receiving rt-PA for acute ischemic stroke between 2006 and 2016. Outcome was sICH according to ECASS-III criteria. A multiple regression model identified variables associated with sICH and receiver operating characteristics were calculated for the best discriminatory model for sICH. The model was validated in an independent thrombolysis cohort (Basel.ResultssICH occurred in 53 (4.0% of 1,336 patients in the derivation cohort. Age, baseline National Institutes of Health Stroke Scale, systolic blood pressure on admission, blood glucose on admission, and prior medication with medium- or high-dose statins were associated with sICH and included into the risk of intracranial hemorrhage score. The validation cohort included 983 patients of whom 33 (3.4% had a sICH. c-Statistics for sICH was 0.72 (95% CI 0.66–0.79 in the derivation cohort and 0.69 (95% CI 0.60–0.77 in the independent validation cohort. Inclusion of severe renal impairment did not improve the score.ConclusionWe developed a simple score with fair discriminating capability to predict rt-PA-related sICH by adding prior statin use to known prognostic factors of sICH. This score may help clinicians to identify patients with higher risk of sICH requiring intensive monitoring.

  10. Toll-like receptor 4 signaling in intracerebral hemorrhage-induced inflammation and injury

    OpenAIRE

    Fang, Huang; Wang, Peng-Fei; Zhou, Yu; Wang, Yan-Chun; Yang, Qing-Wu

    2013-01-01

    Intracerebral hemorrhage (ICH) is a common type of fatal stroke, accounting for about 15% to 20% of all strokes. Hemorrhagic strokes are associated with high mortality and morbidity, and increasing evidence shows that innate immune responses and inflammatory injury play a critical role in ICH-induced neurological deficits. However, the signaling pathways involved in ICH-induced inflammatory responses remain elusive. Toll-like receptor 4 (TLR4) belongs to a large family of pattern recognition ...

  11. Integrins AV and B8 Gene Polymorphisms and Risk for Intracerebral Hemorrhage in Greek and Polish Populations.

    Science.gov (United States)

    Dardiotis, Efthimios; Siokas, Vasileios; Zafeiridis, Tilemachos; Paterakis, Konstantinos; Tsivgoulis, Georgios; Dardioti, Maria; Grigoriadis, Savas; Simeonidou, Constantina; Deretzi, Georgia; Zintzaras, Elias; Jagiella, Jeremiasz; Hadjigeorgiou, Georgios M

    2017-03-01

    Α limited number of genetic variants have been linked to the development of intracerebral hemorrhage (ICH). Ιntegrin AV and/or B8-deficient mice were found to develop ICH. The present candidate gene association study was designed to investigate possible influence of integrin AV (ITGAV) and integrin B8 (ITGB8) gene region polymorphisms on the risk of ICH. 1015 participants (250 Greek and 193 Polish patients with primary ICH and 250 Greek and 322 Polish controls) were included in the study. Using logistic regression analyses, 11 tag single nucleotide polymorphisms (SNPs) for ITGAV and 11 for ITGB8 gene were tested for associations with ICH risk, lobar ICH risk and non-lobar ICH after adjustment for age, gender, history of hypertension and country of origin. Linear regression models were used to test the effect of tag SNPs on the ICH age of onset. Correction for multiple comparisons was carried out. The rs7565633 tag SNP of the ITGAV gene was independently associated with the risk of lobar ICH in the codominant model of inheritance [odds ratio (95 % confidence interval (CI)) 0.56 (0.36-0.86), p = 0.0013]. Furthermore, heterozygous individuals of the rs10251386 and the rs10239099 of the ITGB8 gene had significantly lower age of ICH onset compared to the wild-type genotypes [regression coefficient (b) -3.884 (95 % CI -6.519, -1.249), p = 0.0039 and b = -4.502 (95 % CI -7.159, -1.845), p = 0.0009, respectively]. The present study provides preliminary indication for an influence of ITGAV gene tag SNP in the development of lobar ICH and of ITGB8 gene variants in the age of ICH onset.

  12. European research priorities for intracerebral haemorrhage

    DEFF Research Database (Denmark)

    Steiner, Thorsten; Petersson, Jesper; Al-Shahi Salman, Rustam

    2011-01-01

    Over 2 million people are affected by intracerebral haemorrhage (ICH) worldwide every year, one third of them dying within 1 month, and many survivors being left with permanent disability. Unlike most other stroke types, the incidence, morbidity and mortality of ICH have not declined over time...... and disability. The European Research Network on Intracerebral Haemorrhage EURONICH is a multidisciplinary academic research collaboration that has been established to define current research priorities and to conduct large clinical studies on all aspects of ICH....

  13. [Brazilian guidelines for the manegement of intracerebral hemorrhage].

    Science.gov (United States)

    Pontes-Neto, Octávio M; Oliveira-Filho, Jamary; Valiente, Raul; Friedrich, Maurício; Pedreira, Bruno; Rodrigues, Bruno Castelo Branco; Liberato, Bernardo; Freitas, Gabriel Rodriguez de

    2009-09-01

    Among the stroke subtypes, intracerebral hemorrhage (ICH) has the worst prognosis and still lacks a specific treatment. The present manuscript contains the Brazilian guidelines for the management of ICH. It was elaborated by the executive committee of the Brazilian Cerebrovascular Diseases Society and was based on a broad review of articles about the theme. The text aims to provide a rational for the management of patients with an acute ICH, with the diagnostic and therapeutic resources that are available in Brazil.

  14. Representation of intangible cultural heritage of Bangladesh through social media

    DEFF Research Database (Denmark)

    Khalid, Md. Saifuddin; Chowdhury, Md Saiful Alam

    2018-01-01

    with approximately 160 million people is experiencing an exponential growth of social media users. Towards the goal of strategically representing and diffusing ICH through social media, this study explores the current roles of social media in the transmission of ICH in the virtual world through content analysis....... The potential roles of social media in the process of preserving ICH offer a space for building awareness, creating knowledge, and diffusion of innovations....

  15. Imaging features of intracerebral hemorrhage with cerebral amyloid angiopathy: Systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Neshika Samarasekera

    Full Text Available We sought to summarize Computed Tomography (CT/Magnetic Resonance Imaging (MRI features of intracerebral hemorrhage (ICH associated with cerebral amyloid angiopathy (CAA in published observational radio-pathological studies.In November 2016, two authors searched OVID Medline (1946-, Embase (1974- and relevant bibliographies for studies of imaging features of lobar or cerebellar ICH with pathologically proven CAA ("CAA-associated ICH". Two authors assessed studies' diagnostic test accuracy methodology and independently extracted data.We identified 22 studies (21 cases series and one cross-sectional study with controls of CT features in 297 adults, two cross-sectional studies of MRI features in 81 adults and one study which reported both CT and MRI features in 22 adults. Methods of CAA assessment varied, and rating of imaging features was not masked to pathology. The most frequently reported CT features of CAA-associated ICH in 21 case series were: subarachnoid extension (pooled proportion 82%, 95% CI 69-93%, I2 = 51%, 12 studies and an irregular ICH border (64%, 95% CI 32-91%, I2 = 85%, five studies. CAA-associated ICH was more likely to be multiple on CT than non-CAA ICH in one cross-sectional study (CAA-associated ICH 7/41 vs. non-CAA ICH 0/42; χ2 = 7.8, p = 0.005. Superficial siderosis on MRI was present in 52% of CAA-associated ICH (95% CI 39-65%, I2 = 35%, 3 studies.Subarachnoid extension and an irregular ICH border are common imaging features of CAA-associated ICH, but methodologically rigorous diagnostic test accuracy studies are required to determine the sensitivity and specificity of these features.

  16. Changes in motor function, cognition, and emotion-related behavior after right hemispheric intracerebral hemorrhage in various brain regions of mouse.

    Science.gov (United States)

    Zhu, Wei; Gao, Yufeng; Wan, Jieru; Lan, Xi; Han, Xiaoning; Zhu, Shanshan; Zang, Weidong; Chen, Xuemei; Ziai, Wendy; Hanley, Daniel F; Russo, Scott J; Jorge, Ricardo E; Wang, Jian

    2018-03-01

    Intracerebral hemorrhage (ICH) is a detrimental type of stroke. Mouse models of ICH, induced by collagenase or blood infusion, commonly target striatum, but not other brain sites such as ventricular system, cortex, and hippocampus. Few studies have systemically investigated brain damage and neurobehavioral deficits that develop in animal models of ICH in these areas of the right hemisphere. Therefore, we evaluated the brain damage and neurobehavioral dysfunction associated with right hemispheric ICH in ventricle, cortex, hippocampus, and striatum. The ICH model was induced by autologous whole blood or collagenase VII-S (0.075 units in 0.5 µl saline) injection. At different time points after ICH induction, mice were assessed for brain tissue damage and neurobehavioral deficits. Sham control mice were used for comparison. We found that ICH location influenced features of brain damage, microglia/macrophage activation, and behavioral deficits. Furthermore, the 24-point neurologic deficit scoring system was most sensitive for evaluating locomotor abnormalities in all four models, especially on days 1, 3, and 7 post-ICH. The wire-hanging test was useful for evaluating locomotor abnormalities in models of striatal, intraventricular, and cortical ICH. The cylinder test identified locomotor abnormalities only in the striatal ICH model. The novel object recognition test was effective for evaluating recognition memory dysfunction in all models except for striatal ICH. The tail suspension test, forced swim test, and sucrose preference test were effective for evaluating emotional abnormality in all four models but did not correlate with severity of brain damage. These results will help to inform future preclinical studies of ICH outcomes. Copyright © 2018 Elsevier Inc. All rights reserved.

  17. The value of magnetic resonance imaging for the detection of the bleeding source in non-traumatic intracerebral haemorrhages: a comparison with conventional digital subtraction angiography

    Energy Technology Data Exchange (ETDEWEB)

    Lummel, Nina; Lutz, Juergen; Brueckmann, Hartmut; Linn, Jennifer [University of Munich, Department of Neuroradiology, Munich (Germany)

    2012-07-15

    Conventional digital subtraction angiography (DSA) is currently regarded as the gold standard in detecting underlying vascular pathologies in patients with intracerebral haemorrhages (ICH). However, the use of magnetic resonance imaging (MRI) in the diagnostic workup of ICHs has considerably increased in recent years. Our aim was to evaluate the diagnostic accuracy and yield of MRI for the detection of the underlying aetiology in ICH patients. Sixty-seven consecutive patients with an acute ICH who underwent MRI (including magnetic resonance angiography (MRA) and DSA during their diagnostic workup) were included in the study. Magnetic resonance images were retrospectively analysed by two independent neuroradiologists to determine the localisation and cause of the ICH. DSA was used as a reference standard. In seven patients (10.4%), a DSA-positive vascular aetiology was present (one aneurysm, four arteriovenous malformations, one dural arteriovenous fistula and one vasculitis). All of these cases were correctly diagnosed by both readers on MRI. In addition, MRI revealed the following probable bleeding causes in 39 of the 60 DSA-negative patients: cerebral amyloid angiopathy (17), cavernoma (9), arterial hypertension (8), haemorrhagic transformation of an ischaemic infarction (3) and malignant brain tumour with secondary ICH (2). Performing MRI with MRA proved to be an accurate diagnostic tool in detecting vascular malformations in patients with ICH. In addition, MRI provided valuable information regarding DSA-negative ICH causes, and thus had a high diagnostic yield in ICH patients. (orig.)

  18. Association of subdural hematoma with increased mortality in lobar intracerebral hemorrhage.

    Science.gov (United States)

    Patel, Pratik V; FitzMaurice, Emilie; Nandigam, R N Kaveer; Auluck, Pavan; Viswanathan, Anand; Goldstein, Joshua N; Rosand, Jonathan; Greenberg, Steven M; Smith, Eric E

    2009-01-01

    To determine the prevalence of subdural hematoma (SDH) in patients presenting with primary nontraumatic lobar intracerebral hemorrhage (ICH) and characteristics associated with the presence of SDH. Retrospective analysis of data collected in a prospective cohort study. Hospital. Consecutive sample of 200 patients with primary lobar ICH and 75 patients with deep hemispheric ICH. Presence of SDH and mortality. Subdural hematoma was present in 40 of 200 patients (20%) with primary lobar ICH. By contrast, SDH was not present in any of 75 consecutive patients with deep hemispheric ICH (P Subdural hematoma thickness more than 5 mm was an independent predictor of increased 30-day mortality (OR, 7.60; 95% CI, 1.86-30.99; P = .005) after controlling for other factors including ICH volume. Further analysis showed that the effect of SDH on mortality depended on ICH volume, with larger odds for mortality in those with low ICH volume (OR, 12.85; 95% CI, 2.42-68.23; P = .003 for those with ICH volume subdural space, may be the pathogenic mechanism.

  19. Spontaneous intracerebral hemorrhage: Clinical and computed tomography findings in predicting in-hospital mortality in Central Africans

    Directory of Open Access Journals (Sweden)

    Michel Lelo Tshikwela

    2012-01-01

    Full Text Available Background and Purpose: Intracerebral hemorrhage (ICH constitutes now 52% of all strokes. Despite of its deadly pattern, locally there is no clinical grading scale for ICH-related mortality prediction. The first objective of this study was to develop a risk stratification scale (Kinshasa ICH score by assessing the strength of independent predictors and their association with in-hospital 30-day mortality. The second objective of the study was to create a specific local and African model for ICH prognosis. Materials and Methods: Age, sex, hypertension, type 2 diabetes mellitus (T2DM, smoking, alcohol intake, and neuroimaging data from CT scan (ICH volume, Midline shift of patients admitted with primary ICH and follow-upped in 33 hospitals of Kinshasa, DR Congo, from 2005 to 2008, were analyzed using logistic regression models. Results: A total of 185 adults and known hypertensive patients (140 men and 45 women were examined. 30-day mortality rate was 35% (n=65. ICH volume>25 mL (OR=8 95% CI: 3.1-20.2; P 7 mm, a consequence of ICH volume, was also a significant predictor of mortality. The Kinshasa ICH score was the sum of individual points assigned as follows: Presence of coma coded 2 (2 × 2 = 4, absence of coma coded 1 (1 × 2 = 2, ICH volume>25 mL coded 2 (2 × 2=4, ICH volume of ≤25 mL coded 1(1 × 2=2, left hemispheric site of ICH coded 2 (2 × 1=2, and right hemispheric site of hemorrhage coded 1(1 × 1 = 1. All patients with Kinshasa ICH score ≤7 survived and the patients with a score >7 died. In considering sex influence (Model 3, points were allowed as follows: Presence of coma (2 × 3 = 6, absence of coma (1 × 3 = 3, men (2 × 2 = 4, women (1 × 2 = 2, midline shift ≤7 mm (1 × 3 = 3, and midline shift >7 mm (2 × 3 = 6. Patients who died had the Kinshasa ICH score ≥16. Conclusion: In this study, the Kinshasa ICH score seems to be an accurate method for distinguishing those ICH patients who need continuous and special management

  20. Outcomes from intracerebral hemorrhage among patients pre-treated with statins

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    Flávio Ramalho Romero

    2011-06-01

    Full Text Available OBJECTIVE: 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA reductase inhibitors, or statins, have been associated with improved clinical outcomes after ischemic stroke and subarachnoid hemorrhage, but with an increased risk of incidental spontaneous intracerebral hemorrhage (ICH. We investigated whether the statin use before ICH, was associated with functional independence, 90 days after treatment. METHOD: We analyzed 124 consecutive ICH patients with 90-day outcome data who were enrolled in a prospective cohort study between 2006 and 2009. Eighty-three patients were included in this study. Among ICH survivors, univariate Cox regression models and Kaplan-Meier plots were used to determine subject characteristics that were associated with an increased risk of recurrence. Statin usage was determined through interviewing the patient at the time of ICH and confirmed by reviewing their medical records. Independent status was defined as Glasgow Outcome Scale grades 4 or 5. RESULTS: Statins were used by 20 out of 83 patients (24% before ICH onset. There was no effect from pre-ICH statin use on functional independence rates (28% versus 29%, P=0.84 or mortality (46% versus 45%, P=0.93. CONCLUSION: Pre-ICH statin use is not associated with changes to ICH functional outcome or mortality.

  1. Human neural stem cells over-expressing VEGF provide neuroprotection, angiogenesis and functional recovery in mouse stroke model.

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    Hong J Lee

    Full Text Available BACKGROUND: Intracerebral hemorrhage (ICH is a lethal stroke type. As mortality approaches 50%, and current medical therapy against ICH shows only limited effectiveness, an alternative approach is required, such as stem cell-based cell therapy. Previously we have shown that intravenously transplanted human neural stem cells (NSCs selectively migrate to the brain and induce behavioral recovery in rat ICH model, and that combined administration of NSCs and vascular endothelial growth factor (VEGF results in improved structural and functional outcome from cerebral ischemia. METHODS AND FINDINGS: We postulated that human NSCs overexpressing VEGF transplanted into cerebral cortex overlying ICH lesion could provide improved survival of grafted NSCs, increased angiogenesis and behavioral recovery in mouse ICH model. ICH was induced in adult mice by unilateral injection of bacterial collagenase into striatum. HB1.F3.VEGF human NSC line produced an amount of VEGF four times higher than parental F3 cell line in vitro, and induced behavioral improvement and 2-3 fold increase in cell survival at two weeks and eight weeks post-transplantation. CONCLUSIONS: Brain transplantation of F3 human NSCs over-expressing VEGF near ICH lesion sites provided differentiation and survival of grafted human NSCs and renewed angiogenesis of host brain and functional recovery of ICH animals. These results suggest a possible application of the human neural stem cell line, which is genetically modified to over-express VEGF, as a therapeutic agent for ICH-stroke.

  2. European research priorities for intracerebral haemorrhage

    DEFF Research Database (Denmark)

    Steiner, Thorsten; Petersson, Jesper; Al-Shahi Salman, Rustam

    2011-01-01

    and disability. The European Research Network on Intracerebral Haemorrhage EURONICH is a multidisciplinary academic research collaboration that has been established to define current research priorities and to conduct large clinical studies on all aspects of ICH........ No standardised diagnostic workup for the detection of the various underlying causes of ICH currently exists, and the evidence for medical or surgical therapeutic interventions remains limited. A dedicated European research programme for ICH is needed to identify ways to reduce the burden of ICH-related death...

  3. Genetic Variations of the COL4A1 Gene and Intracerebral Hemorrhage Risk: A Case-Control Study in a Chinese Han Population.

    Science.gov (United States)

    Lin, Sen; Xia, Chao; He, Sha; Yang, Jie; Li, Hao; Zheng, Jun; Liu, Ming; You, Chao

    2018-04-01

    To investigate the association between single nucleotide polymorphisms or haplotypes of the COL4A1 gene and the risk of intracerebral hemorrhage (ICH). We conducted a case-control study that included 181 patients from the Chinese Han population with hypertensive ICH and 197 hypertension patients without ICH. Genomic DNA was extracted by DNA extraction kit, and the 6 single nucleotide polymorphism genotypes of the COL4A1 gene were detected with a MassARRAY Analyzer. Unphased 3.1.4 and SPSS 19.0 were used to analyze the association between alleles, genotypes, and haplotypes of the COL4A1 gene and the risk of ICH. Compared with the control group, patients in the ICH group were significantly younger. There were no differences in gender, diabetes, hyperlipidemia, current smoking, and alcohol consumption between the 2 groups. Our association analysis showed that the rs3742207 A, rs11069830 A, and rs679505 A alleles were association factors of the risks of ICH; rs11069830 AA, rs544012 AC, and rs679505 AA genotypes were association factors of the risk of ICH; AA haplotype (rs3742207-rs11069830) was an association factor of the risk of ICH. After adjusting age and gender by multivariate logistic regression, the rs544012 AC and rs679505 AA genotypes were independently associated with the risk of ICH. Our study showed that the rs544012 AC and rs679505 AA genotypes were independently associated with the risk of ICH in the Chinese Han population and that the AA haplotype (rs3742207-rs11069830) in the COL4A1 gene may be related to the risk of ICH in the Chinese Han population; these conclusions need further confirmation in future studies with larger samples. Copyright © 2018. Published by Elsevier Inc.

  4. Intracranial Hemorrhage: A Devastating Outcome of Congenital Bleeding Disorders-Prevalence, Diagnosis, and Management, with a Special Focus on Congenital Factor XIII Deficiency.

    Science.gov (United States)

    Alavi, Seyed Ezatolla Rafiee; Jalalvand, Masumeh; Assadollahi, Vahideh; Tabibian, Shadi; Dorgalaleh, Akbar

    2018-04-01

    Intracranial hemorrhage (ICH) is a medical emergency. In congenital bleeding disorders, ICH is a devastating presentation accompanied with a high rate of morbidity and mortality. The prevalence of ICH is highly variable among congenital bleeding disorders, with the highest incidence observed in factor (F) XIII deficiency (FXIIID) (∼30%). This life-threatening presentation is less common in afibrinogenemia, FVIII, FIX, FVII, and FX deficiencies, and is rare in severe FV and FII deficiencies, type 3 von Willebrand disease and inherited platelet function disorders (IPFDs). In FXIIID, this diathesis most often occurs after trauma in children, whereas spontaneous ICH is more frequent in adults. About 15% of patients with FXIIID and ICH die; the bleeding causes 80% of deaths in this coagulopathy. Although in FXIIID, the bleed most commonly is intraparenchymal (> 90%), epidural, subdural, and subarachnoid hemorrhages also have been reported, albeit rarely. As this life-threatening bleeding causes neurological complications, early diagnosis can prevent further expansion of the hematoma and secondary damage. Neuroimaging plays a crucial role in the diagnosis of ICH, but signs and symptoms in patients with severe FXIIID should trigger replacement therapy even before establishment of the diagnosis. Although a high dose of FXIII concentrate can reduce the rate of morbidity and mortality of ICH in FXIIID, it may occasionally trigger inhibitor development, thus complicating ICH management and future prophylaxis. Nevertheless, replacement therapy is the mainstay of treatment for ICH in FXIIID. Neurosurgery is performed in patients with FXIIID and epidural hematoma and a hemorrhage diameter exceeding 2 cm or a volume of ICH is more than 30 cm 3 . Contact sports are not recommended in people with FXIIID as they can elicit ICH. However, a considerable number of safe sports and activities have been suggested to have more benefits than dangers for patients with congenital bleeding

  5. The radical scavenger edaravone improves neurologic function and perihematomal glucose metabolism after acute intracerebral hemorrhage.

    Science.gov (United States)

    Shang, Hanbing; Cui, Derong; Yang, Dehua; Liang, Sheng; Zhang, Weifeng; Zhao, Weiguo

    2015-01-01

    Oxidative injury caused by reactive oxygen species plays an important role in the progression of intracerebral hemorrhage (ICH)-induced secondary brain injury. Previous studies have demonstrated that the free radical scavenger edaravone may prevent neuronal injury and brain edema after ICH. However, the influence of edaravone on cerebral metabolism in the early stages after ICH and the underlying mechanism have not been fully investigated. In the present study, we investigated the effect of edaravone on perihematomal glucose metabolism using (18)F-fluorordeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT). Additionally, the neurologic deficits, brain edemas, and cell death that followed ICH were quantitatively analyzed. After blood infusion, the rats treated with edaravone showed significant improvement in both forelimb placing and corner turn tests compared with those treated with vehicle. Moreover, the brain water content of the edaravone-treated group was significantly decreased compared with that of the vehicle group on day 3 after ICH. PET/CT images of ICH rats exhibited obvious decreases in FDG standardized uptake values in perihematomal region on day 3, and the lesion-to-normal ratio of the edaravone-treated ICH rats was significantly increased compared with that of the control rats. Calculation of the brain injury volumes from the PET/CT images revealed that the volumes of the blood-induced injuries were significantly smaller in the edaravone group compared with the vehicle group. Terminal Deoxynucleotidyl Transferase-mediated dUTP Nick End Labeling assays performed 3 days after ICH revealed that the numbers of apoptotic cells in perihematomal region of edaravone-treated ICH rats were decreased relative to the vehicle group. Thus, the present study demonstrates that edaravone has scavenging properties that attenuate neurologic behavioral deficits and brain edema in the early period of ICH. Additionally, edaravone may improve

  6. Audit of CT reporting standards in cases of intracerebral haemorrhage at a comprehensive stroke centre in Australia.

    Science.gov (United States)

    Barras, Christen D; Asadi, Hamed; Phal, Pramit M; Tress, Brian M; Davis, Stephen M; Desmond, Patricia M

    2016-12-01

    Multiple CT-derived biomarkers that are predictive of intracerebral haemorrhage (ICH) growth and outcome have been described in the literature, but the extent to which these appear in imaging reports of ICH is unknown. The aim of this retrospective process audit was to determine which of the known predictors of ICH outcome was recorded in reports of the disease, with a view to providing reporting recommendations, as appropriate. We examined the initial CT report of patients diagnosed with ICH presenting to a metropolitan comprehensive stroke centre and meeting inclusion criteria during the audit period between 1 March 2013 and 28 February 2014. Each report was assessed for the inclusion of the following ICH characteristics: the number of measurement dimensions; volume; location; hydrocephalus; shape; density; 'CTA spot sign' (where CTA was performed). A total of 100 patients met audit inclusion criteria. At least one ICH dimension was recorded in 90% of reports; however, 39% did not include the measurements in three dimensions and volume was reported in just 6%. No ICH dimension was recorded in 10% of reports. With the exception of density and shape, reporting of other CT features exceeded 95%. Where CTA was performed (58%), 14 (24%) of 58 reported the 'CTA spot sign' status. In this audit, volume was the most under-reported of the established ICH characteristics predictive of ICH outcome. Readily calculated from multiplanar reformats using the ABC/2 technique, the routine reporting of ICH volume is recommended. More reporting attention to ICH density heterogeneity and shape irregularity is encouraged, given their emerging importance. Where acute CTA is performed, the presence of any dynamic haemorrhage (CTA spot sign) should be reported. © 2016 The Royal Australian and New Zealand College of Radiologists.

  7. Association between cerebral microbleeds and the first onset of intracerebral hemorrhage - a 3.0 T MR study

    International Nuclear Information System (INIS)

    Sun, Shengjun; Gao, Peiyi; Sui, Binbin; Xue, Jing; Wang, Hui; Wang, Qiong; Jing, Lina; Zhai, Renyou

    2012-01-01

    Background. Cerebral microbleeds (CMBs) detected by gradient-echo MRI have been proven to be a potential risk factor for further bleeding, while the association between CMBs and the first onset of intracerebral hemorrhage has not been well investigated. Purpose. To analyze the association between CMBs and the first onset of primary intracerebral hemorrhage (pICH). Material and Methods. Two hundred and two consecutive inpatients with ICH and 234 consecutive outpatients without ICH as control group were enrolled in this study. MR imaging including T2*-GRE, T 1 W, T 2 W and fluid attenuated inversion recovery (FLAIR) sequences were performed to detect CMBs and other abnormalities. Prevalence, distribution, and grades of CMBs, as well as the location and size of the intracerebral hematoma were analyzed, respectively. Comparison was made between pICH and control group. Logistic analysis was performed to evaluate the association between CMBs and ICH. The correlation between hematoma size and CMBs grade/numbers was analyzed. Results. CMBs were detected in 140 patients in pICH (69.3%) group and 62 patients in control group (26.5%). The incidence of CMBs in pICH group was significantly higher than that in control group (P < 0.0001). As the logistic regression analysis results, CMBs was the risk factor associated with ICH, with modulation OR value of 8.363 (95% CI 5.210-13.421). The volume of ICH with CMBs was 12.57 ± 17.23 mL, and the volume of ICH without CMBs was 17.77 ± 26.97 mL. Negative correlation was demonstrated between CMBs number and ICH volume (rs = -0.1769, P = 0.0118), as well as between CMBs grade and hematoma volume (rs = -0.1185, P = 0.1557). Conclusion CMBs may be an independent risk factor for the first onset of intracerebral hemorrhage

  8. Regulamin rezerwatu. O książce "Jewish Poland Revisited" Eriki Lehrer

    Directory of Open Access Journals (Sweden)

    Konrad Matyjaszek

    2016-01-01

    social and spatial.   Regulamin rezerwatu. O książce Jewish Poland Revisited Eriki Lehrer Artykuł stanowi recenzję książki Jewish Poland Revisited Eriki Lehrer, prezentującej wyniki antropologicznych badań na temat żydowsko-polskich projektów pamięci realizowanych w byłej dzielnicy żydowskiej na krakowskim Kazimierzu. Omawiając tezy pracy, autor poddaje krytycznej analizie proponowany przez Lehrer projekt etnografii możliwości i wynikającą z niego strategię akceptacji współczesnego Kazimierza jako przestrzeni spotkania, za którą idzie akceptacja zasad uczestnictwa narzuconych gościom przez polskich zarządców Kazimierza. W artykule rozpatrywane są dwie takie zasady, warunkujące możliwość uczestnictwa gościa w kurczącej się przestrzeni publicznej Kazimierza. Pierwszą z nich autor opisuje jako nakaz porzucenia bezpośrednio dostępnej, fizycznej przestrzeni dzielnicy i niesionych przez nią historii, których znakiem jest ocalała zabudowa. W to miejsce Lehrer wprowadza podział na przestrzeń społeczną i fizyczną, skutkiem czego stłumione zostają ślady brutalnej przeszłości, w przeciwnym razie bezpośrednio obecne. Drugą zasadę autor odtwarza jako wymóg akceptacji roli współczesnych polskich właścicieli jako brokerów i pośredników żydowskiego dziedzictwa, co w konsekwencji pociąga za sobą akceptację ich wątpliwych prawnie i moralnie roszczeń do zawłaszczonej przestrzeni. Skupienie uwagi na regulaminie uczestnictwa, który ustanawia i utrzymuje warunkowy charakter żydowskiej obecności w przestrzeni Kazimierza, prowadzi autora do wniosku o konieczności rewaluacji i redefinicji tradycyjnego rozdziału dyscyplin, który tworzy konceptualny podział na społeczne przestrzenie i architektoniczne obiekty, oraz do krytycznego namysłu nad obowiązującym obecnie w Europie Środkowo-Wschodniej rozumieniem pojęcia „dziedzictwo”. Tego rodzaju poszukiwanie uznaje autor za warunek przezwyciężenia ignorowanego zwykle

  9. Ocena częstości występowania bólu głowy oraz objawów mu towarzyszących = Assessment of the frequency of the occurrence of headaches and associated with them symptoms

    Directory of Open Access Journals (Sweden)

    Katarzyna Kożuch

    2016-05-01

    4Katedra i Klinika Nefrologii, UM w Lublinie   Uniwersytet Medyczny w Lublinie ul. W. Chodźki 1, 20-093 Lublin e-mail: piotr7176@gmail.com     Streszczenie Celem pracy była ocena częstości występowania bólu głowy oraz objawów mu towarzyszących. W badaniu oceniono również poziom natężenia bólu oraz okoliczności pojawienia się dolegliwości bólowych oraz czas ich trwania i charakter bólu. Badaniem objęto 103 osób. Kobiety stanowiły 56,9% respondentów, natomiast mężczyźni 43,1%. Wiek ankietowanych zawierał się pomiędzy 18 a 75 lat.  Badanie przeprowadzono w okresie od stycznia do marca 2016 roku metodą wywiadu standaryzowanego. Narzędziem użytym do zebrania danych, był autorski, anonimowy kwestionariusz. Kwestionariusz zawierał 43 pytania z możliwością jednokrotnego wyboru w tym trzy pytania z możliwością wielokrotnego wyboru. Przeprowadzono analizę statystyczną z wykorzystaniem testu chi- kwadrat. Wszystkie wartości w których p<0,05 uznano za istotne statystycznie. Wszyscy ankietowani skarżyli się na dolegliwości bólowe głowy. Ankietowani najczęściej (36,5% wskazywali odpowiedź o występowaniu bólu głowy kilka razy w miesiącu. 39,4% ankietowanych odczuwa dolegliwości bólowe głowy o różnej porze dnia. Na pytanie dotyczące długości trwania dolegliwości bólowych ankietowani najczęściej (36,4% wskazywali, że ból głowy trwa zazwyczaj około 1 godzinę. Respondenci istotnie statystycznie (p<0,05 częściej potrafili określić lokalizację bólu głowy. Ankietowani z podobną częstością wskazywali ból w okolicy skroniowej (27,7% oraz w okolicy potylicznej (24,8%. Mężczyźni istotnie statystycznie (p<0,05 częściej odczuwają silniejszy ból głowy w porównaniu do kobiet. Najczęstszym objawem towarzyszącym dolegliwościom bólowym głowy była zmiana nastroju (66,3%, p<0,05. Blisko jedna trzecia ankietowanych odczuwa podczas napadu bólu głowy sztywność karku (28,7%, na nudności i wymioty

  10. The Association Between Specific Substances of Abuse and Subcortical Intracerebral Hemorrhage versus Ischemic Lacunar Infarction

    Directory of Open Access Journals (Sweden)

    Emma H Kaplan

    2014-09-01

    Full Text Available Background: Hypertension damages small vessels, resulting in both lacunar infarction and subcortical intracerebral hemorrhage (ICH. Substance abuse has also been linked to small vessel pathology. This study explores whether the use of specific substances (eg., cocaine, tobacco is associated with subcortical ICH over ischemia in hypertensive individuals.Methods: Patients with hypertension, admitted with lacunar infarcts (measuring 1 drink per day (women, >2 drinks per day (men. Logistic regression was performed with ICH as the dependent variable comparing those presenting with ICH to those presenting with ischemia.Results: Of the 580 patients included in analysis, 217 (37% presented with ICH. The average age was similar between the two groups (64.7 versus 66.3 years. Illicit/controlled drug use was associated with a significantly increased risk of ICH over stroke in unadjusted models (25% versus 15%, p=0.02, with the largest effect seen in users ≥65 years old (not statistically significant. Smoking was associated with ischemia over ICH in a dose-dependent manner: any history of smoking OR 1.84, CI 1.19-2.84; current use OR 2.23, CI 1.37-3.62; heavy use OR 2.48, CI 1.50-4.13. Alcohol use was not preferentially associated with either outcome (p=0.29.Conclusions: In hypertensive patients, tobacco use is associated with an increased risk of subcortical ischemia compared to ICH; while use of illicit/controlled substances appears to be predictive of hemorrhage.

  11. Predictors of intracranial hemorrhage in adult patients on extracorporeal membrane oxygenation

    DEFF Research Database (Denmark)

    Fletcher Sandersjöö, Alexander; Bartek, Jiri; Thelin, Eric Peter

    2017-01-01

    was to identify predictors of ICH in ECMO-treated adult patients. METHODS: We conducted a retrospective review of adult patients (≥18 years) treated with ECMO at the Karolinska University Hospital (Stockholm, Sweden) between September 2005 and June 2016, excluding patients with ICH upon admission or those who...

  12. Effect of intracranial bleeds on the neurocognitive, academic, behavioural and adaptive functioning of boys with haemophilia.

    Science.gov (United States)

    Miles, B S; Anderson, P; Agostino, A; Golomb, M R; Achonu, C; Blanchette, V; Feldman, B M; McLimont, M; Revel-Vilk, S; Stain, A; Barnes, M A

    2012-03-01

    Brain insults are a risk factor for neuropsychological and academic deficits across several paediatric conditions. However, little is known about the specific effects of intracranial haemorrhage (ICH) in boys with haemophilia. The study compared neurocognitive, academic and socio-emotional/behavioural outcomes of boys with haemophilia with and without a history of ICH. Of 172 consecutive patients seen at a Pediatric Comprehensive Care Hemophila Centre, 18 had a history of ICH. Sixteen boys between the ages of 3 and 17 years were available for study and were matched to controls with haemophilia of the same age and disease severity and on the basis of maternal education. Groups were compared on neuropsychological and academic outcomes. Attention, socio-emotional function and executive skills were compared using data from parent questionnaires. Differences were found in intellectual function, visual-spatial skill, fine motor dexterity and particularly language-related skills, including vocabulary, word reading and applied math problem solving. Despite these group differences, outcomes were within the average range for most boys with ICH. No group differences were found in behavioural and socio-emotional functioning. Although ICH in haemophilia is not benign, it was not associated with significant cognitive and academic consequences for most boys. Early neuropsychological assessment may be indicated when there is a history of ICH. Investigation of age at ICH and quantitative measures of brain in relation to neurocognitive outcomes in larger groups of boys with ICH would be useful. © 2011 Blackwell Publishing Ltd.

  13. Intracranial hemorrhage in congenital bleeding disorders.

    Science.gov (United States)

    Tabibian, Shadi; Motlagh, Hoda; Naderi, Majid; Dorgalaleh, Akbar

    2018-01-01

    : Intracranial hemorrhage (ICH), as a life-threatening bleeding among all kinds of congenital bleeding disorders (CBDs), is a rare manifestation except in factor XIII (FXIII) deficiency, which is accompanied by ICH, early in life, in about one-third of patients. Most inherited platelet function disorders (IPFDs) are mild to moderate bleeding disorders that can never experience a severe bleeding as in ICH; however, Glanzmann's thrombasthenia, a common and severe inherited platelet function disorder, can lead to ICH and occasional death. This bleeding feature can also be observed in grey platelet syndrome, though less frequently than in Glanzmann's thrombasthenia. In hemophilia, intracerebral hemorrhage is affected by various risk factors one of which is the severity of the disease. The precise prevalence of ICH in these patients is not clear but an estimated incidence of 3.5-4% among newborns with hemophilia is largely ascertained. Although ICH is a rare phenomenon in CBDs, it can be experienced by every patient with severe hemophilia A and B, FXIII deficiency (FXIIID), FVIID, FXD, FVD, FIID, and afibrinogenemia. Upon observing the general signs and symptoms of ICH such as vomiting, seizure, unconsciousness, and headache, appropriate replacement therapies and cranial ultrasound scans must be done to decrease ICH-related morbidity and mortality.

  14. Human Placenta-Derived Mesenchymal Stem Cells Reduce Mortality and Hematoma Size in a Rat Intracerebral Hemorrhage Model in an Acute Phase

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    Bo Young Choi

    2018-01-01

    Full Text Available Intracerebral hemorrhage (ICH is a critical disease, highly associated with mortality and morbidity. Several studies have demonstrated the beneficial effect of mesenchymal stem cells (MSCs on ICH, mostly focused on their mid-to-long-term effect. Acute hematoma expansion is one of the most important prognostic factors of ICH. We hypothesized that MSCs would decrease mortality and hematoma size in acute ICH, based on the findings of a few recent researches reporting their effect on blood-brain barrier and endothelial integrity. Rat ICH models were made using bacterial collagenase. One hour after ICH induction, the rats were randomly divided into MSC-treated and control groups. Mortality, hematoma volume, ventricular enlargement, brain edema, and degenerating neuron count were compared at 24 hours after ICH induction. Expression of tight junction proteins (ZO-1, occludin and coagulation factor VII mRNA was also compared. Mortality rate (50% versus 8.3%, hematoma size, ventricular size, hemispheric enlargement, and degenerating neuron count were significantly lower in the MSC-treated group (p=0.034, 0.038, 0.001, 0.022, and <0.001, resp., while the expression of ZO-1 and occludin was higher (p=0.007 and 0.012. Administration of MSCs may prevent hematoma expansion in the hyperacute stage of ICH and decrease acute mortality by enhancing the endothelial integrity of cerebral vasculature.

  15. 76 FR 20690 - Preparation for International Conference on Harmonization Steering Committee and Expert Working...

    Science.gov (United States)

    2011-04-13

    ... ICH sponsors are the European Commission; the European Federation of Pharmaceutical Industries... Pharmaceutical Research and Manufacturers of America. The ICH Secretariat, which coordinates the preparation of.../industry project to improve, through harmonization, the efficiency of the process for developing and...

  16. 75 FR 57803 - Preparation for International Conference on Harmonisation Steering Committee and Expert Working...

    Science.gov (United States)

    2010-09-22

    ... the European Commission; the European Federation of Pharmaceutical Industries Associations; the... Pharmaceutical Research and Manufacturers of America. The ICH Secretariat, which coordinates the preparation of... ICH was established in 1990 as a joint regulatory/industry project to improve, through harmonization...

  17. 75 FR 17148 - International Conference on Harmonisation; Guidance on Q4B Evaluation and Recommendation of...

    Science.gov (United States)

    2010-04-05

    .... The six ICH sponsors are the European Commission; the European Federation of Pharmaceutical Industries... Pharmaceutical Research and Manufacturers of America. The ICH Secretariat, which coordinates the preparation of... recent years, many important initiatives have been undertaken by regulatory authorities and industry...

  18. Hybrid Assistive Limb (HAL) Rehabilitation in Patients with Acute Hemorrhagic Stroke.

    Science.gov (United States)

    Ogata, Toshiyasu; Abe, Hiroshi; Samura, Kazuhiro; Hamada, Omi; Nonaka, Masani; Iwaasa, Mitsutoshi; Higashi, Toshio; Fukuda, Hiroyuki; Shiota, Etsuji; Tsuboi, Yoshio; Inoue, Tooru

    2015-01-01

    The efficacy of hybrid assistive limb (HAL) rehabilitation in the acute phase of stroke remains unclear. The purpose of this study was to evaluate the outcomes of patients with acute intracranial hemorrhage (ICH) who were treated with or without HAL rehabilitation. Among 270 patients with acute ICH from 2009 to 2014, 91 patients with supratentorial ICH were included in this retrospective study. Of these, 14 patients (HAL group) received HAL rehabilitation at approximately 1 week after ICH occurrence, while the remaining 77 patients received usual rehabilitation without HAL (N-HAL group). We obtained various patient data from the hospitals where the patients were moved to for further rehabilitation. Statistical comparisons were performed for the characteristics of the ICH patients, and outcomes between the HAL and N-HAL groups. There were no differences in outcomes between the HAL and N-HAL groups. However, patients with right ICH in the HAL group exhibited a significant association with a functional independence measure (FIM) score of ≥ 110 compared with patients in the N-HAL group (HAL group: 81.8%, N-HAL group: 43.9%, P = 0.04). In patients with right ICH, HAL rehabilitation was associated with improved outcomes as evaluated by the FIM score. Thus, HAL rehabilitation may improve outcomes of acute ICH in appropriately selected patients.

  19. Obstructive ventriculomegaly

    International Nuclear Information System (INIS)

    Amato, M.; Howald, H.; Muralt, G. von

    1986-01-01

    Intracranial Hemorrhage (ICH) occurs primarily in premature infants, and posthemorrhagic ventricular dilatation is a well-known complication in this age-group. Blood clots within the ventricle are diagnostic of ICH but not usually seen. In our case Real-Time Ultrasonography has proved to be very helpful to identify intraventricular hematomas and to control obstructive ventriculomegaly without therapeutic intervention. (Author)

  20. Parnassiana nova : XIII. Vier neue Hybriden

    NARCIS (Netherlands)

    Eisner, C.

    1957-01-01

    Zu dem Gelingen der nachstehend beschriebenen Kreuzungen haben drei Wiener Entomologen beigetragen, deren Namen ich eigentlich bei der Benennung der Hybriden festzuhalten die Absicht hatte. Da das indessen nach den neuesten Nomenklaturregeln nicht statthaft ist, muss ich mich darauf beschränken zu

  1. Eine neue Tornaria aus der Adria

    NARCIS (Netherlands)

    Stiasny, G.

    1928-01-01

    In einer kurzen Mitteilung über adriatische Tornarien habe ich (4) vor Jahren beiläufig erwähnt, dass im Plankton des Triester Golfes ausser den relativ grossen Tornarien des Balanoglossus clavigerus noch eine zweite kleine Larvenform vorkommt. Diese kleine Tornaria, über welche ich seinerzeit keine

  2. Aspirin in Alzheimer's Disease Increased Risk of Intracerebral Hemorrhage: Cause for Concern?

    NARCIS (Netherlands)

    Thoonsen, Hanneke; Richard, Edo; Bentham, Peter; Gray, Richard; van Geloven, Nan; de Haan, Rob J.; van Gool, Willem A.; Nederkoorn, Paul J.

    2010-01-01

    Background and Purpose-In a randomized controlled trial in Alzheimer's disease (AD), we found a higher number of intracerebral hemorrhages (ICHs) in patients randomized to aspirin treatment. Here, we evaluate the literature on the risk of ICH as a complication in patients with AD treated with

  3. Statins and the Risk of Intracerebral Hemorrhage in Patients With Previous Ischemic Stroke or Transient Ischemic Attack

    DEFF Research Database (Denmark)

    Gaist, David; Goldstein, Larry B; Cea Soriano, Lucía

    2017-01-01

    to identify incident cases of ICH, with validation by manual review of patient records and linkage to hospitalization data. In a nested case-control study, we compared the adjusted odds ratios (ORs) with 95% confidence intervals (CIs) for ICH based on statin use in the subgroup of individuals with history...

  4. Effects of Ichthyophthirius multifiliis parasitism on the survival, hematology and bacterial load in channel catfish previously exposed to Edwardsiella ictaluri

    Science.gov (United States)

    The effect of Ichthyophthirius multifiliis (Ich) parasitism on survival, hematology and bacterial load in channel catfish, Ictalurus punctatus, previously exposed to Edwardsiella ictaluri was studied. Fish were exposed to E. ictaluri one day prior to Ich in the following treatments: 1)- infected by...

  5. Gedichte aus den Jahren 1968 bis 1975 / Viivi Luik ; tõlk. Gisbert Jänicke

    Index Scriptorium Estoniae

    Luik, Viivi, 1946-

    1999-01-01

    Tekst saksa ja eesti keeles. Sisu: Weite = Avarus ; "Wie der Krieg..." = "Otsekui sõda..." ; "es vergehn..." = "hävivad..." ; Das Geheimnis = Saladus ; "Ob auch ich weiss..." = "Kas minagi tean..." ; "Ich redete einmal von Feldern..." = "Rääkisin väljadest ükskord..." ; Andere = Teine ; Der Tag = Päev

  6. Keramik-Datierungen

    DEFF Research Database (Denmark)

    Philippsen, Bente

    Dieser Vortrag bietet eine allgemeine Einführung in Krustendatierungen und Süßwasserreservoireffekte. Ich skizziere, mit welchen Methoden man die Zutaten der Speisekrusten rekonstruieren kann. Außerdem diskutiere ich die bisherigen Radiokarbondatierungen der Keramik vom Fundplatz Friesack 4....

  7. Parasiticidal effects of Morus alba root bark extracts against Ichthyophthirius multifiliis infecting grass carp

    Science.gov (United States)

    Ichthyophthirius multifiliis (Ich) is an important fish parasite that can result in significant losses in aquaculture. In order to find efficacious drugs to control Ich, the root bark of Morus alba, a traditional Chinese medicine, was evaluated for its antiprotozoal activity. The M. alba root bark w...

  8. Clinical Course and Outcomes of Small Supratentorial Intracerebral Hematomas

    NARCIS (Netherlands)

    Behrouz, R.; Misra, V.; Godoy, D.A.; Topel, C.H.; Masotti, L.; Klijn, C.J.M.; Smith, C.J.; Parry-Jones, A.R.; Slevin, M.A.; Silver, B.; Willey, J.Z.; Vallejo, J. Masjuan; Nzwalo, H.; Popa-Wagner, A.; Malek, A.R.; Hafeez, S.; Napoli, M. Di

    2017-01-01

    BACKGROUND AND PURPOSE: Intracerebral hemorrhage (ICH) volume, particularly if >/=30 mL, is a major determinant of poor outcome. We used a multinational ICH data registry to study the characteristics, course, and outcomes of supratentorial hematomas with volumes <30 mL. METHODS: Basic

  9. Zehn Oden = Kümme oodi / Kristjan Jaak Peterson ; Deutsch von Gisbert Jänicke

    Index Scriptorium Estoniae

    Peterson, Kristjan Jaak, 1801-1822

    2001-01-01

    Sisu: An Gott ; Sonnenuntergang ; Herbst ; Der Mensch ; Der Mond ; Freundschaft ; Ich muss trinken. Liedchen ; Hoffnung ; Ich bin wieder glücklich ; Der Sänger. Orig.: Jummalale ; Päva loja-minneminne ; Süggise ; Innimenne ; Kuu ; Söbradus ; Ma pean joma. Lauloke ; Lotus ; Ollen jälle önnis ; Laulja

  10. Dual-energy CT of the brain: Comparison between DECT angiography-derived virtual unenhanced images and true unenhanced images in the detection of intracranial haemorrhage

    International Nuclear Information System (INIS)

    Bonatti, Matteo; Pernter, Patrizia; Bonatti, Giampietro; Lombardo, Fabio; Zamboni, Giulia A.; Pozzi Mucelli, Roberto

    2017-01-01

    To evaluate the diagnostic performance of virtual non-contrast (VNC) images in detecting intracranial haemorrhages (ICHs). Sixty-seven consecutive patients with and 67 without ICH who underwent unenhanced brain CT and DECT angiography were included. Two radiologists independently evaluated VNC and true non-contrast (TNC) images for ICH presence and type. Inter-observer agreement for VNC and TNC image evaluation was calculated. Sensitivity and specificity of VNC images for ICH detection were calculated using Fisher's exact test. VNC and TNC images were compared for ICH extent (qualitatively and quantitatively) and conspicuity assessment. On TNC images 116 different haemorrhages were detected in 67 patients. Inter-observer agreement ranged from 0.98-1.00 for TNC images and from 0.86-1.00 for VNC images. VNC sensitivity ranged from 0.90-1, according to the different ICH types, and specificity from 0.97-1. Qualitatively, ICH extent was underestimated on VNC images in 11.9% of cases. Haemorrhage volume did not show statistically significant differences between VNC and TNC images. Mean haemorrhage conspicuity was significantly lower on VNC images than on TNC images for both readers (p < 0.001). VNC images are accurate for ICH detection. Haemorrhages are less conspicuous on VNC images and their extent may be underestimated. (orig.)

  11. Efficacy of deferoxamine in animal models of intracerebral hemorrhage: a systematic review and stratified meta-analysis.

    Directory of Open Access Journals (Sweden)

    Han-Jin Cui

    Full Text Available Intracerebral hemorrhage (ICH is a subtype of stroke associated with high morbidity and mortality rates. No proven treatments are available for this condition. Iron-mediated free radical injury is associated with secondary damage following ICH. Deferoxamine (DFX, a ferric-iron chelator, is a candidate drug for the treatment of ICH. We performed a systematic review of studies involving the administration of DFX following ICH. In total, 20 studies were identified that described the efficacy of DFX in animal models of ICH and assessed changes in the brain water content, neurobehavioral score, or both. DFX reduced the brain water content by 85.7% in animal models of ICH (-0.86, 95% CI: -.48- -0.23; P < 0.01; 23 comparisons, and improved the neurobehavioral score by -1.08 (95% CI: -1.23- -0.92; P < 0.01; 62 comparisons. DFX was most efficacious when administered 2-4 h after ICH at a dose of 10-50 mg/kg depending on species, and this beneficial effect remained for up to 24 h postinjury. The efficacy was higher with phenobarbital anesthesia, intramuscular injection, and lysed erythrocyte infusion, and in Fischer 344 rats or aged animals. Overall, although DFX was found to be effective in experimental ICH, additional confirmation is needed due to possible publication bias, poor study quality, and the limited number of studies conducting clinical trials.

  12. Reta'maxik Qatzij--Conociendo Nuestro Idioma (Knowing Our Language). [CD-ROM].

    Science.gov (United States)

    Academy for Educational Development, Washington, DC.

    This CD-ROM is part of an interactive and dynamic multimedia package of information and games for learning K'iche' and Ixil. This CD-ROM includes six books in electronic format with interactive exercises that support improved bilingual and intercultural education and teacher training, specifically in the languages of K'iche' and Ixil. Books…

  13. Dual-energy CT of the brain: Comparison between DECT angiography-derived virtual unenhanced images and true unenhanced images in the detection of intracranial haemorrhage

    Energy Technology Data Exchange (ETDEWEB)

    Bonatti, Matteo; Pernter, Patrizia; Bonatti, Giampietro [Bolzano Central Hospital, Department of Radiology, Bolzano (Italy); Lombardo, Fabio; Zamboni, Giulia A.; Pozzi Mucelli, Roberto [University of Verona, Department of Radiology, Verona (Italy)

    2017-07-15

    To evaluate the diagnostic performance of virtual non-contrast (VNC) images in detecting intracranial haemorrhages (ICHs). Sixty-seven consecutive patients with and 67 without ICH who underwent unenhanced brain CT and DECT angiography were included. Two radiologists independently evaluated VNC and true non-contrast (TNC) images for ICH presence and type. Inter-observer agreement for VNC and TNC image evaluation was calculated. Sensitivity and specificity of VNC images for ICH detection were calculated using Fisher's exact test. VNC and TNC images were compared for ICH extent (qualitatively and quantitatively) and conspicuity assessment. On TNC images 116 different haemorrhages were detected in 67 patients. Inter-observer agreement ranged from 0.98-1.00 for TNC images and from 0.86-1.00 for VNC images. VNC sensitivity ranged from 0.90-1, according to the different ICH types, and specificity from 0.97-1. Qualitatively, ICH extent was underestimated on VNC images in 11.9% of cases. Haemorrhage volume did not show statistically significant differences between VNC and TNC images. Mean haemorrhage conspicuity was significantly lower on VNC images than on TNC images for both readers (p < 0.001). VNC images are accurate for ICH detection. Haemorrhages are less conspicuous on VNC images and their extent may be underestimated. (orig.)

  14. The Intracranial-B2LEED3S Score and the Risk of Intracranial Hemorrhage in Ischemic Stroke Patients Under Antiplatelet Treatment

    NARCIS (Netherlands)

    Amarenco, Pierre; Sissani, Leila; Labreuche, Julien; Vicaut, Eric; Bousser, Marie Germaine; Chamorro, Angel; Fisher, Marc; Ford, Ian; Fox, Kim M; Hennerici, Michael G; Mattle, Heinrich; Rothwell, Peter M; Steg, Philippe Gabriel; Diener, Hans-Christoph; Sacco, Ralph L; Greving, Jacoba P; Algra, Ale

    2017-01-01

    BACKGROUND: Chronic antiplatelet therapy in the post-acute phase of non-cardioembolic ischemic stroke is limited by the risk of intracranial hemorrhage (ICH) complications. METHODS: We developed an ICH risk score based on the PERFORM trial cohort (n = 19,100), which included patients with a

  15. Intracerebral hemorrhage in children | Zidan | Alexandria Journal of ...

    African Journals Online (AJOL)

    Introduction: Intracerebral hemorrhage (ICH) in children is relatively less common as compared to adults. It could be traumatic or spontaneous. Objective: There are limited studies about ICH in children. In this study, we analyze the etiology, clinical features, management options and outcome assessment in this population.

  16. Attempting to Predict Success in the Qualifying Round of the International Chemistry Olympiad

    Science.gov (United States)

    Urhahne, Detlef; Ho, Lok Hang; Parchmann, Ilka; Nick, Sabine

    2012-01-01

    The aim of this study was trying to predict success in the qualifying round for the International Chemistry Olympiad (IChO) on the basis of the expectancy-value model of achievement motivation by Eccles et al. The investigation with 52 participants, including 14 females, was conducted during the third of four qualifying rounds of the IChO in…

  17. Prognostic Factors for Cognitive Decline After Intracerebral Hemorrhage

    NARCIS (Netherlands)

    Benedictus, M.R.; Hochart, A.; Rossi, C.; Boulouis, G.; Henon, H.; van der Flier, W.M.; Cordonnier, C.

    2015-01-01

    Background and Purpose-Stroke and dementia are closely related, but no prospective study ever focused on poststroke cognitive decline in patients with intracerebral hemorrhage (ICH). We aimed to determine prognostic factors for cognitive decline in patients with ICH. Methods-We prospectively

  18. Computed tomography angiography spot sign predicts intraprocedural aneurysm rupture in subarachnoid hemorrhage.

    Science.gov (United States)

    Burkhardt, Jan-Karl; Neidert, Marian Christoph; Stienen, Martin Nikolaus; Schöni, Daniel; Fung, Christian; Roethlisberger, Michel; Corniola, Marco Vincenzo; Bervini, David; Maduri, Rodolfo; Valsecchi, Daniele; Tok, Sina; Schatlo, Bawarjan; Bijlenga, Philippe; Schaller, Karl; Bozinov, Oliver; Regli, Luca

    2017-07-01

    To analyze whether the computed tomography angiography (CTA) spot sign predicts the intraprocedural rupture rate and outcome in patients with aneurysmal subarachnoid hemorrhage (aSAH). From a prospective nationwide multicenter registry database, 1023 patients with aneurysmal subarachnoid hemorrhage (aSAH) were analyzed retrospectively. Descriptive statistics and logistic regression analysis were used to compare spot sign-positive and -negative patients with aneurysmal intracerebral hemorrhage (aICH) for baseline characteristics, aneurysmal and ICH imaging characteristics, treatment and admission status as well as outcome at discharge and 1-year follow-up (1YFU) using the modified Rankin Scale (mRS). A total of 218 out of 1023 aSAH patients (21%) presented with aICH including 23/218 (11%) patients with spot sign. Baseline characteristics were comparable between spot sign-positive and -negative patients. There was a higher clip-to-coil ratio in patients with than without aICH (both spot sign positive and negative). Median aICH volume was significantly higher in the spot sign-positive group (50 ml, 13-223 ml) than in the spot sign-negative group (18 ml, 1-416; p spot sign-positive aICH thus were three times as likely as those with spot sign-negative aICH to show an intraoperative aneurysm rupture [odds ratio (OR) 3.04, 95% confidence interval (CI) 1.04-8.92, p = 0.046]. Spot sign-positive aICH patients showed a significantly worse mRS at discharge (p = 0.039) than patients with spot sign-negative aICH (median mRS 5 vs. 4). Logistic regression analysis showed that the spot sign was an aICH volume-dependent predictor for outcome. Both spot sign-positive and -negative aICH patients showed comparable rates of hospital death, death at 1YFU and mRS at 1YFU. In this multicenter data analysis, patients with spot sign-positive aICH showed higher aICH volumes and a higher rate of intraprocedural aneurysm rupture, but comparable long-term outcome to spot sign

  19. Predicting of mortality in patients with intracrani al hemorrhage: A review article

    Directory of Open Access Journals (Sweden)

    Farzad Rahmani

    2014-11-01

    Full Text Available Introduction: Stroke is one of the important and common diseases, which can lead to permanent disability or even death to people. Intracranial hemorrhage (ICH is a type of stroke that is associated with high mortality despite improved diagnostic and treatment methods, as well as the mortality rate remains high. Methods: In the present review article, reputable internet databases since 2000 were analyzed. Studies that discussed the predicting mortality of ICH were included in this review. Results: For predicting the mortality rates in patients with primary ICH, physicians use several methods such as level of consciousness, bleeding volume and multiple rating systems. In this review, we introduce three scoring system of ICH in patients with ICH. Conclusion: Perhaps its cut-off point of these three score systems were different in different societies according to conditions and facilities therefore it is needed to review these scores and record their results in different societies.

  20. Wavelet entropy characterization of elevated intracranial pressure.

    Science.gov (United States)

    Xu, Peng; Scalzo, Fabien; Bergsneider, Marvin; Vespa, Paul; Chad, Miller; Hu, Xiao

    2008-01-01

    Intracranial Hypertension (ICH) often occurs for those patients with traumatic brain injury (TBI), stroke, tumor, etc. Pathology of ICH is still controversial. In this work, we used wavelet entropy and relative wavelet entropy to study the difference existed between normal and hypertension states of ICP for the first time. The wavelet entropy revealed the similar findings as the approximation entropy that entropy during ICH state is smaller than that in normal state. Moreover, with wavelet entropy, we can see that ICH state has the more focused energy in the low wavelet frequency band (0-3.1 Hz) than the normal state. The relative wavelet entropy shows that the energy distribution in the wavelet bands between these two states is actually different. Based on these results, we suggest that ICH may be formed by the re-allocation of oscillation energy within brain.

  1. Intracerebral Hemorrhage, Oxidative Stress, and Antioxidant Therapy

    Science.gov (United States)

    Duan, Xiaochun; Wen, Zunjia; Shen, Haitao; Shen, Meifen

    2016-01-01

    Hemorrhagic stroke is a common and severe neurological disorder and is associated with high rates of mortality and morbidity, especially for intracerebral hemorrhage (ICH). Increasing evidence demonstrates that oxidative stress responses participate in the pathophysiological processes of secondary brain injury (SBI) following ICH. The mechanisms involved in interoperable systems include endoplasmic reticulum (ER) stress, neuronal apoptosis and necrosis, inflammation, and autophagy. In this review, we summarized some promising advances in the field of oxidative stress and ICH, including contained animal and human investigations. We also discussed the role of oxidative stress, systemic oxidative stress responses, and some research of potential therapeutic options aimed at reducing oxidative stress to protect the neuronal function after ICH, focusing on the challenges of translation between preclinical and clinical studies, and potential post-ICH antioxidative therapeutic approaches. PMID:27190572

  2. What are the current therapeutic options for haemorrhagic strokes

    International Nuclear Information System (INIS)

    Khan, M.; Kamal, A.K.

    2010-01-01

    The Factor Seven for Acute Haemorrhagic Stroke Trial (FAST) and Intensive Blood Pressure Reduction in Acute Cerebral Haemorrhage trial (INTERACT). Intracerebral haemorrhage (ICH) is the most devastating form of stroke carrying a mortality of up to 40% at one month. In our part of the world the levels of uncontrolled hypertension pose a greater risk of ICH for our population where ICH is about 30% of all strokes compared to 14% in developed countries. There is evidence to suggest that haematoma expansion occurs in as many as 70% of patients. This expansion translates into increased disability and death. Most of this expansion is within the initial three hours. Also early elevation of blood pressure (BP) is very common after ICH and many studies have highlighted an association between elevated BP post ICH and poor outcomes. The reason for this is postulated to be an increase in both the size of the haematoma and perilesional oedema. (author)

  3. Intracerebral Hemorrhage, Oxidative Stress, and Antioxidant Therapy

    Directory of Open Access Journals (Sweden)

    Xiaochun Duan

    2016-01-01

    Full Text Available Hemorrhagic stroke is a common and severe neurological disorder and is associated with high rates of mortality and morbidity, especially for intracerebral hemorrhage (ICH. Increasing evidence demonstrates that oxidative stress responses participate in the pathophysiological processes of secondary brain injury (SBI following ICH. The mechanisms involved in interoperable systems include endoplasmic reticulum (ER stress, neuronal apoptosis and necrosis, inflammation, and autophagy. In this review, we summarized some promising advances in the field of oxidative stress and ICH, including contained animal and human investigations. We also discussed the role of oxidative stress, systemic oxidative stress responses, and some research of potential therapeutic options aimed at reducing oxidative stress to protect the neuronal function after ICH, focusing on the challenges of translation between preclinical and clinical studies, and potential post-ICH antioxidative therapeutic approaches.

  4. Risk of intracranial hemorrhage and cerebrovascular accidents in non-small cell lung cancer brain metastasis patients.

    Science.gov (United States)

    Srivastava, Geetika; Rana, Vishal; Wallace, Suzy; Taylor, Sarah; Debnam, Matthew; Feng, Lei; Suki, Dima; Karp, Daniel; Stewart, David; Oh, Yun

    2009-03-01

    Brain metastases confer significant morbidity and a poorer survival in non-small cell lung cancer (NSCLC). Vascular endothelial growth factor-targeted antiangiogenic therapies (AAT) have demonstrated benefit for patients with metastatic NSCLC and are expected to directly inhibit the pathophysiology and morbidity of brain metastases, yet patients with brain metastases have been excluded from most clinical trials of AAT for fear of intracranial hemorrhage (ICH). The underlying risk of ICH from NSCLC brain metastases is low, but needs to be quantitated to plan clinical trials of AAT for NSCLC brain metastases. Data from MD Anderson Cancer Center Tumor Registry and electronic medical records from January 1998 to March 2006 was interrogated. Two thousand one hundred forty-three patients with metastatic NSCLC registering from January 1998 to September 2005 were followed till March 2006. Seven hundred seventy-six patients with and 1,367 patients without brain metastases were followed till death, date of ICH, or last date of study, whichever occurred first. The incidence of ICH seemed to be higher in those with brain metastasis compared with those without brain metastases, in whom they occurred as result of cerebrovascular accidents. However, the rates of symptomatic ICH were not significantly different. All ICH patients with brain metastasis had received radiation therapy for them and had been free of anticoagulation. Most of the brain metastasis-associated ICH's were asymptomatic, detected during increased radiologic surveillance. The rates of symptomatic ICH, or other cerebrovascular accidents in general were similar and not significantly different between the two groups. In metastatic NSCLC patients, the incidence of spontaneous ICH appeared to be higher in those with brain metastases compared with those without, but was very low in both groups without a statistically significant difference. These data suggest a minimal risk of clinically significant ICH for NSCLC

  5. Risk of intracerebral hemorrhage associated with phenprocoumon exposure: a nested case-control study in a large population-based German database.

    Science.gov (United States)

    Behr, Sigrid; Andersohn, Frank; Garbe, Edeltraut

    2010-07-01

    Intracerebral hemorrhage (ICH) is the most serious complication of oral anticoagulation. This study investigated the risk of ICH for phenprocoumon which is the most widely used oral anticoagulant in Germany. We conducted a nested case-control study in a cohort of 13.4 million insurants of 4 German statutory health insurances (SHIs) who were continuously enrolled for 6 months prior to cohort entry. Cases were patients hospitalized for ICH. Ten controls were matched to each case by SHI, birth year, and sex using incidence density sampling. Rate ratios (RR) of ICH for current phenprocoumon use as compared to non-use were estimated from odds ratios calculated by conditional logistic regression analyses considering multiple risk factors. Analysis of the full cohort revealed a strong increase in incidence of ICH with increasing age. In the nested case-control study including 8138 cases of ICH and 81,373 matched controls, we observed an increased risk of ICH for current phenprocoumon exposure that varied with age. The phenprocoumon-associated risk of ICH was lower in older age groups with RRs from 4.20 (95% confidence interval (CI) 2.44-7.21) for phenprocoumon users less than 55 years of age to 2.43 (95%CI, 1.81-3.27) for those older than 85 years. Our study confirmed known risk factors of ICH. Phenprocoumon exposure was associated with an increased risk of ICH. The interaction of risk for phenprocoumon with age was unexpected and needs further study. (c) 2010 John Wiley & Sons, Ltd.

  6. Comparing intracerebral hemorrhages associated with direct oral anticoagulants or warfarin.

    Science.gov (United States)

    Kurogi, Ryota; Nishimura, Kunihiro; Nakai, Michikazu; Kada, Akiko; Kamitani, Satoru; Nakagawara, Jyoji; Toyoda, Kazunori; Ogasawara, Kuniaki; Ono, Junichi; Shiokawa, Yoshiaki; Aruga, Toru; Miyachi, Shigeru; Nagata, Izumi; Matsuda, Shinya; Yoshimura, Shinichi; Okuchi, Kazuo; Suzuki, Akifumi; Nakamura, Fumiaki; Onozuka, Daisuke; Ido, Keisuke; Kurogi, Ai; Mukae, Nobutaka; Nishimura, Ataru; Arimura, Koichi; Kitazono, Takanari; Hagihara, Akihito; Iihara, Koji

    2018-03-27

    This cross-sectional survey explored the characteristics and outcomes of direct oral anticoagulant (DOAC)-associated nontraumatic intracerebral hemorrhages (ICHs) by analyzing a large nationwide Japanese discharge database. We analyzed data from 2,245 patients who experienced ICHs while taking anticoagulants (DOAC: 227; warfarin: 2,018) and were urgently hospitalized at 621 institutions in Japan between April 2010 and March 2015. We compared the DOAC- and warfarin-treated patients based on their backgrounds, ICH severities, antiplatelet therapies at admission, hematoma removal surgeries, reversal agents, mortality rates, and modified Rankin Scale scores at discharge. DOAC-associated ICHs were less likely to cause moderately or severely impaired consciousness (DOAC-associated ICHs: 31.3%; warfarin-associated ICHs: 39.4%; p = 0.002) or require surgical removal (DOAC-associated ICHs: 5.3%; warfarin-associated ICHs: 9.9%; p = 0.024) in the univariate analysis. Propensity score analysis revealed that patients with DOAC-associated ICHs also exhibited lower mortality rates within 1 day (odds ratio [OR] 4.96, p = 0.005), within 7 days (OR 2.29, p = 0.037), and during hospitalization (OR 1.96, p = 0.039). This nationwide study revealed that DOAC-treated patients had less severe ICHs and lower mortality rates than did warfarin-treated patients, probably due to milder hemorrhages at admission and lower hematoma expansion frequencies. Copyright © 2018 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology.

  7. Polymorphonuclear neutrophil in brain parenchyma after experimental intracerebral hemorrhage.

    Science.gov (United States)

    Zhao, Xiurong; Sun, Guanghua; Zhang, Han; Ting, Shun-Ming; Song, Shen; Gonzales, Nicole; Aronowski, Jaroslaw

    2014-10-01

    Polymorphonuclear neutrophils (PMNs) infiltration into brain parenchyma after cerebrovascular accidents is viewed as a key component of secondary brain injury. Interestingly, a recent study of ischemic stroke suggests that after ischemic stroke, PMNs do not enter brain parenchyma and as such may cause no harm to the brain. Thus, the present study was designed to determine PMNs' behavior after intracerebral hemorrhage (ICH). Using the autologous blood injection model of ICH in rats and immunohistochemistry for PMNs and vascular components, we evaluated the temporal and spatial PMNs distribution in the ICH-affected brain. We found that, similar to ischemia, there is a robust increase in presence of PMNs in the ICH-injured tissue that lasts for at least 1 to 2 weeks. However, in contrast to what was suggested for ischemia, besides PMNs that stay in association with the vasculature, after ICH, we found abundance of intraparenchymal PMNs (with no obvious association with vessels) in the ICH core and hematoma border, especially between 1 and 7 days after the ictus. Interestingly, the increased presence of intraparenchymal PMNs after ICH coincided with the massive loss of microvascular integrity, suggesting vascular disruption as a potential cause of PMNs presence in the brain parenchyma. Our study indicates that in contrast to ischemic stroke, after ICH, PMNs target not only vascular compartment but also brain parenchyma in the affected brain. As such, it is possible that the pathogenic role and therapeutic implications of targeting PMNs after ICH could be different from these after ischemic stroke. Our work suggests the needs for more studies addressing the role of PMNs in ICH.

  8. Dual-energy CT of the brain: Comparison between DECT angiography-derived virtual unenhanced images and true unenhanced images in the detection of intracranial haemorrhage.

    Science.gov (United States)

    Bonatti, Matteo; Lombardo, Fabio; Zamboni, Giulia A; Pernter, Patrizia; Pozzi Mucelli, Roberto; Bonatti, Giampietro

    2017-07-01

    To evaluate the diagnostic performance of virtual non-contrast (VNC) images in detecting intracranial haemorrhages (ICHs). Sixty-seven consecutive patients with and 67 without ICH who underwent unenhanced brain CT and DECT angiography were included. Two radiologists independently evaluated VNC and true non-contrast (TNC) images for ICH presence and type. Inter-observer agreement for VNC and TNC image evaluation was calculated. Sensitivity and specificity of VNC images for ICH detection were calculated using Fisher's exact test. VNC and TNC images were compared for ICH extent (qualitatively and quantitatively) and conspicuity assessment. On TNC images 116 different haemorrhages were detected in 67 patients. Inter-observer agreement ranged from 0.98-1.00 for TNC images and from 0.86-1.00 for VNC images. VNC sensitivity ranged from 0.90-1, according to the different ICH types, and specificity from 0.97-1. Qualitatively, ICH extent was underestimated on VNC images in 11.9% of cases. Haemorrhage volume did not show statistically significant differences between VNC and TNC images. Mean haemorrhage conspicuity was significantly lower on VNC images than on TNC images for both readers (p < 0.001). VNC images are accurate for ICH detection. Haemorrhages are less conspicuous on VNC images and their extent may be underestimated. • VNC images represent a reproducible tool for detecting ICH. • ICH can be identified on VNC images with high sensitivity and specificity. • Intracranial haemorrhages are less conspicuous on VNC images than on TNC images. • Intracranial haemorrhages extent may be underestimated on VNC images.

  9. Statins and risk of poststroke hemorrhagic complications

    Science.gov (United States)

    MacIsaac, Rachael L.; Abdul-Rahim, Azmil H.; Siegerink, Bob; Bath, Philip M.; Endres, Matthias; Lees, Kennedy R.; Nolte, Christian H.

    2016-01-01

    Objective: To assess whether statin treatment before or after acute ischemic stroke (AIS) affects the risk of acute intracerebral hemorrhage (ICH), postacute ICH, and mortality within 90 days. Methods: Data were sought from the Virtual International Stroke Trials Archive, an international repository of clinical trials data. Using propensity score matching, we retrospectively compared patients with prior statin treatment and newly initiated statin within 3 days after AIS to patients without statin exposure. Outcomes of interest were acute symptomatic ICH (sICH), any acute ICH, postacute ICH, and mortality during follow-up of 3 months. Results: A total of 8,535 patients (mean age 70 years, 54% male, median baseline NIH Stroke Scale score 13) were analyzed. After propensity score matching, prior statin use was not strongly associated with sICH (adjusted odds ratio [OR] 1.33, 95% confidence interval [CI] 0.83–2.14) or any ICH (adjusted OR 1.35, 95% CI 0.92–1.98). There was no evidence of an interaction between prior statin use and thrombolysis. New initiation of statins was not associated with postacute ICH (adjusted hazard ratio [HR] 1.60, 95% CI 0.70–3.65). There was a signal towards lower 90-day mortality in patients with prior statin use (adjusted HR 0.84, 95% CI 0.70–1.00) and especially early initiation of statins (adjusted HR 0.67, 95% CI 0.46–0.97). Conclusions: Statin use prior to AIS was not associated with early hemorrhagic complications, irrespective of treatment with thrombolysis. New initiation of statin treatment early after AIS did not affect risk of postacute ICH, but might be associated with reduced mortality. PMID:27016519

  10. Motor skills training promotes motor functional recovery and induces synaptogenesis in the motor cortex and striatum after intracerebral hemorrhage in rats.

    Science.gov (United States)

    Tamakoshi, Keigo; Ishida, Akimasa; Takamatsu, Yasuyuki; Hamakawa, Michiru; Nakashima, Hiroki; Shimada, Haruka; Ishida, Kazuto

    2014-03-01

    We investigated the effects of motor skills training on several types of motor function and synaptic plasticity following intracerebral hemorrhage (ICH) in rats. Male Wistar rats were injected with collagenase into the left striatum to induce ICH, and they were randomly assigned to the ICH or sham groups. Each group was divided into the motor skills training (acrobatic training) and control (no exercise) groups. The acrobatic group performed acrobatic training from 4 to 28 days after surgery. Motor functions were assessed by motor deficit score, the horizontal ladder test and the wide or narrow beam walking test at several time points after ICH. The number of ΔFosB-positive cells was counted using immunohistochemistry to examine neuronal activation, and the PSD95 protein levels were analyzed by Western blotting to examine synaptic plasticity in the bilateral sensorimotor cortices and striata at 14 and 29 days after ICH. Motor skills training following ICH significantly improved gross motor function in the early phase after ICH and skilled motor coordinated function in the late phase. The number of ΔFosB-positive cells in the contralateral sensorimotor cortex in the acrobatic group significantly increased compared to the control group. PSD95 protein expression in the motor cortex significantly increased in the late phase, and in the striatum, the protein level significantly increased in the early phase by motor skills training after ICH compared to no training after ICH. We demonstrated that motor skills training improved motor function after ICH in rats and enhanced the neural activity and synaptic plasticity in the striatum and sensorimotor cortex. Copyright © 2013 Elsevier B.V. All rights reserved.

  11. Motor Skills Training Enhances α-Amino-3-hydroxy-5-methyl-4-isoxazolepropionic Acid Receptor Subunit mRNA Expression in the Ipsilateral Sensorimotor Cortex and Striatum of Rats Following Intracerebral Hemorrhage.

    Science.gov (United States)

    Tamakoshi, Keigo; Ishida, Kazuto; Kawanaka, Kentaro; Takamatsu, Yasuyuki; Tamaki, Hiroyuki

    2017-10-01

    We investigated the effects of acrobatic training (AT) on expression of α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptor (AMPAR) subunits in the sensorimotor cortex and striatum after intracerebral hemorrhage (ICH). Male Wistar rats were divided into 4 groups: ICH without AT (ICH), ICH with AT (ICH + AT), sham operation without AT (SHAM), and sham operation with AT (SHAM + AT). ICH was induced by collagenase injection into the left striatum. The ICH + AT group performed 5 acrobatic tasks daily on days 4-28 post ICH. Forelimb sensorimotor function was evaluated using the forelimb placing test. On days 14 and 29, mRNA expression levels of AMPAR subunits GluR1-4 were measured by real-time reverse transcription-polymerase chain reaction. Forelimb placing test scores were significantly higher in the ICH + AT group than in the ICH group. Expression levels of all AMPAR subunit mRNAs were significantly higher in the ipsilateral sensorimotor cortex of rats in the ICH + AT group than in that of rats in the ICH group on day 29. GluR3 and GluR4 expression levels were reduced in the ipsilateral striatum of rats in the ICH group compared with that of rats in the SHAM group on day 14. These changes may play a critical role in motor skills training-induced recovery after ICH. Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  12. Turystyka kontrowersyjna jako emanacja gospodarki doświadczeń

    OpenAIRE

    Stasiak, Andrzej

    2015-01-01

    Turystyka XXI wieku staje się coraz bardziej skomplikowanym, złożonym i trudnym do jednoznacznej oceny zjawiskiem. Najważniejszymi obszarami kontrowersji są: zachowania turystów, miejsca wypoczynku, formy turystyki, produkty turystyczne i skutki, jakie turystyka wywołuje. Pojawiające się wątpliwości mogą mieć przy tym charakter: prawny, etyczno-moralny, kulturowy, estetyczny, zdrowotny, ekonomiczny, ekologiczny. W artykule omówiono najnowsze kontrowersyjne formy turystyki, m.in. turystykę abo...

  13. Parapsihologija u svjetlu znanosti i teologije (I)

    OpenAIRE

    Kusić, Ante

    1982-01-01

    In dem Aufsatz wird von den pärapsychologischen Phänomenen gesprochen, insoweit solche Phänomene bis heute wissenschaftlich bzw. empirisch festgestellt sind. Der Verfasser erklärt die paranormalen Phänomene, die durch keine ausgeprägt religiöse Merkmale bezeichnet sind (Astnal-Exkursion, Hellsehen, Präkognition, Psychometrie, Telepathie, paranormale Heilung, Materialisationserscheinungen usw.), dann spricht er von den paranormalen Phânomënen, die durch einige mehr religiöse Merkmale charakter...

  14. Działalność gospodarcza pośredników ubezpieczeniowych. Studium publicznoprawne

    OpenAIRE

    Szaraniec, Monika

    2017-01-01

    Prezentowana monografia stanowi całościowe opracowanie problematyki publicznoprawnych aspektów podejmowania i wykonywania działalności gospodarczej przez pośredników ubezpieczeniowych. Na aktualny charakter tematyki będącej przedmiotem monografii wskazuje rozpoczęty proces implementacji do polskiego systemu prawnego dyrektywy Parlamentu Europejskiego i Rady (UE) 2016/97 z 20 stycznia 2016 r. w sprawie dystrybucji ubezpieczeń (IDD). Poglądy wyrażone w monografii zawierają istotne propozycje do...

  15. Perswazyjność komunikatów reklamowych w Internecie na podstawie analizy usług finansowych SKOK-ów

    OpenAIRE

    Idzik, Beata

    2014-01-01

    Praca jest wynikiem kilkuletnich obserwacji praktycznej strony funkcjonowania reklamy w zakresie usług finansowych. Autorka starała się oddać wyraz swojemu zainteresowaniu psychologią konsumenta, marketingiem w sektorze finansowym a także fascynacji możliwościom, jakie stwarzają w tym zakresie nowe technologie oparte na Internecie. Praca ma charakter teoretyczno - badawczy. W założeniach metodologicznych sformułowano problem badawczy, cele oraz cztery hipotezy badawcze, które poddano wery...

  16. Die Bedeutung von Musiker- und Komponistenbriefe für die regionale und europäische Kulturgeschichte

    Directory of Open Access Journals (Sweden)

    Buschmeier Gabriele

    2002-01-01

    Full Text Available (nemački Die Entwicklung der Musikkultur insbesondere in Mittel- und Osteuropa ist von einem äußerst regen Austausch und lebendigen Beziehungen gekennzeichnet. Die Dokumente dieser Beziehungen sind zum Teil die erhaltene Briefe. Für den Musikwissenschaftler sind dabei alle Arten von Briefen sowohl privaten als auch geschäftlichen Charakters, von Interesse und zwar nicht nur Briefe von den sogenannten "Heroen" der Musikgeschichte, sondern insbesondere auch von nur lokal bekannten Musikern oder Menschen, die sich mit Musik beschäftigen.

  17. Student und Wissenschaft: soziale Faktoren des wissenschaftlichen Engagements der Studenten ; spezieller Bericht "Student 79"

    OpenAIRE

    Lange, Günter

    1982-01-01

    Die Ausgangsfragestellung, wie soziale Beziehungen im Studienprozeß das wissenschaftliche Engagement der Studenten beeinflussen, wird aufgrund vorliegenden empirischen Materials (der Autor stützt sich primär auf die Ergebnisse der Untersuchung STUDENT 79) auf die Analyse des Verhältnisses der Studenten zu den Lehrkräften eingegrenzt. Der Verfasser äußert sich zur Gültigkeit seiner Aussagen: "Der Bericht trägt den Charakter einer Zusammenfassung vorläufiger Ergebnisse zum Problem und bedarf ti...

  18. Dietoterapia doustna u pacjentów z anoreksją

    OpenAIRE

    Agata Dutkiewicz; Teresa Grzelak

    2016-01-01

    Anorexia nervosa jest polietiologicznym specyficznym zaburzeniem odżywiania, którego objawy i powikłania mają charakter psychologiczny, społeczny i somatyczny. W leczeniu, obok psychoterapii i ewentualnej farmakoterapii, ważną rolę odgrywa prowadzona równolegle terapia żywieniowa. Zdaniem autorytetów w dziedzinie leczenia zaburzeń odżywiania w skład interdyscyplinarnego zespołu terapeutycznego powinien wchodzić wykwalifikowany dietetyk, odpowiedzialny za zaplanowanie, przeprowadzenie i kon...

  19. Genetic variations of MMP9 gene and intracerebral hemorrhage susceptibility: a case-control study in Chinese Han population.

    Science.gov (United States)

    Yang, Jie; Wu, Bo; Lin, Sen; Zhou, Junshan; Li, Yingbin; Dong, Wei; Arima, Hisatomi; Zhang, Chanfei; Liu, Yukai; Liu, Ming

    2014-06-15

    To investigate the association between genetic variations of matrix metalloproteinase 9 (MMP9) gene and intracerebral hemorrhage (ICH) susceptibility in Chinese Han population. The clinical data and peripheral blood samples from the patients with ICH and hypertension, and controlled subjects with hypertension only, were collected. MassARRAY Analyzer was used to genotype the tagger single nucleotide polymorphism (SNP) of MMP9 gene. Haploview4.2 and Unphased3.1.7 were employed to construct haplotypes and to analyze the association between genetic variations (alleles, genotypes and haplotypes) of MMP9 gene and ICH susceptibility. 181 patients with ICH and hypertension, and 197 patients with hypertension only, were recruited between Sep 2009 and Oct 2010. Patients in the ICH group were younger (61.80 ± 13.27 vs. 72.44 ± 12.71 years, ppopulation. Our logistical regression analysis showed that there were no significant associations between genetic variations of the MPP9 gene and ICH susceptibility (all p>0.05). The genetic variations of MMP9 gene were not significantly associated with ICH susceptibility in the Chinese Han population. Copyright © 2014 Elsevier B.V. All rights reserved.

  20. Does the Short-Term Effect of Air Pollution Influence the Incidence of Spontaneous Intracerebral Hemorrhage in Different Patient Groups? Big Data Analysis in Taiwan.

    Science.gov (United States)

    Chien, Ting-Ying; Ting, Hsien-Wei; Chan, Chien-Lung; Yang, Nan-Ping; Pan, Ren-Hao; Lai, K Robert; Hung, Su-In

    2017-12-10

    Spontaneous intracerebral hemorrhage (sICH) has a high mortality rate. Research has demonstrated that the occurrence of sICH is related to air pollution. This study used big data analysis to explore the impact of air pollution on the risk of sICH in patients of differing age and geographic location. 39,053 cases were included in this study; 14,041 in the Taipei region (Taipei City and New Taipei City), 5537 in Taoyuan City, 7654 in Taichung City, 4739 in Tainan City, and 7082 in Kaohsiung City. The results of correlation analysis indicated that there were two pollutants groups, the CO and NO₂ group and the PM 2.5 and PM 10 group. Furthermore, variations in the correlations of sICH with air pollutants were identified in different age groups. The co-factors of the influence of air pollutants in the different age groups were explored using regression analysis. This study integrated Taiwan National Health Insurance data and air pollution data to explore the risk factors of sICH using big data analytics. We found that PM 2.5 and PM 10 are very important risk factors for sICH, and age is an important modulating factor that allows air pollutants to influence the incidence of sICH.

  1. Does the Short-Term Effect of Air Pollution Influence the Incidence of Spontaneous Intracerebral Hemorrhage in Different Patient Groups? Big Data Analysis in Taiwan

    Science.gov (United States)

    Chien, Ting-Ying; Ting, Hsien-Wei; Chan, Chien-Lung; Lai, K. Robert; Hung, Su-In

    2017-01-01

    Spontaneous intracerebral hemorrhage (sICH) has a high mortality rate. Research has demonstrated that the occurrence of sICH is related to air pollution. This study used big data analysis to explore the impact of air pollution on the risk of sICH in patients of differing age and geographic location. 39,053 cases were included in this study; 14,041 in the Taipei region (Taipei City and New Taipei City), 5537 in Taoyuan City, 7654 in Taichung City, 4739 in Tainan City, and 7082 in Kaohsiung City. The results of correlation analysis indicated that there were two pollutants groups, the CO and NO2 group and the PM2.5 and PM10 group. Furthermore, variations in the correlations of sICH with air pollutants were identified in different age groups. The co-factors of the influence of air pollutants in the different age groups were explored using regression analysis. This study integrated Taiwan National Health Insurance data and air pollution data to explore the risk factors of sICH using big data analytics. We found that PM2.5 and PM10 are very important risk factors for sICH, and age is an important modulating factor that allows air pollutants to influence the incidence of sICH. PMID:29232865

  2. Thirty-day readmission after spontaneous intracerebral hemorrhage.

    Science.gov (United States)

    Bjerkreim, Anna Therese; Khanevski, Andrej Netland; Glad, Solveig Bergliot; Thomassen, Lars; Naess, Halvor; Logallo, Nicola

    2018-03-01

    Intracerebral hemorrhage (ICH) is the most severe form of stroke, but data on readmission after ICH are sparse. We aimed to determine frequency, causes, and predictors of 30-day readmission after ICH. This retrospective cohort study includes all spontaneous ICH survivors admitted to the stroke unit at Haukeland University Hospital in Bergen in Norway from July 2007 to December 2013. Patients were followed by review of electronic medical charts, and the first unplanned readmission within 30 days after discharge was used as final outcome. Cox regression analysis was performed to identify predictors of 30-day readmission. We identified 226 patients with spontaneous ICH, 70 (31.0%) of whom died before discharge or were discharged to palliative care. Of the remaining 156 ICH survivors, 28 (18.0%) were readmitted within 30 days. Median time to readmission was 12 days (IQR 4.5 - 18.5). Most patients were readmitted due to infections ( N  = 13). None of the patients were readmitted with recurrent stroke. Pneumonia and enteral feeding during the index hospitalization were associated with readmission for infections (both p  readmission (HR 1.06, 95% CI 1.02 - 1.11, p  =   .006). Almost one in five of our spontaneous ICH survivors was readmitted within 30 days, and most readmissions were caused by infections.

  3. The critical care management of spontaneous intracranial hemorrhage: a contemporary review.

    Science.gov (United States)

    de Oliveira Manoel, Airton Leonardo; Goffi, Alberto; Zampieri, Fernando Godinho; Turkel-Parrella, David; Duggal, Abhijit; Marotta, Thomas R; Macdonald, R Loch; Abrahamson, Simon

    2016-09-18

    Spontaneous intracerebral hemorrhage (ICH), defined as nontraumatic bleeding into the brain parenchyma, is the second most common subtype of stroke, with 5.3 million cases and over 3 million deaths reported worldwide in 2010. Case fatality is extremely high (reaching approximately 60 % at 1 year post event). Only 20 % of patients who survive are independent within 6 months. Factors such as chronic hypertension, cerebral amyloid angiopathy, and anticoagulation are commonly associated with ICH. Chronic arterial hypertension represents the major risk factor for bleeding. The incidence of hypertension-related ICH is decreasing in some regions due to improvements in the treatment of chronic hypertension. Anticoagulant-related ICH (vitamin K antagonists and the newer oral anticoagulant drugs) represents an increasing cause of ICH, currently accounting for more than 15 % of all cases. Although questions regarding the optimal medical and surgical management of ICH still remain, recent clinical trials examining hemostatic therapy, blood pressure control, and hematoma evacuation have advanced our understanding of ICH management. Timely and aggressive management in the acute phase may mitigate secondary brain injury. The initial management should include: initial medical stabilization; rapid, accurate neuroimaging to establish the diagnosis and elucidate an etiology; standardized neurologic assessment to determine baseline severity; prevention of hematoma expansion (blood pressure management and reversal of coagulopathy); consideration of early surgical intervention; and prevention of secondary brain injury. This review aims to provide a clinical approach for the practicing clinician.

  4. Stem Cell Therapy: A Promising Therapeutic Method for Intracerebral Hemorrhage.

    Science.gov (United States)

    Gao, Liansheng; Xu, Weilin; Li, Tao; Chen, Jingyin; Shao, Anwen; Yan, Feng; Chen, Gao

    2018-01-01

    Spontaneous intracerebral hemorrhage (ICH) is one type of the most devastating cerebrovascular diseases worldwide, which causes high morbidity and mortality. However, efficient treatment is still lacking. Stem cell therapy has shown good neuroprotective and neurorestorative effect in ICH and is a promising treatment. In this study, our aim was to review the therapeutic effects, strategies, related mechanisms and safety issues of various types of stem cell for ICH treatment. Numerous studies had demonstrated the therapeutic effects of diverse stem cell types in ICH. The potential mechanisms include tissue repair and replacement, neurotrophy, promotion of neurogenesis and angiogenesis, anti-apoptosis, immunoregulation and anti-inflammation and so forth. The microenvironment of the central nervous system (CNS) can also influence the effects of stem cell therapy. The detailed therapeutic strategies for ICH treatment such as cell type, the number of cells, time window, and the routes of medication delivery, varied greatly among different studies and had not been determined. Moreover, the safety issues of stem cell therapy for ICH should not be ignored. Stem cell therapy showed good therapeutic effect in ICH, making it a promising treatment. However, safety should be carefully evaluated, and more clinical trials are required before stem cell therapy can be extensively applied to clinical use.

  5. Prior Cannabis Use Is Associated with Outcome after Intracerebral Hemorrhage.

    Science.gov (United States)

    Di Napoli, Mario; Zha, Alicia M; Godoy, Daniel A; Masotti, Luca; Schreuder, Floris H B M; Popa-Wagner, Aurel; Behrouz, Réza

    2016-01-01

    Recent evidence suggests that a potential harmful relationship exists between cannabis use and ischemic stroke. The purpose of this study was to determine the implications of cannabis use in intracerebral hemorrhage (ICH) patients. An analysis of an international, multicenter, observational database of consecutive patients with spontaneous ICH was conducted. We extracted the following characteristics on presentation: demographics, risk factors, antiplatelet or anticoagulant use, Glasgow Coma Scale, ICH score, neuroimaging parameters, and urine toxicology screen (UTS) results. Modified Rankin Scale (mRS) score was utilized for determination of outcome at discharge. Adjusted logistic ordinal regression was used as shift analysis to assess the impact of cannabis use on mRS score at discharge. The adjusted common OR measured the likelihood that cannabis use would lead to lower mRS scores. Within a cohort of 725 spontaneous ICH patients, UTS was positive for cannabinoids in 8.6%. Cannabinoids-positive (CB+) patients were more frequently Caucasian (p cannabis use was discovered in nearly 10% of patients with spontaneous ICH. Although there was no relationship between cannabis use and specific ICH characteristics, CB+ patients had milder ICH presentation and less disability at discharge. © 2016 S. Karger AG, Basel.

  6. Spontaneous Intracerebral Hemorrhage Image Analysis Methods: A Survey

    Science.gov (United States)

    Pérez, Noel; Valdés, Jose; Guevara, Miguel; Silva, Augusto

    Spontaneous intracerebral hemorrhages (ICH) account for 10-30% of all strokes and are a result of acute bleeding into the brain due to ruptures of small penetrating arteries. Despite major advancements in the management of ischemic strokes and other causes of hemorrhagic strokes, such as ruptured aneurysm, arteriovenous malformations (AVMs), or cavernous angioma, during the past several decades, limited progress has been made in the treatment of ICH, and the prognosis for patients who suffer them remains poor. The societal impact of these hemorrhagic strokes is magnified by the fact that affected patients typically are a decade younger than those afflicted with ischemic strokes. The ICH continues to kill or disable most of their victims. Some studies show that those who suffer ICH have a 30-day mortality rate of 35-44% and a 6-month mortality rate approaching 50%. Approximately 700,000 new strokes occur in the United States annually and approximately 15% are hem-orrhagic strokes related to ICH. The poor outcome associated with ICH is related to the extent of brain damage. ICH produces direct destruction and compression of surrounding brain tissue. Direct compression causes poor perfusion and venous drainage to surrounding penumbra at risk, resulting in ischemia to the tissues that most need perfusion [16].

  7. Necrostatin-1 Reduces Neurovascular Injury after Intracerebral Hemorrhage

    Directory of Open Access Journals (Sweden)

    Melanie D. King

    2014-01-01

    Full Text Available Intracerebral hemorrhage (ICH is the most common form of hemorrhagic stroke, accounting for 15% of all strokes. ICH has the highest acute mortality and the worst long-term prognosis of all stroke subtypes. Unfortunately, the dearth of clinically effective treatment options makes ICH the least treatable form of stroke, emphasizing the need for novel therapeutic targets. Recent work by our laboratory identified a novel role for the necroptosis inhibitor, necrostatin-1, in limiting neurovascular injury in tissue culture models of hemorrhagic injury. In the present study, we tested the hypothesis that necrostatin-1 reduces neurovascular injury after collagenase-induced ICH in mice. Necrostatin-1 significantly reduced hematoma volume by 54% at 72 h after-ICH, as compared to either sham-injured mice or mice administered an inactive, structural analogue of necrostatin-1. Necrostatin-1 also limited cell death by 48%, reduced blood-brain barrier opening by 51%, attenuated edema development to sham levels, and improved neurobehavioral outcomes after ICH. These data suggest a potential clinical utility for necrostatin-1 and/or novel necroptosis inhibitors as an adjunct therapy to reduce neurological injury and improve patient outcomes after ICH.

  8. Intensive Blood Pressure Reduction and Spot Sign in Intracerebral Hemorrhage: A Secondary Analysis of a Randomized Clinical Trial.

    Science.gov (United States)

    Morotti, Andrea; Brouwers, H Bart; Romero, Javier M; Jessel, Michael J; Vashkevich, Anastasia; Schwab, Kristin; Afzal, Mohammad Rauf; Cassarly, Christy; Greenberg, Steven M; Martin, Renee Hebert; Qureshi, Adnan I; Rosand, Jonathan; Goldstein, Joshua N

    2017-08-01

    The computed tomographic angiography (CTA) spot sign is associated with intracerebral hemorrhage (ICH) expansion and may mark those patients most likely to benefit from intensive blood pressure (BP) reduction. To investigate whether the spot sign is associated with ICH expansion across a wide range of centers and whether intensive BP reduction decreases hematoma expansion and improves outcome in patients with ICH and a spot sign. SCORE-IT (Spot Sign Score in Restricting ICH Growth) is a preplanned prospective observational study nested in the Antihypertensive Treatment of Acute Cerebral Hemorrhage II (ATACH-II) randomized clinical trial. Participants included consecutive patients with primary ICH who underwent a CTA within 8 hours from onset at 59 sites from May 15, 2011, through December 19, 2015. Data were analyzed for the present study from July 1 to August 31, 2016. Patients in ATACH-II were randomized to intensive (systolic BP target, spot sign, and 24 of 123 without missing data (19.5%) experienced ICH expansion. The spot sign was associated with expansion with sensitivity of 0.54 (95% CI, 0.34-0.74) and specificity of 0.63 (95% CI, 0.53-0.72). After adjustment for potential confounders, intensive BP treatment was not associated with a significant reduction of ICH expansion (relative risk, 0.83; 95% CI, 0.27-2.51; P = .74) or improved outcome (relative risk of 90-day modified Rankin Scale score ≥4, 1.24; 95% CI, 0.53-2.91; P = .62) in spot sign-positive patients. The predictive performance of the spot sign for ICH expansion was lower than in prior reports from single-center studies. No evidence suggested that patients with ICH and a spot sign specifically benefit from intensive BP reduction. clinicaltrials.gov Identifier: NCT01176565.

  9. Characteristics of Symptomatic Intracranial Hemorrhage in Patients Receiving Non-Vitamin K Antagonist Oral Anticoagulant Therapy.

    Directory of Open Access Journals (Sweden)

    Hisanao Akiyama

    Full Text Available The first non-vitamin K antagonist oral anticoagulant (NOAC introduced to the market in Japan was dabigatran in March 2011, and three more NOACs, rivaroxaban, apixaban, and edoxaban, have since become available. Randomized controlled trials of NOACs have revealed that intracranial hemorrhage (ICH occurs less frequently with NOACs compared with warfarin. However, the absolute incidence of ICH associated with NOACs has increased with greater use of these anticoagulants, and we wanted to explore the incidence, clinical characteristics, and treatment course of patients with NOACs-associated ICH.We retrospectively analyzed the characteristics of symptomatic ICH patients receiving NOACs between March 2011 and September 2014.ICH occurred in 6 patients (5 men, 1 woman; mean ± SD age, 72.8 ± 3.2 years. Mean time to onset was 146.2 ± 111.5 days after starting NOACs. Five patients received rivaroxaban and 1 patient received apixaban. None received dabigatran or edoxaban. Notably, no hematoma expansion was observed within 24 h of onset in the absence of infusion of fresh frozen plasma, activated prothrombin complex concentrate, recombinant activated factor VIIa or hemodialysis. When NOAC therapy was initiated, mean HAS-BLED and PANWARDS scores were 1.5 ± 0.5 and 39.5 ± 7.7, respectively. Mean systolic blood pressure was 137.8 ± 15.9 mmHg within 1 month before spontaneous ICH onset.Six symptomatic ICHs occurred early in NOAC therapy but hematoma volume was small and did not expand in the absence of infusion of reversal agents or hemodialysis. The occurrence of ICH during NOAC therapy is possible even when there is acceptable mean systolic blood pressure control (137.8 ± 15.9 mmHg and HAS-BLED score ≤ 2. Even stricter blood pressure lowering and control within the acceptable range may be advisable to prevent ICH during NOAC therapy.

  10. Volume-Dependent Overestimation of Spontaneous Intracerebral Hematoma Volume by the ABC/2 Formula

    International Nuclear Information System (INIS)

    Chih-Wei Wang; Chun-Jung Juan; Hsian-He Hsu; Hua-Shan Liu; Cheng-Yu Chen; Chun-Jen Hsueh; Hung-Wen Kao; Guo-Shu Huang; Yi-Jui Liu; Chung-Ping Lo

    2009-01-01

    Background: Although the ABC/2 formula has been widely used to estimate the volume of intracerebral hematoma (ICH), the formula tends to overestimate hematoma volume. The volume-related imprecision of the ABC/2 formula has not been documented quantitatively. Purpose: To investigate the volume-dependent overestimation of the ABC/2 formula by comparing it with computer-assisted volumetric analysis (CAVA). Material and Methods: Forty patients who had suffered spontaneous ICH and who had undergone non-enhanced brain computed tomography scans were enrolled in this study. The ICH volume was estimated based on the ABC/2 formula and also calculated by CAVA. Based on the ICH volume calculated by the CAVA method, the patients were divided into three groups: group 1 consisted of 17 patients with an ICH volume of less than 20 ml; group 2 comprised 13 patients with an ICH volume of 20 to 40 ml; and group 3 was composed of 10 patients with an ICH volume larger than 40 ml. Results: The mean estimated hematoma volume was 43.6 ml when using the ABC/2 formula, compared with 33.8 ml when using the CAVA method. The mean estimated difference was 1.3 ml, 4.4 ml, and 31.4 ml for groups 1, 2, and 3, respectively, corresponding to an estimation error of 9.9%, 16.7%, and 37.1% by the ABC/2 formula (P<0.05). Conclusion: The ABC/2 formula significantly overestimates the volume of ICH. A positive association between the estimation error and the volume of ICH is demonstrated

  11. The effect of monascin on hematoma clearance and edema after intracerebral hemorrhage in rats.

    Science.gov (United States)

    Wang, Juan; Wang, Gaiqing; Yi, Jinying; Xu, Yi; Duan, Shuna; Li, Tong; Sun, Xin-Gang; Dong, Liang

    2017-09-01

    Intracerebral hemorrhage (ICH) is a particularly devastating form of stroke with high mortality and morbidity. Hematomas are the primary cause of neurologic deficits associated with ICH. The products of hematoma are recognized as neurotoxins and the main contributors to edema formation and tissue damage after ICH. Finding a means to efficiently promote absorption of hematoma is a novel clinical challenge for ICH. Peroxisome proliferator-activated receptor gamma (PPARγ) and nuclear factor erythroid 2-related factor 2 (Nrf2), had been shown that, can take potential roles in the endogenous hematoma clearance. However, monascin, a novel natural Nrf2 activator with PPARγ agonist, has not been reported to play a role in ICH. This study was designed to evaluate the effect of monascin on neurological deficits, hematoma clearance and edema extinction in a model of ICH in rats. 164 adult male Sprague-Dawley (SD) rats were randomly divided into sham; vehicle; monascin groups with low dosages (1mg/kg/day), middle dosages (5mg/kg/day) and high dosages (10mg/kg/day) respectively. Animals were euthanized at 1, 3 and 7days following neurological evaluation after surgery. We examined the effect of monascin on the brain water contents, blood brain barrier (BBB) permeability and hemoglobin levels, meanwhile reassessed the volume of hematoma and edema around the hematoma by Magnetic Resonance Imaging (MRI) in each group. The high dosage of monascin significantly improved neurological deficits, reduced the volume of hematoma in 1-7days after ICH, decreased BBB permeability and edema formation in 1-3days following ICH. Our study demonstrated that the high dosage of monascin played a neuroprotective role in ICH through reducing BBB permeability, edema and hematoma volume. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. The Cushing Reflex: Oliguria as a Reflection of an Elevated Intracranial Pressure

    Directory of Open Access Journals (Sweden)

    K. Leyssens

    2017-01-01

    Full Text Available Oliguria is one of the clinical hallmarks of renal failure. The broad differential diagnosis is well known, but a rare cause of oliguria is intracranial hypertension (ICH. The actual knowledge to explain this relationship is scarce. Almost all literature is about animals where authors describe the Cushing reflex in response to ICH. We hypothesize that the Cushing reflex is translated towards the sympathetic nervous system and renin-angiotensin-aldosterone system with a subsequent reduction in medullary blood flow and oliguria. Recently, we were confronted with a patient who had complicated pituitary surgery and displayed multiple times an oliguria while he developed ICH.

  13. Richard Wollheim über die Metapher in der Malerei

    OpenAIRE

    Heinrich, Richard

    1993-01-01

    Es handelt sich um den Text eines Vortrages, den ich Jänner 1993 im Rahmen einer Vortragsreihe am Institut für Kunstgeschichte der Universität Wien gehalten habe. Er ist bisher unpubliziert und nicht redigiert. Das worüber ich spreche ist ein Artikel von Richard Wollheim mit dem Titel "Die Metapher in der Malerei". Diesen Artikel habe ich herausgegeben, gemeinsam mit meinem Kollegen Helmuth Vetter, 1991 in dem Band "Bilder der Philosophie". Ursprünglich handelt es sich um einen Vortrag, d...

  14. Multimediale Kommunikationsarchitekturen: Herausforderungen und Weiterentwicklungen der Forschungen im Kulturraum Internet

    Directory of Open Access Journals (Sweden)

    Winfried Marotzki

    2008-04-01

    Full Text Available Im Folgenden setze ich mich mit der Frage auseinander, wie der sich rasch verändernde kulturelle Raum Internet forschungsmässig zu erschliessen ist. Dabei möchte ich weniger den aktuellen Stand der Internet Forschung bilanzieren, das ist durch verschiedene einschlägige Publikationen bereits geschehen. Vielmehr werde ich mich darauf konzentrieren, die Hauptveränderungen des Internet in den letzten Jahren zu skizzieren, um daran anknüpfend einige ausgewählte methodische Probleme, die damit verbunden sind, zu bearbeiten.

  15. Clinical course of untreated cerebral cavernous malformations: a meta-analysis of individual patient data.

    Science.gov (United States)

    Horne, Margaret A; Flemming, Kelly D; Su, I-Chang; Stapf, Christian; Jeon, Jin Pyeong; Li, Da; Maxwell, Susanne S; White, Philip; Christianson, Teresa J; Agid, Ronit; Cho, Won-Sang; Oh, Chang Wan; Wu, Zhen; Zhang, Jun-Ting; Kim, Jeong Eun; Ter Brugge, Karel; Willinsky, Robert; Brown, Robert D; Murray, Gordon D; Al-Shahi Salman, Rustam

    2016-02-01

    Cerebral cavernous malformations (CCMs) can cause symptomatic intracranial haemorrhage (ICH), but the estimated risks are imprecise and predictors remain uncertain. We aimed to obtain precise estimates and predictors of the risk of ICH during untreated follow-up in an individual patient data meta-analysis. We invited investigators of published cohorts of people aged at least 16 years, identified by a systematic review of Ovid MEDLINE and Embase from inception to April 30, 2015, to provide individual patient data on clinical course from CCM diagnosis until first CCM treatment or last available follow-up. We used survival analysis to estimate the 5-year risk of symptomatic ICH due to CCMs (primary outcome), multivariable Cox regression to identify baseline predictors of outcome, and random-effects models to pool estimates in a meta-analysis. Among 1620 people in seven cohorts from six studies, 204 experienced ICH during 5197 person-years of follow-up (Kaplan-Meier estimated 5-year risk 15·8%, 95% CI 13·7-17·9). The primary outcome of ICH within 5 years of CCM diagnosis was associated with clinical presentation with ICH or new focal neurological deficit (FND) without brain imaging evidence of recent haemorrhage versus other modes of presentation (hazard ratio 5·6, 95% CI 3·2-9·7) and with brainstem CCM location versus other locations (4·4, 2·3-8·6), but age, sex, and CCM multiplicity did not add independent prognostic information. The 5-year estimated risk of ICH during untreated follow-up was 3·8% (95% CI 2·1-5·5) for 718 people with non-brainstem CCM presenting without ICH or FND, 8·0% (0·1-15·9) for 80 people with brainstem CCM presenting without ICH or FND, 18·4% (13·3-23·5) for 327 people with non-brainstem CCM presenting with ICH or FND, and 30·8% (26·3-35·2) for 495 people with brainstem CCM presenting with ICH or FND. Mode of clinical presentation and CCM location are independently associated with ICH within 5 years of CCM diagnosis. These

  16. Left atrial appendage occlusion versus standard medical care in patients with atrial fibrillation and intracerebral hemorrhage

    DEFF Research Database (Denmark)

    Nielsen-Kudsk, Jens Erik; Johnsen, Søren Paaske; Wester, Per

    2017-01-01

    -VASc and HAS-BLED scores). The standard care patients were identified from the Danish Stroke Registry among 787 patients with AF and ICH. The primary endpoint was a composite of all-cause mortality, ischaemic stroke and major bleeding. Patients with AF and a prior ICH treated with LAAO had a lower risk...... countries with AF and previous ICH who underwent LAAO using the AMPLATZER Cardiac Plug or the AMPLATZER AMULET were compared to a propensity score-matched group of 151 patients receiving standard medical therapy. The two groups were matched so that their risks for stroke and bleeding were similar (CHA2DS2...

  17. Judaica et Aegyptiaca : de Maccabaeorum libro III quaestiones historicae

    NARCIS (Netherlands)

    Cohen, Jakob

    1941-01-01

    Disputans de libro, quem composuerat H. Willrich, inscripto "Judaica, Forschungen zur hellenistisch-jiidischen Geschichte und Litteratur", 1900, dixit P. Wendland (Berl. Philol. Wochenschrift anni 1900, p. 1197 seqq.) : "Ich unterschreibe Willrichs Urteil, dasz die Geschichte des hellenistischen

  18. 76 FR 37129 - International Conference on Harmonisation; Guidance on Q4B Evaluation and Recommendation of...

    Science.gov (United States)

    2011-06-24

    ... sponsors are the European Commission; the European Federation of Pharmaceutical Industries Associations... Pharmaceutical Research and Manufacturers of America. The ICH Secretariat, which coordinates the preparation of... recent years, many important initiatives have been undertaken by regulatory authorities and industry...

  19. 76 FR 49773 - International Conference on Harmonisation; Guidance on E16 Biomarkers Related to Drug or...

    Science.gov (United States)

    2011-08-11

    ... sponsors are the European Commission; the European Federation of Pharmaceutical Industries Associations... Pharmaceutical Research and Manufacturers of America. The ICH Secretariat, which coordinates the preparation of..., many important initiatives have been undertaken by regulatory authorities and industry associations to...

  20. 75 FR 53973 - International Conference on Harmonisation; Guidance on Q4B Evaluation and Recommendation of...

    Science.gov (United States)

    2010-09-02

    ... Pharmaceutical Industries Associations; the Japanese Ministry of Health, Labour, and Welfare; the Japanese... and Research, FDA; and the Pharmaceutical Research and Manufacturers of America. The ICH Secretariat... regulatory authorities and industry associations to promote international harmonization of regulatory...

  1. 75 FR 54153 - International Conference on Harmonisation; Guidance on Q4B Evaluation and Recommendation of...

    Science.gov (United States)

    2010-09-03

    ... Pharmaceutical Industries Associations; the Japanese Ministry of Health, Labour, and Welfare; the Japanese... and Research, FDA; and the Pharmaceutical Research and Manufacturers of America. The ICH Secretariat... regulatory authorities and industry associations to promote international harmonization of regulatory...

  2. 75 FR 17147 - International Conference on Harmonisation; Guidance on Q4B Evaluation and Recommendation of...

    Science.gov (United States)

    2010-04-05

    ... sponsors are the European Commission; the European Federation of Pharmaceutical Industries Associations... Pharmaceutical Research and Manufacturers of America. The ICH Secretariat, which coordinates the preparation of... recent years, many important initiatives have been undertaken by regulatory authorities and industry...

  3. 75 FR 18509 - International Conference on Harmonisation; Guidance on Q4B Evaluation and Recommendation of...

    Science.gov (United States)

    2010-04-12

    ... sponsors are the European Commission; the European Federation of Pharmaceutical Industries Associations... Pharmaceutical Research and Manufacturers of America. The ICH Secretariat, which coordinates the preparation of... recent years, many important initiatives have been undertaken by regulatory authorities and industry...

  4. 78 FR 31944 - International Conference on Harmonisation; Guidance on Q4B Evaluation and Recommendation of...

    Science.gov (United States)

    2013-05-28

    ... Commission; the European Federation of Pharmaceutical Industries Associations; the Japanese Ministry of...; and the Pharmaceutical Research and Manufacturers of America. The ICH Secretariat, which coordinates... initiatives have been undertaken by regulatory authorities and industry associations to promote international...

  5. 77 FR 29665 - International Conference on Harmonisation; Addendum to International Conference on Harmonisation...

    Science.gov (United States)

    2012-05-18

    ... three regions: The European Union, Japan, and the United States. The six ICH sponsors are the European... products derived from cell-culture systems such as bacteria, yeast, and eukaryotic cells, including...

  6. Mr. Robot: Schizophrenie, Paranoia und korporative Gier

    Directory of Open Access Journals (Sweden)

    jan jagodzinski

    2016-11-01

    Full Text Available Der vorliegende Beitrag untersucht die erste Staffel von Mr. Robot (2015 − aus Gilles Deleuzes symptomatologischer Position, die sich auf das Spannungsfeld zwischen ‹dem Klinischen und dem Kritischen› fokussiert. Zum Zeitpunkt des Verfassens dieses Artikels war nur die erste Staffel verfügbar. Im Folgenden zeige ich am Beispiel der Hauptfigur Elliot Anderson, inwiefern die Serie Einblicke in unsere ‹Kontrollgesellschaft› – auch eine Deleuzsche Entwicklung – gewähren kann. Zudem wird ein Vergleich mit dem Film «Kein System ist sicher», der ähnliche gesellschaftliche Fragen thematisiert, vorgenommen. Obwohl ich auf medienpädagogische Aspekte nur indirekt eingehen werde, hebe ich im Laufe der Argumentation hervor, dass solche Fernsehnarrative das allgemeine Publikum oder das, was ich als ‹jedermann› beschreibe, mit ethischen Problemen und Dilemmata unserer globalen kapitalistischen Ordnung konfrontieren.

  7. Risk Profile of Symptomatic Lacunar Stroke Versus Nonlobar Intracerebral Hemorrhage.

    Science.gov (United States)

    Morotti, Andrea; Paciaroni, Maurizio; Zini, Andrea; Silvestrelli, Giorgio; Del Zotto, Elisabetta; Caso, Valeria; Dell'Acqua, Maria Luisa; Simone, Anna Maria; Lanari, Alessia; Costa, Paolo; Poli, Loris; De Giuli, Valeria; Gamba, Massimo; Ciccone, Alfonso; Ritelli, Marco; Di Castelnuovo, Augusto; Iacoviello, Licia; Colombi, Marina; Agnelli, Giancarlo; Grassi, Mario; de Gaetano, Giovanni; Padovani, Alessandro; Pezzini, Alessandro

    2016-08-01

    Although lacunar stroke (LS) and deep intracerebral hemorrhage (dICH) represent acute manifestations of the same pathological process involving cerebral small vessels (small vessel disease), it remains unclear what factors predispose to one phenotype rather than the other at individual level. Consecutive patients with either acute symptomatic LS or dICH were prospectively enrolled as part of a multicenter Italian study. We compared the risk factor profile of the 2 subgroups using multivariable logistic regression. During a time course of 9.5 years, 1931 subjects (1434 LS and 497 dICH; mean age, 71.3±13.3 years; males, 55.5%) qualified for the analysis. Current smoking was associated with LS (odds ratio [OR], 2.17; Prisk factor profile of dICH differs from that associated with LS. This might be used for disease risk stratification at individual level. © 2016 American Heart Association, Inc.

  8. Vägistatud sakslanna kirjutas sellest raamatu / Evelyn Kaldoja

    Index Scriptorium Estoniae

    Kaldoja, Evelyn, 1980-

    2010-01-01

    15. aastaselt punaarmeelaste vägistamiste ohvriks langenud sakslanna Gabriele Köpp avaldas teda tabanud kannatustest raamatu "Warum war ich bloss ein Mädchen : das Trauma einer Flucht 1945" (München, 2010)

  9. Немка написала книгу о насилии солдат / Эвелин Калдоя

    Index Scriptorium Estoniae

    Калдоя, Эвелин, 1980-

    2010-01-01

    15. aastaselt punaarmeelaste vägistamiste ohvriks langenud sakslanna Gabriele Köpp avaldas teda tabanud kannatustest raamatu "Warum war ich bloss ein Mädchen : das Trauma einer Flucht 1945" (München, 2010)

  10. Disease: H00613 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available hyperostosis mainly affecting long bones, mandible, clavicles, and ribs. It usually affects infants less tha...re prenatal form of ICH is lethal in which extensive hyperostosis affects nearly all long bones and the fetu

  11. 2015 - das Jahr der RDA - ein erster Statusbericht

    Directory of Open Access Journals (Sweden)

    Inge Neuböck

    2015-06-01

    geben. Manchmal bin ich selbst erstaunt, wieviel eine so kleine Gruppe bewegen kann – Motor dazu ist das wirklich intensive Interesse und die Freude an der Mitarbeit von etwas Neuem bei jedem einzelnen Mitglied der AGs...

  12. Participation of older people in preauthorization trials of recently approved medicines

    NARCIS (Netherlands)

    Beers, Erna; Moerkerken, Dineke C; Leufkens, Hubert G M; Egberts, Toine C G; Jansen, Paul A F

    2014-01-01

    OBJECTIVES: To investigate the inclusion of older people in clinical trials of recently authorized medicines, evaluating adherence to the 20-year-old International Conference of Harmonisation (ICH) guideline on geriatrics (E7). DESIGN: Observational. SETTING: European public assessment reports,

  13. Explorative investigation of biomarkers of brain damage and coagulation system activation in clinical stroke differentiation

    DEFF Research Database (Denmark)

    Undén, Johan; Strandberg, Karin; Malm, Jan

    2009-01-01

    INTRODUCTION: A simple and accurate method of differentiating ischemic stroke and intracerebral hemorrhage (ICH) is potentially useful to facilitate acute therapeutic management. Blood measurements of biomarkers of brain damage and activation of the coagulation system may potentially serve as nov...

  14. Intracerebral hemorrhage associated with Sneddon's syndrome: is ischemia-related angiogenesis the cause? Case report and review of the literature

    International Nuclear Information System (INIS)

    Aquino Gondim, F. de A.; Leacock, R.O.; Subrammanian, T.A.; Cruz-Flores, S.

    2003-01-01

    Sneddon's syndrome is characterized by livedo reticularis and multiple ischemic infarcts often associated with antiphospholipid antibodies. Intracerebral hemorrhage (ICH) is unusual in Sneddon's syndrome and has not been reported as the presenting complaint. We report a 38-year-old woman with a history of two miscarriages, Raynaud's phenomenon and livedo reticularis who presented acutely with ICH. Angiography showed prominent leptomeningeal and transdural anastomoses (pseudoangiomatosis). Anticardiolipin antibodies were positive. A right frontal brain biopsy failed to reveal vasculitis and a skin biopsy was nonspecific. MRI showed residual intracerebral hemorrhage (ICH), diffuse atrophy, multiple small white matter infarcts and leptomeningeal enhancement. This is the first report of Sneddon's syndrome presenting with an ICH. It shares features with the Divry-van Bogaert syndrome. We discuss the cause of the pseudoangiomatosis pattern and its role in the genesis of the hemorrhage and suggest that cerebral angiography should be done in every patient with Sneddon's syndrome, as it could impact therapy. (orig.)

  15. Pattern and location of intracerebral hemorrhage in Enugu, South ...

    African Journals Online (AJOL)

    2015-10-16

    Oct 16, 2015 ... review of ICH using a modern neuroimaging technique. Objectives: To determine .... brain tumors, subdural hematomas, and post‑traumatic cases were .... frequently caused by chronic hypertension and were seen in 53.2% of ...

  16. The value and benefits of the International Conference on Harmonisation to drug regulatory authorities: advancing harmonization for better public health.

    Science.gov (United States)

    Molzon, J A; Giaquinto, A; Lindstrom, L; Tominaga, T; Ward, M; Doerr, P; Hunt, L; Rago, L

    2011-04-01

    The International Conference on Harmonisation (ICH) is an unparalleled undertaking, which has brought together drug regulatory authorities and pharmaceutical trade associations from Europe, Japan, and the United States, to discuss the scientific and technical aspects of medical product registration. Launched in 1990, the value and benefits of ICH to regulators are being realized. ICH has harmonized submission requirements and created a harmonized submission format that is relieving both companies and regulatory authorities of the burdens of assembling and reviewing separate submissions for each region. As more countries embrace ICH guidelines, we anticipate additional benefits, including the promotion of good review practices and, ultimately, a common regulatory language that will facilitate further interactions among global drug regulatory authorities.

  17. Mittheilungen über Scyphomedusen I

    NARCIS (Netherlands)

    Stiasny, G.

    1921-01-01

    Hiemit beabsichtige ich eine Reihe kleinerer Mittheilungen über Semaeostomeen und Rhizostomeen des Rijksmuseums van Natuurlijke Historie in Leiden zu veröffentlichen, welche die Systematik, Biologie, Entwicklungsgeschichte und Anatomie verschiedener Scyphomedusen behandeln. Die vorliegenden beiden

  18. European Stroke Organisation (ESO) guidelines for the management of spontaneous intracerebral hemorrhage

    DEFF Research Database (Denmark)

    Steiner, Thorsten; Al-Shahi Salman, Rustam; Beer, Ronnie

    2014-01-01

    graduated compression stockings, using intermittent pneumatic compression in immobile patients, and using blood pressure lowering for secondary prevention. We found moderate-quality evidence to support weak recommendations for intensive lowering of systolic blood pressure to ...BACKGROUND: Intracerebral hemorrhage (ICH) accounted for 9% to 27% of all strokes worldwide in the last decade, with high early case fatality and poor functional outcome. In view of recent randomized controlled trials (RCTs) of the management of ICH, the European Stroke Organisation (ESO) has...... Assessment, Development and Evaluation (GRADE) approach. RESULTS: We found moderate- to high-quality evidence to support strong recommendations for managing patients with acute ICH on an acute stroke unit, avoiding hemostatic therapy for acute ICH not associated with antithrombotic drug use, avoiding...

  19. Føtal og neonatal alloimmun trombocytopeni er en mulig fatal tilstand

    DEFF Research Database (Denmark)

    Morling Taaning, Ellen Birkerod; Kjeldsen-Kragh, Jens; Hedegaard, Morten

    2011-01-01

    Fetal and neonatal alloimmune thrombocytopenia (FNAIT) may lead to intracranial haemorrhage (ICH) resulting in neurological damage or death. In FNAIT, transplacental maternal antibodies cause destruction of fetal platelets. Maternal immunisation occurs to fetal human platelet antigens (HPAs...

  20. Revize archeologického výzkumu v Rousovicích u Mělníka z pohledu antropologie

    Czech Academy of Sciences Publication Activity Database

    Krupová, Z.; Stránská, Petra; Stella, M.

    2015-01-01

    Roč. 19, č. 1 (2015), s. 319-326 ISSN 1214-3553 Institutional support: RVO:67985912 Keywords : skeletal remains * paleodemography * paleopathology * Jindřich Matiegka * Early Middle Ages Subject RIV: AC - Archeology, Anthropology , Ethnology

  1. ISSN 2073-9990 East Cent Afr J Surg

    African Journals Online (AJOL)

    The ICH showed evidence of significant mass effect on brain computed .... Laterality. Right. Left. 13 (61.9). 8 (38.1). Intracerebral distribution*. Superficial cortical ... Early surgery versus initial conservative treatment in patients with spontaneous.

  2. DEVELOPMENT OF SUSTAINED RELEASE TABLETS ...

    African Journals Online (AJOL)

    2013-12-31

    Dec 31, 2013 ... The SR dosage forms that release drugs pH independently in .... were determined; Post compression parameters such as weight variation test, hardness, ... Based on the ICH guidelines 12, the stability studies were carried out ...

  3. Development of a Visible Spectrophotometric Method for the ...

    African Journals Online (AJOL)

    determination of ganciclovir in bulk sample and dosage form. ... Validation of the new method was carried out using current ICH guidelines .... for the reaction was established by spot test and .... stable for more than 4 h when monitored by its.

  4. 78 FR 26375 - Food and Drug Administration/International Society for Pharmaceutical Engineering Co-Sponsorship...

    Science.gov (United States)

    2013-05-06

    ...] Food and Drug Administration/International Society for Pharmaceutical Engineering Co-Sponsorship... Society of Pharmaceutical Engineering (ISPE), is announcing a conference entitled ``Redefining the `C' in CGMP: Creating, Implementing and Sustaining a Culture of Quality'' Pharmaceutical Quality System (ICH...

  5. Isolated clinic hypertension: diagnostic criteria based on 24-h blood pressure definition.

    Science.gov (United States)

    Vinyoles, Ernest; Rodriguez-Blanco, Teresa; de la Sierra, Alejandro; Felip, Angela; Banegas, José R; de la Cruz, Juan J; Gorostidi, Manuel; Sobrino, Javier; Segura, Julián; Roca-Cusachs, Alex; Ruilope, Luís M

    2010-12-01

    The use of diagnostic criteria based on 24-h ambulatory blood pressure (BP) values could improve prognostic value by incorporating night BP, minimize biases and improve the diagnostic reproducibility of isolated clinic hypertension (ICH). We estimate the 24-h BP cut-off points that best discriminate and predict the two diagnostic thresholds of mean daytime BP for ICH (135/85 and 130/80 mmHg). Cross-sectional, comparative, multicentre study in 6176 untreated hypertensive patients, whose BP was measured by ambulatory BP monitoring. ICH was defined with an office BP of ≥140/≥90 mmHg and a daytime BP of <135/<85 mmHg (ICH1) or <130/80 mmHg (ICH2). Sensitivity, specificity, positive likelihood ratio (LR+), odds ratio (OR), error rate, predictive values, κ values and 95% confidence interval were calculated for each possible cut-off point for ICH1 and ICH2. One thousand eight hundred and seven patients (29.2%) and 960 patients (15.5%) met ICH1 and ICH2 criteria, respectively. The 24-h BP cut-off points that best predict ICH1 and ICH2 are less than 132/82 mmHg (sensitivity: 93.6%, specificity: 94.3%, LR+: 16.6, OR: 1367.1, error rate: 5.9, κ 0.86) and less than 127/77 mmHg (sensitivity: 90.8%, specificity: 97.4%, LR+: 34.6, OR: 1041.5, error rate: 3.6,κ 0.86), respectively. These values achieved the best balance of sensitivity and specificity, together with the highest values of LR+ and OR and the lowest error rate. The 24-h BP cut-off point that best predicts the daytime criterion of less than 135/85 and less than 130/80 mmHg are 132/82 and 127/77 mmHg, respectively. These 24-h cut-off points may add value to ambulatory blood pressure monitoring for both diagnostic and management future decisions.

  6. High prevalence of cognitive impairment after intracerebral hemorrhage.

    Directory of Open Access Journals (Sweden)

    Mélanie Planton

    Full Text Available Cognitive impairment seems to be frequent in intracerebral hemorrhage (ICH survivors, but remains widely understudied. In this study, we investigated the frequency and patterns of vascular cognitive disorders (VCDs in patients with cerebral amyloid angiopathy (CAA-related and deep ICH compared to patients with mild cognitive impairment due to Alzheimer's disease (MCI-AD and healthy controls.We prospectively recruited 20 patients with CAA-related lobar ICH, 20 with deep ICH, 20 with MCI-AD and 17 healthy controls. Patients with cognitive decline pre-ICH were excluded from the analysis. Each participant underwent a comprehensive neuropsychological assessment and a structural brain MRI. Cognitive assessment was performed at a median delay of 4 months after the acute phase in ICH patients, and more than 6 months after the first complaint in MCI-AD patients. Cognitive profiles were compared between groups. The prevalence of VCDs in the ICH groups was estimated using the recent VASCOG criteria."Mild" and "major VCDs" were respectively observed in 87.5% and 2.5% of all ICH patients. Every patient in the CAA group had mild VCDs. No significant difference was observed in cognitive functioning between CAA-related and deep ICH patients. The most impaired process in the CAA group was naming, with a mean (±standard deviation z-score of -5.2 ±5.5, followed by processing speed (-4.1±3.3, executive functioning (-2.6 ±2.5, memory (-2.4 ±3.5 and attention (-0.9 ±1.3. This cognitive pattern was different from the MCI-AD patients, but the groups were only different in gestural praxis, and by construction, in memory processes.VCDs are frequent after ICH. Cognitive patterns of patients with deep or CAA-related ICH did not differ, but there was impaired performance in specific domains distinct from the effects of Alzheimer's disease.URL: http://www.clinicaltrials.gov. Unique identifier: NCT01619709.

  7. Low-Density Lipoprotein and Intracerebral Hematoma Expansion in Daily Alcohol Users

    Directory of Open Access Journals (Sweden)

    Gayle R. Pletsch

    2014-01-01

    Full Text Available Background: Epidemiological studies suggest that the intracerebral hemorrhage (ICH rate correlates with alcohol consumption. Alcohol leads to elevated blood pressure (BP and inhibition of platelet aggregation. These factors could promote excessive bleeding. To our knowledge, in the setting of normal liver function tests, there are no studies that have systematically evaluated the relationship between daily alcohol use and hematoma expansion. The aim of this study is to compare the baseline ICH characteristics, frequency of hematoma expansion, and outcomes in patients with ICH who are daily alcohol users with those who are not daily alcohol users. Methods: A retrospective chart review was performed on consecutive patients who presented from July 2008 to July 2013 to the Tulane University Hospital in New Orleans, La., USA, with a spontaneous ICH. Ninety-nine patients who met these criteria were admitted. Patients who underwent hematoma evacuation were excluded. Hemorrhage volumes were calculated based on the ABC/2 method. Low-density lipoprotein (LDL was dichotomized into low (2 and nonparametric equivalents where appropriate. ICH growth in 24 h and LDL were evaluated using linear regression. Results: Of the 226 patients who met inclusion criteria, 20.4% had a history of daily alcohol use. The average age was 61 years (range 19-94, 55.6% of the patients were males, and 67.1% were of African American origin. Daily alcohol use was associated with male gender, lower rate of home antihypertensive, higher presenting BP, and lower platelet counts, but there was no difference in ICH characteristics, ICH growth, or clinical outcome. Daily alcohol use in patients with a low LDL level was associated with supratentorial location and trends for lower baseline Glasgow Coma Scale score, higher ICH score, and follow-up ICH volume, but no significant difference in significant hematoma expansion or clinical outcome except for a trend for higher mortality was found

  8. Hemorrhage recurrence risk factors in cerebral amyloid angiopathy: Comparative analysis of the overall small vessel disease severity score versus individual neuroimaging markers.

    Science.gov (United States)

    Boulouis, Gregoire; Charidimou, Andreas; Pasi, Marco; Roongpiboonsopit, Duangnapa; Xiong, Li; Auriel, Eitan; van Etten, Ellis S; Martinez-Ramirez, Sergi; Ayres, Alison; Vashkevich, Anastasia; Schwab, Kristin M; Rosand, Jonathan; Goldstein, Joshua N; Gurol, M Edip; Greenberg, Steven M; Viswanathan, Anand

    2017-09-15

    An MRI-based score of total small vessel disease burden (CAA-SVD-Score) in cerebral amyloid angiopathy (CAA) has been demonstrated to correlate with severity of pathologic changes. Evidence suggests that CAA-related intracerebral hemorrhage (ICH) recurrence risk is associated with specific disease imaging manifestations rather than overall severity. We compared the correlation between the CAA-SVD-Score with the risk of recurrent CAA-related lobar ICH versus the predictive role of each of its components. Consecutive patients with CAA-related ICH from a single-center prospective cohort were analyzed. Radiological markers of CAA related SVD damage were quantified and categorized according to the CAA-SVD-Score (0-6 points). Subjects were followed prospectively for recurrent symptomatic ICH. Adjusted Cox proportional hazards models were used to investigate associations between the CAA-SVD-Score as well as each of the individual MRI signatures of CAA and the risk of recurrent ICH. In 229 CAA patients with ICH, a total of 56 recurrent ICH events occurred during a median follow-up of 2.8years [IQR 0.9-5.4years, 781 person-years). Higher CAA-SVD-Score (HR=1.26 per additional point, 95%CI [1.04-1.52], p=0.015) and older age were independently associated with higher ICH recurrence risk. Analysis of individual markers of CAA showed that CAA-SVD-Score findings were due to the independent effect of disseminated superficial siderosis (HR for disseminated cSS vs none: 2.89, 95%CI [1.47-5.5], p=0.002) and high degree of perivascular spaces enlargement (RR=3.50-95%CI [1.04-21], p=0.042). In lobar CAA-ICH patients, higher CAA-SVD-Score does predict recurrent ICH. Amongst individual elements of the score, superficial siderosis and dilated perivascular spaces are the only markers independently associated with ICH recurrence, contributing to the evidence for distinct CAA phenotypes singled out by neuro-imaging manifestations. Copyright © 2017 Elsevier B.V. All rights reserved.

  9. Preexisting cognitive impairment in intracerebral hemorrhage.

    Science.gov (United States)

    Laible, M; Horstmann, S; Möhlenbruch, M; Schueler, S; Rizos, T; Veltkamp, R

    2017-06-01

    Preexisting cognitive impairment is a predictor of cognitive decline after ischemic stroke, but evidence in intracerebral hemorrhage (ICH) is limited. We aimed to determine the prevalence of premorbid cognitive impairment in patients with ICH. We included patients with acute ICH. Pre-ICH cognitive impairment was determined based on the results of the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) that uses information from close relatives. Patients were assessed as having been cognitively impaired with an IQCODE score of ≥3.44; an IQCODE ≥4.00 indicated pre-ICH dementia. CT and MRI images were reviewed to determine the extent of white matter lesions and to measure the radial width of the temporal horn as marker of brain atrophy. We investigated differences of cardiovascular risk factors and imaging data between patients with and without pre-ICH cognitive impairment using correlation analyses, uni- and multivariable regression models. Functional neurological state was assessed using the modified Rankin Scale (mRS). The mRS was dichotomized at the level of 3, and a premorbid mRS of 0-2 was considered as functional independency. Among the 89 participants, median age was 70 years (interquartile range 58-78) and 52 (58.4%) were male. IQCODE indicated pre-ICH cognitive impairment in 18.0% (16 of 89), and 83.1% were functionally independent before ICH. Cognitive impairment was associated with a premorbid mRS≥3 (chi squared test, P=0.009). In multivariable analysis, prior stroke/transient ischemic attack (OR 18.29, 95%-CI 1.945-172.033, P=.011) and hematoma volume (OR 0.90, 95%-CI 0.812-0.991, P=.033) were independently associated with pre-ICH cognitive impairment. In conclusion, cognitive impairment frequently precedes ICH. A higher frequency of cerebrovascular events suggests a role of vascular processes in the development of cognitive impairment before ICH. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  10. Implicit Personality Self-Concept

    OpenAIRE

    Schnabel, Konrad

    2004-01-01

    In meiner Dissertationsschrift unterschied ich zwischen expliziten und impliziten Repräsentationen der eigenen Persönlichkeit und konzeptualisierte diese als Teile des reflektiven bzw. impulsiven Systems (Strack & Deutsch, in press). Am Beispiel der Persönlichkeitseigenschaften Schüchternheit, Ängstlichkeit und Ärgerlichkeit erfasste ich implizite Repräsentationen des Persönlichkeits-Selbstkonzeptes mit Hilfe von Impliziten Assoziations Tests (IATs, Greenwald, McGhee & Schwartz, 1998) und den...

  11. The Association between Specific Substances of Abuse and Subcortical Intracerebral Hemorrhage Versus Ischemic Lacunar Infarction.

    Science.gov (United States)

    Kaplan, Emma H; Gottesman, Rebecca F; Llinas, Rafael H; Marsh, Elisabeth B

    2014-01-01

    Hypertension damages small vessels, resulting in both lacunar infarction and subcortical intracerebral hemorrhage (ICH). Substance abuse has also been linked to small vessel pathology. This study explores whether the use of specific substances (e.g., cocaine, tobacco) is associated with subcortical ICH over ischemia in hypertensive individuals. Patients with hypertension, admitted with lacunar infarcts (measuring 1 drink per day (women), >2 drinks per day (men). Logistic regression was performed with ICH as the dependent variable comparing those presenting with ICH to those presenting with ischemia. Of the 580 patients included in analysis, 217 (37%) presented with ICH. The average age was similar between the two groups (64.7 versus 66.3 years). Illicit/controlled drug use was associated with a significantly increased risk of ICH over stroke in unadjusted models (25 versus 15%, p = 0.02), with the largest effect seen in users ≥65 years old (not statistically significant). Smoking was associated with ischemia over ICH in a dose-dependent manner: any history of smoking OR 1.84, CI 1.19-2.84; current use OR 2.23, CI 1.37-3.62; heavy use OR 2.48, CI 1.50-4.13. Alcohol use was not preferentially associated with either outcome (p = 0.29). In hypertensive patients, tobacco use is associated with an increased risk of subcortical ischemia compared to ICH, while use of illicit/controlled substances appears to be predictive of hemorrhage.

  12. Top 100 Most-Cited Articles on Spontaneous Intracerebral Hemorrhage: A Bibliometric Analysis.

    Science.gov (United States)

    Nasir, Syed Ali Raza; Gilani, Jaleed Ahmed; Fatima, Kaneez; Faheem, Urooba; Kazmi, Omar; Siddiqi, Javed; Khosa, Faisal

    2018-02-01

    A bibliometric uses the citation count of an article to determine its impact on the clinical world. There is a paucity of literature concerning top article citations on spontaneous intracerebral hemorrhage (ICH). The main objective of this investigation was to bridge this gap and to provide understanding of the trends on the most influential articles written on this subject. The Scopus Library database was searched to determine the citations of all articles published on spontaneous ICH. Articles that focused on other forms of ICH, such as trauma-related hemorrhages, subarachnoid hemorrhages, or hemorrhages caused by anticoagulation, vascular malformations, or cavernomas, were excluded from our list. The articles were divided into 2 groups: "specific" articles, which focused specifically on spontaneous ICH, and "generalized" articles, which were about ICH in general, including spontaneous as well as other forms of ICH. We did not apply any time or study-type restriction in our search. The top 100 cited articles were selected and analyzed by 2 independent investigators. J. Broderick was the author with most publications in the list (n = 21). The largest subset of spontaneous ICH articles was published in the 5-year periods from 1996 to 2000 and 2001 to 2005 (n = 27 each). The United States had the highest number of articles (n = 49). The journal with the highest number of top 100 cited articles was Stroke, with 39, followed by Neurology with 16. Our study identifies the trends related to spontaneous ICH by analyzing the citation frequency of the most-cited articles in the field. Copyright © 2017 Elsevier Inc. All rights reserved.

  13. Fetal Intracranial Hemorrhage (Fetal Stroke: Report of Four Antenatally Diagnosed Casesand Review of the Literature

    Directory of Open Access Journals (Sweden)

    Ying-Fen Huang

    2006-06-01

    Conclusion: This small series demonstrate that an antenatal diagnosis of fetal stroke with intraventricular hemorrhage Grades III and IV or with brain parenchymal involvement appears to be associated with poor neurologic outcome. Due to the significant neonatal neurologic impairment and potential medicolegal implications of antepartum fetal ICH, it follows that obstetricians and sonographers should be familiar with predisposing factors and typical diagnostic imaging findings of rare in utero ICH events.

  14. Soviet Dissident Scientists, 1966-78: A Study.

    Science.gov (United States)

    1979-06-01

    could be meaning.ully determined. Other factors, such s marital status, career aspirations , or previous military service, mignt have bec-. as relevant...LNT0VCh, LOEOSAa T. VZMAO VAp VOL’PIN, GESh0ICh, 14~i LAVUTl’, IMLAM3ICh, MLI~hch, PODrapOL’ =, RUDAID, THAChZV. 5DB v9 15696 p 2-3. 88. 8DB v24 AS1283

  15. "Esst estnische Pasteten in estnischen Nischen" : Ilmar Laabans poetische Welt / Gisbert Jänicke

    Index Scriptorium Estoniae

    Jänicke, Gisbert, 1937-

    2000-01-01

    Artikkel sisaldab I. Laabani luuletusi saksa k.: Das Ende der Ankerkette ist des Gesanges Beginn ; Ich liebe euch ; "Die Quelle des Tods in sauberen Wolken..." ; Vögel des Selbstmords ; "Ich zerstreue mich über meinen Tisch..." ; Pornografisch ; Die Moral des Nordlichts ; Mikrokosmos 1, 20, 23, 26, 29, 30, 34, 49. Samuti sisaldab artikkel I. Laabani rootsik. luuletuse "Hur står det till?" saksak. teksti ja I. Laabani saksa k. kirjutatud luuletuse "Funkenspielstück".

  16. Agmag Igbo dka Ngwar n'kwalite Ezi Nchekwa na Nkwsiike haobodo

    African Journals Online (AJOL)

    Ka Najira nwerechara onwe ya n'af 1960, olileanya tt mamala ya b na ihe ga-adz mma. Mana ka oge na-aga, a chptara na ihe na-akawanye nj. Usoro chch d iche iche daptara. Nd am na nd nkt achala mana nd gara n'ihu na-akawanye nj. O bu ihe doro anya na chch ha b nke nchgbu na fnfju akpa. N'agbanyegh na ...

  17. Pepsi und Coca ewige Rivallen

    OpenAIRE

    POLJAKOW ANDREJ; POLJAKOW WLADIMIR

    2016-01-01

    Fast jeder kennt Pepsi und Coca. Man kann sie treffen praktisch in jedem Geschaeft. Dennoch nicht alle wissen, dass diese Firmen Erzrivallen sind und das ihre Rivallitaet sich seit Ewigkeit dauert. In meinem Artikel, welches ich in der Zusammenarbeit mit meinem Vater schrieb versuchte ich den Weg beider Firmen von der Gruendung bis heutigen Tagen zu beschreiben. Auf diesem Weg trafen sich technologische Aenderungen, Gerichtsverhandlungen, sowie geschickte Tricks. Wichtige Rolle spielt auch Ma...

  18. Zehn Oden / Kristjan Jaak Peterson ; [Deutsch von Gisbert Jänicke

    Index Scriptorium Estoniae

    Peterson, Kristian Jaak, 1801-1822

    2001-01-01

    On ilmunud ka kogumikus "Iaak. Kristian Jaak Peterson 200" (Tln. : Eesti Keele Sihtasutus, 2001, lk. 105-122). Sisu: Der Mond = Kuu ; Freundschaft = Sõprus ; Der Sänger = Laulja ; An Gott = Jumalale ; Hoffnung = Lootus ; Ich muss Trinken. Liedchen = Ma pean jooma. Lauluke ; Ich bin wieder glücklich = Olen jälle õnnis ; Der Mensch = Inimene ; Sonnenuntergang = Päeva loojaminemine ; Herbst = Sügise.

  19. Iwulite Amumamu Asusu Igbo site n'Usoro Ozi Ozuru Uwa na ...

    African Journals Online (AJOL)

    Ederede a nyochara usoro ozuru wa d ka mettara mm ass Igbo na Najiria. A malitere site n'kwa ihe Ozuru wa ptara na mkprokwu nd z mettara ya. E lebara anya n'uru usoro ozuru wa nwere ike ba n'ammam ass Igbo. A chptara na e nwere ihe mkpbi kw nye uru nd a wee gbala gosipta z d iche iche e nwere ike isi gbanah ihe ...

  20. Ontologische und epistemologische Grundlagen qualitative Forschung

    OpenAIRE

    Vasilachis de Gialdino, Irene

    2009-01-01

    Dieser Beitrag zielt auf das Herzstück qualitativer Forschung, indem gezeigt wird, dass es – aus der Perspektive einer Epistemologie des "gewussten" Subjekts – erforderlich ist, zunächst deren ontologische und dann deren epistemologische Grundlagen neu zu überdenken. Hierzu zeichne ich in einem ersten Schritt den Weg von einer Epistemologie des "bewussten" Subjekts hin zu einer Epistemologie des "gewussten" Subjekts nach, die ich als neuen (und nicht exklusiven) Weg des Wissens vorschlage. Da...

  1. Emergency Neurological Life Support: Intracerebral Hemorrhage.

    Science.gov (United States)

    Jauch, Edward C; Pineda, Jose A; Hemphill, J Claude

    2015-12-01

    Intracerebral hemorrhage (ICH) is a subset of stroke due to bleeding within the parenchyma of the brain. It is potentially lethal, and survival depends on ensuring an adequate airway, reversal of coagulopathy, and proper diagnosis. ICH was chosen as an Emergency Neurological Life Support protocol because intervention within the first critical hour may improve outcome, and it is critical to have site-specific protocols to drive care quickly and efficiently.

  2. Erinnerungsskizzen

    OpenAIRE

    Lee, Karen V.

    2008-01-01

    Im Zentrum der im Folgenden präsentierten Autoethnografie (BARONE 2003; SLATTERY 2001) steht ein emotionaler Umbruch, der einem einwöchigen Campingurlaub meiner Tochter mit deren Vater und einem damit einhergehenden persönlichen und sozialen Verlusterleben folgte. In meiner Autobiografie versuche ich zu reflektieren, wie ich zugleich in einer Kultur der Unabhängigkeit und der Abhängigkeit lebte. Wichtig in diesem Prozess waren die Skizzenmappen meiner Tochter: ihre Zeichnungen wiederanzusehen...

  3. A Sketchbook of Memories

    OpenAIRE

    Lee, Karen V.

    2008-01-01

    Im Zentrum der im Folgenden präsentierten Autoethnografie (BARONE 2003; SLATTERY 2001) steht ein emotionaler Umbruch, der einem einwöchigen Campingurlaub meiner Tochter mit deren Vater und einem damit einhergehenden persönlichen und sozialen Verlusterleben folgte. In meiner Autobiografie versuche ich zu reflektieren, wie ich zugleich in einer Kultur der Unabhängigkeit und der Abhängigkeit lebte. Wichtig in diesem Prozess waren die Skizzenmappen meiner Tochter: ihre Zeichnungen wiederanzusehen...

  4. Multiresolution analysis of pathological changes in cerebral venous dynamics in newborn mice with intracranial hemorrhage: adrenorelated vasorelaxation

    International Nuclear Information System (INIS)

    Pavlov, A N; Pavlova, O N; Tuchin, V V; Semyachkina-Glushkovskaya, O V; Zhang, Y; Bibikova, O A; Huang, Q; Zhu, D; Li, P; Luo, Q

    2014-01-01

    Intracranial hemorrhage (ICH) is the major problem of modern neonatal intensive care. Abnormalities of cerebral venous blood flow (CVBF) can play a crucial role in the development of ICH in infants. The mechanisms underlying these pathological processes remain unclear; however it has been established that the activation of the adrenorelated vasorelaxation can be an important reason. Aiming to reach a better understanding of how the adrenodependent relaxation of cerebral veins contributes to the development of ICH in newborns, we study here the effects of pharmacological stimulation of adrenorelated dilation of the sagittal sinus by isoproterenol on the cerebral venous hemodynamics. Our study is performed in newborn mice at different stages of ICH using the laser speckle contrast imaging and wavelet analysis of the vascular dynamics of CVBF. We show that the dilation of the sagittal sinus with the decreased velocity of blood flow presides to the stress-induced ICH in newborn mice. These morphofunctional vascular changes are accompanied by an increased variance of the wavelet-coefficients in the areas of endothelial and non-endothelial (K ATP -channels activity of vascular muscle) sympathetic components of the CVBF variability. Changes in the cerebral venous hemodynamics at the latent stage of ICH are associated with a high responsiveness of the sagittal sinus to isoproterenol quantifying by wavelet-coefficients related to a very slow region of the frequency domain. The obtained results certify that a high activation of the adrenergic-related vasodilatory responses to severe stress in newborn mice can be one of the important mechanisms underlying the development of ICH. Thus, the venous insufficiency with the decreased blood outflow from the brain associated with changes in the endothelial and the sympathetic components of CVBF-variability can be treated as prognostic criteria for the risk of ICH during the first days after birth. (paper)

  5. Page 1 OMUMŲ OMENALA IGBO NA NGALABA GS NKE ...

    African Journals Online (AJOL)

    JONATHAN

    N' [kwado nke a, Fafunwa (197. Agbxrx qbxla n'agbanyghſ etu ha ha ibu nwere usoro ha si azxlite ma na akxziri xmxntak[r[ ha na nd[ ntorob[a ha ihe, izxlite xmxaka n'obibi ndx d[ ara ya anagh[ abx otu n'agbxrx niile. Nkowa Omenala: E nwere ike ikowa omenala n'uzo dį iche iche. Nke a bų ufodụ nkowa ndị mmadụ nyere.

  6. Fluorine donor bound electron spins as quibits

    OpenAIRE

    Kim, Youngmin Martin

    2013-01-01

    Im Laufe dieser Arbeit werde ich die Potentiale des gebundenen Elektrons in einem ZnSe:F System hervorheben, indem experimentell einige ihrer erforderlichen Eigenschaften als Qubits aufgezeigt werden. In Kapitel 3 werde ich die QW-confinement für eine gesteigerte optische Helligkeit und eine Reduktion der inhomogenen Ausdehnung vorstellen. Auf Grund der Kompression der Donorwellenfunktion in den QWs konnte ebenfalls eine erhöhte Bindungsenergie des Exzitons beobachtet werden. In Kapitel 4 wir...

  7. Factors affecting the occurrence of symptomatic intracerebral haemorrhage after intravenous thrombolysis depending on the haemorrhage definition.

    Science.gov (United States)

    Sledzińska-Dźwigał, M; Sobolewski, Piotr; Szczuchniak, W

    2013-01-01

    Symptomatic intracerebral haemorrhage (sICH) remains the most feared complication of systemic thrombolysis in patients with ischaemic stroke. The aim of the study was to analyze the impact of different factors on the occurrence of sICH, depending on definition used. We retrospectively evaluated the influence of several factors on the occurrence of sICH (according to definitions used in ECASS2, SITS-MOST and NINDS studies) in 200 patients treated with systemic thrombolysis from 2006 to 2011. Multivariate analysis of impact of individual variables on the occurrence of haemorrhagic transformation (HT) and parenchymal haemorrhage type 2 (PH2) were performed. Haemorrhagic transformation occurred in 35 cases (17.5%). SICH was found in 10 cases according to ECASS2, in 7 cases according to SITS and in 13 cases according to NINDS. Older age was related to higher risk of sICH, regardless which definition was used (ECASS2: p = 0.014, SITS-MOST: p = 0.048, NINDS: p = 0.008), and female sex was related to higher risk of sICH according to NINDS and ECASS2 definition (p = 0.002 and p = 0.04, respectively). Blood glucose level and high NIHSS score (> 14 pts) were found as risk factor of sICH in ECASS2 definition (p = 0.044 and p = 0.03, respectively). In multivariate logistic regression higher NIHSS scores were associated with HT independent of age, gender and glucose level (p = 0.012). Multivariate analysis showed no impact of age, gender, severity of stroke and glucose level on presence of PH2. Definition of sICH can determine variables that are related to a high risk of this complication. In our study most factors correlated with sICH using the ECASS2 definition.

  8. Implications of in-use photostability

    DEFF Research Database (Denmark)

    Baertschi, Steven W; Clapham, David; Foti, Chris

    2013-01-01

    Basic guidance on the photostability testing of pharmaceuticals, designed to cover manufacturing and storage over shelf life, has long been established within ICH Q1(ICH,B(10) , but the guideline does not cover the photostability of drugs during or after administration (i.e., under conditions of ...... light sources, to provide valuable data to pharmaceutical manufacturers and compounding pharmacists for the safe and effective use of photosensitive injection products....

  9. Pyridostimine Bromide 30mg Stability in Extended Storage Conditions

    Science.gov (United States)

    2017-12-03

    States Pharmacopeia (USP) >. The real-life storage conditions will be determined using the International Commission for Harmonization’s (ICH) Quality ...Packaging and Storage Requirements. 4 ~ Real-life storage conditions are defined based on the International Council for Harmonisation’s (ICH) Quality ...information, including suggestions for reducing the burden, to the Department of Defense, Executive Service Directorate {0704-0188). Respondents should be

  10. Zarządzanie talentami na przykładzie Wojskowych Zespołów Sportowych oraz Wojskowych Centrach Szkolenia Sportowego / The talent management based on the example of Military Sports Teams and Military Sports Training Centers

    OpenAIRE

    Malinowski, Łukasz

    2015-01-01

    Streszczenie Artykuł dotyczy problematyki pozyskiwania talentów dla Wojskowych Centrów Szkolenia Sportowego wraz z opisaniem wsparcia finansowego udzielanego przez Ministerstwo Sportu i Turystyki i ich działania oraz funkcjonowania w Polsce Wojskowych Zespołów Sportowych i ich osiągnięć. Słowa kluczowe: wojsko, sport, szkolenie, talent Abstract The article concerns the problems of sourcing talent for Military Sports Tr...

  11. Regularization design for high-quality cone-beam CT of intracranial hemorrhage using statistical reconstruction

    Science.gov (United States)

    Dang, H.; Stayman, J. W.; Xu, J.; Sisniega, A.; Zbijewski, W.; Wang, X.; Foos, D. H.; Aygun, N.; Koliatsos, V. E.; Siewerdsen, J. H.

    2016-03-01

    Intracranial hemorrhage (ICH) is associated with pathologies such as hemorrhagic stroke and traumatic brain injury. Multi-detector CT is the current front-line imaging modality for detecting ICH (fresh blood contrast 40-80 HU, down to 1 mm). Flat-panel detector (FPD) cone-beam CT (CBCT) offers a potential alternative with a smaller scanner footprint, greater portability, and lower cost potentially well suited to deployment at the point of care outside standard diagnostic radiology and emergency room settings. Previous studies have suggested reliable detection of ICH down to 3 mm in CBCT using high-fidelity artifact correction and penalized weighted least-squared (PWLS) image reconstruction with a post-artifact-correction noise model. However, ICH reconstructed by traditional image regularization exhibits nonuniform spatial resolution and noise due to interaction between the statistical weights and regularization, which potentially degrades the detectability of ICH. In this work, we propose three regularization methods designed to overcome these challenges. The first two compute spatially varying certainty for uniform spatial resolution and noise, respectively. The third computes spatially varying regularization strength to achieve uniform "detectability," combining both spatial resolution and noise in a manner analogous to a delta-function detection task. Experiments were conducted on a CBCT test-bench, and image quality was evaluated for simulated ICH in different regions of an anthropomorphic head. The first two methods improved the uniformity in spatial resolution and noise compared to traditional regularization. The third exhibited the highest uniformity in detectability among all methods and best overall image quality. The proposed regularization provides a valuable means to achieve uniform image quality in CBCT of ICH and is being incorporated in a CBCT prototype for ICH imaging.

  12. Recurrent Intracerebral Hemorrhage

    DEFF Research Database (Denmark)

    Schmidt, Linnea Boegeskov; Goertz, Sanne; Wohlfahrt, Jan

    2016-01-01

    BACKGROUND: Intracerebral hemorrhage (ICH) is a disease with high mortality and a substantial risk of recurrence. However, the recurrence risk is poorly documented and the knowledge of potential predictors for recurrence among co-morbidities and medicine with antithrombotic effect is limited....... OBJECTIVES: 1) To estimate the short- and long-term cumulative risks of recurrent intracerebral hemorrhage (ICH). 2) To investigate associations between typical comorbid diseases, surgical treatment, use of medicine with antithrombotic effects, including antithrombotic treatment (ATT), selective serotonin...

  13. Acesso aos medicamentos para tratamento da doença de Alzheimer fornecidos pelo Sistema Único de Saúde em Minas Gerais, Brasil

    Directory of Open Access Journals (Sweden)

    Celline Cardoso Almeida-Brasil

    Full Text Available Resumo: Avaliou-se as barreiras de acesso ao tratamento da doença de Alzheimer com base nos processos administrativos de medicamentos inibidores da colinesterase (IChE, enviados à Secretaria de Estado de Saúde de Minas Gerais, Brasil, entre 2012 e 2013. Utilizando-se informações de 165 processos selecionados aleatoriamente, abordaram-se as dimensões de acesso: acessibilidade geográfica, acomodação, aceitabilidade, disponibilidade e capacidade aquisitiva. O trâmite administrativo para o fornecimento dos IChE levou em média 39 dias e foi influenciado por características do trajeto percorrido pelo usuário. A maioria dos prescritores cumpriu menos de 80% dos critérios exigidos pelo Protocolo Clínico e Diretrizes Terapêuticas (PCDT da doença de Alzheimer. Como resultado, 38% dos processos não foram deferidos. A capacidade aquisitiva para o tratamento privado mensal com IChE foi de cerca de 21 dias de salário mínimo. Conclui-se que a burocracia do trâmite administrativo e a dificuldade de seguimento do PCDT pelos prescritores prejudicam o acesso ao tratamento da doença de Alzheimer e constituem uma grande carga para o orçamento dos pacientes.

  14. Aging exacerbates intracerebral hemorrhage-induced brain injury.

    Science.gov (United States)

    Lee, Jae-Chul; Cho, Geum-Sil; Choi, Byung-Ok; Kim, Hyoung Chun; Kim, Won-Ki

    2009-09-01

    Aging may be an important factor affecting brain injury by intracerebral hemorrhage (ICH). In the present study, we investigated the responses of glial cells and monocytes to intracerebral hemorrhage in normal and aged rats. ICH was induced by microinjecting autologous whole blood (15 microL) into the striatum of young (4 month old) and aged (24 month old) Sprague-Dawley rats. Age-dependent relations of brain tissue damage with glial and macrophageal responses were evaluated. Three days after ICH, activated microglia/macrophages with OX42-positive processes and swollen cytoplasm were more abundantly distributed around and inside the hemorrhagic lesions. These were more dramatic in aged versus the young rats. Western blot and immunohistochemistry analyses showed that the expression of interleukin-1beta protein after ICH was greater in aged rats, whereas the expression of GFAP and ciliary neurotrophic factor protein after ICH was significantly lower in aged rats. These results suggest that ICH causes more severe brain injury in aged rats most likely due to overactivation of microglia/macrophages and concomitant repression of reactive astrocytes.

  15. Evaluating Current Practices in Shelf Life Estimation.

    Science.gov (United States)

    Capen, Robert; Christopher, David; Forenzo, Patrick; Huynh-Ba, Kim; LeBlond, David; Liu, Oscar; O'Neill, John; Patterson, Nate; Quinlan, Michelle; Rajagopalan, Radhika; Schwenke, James; Stroup, Walter

    2018-02-01

    The current International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use (ICH) methods for determining the supported shelf life of a drug product, described in ICH guidance documents Q1A and Q1E, are evaluated in this paper. To support this evaluation, an industry data set is used which is comprised of 26 individual stability batches of a common drug product where most batches are measured over a 24 month storage period. Using randomly sampled sets of 3 or 6 batches from the industry data set, the current ICH methods are assessed from three perspectives. First, the distributional properties of the supported shelf lives are summarized and compared to the distributional properties of the true shelf lives associated with the industry data set, assuming the industry data set represents a finite population of drug product batches for discussion purposes. Second, the results of the ICH "poolability" tests for model selection are summarized and the separate shelf life distributions from the possible alternative models are compared. Finally, the ICH methods are evaluated in terms of their ability to manage risk. Shelf life estimates that are too long result in an unacceptable percentage of nonconforming batches at expiry while those that are too short put the manufacturer at risk of possibly having to prematurely discard safe and efficacious drug product. Based on the analysis of the industry data set, the ICH-recommended approach did not produce supported shelf lives that effectively managed risk. Alternative approaches are required.

  16. Computed tomography of arteriovenous malformation in children

    International Nuclear Information System (INIS)

    Takahashi, Shinichiro; Sonobe, Makoto; Kuwayama, Naoya; Suzuki, Michiyasu

    1985-01-01

    Cases of AVM in children under the age of 15 were analyzed and compared with adult cases. Thirty-nine cases of AVM have been experienced since CT was introduced, consisting of eight cases in children. The initial symptom in children was hemorrhage in seven cases and convulsive seizure in one case. In adults, hemorrhage was found in 26 cases and convulsive seizure in five cases. Initial CT was performed within 24 hours after onset in seven cases in children and in 12 cases in adults. In children, findings of those initial CT were intracerebral hematoma (ICH) in one case, ICH+intraventricular hemorrhage (IVH) in three cases and IVH in two cases. In adults, ICH was found in five cases, ICH+IVH in five cases and ICH+IVH+SAH in two cases. As in the adult cases, it may be proper to consider that the primary lesion in the acute stage of ruptured AVM in children is not SAH but ICH or IVH. (author)

  17. Preventive effect of aggressive blood pressure lowering on hematoma enlargement in patients with ultra-acute intracerebral hemorrhage

    International Nuclear Information System (INIS)

    Nishikawa, Tomofumi; Ueba, Tetsuya; Kajiwara, Motohiro; Iwata, Ryoichi; Yamashita, Kohsuke; Miyamatsu, Naomi

    2010-01-01

    The preventive effect of aggressive blood pressure lowering on hematoma enlargement was investigated in patients with ultra-acute spontaneous intracerebral hemorrhage (ICH). Retrospective review of 248 patients (145 males, 103 females) with spontaneous ICH treated in our hospital between 2005 and 2008 identified patients with ultra-acute ICH who were directly taken to our institute by ambulance within 3 hours after onset. Patients who could not be assessed twice by computed tomography (CT) within 24 hours after arrival were excluded. Systolic blood pressure (SBP) was aggressively controlled in all patients using intravenous nicardipine to below 140 mmHg as soon as possible after diagnosis of ICH with CT. Hematoma enlargement was defined as increase in volume of more than 33% or more than 12.5 ml in the first 24 hours. Hematoma enlargement was observed in 11 of the 73 patients (15.0%). The time course of SBP change was not significantly different in patients with and without hematoma enlargement. The incidence of hematoma enlargement in patients with ultra-acute ICH in this study was 15.0%, which was lower than that in other series in which blood pressure was not reduced aggressively. This finding suggests that aggressive SBP lowering to below 140 mmHg has a preventive effect on hematoma enlargement in patients with ultra-acute ICH. (author)

  18. History and Mechanism for Treatment of Intracerebral Hemorrhage with Scalp Acupuncture

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    Zhe Liu

    2012-01-01

    Full Text Available Intracerebral hemorrhage (ICH is an important public health problem with high rates of mortality, morbidity, and disability, but no clinically proven treatment strategy is available to date. Scalp acupuncture (SA refers to a therapy for treating diseases by needling and stimulating the specific areas of the scalp. The evidence from clinical studies suggested that SA therapy may produce significant benefits for patients with acute ICH. However, the therapeutic mechanisms are yet not well addressed. Therefore, in this paper, we provide a comprehensive overview on the history and mechanisms of SA therapy on acute ICH. Although SA has been practiced for thousands of years in China and could date back to 5 BC, SA therapy for acute ICH develops only in the recent 30 years. The possible mechanisms associated with the therapeutic effects of SA on ICH include the influence on hematoma, brain edema, and blood brain barrier, the products released from haematoma, the immune and inflammatory reaction, focal perihemorrhagic hypoperfusion and hemorheology, neuroelectrophysiology, and so on. At last, the existence of instant effect of SA on acute ICH and its possible mechanisms are presented.

  19. Fisetin Protects against Intracerebral Hemorrhage-Induced Neuroinflammation in Aged Mice.

    Science.gov (United States)

    Chen, Cheng; Yao, Li; Cui, Jing; Liu, Bao

    2018-01-01

    Fisetin is commonly used as an anti-inflammatory and neuroprotective drug. In this study, we aimed to investigate the efficacy of fisetin in alleviating intracerebral hemorrhage (ICH)-induced brain injury. Mouse ICH models were constructed using the collagenase-induction method. ICH mice received fisetin treatment at the dose of 10-90 mg/kg, followed by the evaluation of neurological deficit through neurologic severity scores (mNSS), brain water content and terminal deoxynucleotidyl transferase dUTP nick end labeling analysis of cell apoptosis. Cytokine levels were also assessed with enzyme-linked immunosorbent assay. The activation of astrocytes and microglia was evaluated through S100 staining and Western blot analysis of ionized calcium-binding adaptor molecule 1 respectively. Nuclear factor kappa-B (NF-κB) signaling was also evaluated by Western blot. ICH mice demonstrated dramatic increase in mNSS, brain edema and cell apoptosis, indicating severe brain deficit. Fisetin treatment lowered these parameters, suggesting the alleviation of brain injury. Levels of proinflammatory cytokines were reduced, accompanied by a prominent decrease in activated astrocytes and microglia. NF-κB signaling was also attenuated by fisetin treatment. Fisetin effectively alleviates ICH by downregulating proinflammatory cytokines and attenuating NF-κB signaling. These data suggest fisetin as a valuable natural flavonol for clinical management of ICH-induced brain injury. © 2018 S. Karger AG, Basel.

  20. Association Between Blood Glucose and Functional Outcome in Intracerebral Hemorrhage: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Zheng, Jun; Yu, Zhiyuan; Ma, Lu; Guo, Rui; Lin, Sen; You, Chao; Li, Hao

    2018-03-16

    Intracerebral hemorrhage (ICH) is a devastating subtype of stroke. Patients with ICH have poor functional outcomes. The association between blood glucose level and functional outcome in ICH remains unclear. This systematic review and meta-analysis aimed to investigate the association between blood glucose level and functional outcomes in patients with ICH. Literature was searched systemically in PubMed, EMBASE, Web of Science, and Cochrane Library. Published cohort studies evaluating the association between blood glucose and functional outcome in patients with ICH were included. This meta-analysis was performed using odds ratios (ORs) and 95% confidence intervals (CIs). A total of 16 studies were included in our meta-analysis. Our data show that hyperglycemia defined by cutoff values was significantly associated with unfavorable functional outcome (OR, 1.80; 95% CI, 1.36-2.39; P analysis also suggested a significant association between increased blood glucose levels and functional outcomes (OR, 1.05; 95% CI, 1.03-1.07; P functional outcome in ICH. Further studies with larger sample sizes, more time points, and longer follow-up times are necessary to confirm this association. Copyright © 2018 Elsevier Inc. All rights reserved.

  1. Electroacupuncture Exerts Neuroprotection through Caveolin-1 Mediated Molecular Pathway in Intracerebral Hemorrhage of Rats.

    Science.gov (United States)

    Li, Hui-Qin; Li, Yan; Chen, Zi-Xian; Zhang, Xiao-Guang; Zheng, Xia-Wei; Yang, Wen-Ting; Chen, Shuang; Zheng, Guo-Qing

    2016-01-01

    Spontaneous intracerebral hemorrhage (ICH) is one of the most devastating types of stroke. Here, we aim to demonstrate that electroacupuncture on Baihui (GV20) exerts neuroprotection for acute ICH possibly via the caveolin-1/matrix metalloproteinase/blood-brain barrier permeability pathway. The model of ICH was established by using collagenase VII. Rats were randomly divided into three groups: Sham-operation group, Sham electroacupuncture group, and electroacupuncture group. Each group was further divided into 4 subgroups according to the time points of 6 h, 1 d, 3 d, and 7 d after ICH. The methods were used including examination of neurological deficit scores according to Longa's scale, measurement of blood-brain barrier permeability through Evans Blue content, in situ immunofluorescent detection of caveolin-1 in brains, western blot analysis of caveolin-1 in brains, and in situ zymography for measuring matrix metalloproteinase-2/9 activity in brains. Compared with Sham electroacupuncture group, electroacupuncture group has resulted in a significant improvement in neurological deficit scores and in a reduction in Evans Blue content, expression of caveolin-1, and activity of matrix metalloproteinase-2/9 at 6 h, 1 d, 3 d, and 7 d after ICH ( P electroacupuncture on GV20 can improve neurological deficit scores and reduce blood-brain barrier permeability after ICH, and the mechanism possibly targets caveolin-1/matrix metalloproteinase/blood-brain barrier permeability pathway.

  2. Diagnosis of acute lymphoblastic leukemia from intracerebral hemorrhage and blast crisis. A case report and review of the literature.

    Science.gov (United States)

    Naunheim, Matthew R; Nahed, Brian V; Walcott, Brian P; Kahle, Kristopher T; Soupir, Chad P; Cahill, Daniel P; Borges, Lawrence F

    2010-09-01

    Intracerebral hemorrhage (ICH) contributes significantly to the morbidity and mortality of patients suffering from acute leukemia. While ICH is often identified in autopsy studies of leukemic patients, it is rare for ICH to be the presenting sign that ultimately leads to the diagnosis of leukemia. We report a patient with previously undiagnosed acute precursor B-cell lymphoblastic leukemia (ALL) who presented with diffuse encephalopathy due to ICH in the setting of an acute blast crisis. The diagnosis of ALL was initially suspected, because of the hyperleukocytosis observed on presentation, then confirmed with a bone marrow biopsy and flow cytometry study of the peripheral blood. Furthermore, detection of the BCR/ABL Philadelphia translocation t(9:22)(q34:q11) in this leukemic patient by fluorescent in situ hybridization permitted targeted therapy of the blast crisis with imatinib (Gleevec). Understanding the underlying etiology of ICH is pivotal in its management. This case demonstrates that the presence of hyperleukocytosis in a patient with intracerebral hemorrhage should raise clinical suspicion for acute leukemia as the cause of the ICH.

  3. Gender Differences in Patients with Intracerebral Hemorrhage: A Hospital-Based Multicenter Prospective Study

    Directory of Open Access Journals (Sweden)

    Monique Bueno Alves

    2012-10-01

    Full Text Available Gender differences are well described for patients with ischemic stroke. Conversely, sex disparities in stroke presentation, risk factors, treatment, and outcomes for intracerebral hemorrhage (ICH were not previously studied. Our objective was to compare the frequency of risk factors, management patterns, symptoms at presentation, complication rates, and outcomes between genders in patients with ICH in Fortaleza, Brazil. Methods: Data were prospectively collected from patients admitted to 19 hospitals in Fortaleza with a diagnosis of ICH by trained research coordinators from June 2009 to October 2010. Daily visits to the selected hospitals were performed, and all patients admitted with a diagnosis of ICH were prospectively evaluated. Results: We evaluated 364 patients, 47.5% of whom were women. Men were younger (59.3 ± 14.58 years vs. 66.3 ± 14.6 years, p Conclusion: Overall risk factors for ICH in men and women were similar in our series. Men had a higher frequency of alcohol abuse and smoking. Women were older, had an increased time length from symptoms onset to hospital admission and had a worse prognosis at discharge. A better understanding of the gender disparities in patients with ICH will hopefully lead to better outcomes in both sexes in the future.

  4. Mortality after hemorrhagic stroke: data from general practice (The Health Improvement Network).

    Science.gov (United States)

    González-Pérez, Antonio; Gaist, David; Wallander, Mari-Ann; McFeat, Gillian; García-Rodríguez, Luis A

    2013-08-06

    To investigate short-term case fatality and long-term mortality after intracerebral hemorrhage (ICH) and subarachnoid hemorrhage (SAH) using data from The Health Improvement Network database. Thirty-day case fatality was stratified by age, sex, and calendar year after ICH and SAH using logistic regression. Cox proportional hazards regression analyses were used to estimate the risk of death during the first year of follow-up and survivors at 1 year. Case fatality after ICH was 42.0%, compared with 28.7% after SAH. It increased with age (ICH: 29.7% for 20-49 years, 54.6% for 80-89 years; SAH: 20.3% for 20-49 years, 56.7% for 80-89 years; both p-trend stroke patients during the first year of follow-up compared with controls (ICH: hazard ratio [HR] 2.60, 95% confidence interval [CI] 2.09-3.24, p hemorrhagic stroke, and patients younger than 50 years are more likely to die after ICH than SAH. Short-term case fatality has decreased over time. Patients who survive hemorrhagic stroke have a continuing elevated risk of death compared with matched individuals from the general population.

  5. Thromboembolic risks of recombinant factor VIIa Use in warfarin-associated intracranial hemorrhage: a case–control study

    Directory of Open Access Journals (Sweden)

    H-Y Chou Sherry

    2012-12-01

    Full Text Available Abstract Background Recombinant factor VIIa (rFVIIa may be used for rapid hemostasis in life-threatening hemorrhage. In warfarin-associated intracerebral hemorrhage (wICH, FVIIa use is controversial and may carry significant thromboembolic risks. We compared incidence of baseline thromboembolic risk factors and thromboembolism rates in wICH patients treated with additional rFVIIa to those treated with standard therapy of fresh frozen plasma (FFP and vitamin K alone. Methods We identified 45 consecutive wICH patients treated with additional rFVIIa over 5-year period, and 34 consecutive wICH patients treated with standard therapy alone as comparison group. We compared the incidence of post-hemorrhage cardiac and extra-cardiac thromboembolic complications between two treatment groups, and used logistic regression to adjust for significant confounders such as baseline thromboembolic risk factors. We performed secondary analysis comparing the quantity of FFP transfused between two treatment cohorts. Results Both rFVIIa-treated and standard therapy-treated wICH patients had a high prevalence of pre-existing thromboembolic diseases including atrial fibrillation (73% vs 68%, deep venous thrombosis (DVT or pulmonary embolism (PE (22% vs 18%, coronary artery disease (CAD (38% vs 32%, and abnormal electrocardiogram (EKG (78% vs 85%. Troponin elevation following wICH was prevalent in both groups (47% vs 41%. Clinically significant myocardial infarction (MI, defined as troponin > 1.0 ng/dL, occurred in 13% of rFVIIa-treated and 6% of standard therapy-treated patients (p=0.52. Past history of CAD (p=0.0061 and baseline abnormal EKG (p=0.02 were independently associated with clinically significant MI following wICH while rFVIIa use was not. The incidences of DVT/PE (2% vs 9%; p=0.18 and ischemic stroke (2% vs 0%; p=0.38 were similar between two treatment groups. Recombinant FVIIa-treated patients had lower mean INR at 3 (p=0.0001 and 6 hours (p Conclusions Pre

  6. Chiral Spirals from Discontinuous Chiral Symmetry

    Science.gov (United States)

    Kojo, Toru

    2014-09-01

    Recently phases of the inhomongeneous chiral condensates (IChC) attract renewed attentions in quark matter context. A number of theoretical studies have suggested that in some domain of moderate quark density the IChC phases are energetically more favored than the normal, chiral symmetric phase. In particular, the NJL-type model studies indicate that the phase of IChCs may mask the usual 1st order chiral phase transition line and its critical end point, and might change the conventional wisdom. In this talk, I will discuss characteristic features of the IChC phases and their potential impacts on the compact star physics. In particular, some of the IChC phases open gaps near the quark Fermi surface, suppressing back-reaction from the quark to gluon sectors. This mechanism delays the chiral restoration in the strange quark sector, forbids the emergence of the large bag constant, and as a consequence, makes the quark matter EOS very stiff. Recently phases of the inhomongeneous chiral condensates (IChC) attract renewed attentions in quark matter context. A number of theoretical studies have suggested that in some domain of moderate quark density the IChC phases are energetically more favored than the normal, chiral symmetric phase. In particular, the NJL-type model studies indicate that the phase of IChCs may mask the usual 1st order chiral phase transition line and its critical end point, and might change the conventional wisdom. In this talk, I will discuss characteristic features of the IChC phases and their potential impacts on the compact star physics. In particular, some of the IChC phases open gaps near the quark Fermi surface, suppressing back-reaction from the quark to gluon sectors. This mechanism delays the chiral restoration in the strange quark sector, forbids the emergence of the large bag constant, and as a consequence, makes the quark matter EOS very stiff. NSF Grants PHY09-69790, PHY13-05891.

  7. Intracranial hemorrhage in full-term newborns: a hospital-based cohort study

    International Nuclear Information System (INIS)

    Brouwer, Annemieke J.; Groenendaal, Floris; Koopman, Corine; Vries, Linda S. de; Nievelstein, Rutger-Jan A.; Han, Sen K.

    2010-01-01

    In recent years, intracranial hemorrhage (ICH) with parenchymal involvement has been diagnosed more often in full-term neonates due to improved neuroimaging techniques. The aim of this study is to describe clinical and neuroimaging data in the neonatal period and relate imaging findings to outcome in a hospital-based population admitted to a level 3 neonatal intensive care unit (NICU). From our neuroimaging database, we retrospectively retrieved records and images of 53 term infants (1991-2008) in whom an imaging diagnosis of ICH with parenchymal involvement was made. Clinical data, including mode of delivery, clinical manifestations, neurological symptoms, extent and site of hemorrhage, neurosurgical intervention, and neurodevelopmental outcomes, were recorded. Seventeen of the 53 term infants had infratentorial ICH, 20 had supratentorial ICH, and 16 had a combination of the two. Seizures were the most common presenting symptom (71.7%), another ten infants (18.9%) presented with apneic seizures, and five infants had no clinical signs but were admitted to our NICU because of perinatal asphyxia (n = 2), respiratory distress (n = 2), and development of posthemorrhagic ventricular dilatation (n = 1). Continuous amplitude-integrated electroencephalography recordings were performed in all infants. Clinical or subclinical seizures were seen in 48/53 (90.6%) infants; all received anti-epileptic drugs. Thirteen of all 53 (24.5%) infants died. The lowest mortality rate was seen in infants with supratentorial ICH (10%). Three infants with a midline shift required craniotomy, six infants needed a subcutaneous reservoir due to outflow obstruction, and three subsequently required a ventriculoperitoneal shunt. The group with poor outcome (death or developmental quotient (DQ) <85) had a significantly lower 5-min Apgar score (p =.006). Follow-up data were available for 37/40 survivors aged at least 15 months. Patients were assessed with the Griffiths Mental Developmental Scales

  8. Intracranial hemorrhage in full-term newborns: a hospital-based cohort study

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    Brouwer, Annemieke J.; Groenendaal, Floris; Koopman, Corine; Vries, Linda S. de [University Medical Center Utrecht, Department of Neonatology, Wilhelmina Children' s Hospital, PO Box 85090, Utrecht (Netherlands); Nievelstein, Rutger-Jan A. [University Medical Center Utrecht, Department of Radiology, Wilhelmina Children' s Hospital, Utrecht (Netherlands); Han, Sen K. [University Medical Center Utrecht, Department of Neurosurgery, Wilhelmina Children' s Hospital, Utrecht (Netherlands)

    2010-06-15

    In recent years, intracranial hemorrhage (ICH) with parenchymal involvement has been diagnosed more often in full-term neonates due to improved neuroimaging techniques. The aim of this study is to describe clinical and neuroimaging data in the neonatal period and relate imaging findings to outcome in a hospital-based population admitted to a level 3 neonatal intensive care unit (NICU). From our neuroimaging database, we retrospectively retrieved records and images of 53 term infants (1991-2008) in whom an imaging diagnosis of ICH with parenchymal involvement was made. Clinical data, including mode of delivery, clinical manifestations, neurological symptoms, extent and site of hemorrhage, neurosurgical intervention, and neurodevelopmental outcomes, were recorded. Seventeen of the 53 term infants had infratentorial ICH, 20 had supratentorial ICH, and 16 had a combination of the two. Seizures were the most common presenting symptom (71.7%), another ten infants (18.9%) presented with apneic seizures, and five infants had no clinical signs but were admitted to our NICU because of perinatal asphyxia (n = 2), respiratory distress (n = 2), and development of posthemorrhagic ventricular dilatation (n = 1). Continuous amplitude-integrated electroencephalography recordings were performed in all infants. Clinical or subclinical seizures were seen in 48/53 (90.6%) infants; all received anti-epileptic drugs. Thirteen of all 53 (24.5%) infants died. The lowest mortality rate was seen in infants with supratentorial ICH (10%). Three infants with a midline shift required craniotomy, six infants needed a subcutaneous reservoir due to outflow obstruction, and three subsequently required a ventriculoperitoneal shunt. The group with poor outcome (death or developmental quotient (DQ) <85) had a significantly lower 5-min Apgar score (p =.006). Follow-up data were available for 37/40 survivors aged at least 15 months. Patients were assessed with the Griffiths Mental Developmental Scales

  9. Serum creatinine may indicate risk of symptomatic intracranial hemorrhage after intravenous tissue plasminogen activator (IV tPA).

    Science.gov (United States)

    Marsh, Elisabeth B; Gottesman, Rebecca F; Hillis, Argye E; Urrutia, Victor C; Llinas, Rafael H

    2013-11-01

    Symptomatic intracranial hemorrhage (sICH) is a known complication following administration of intravenous tissue plasminogen activator (IV tPA) for acute ischemic stroke. sICH results in high rates of death or long-term disability. Our ability to predict its occurrence is important in clinical decision making and when counseling families. The initial National Institute of Neurological Disorders and Stroke (NINDS) investigators developed a list of relative contraindications to IV tPA meant to decrease the risk of subsequent sICH. To date, the impact of renal impairment has not been well studied. In the current study we evaluate the potential association between renal impairment and post-tPA intracranial hemorrhage (ICH). Admission serum creatinine and estimated glomerular filtration rate (eGFR) were recorded in 224 patients presenting within 4.5 hours from symptom onset and treated with IV tPA based on NINDS criteria. Neuroimaging was obtained 1 day post-tPA and for any change in neurologic status to evaluate for ICH. Images were retrospectively evaluated for hemorrhage by a board-certified neuroradiologist and 2 reviewers blinded to the patient's neurologic status. Medical records were reviewed retrospectively for evidence of neurologic decline indicating a "symptomatic" hemorrhage. sICH was defined as subjective clinical deterioration (documented by the primary neurology team) and hemorrhage on neuroimaging that was felt to be the most likely cause. Renal impairment was evaluated using both serum creatinine and eGFR in a number of ways: 1) continuous creatinine; 2) any renal impairment by creatinine (serum creatinine >1.0 mg/dL); 3) continuous eGFR; and 4) any renal impairment by eGFR (eGFR creatinine >1.0 mg/dL) was not associated with combined symptomatic and asymptomatic intracranial bleeding (p = 0.359); however, there was an adjusted 5.5-fold increased odds of sICH when creatinine was >1.0 mg/dL (95% confidence interval, 1.08-28.39), and the frequency of sICH

  10. The Increase of The Mean Platelet Volume in Patients With Intracerebral Haemorrhage

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    Adalet Arıkanoğlu

    2012-06-01

    Full Text Available OBJECTIVE: The mean platelet volume (MPV is a biomarker of platelet function and activity. The influence of platelet function disorders on the aetiology of intracerebral haemorrhages (ICH and mortality is not clear yet. The purpose of this study is to investigate the change in the MPV values in patients with ICH and to observe its influence on mortality in a retrospective manner. METHODS: Sixty-six patients with intracerebral haemorrhage (32 males, 34 females; mean age: 61.9± 16.9 were enrolled in the study. Patients with ICH were divided into two groups as those who died within the first 10 days and those who survived. The MPV values and the haematoma volumes were compared between the groups. Also, the MPV values and platelet counts of the patients with ICH were compared with the values of healthy volunteers from similar age and sex groups (27 males, 17 females; mean age: 59.9 ±3.2. RESULTS: The MPV values of the patients with ICH measured within 24 hours following the intracerebral haemorrhage (8.33 ± 1.27 fl/mL were statistically significantly higher than the MPV values of the control group (7.76 ± 1.14 fl/mL (p=0.018. The platelet counts of the patients with ICH also measured within the first 24 hours (235.8±94.9 x103/mL were statistically significantly lower than the platelet counts of the control group (279.1 ± 94.9 x103/mL (p=0.022. No statistically significant difference in terms of the MPV values and platelet counts was observed between the patients with ICH who died within the first 10 days and those who survived (p>0.05. However, the difference observed in the haematoma volume between the patients with ICH who died within the first 10 days (31.1 ±33.7 ml and those who survived (8.7± 13.4 ml was statistically significant (p<0.001. No correlation was found between the haematoma volume and the MPV value in the patients with ICH. CONCLUSION: The increase observed in the mean platelet volume in patients with ICH may point to a

  11. Phantom-based standardization of CT angiography images for spot sign detection.

    Science.gov (United States)

    Morotti, Andrea; Romero, Javier M; Jessel, Michael J; Hernandez, Andrew M; Vashkevich, Anastasia; Schwab, Kristin; Burns, Joseph D; Shah, Qaisar A; Bergman, Thomas A; Suri, M Fareed K; Ezzeddine, Mustapha; Kirmani, Jawad F; Agarwal, Sachin; Shapshak, Angela Hays; Messe, Steven R; Venkatasubramanian, Chitra; Palmieri, Katherine; Lewandowski, Christopher; Chang, Tiffany R; Chang, Ira; Rose, David Z; Smith, Wade; Hsu, Chung Y; Liu, Chun-Lin; Lien, Li-Ming; Hsiao, Chen-Yu; Iwama, Toru; Afzal, Mohammad Rauf; Cassarly, Christy; Greenberg, Steven M; Martin, Renee' Hebert; Qureshi, Adnan I; Rosand, Jonathan; Boone, John M; Goldstein, Joshua N

    2017-09-01

    The CT angiography (CTA) spot sign is a strong predictor of hematoma expansion in intracerebral hemorrhage (ICH). However, CTA parameters vary widely across centers and may negatively impact spot sign accuracy in predicting ICH expansion. We developed a CT iodine calibration phantom that was scanned at different institutions in a large multicenter ICH clinical trial to determine the effect of image standardization on spot sign detection and performance. A custom phantom containing known concentrations of iodine was designed and scanned using the stroke CT protocol at each institution. Custom software was developed to read the CT volume datasets and calculate the Hounsfield unit as a function of iodine concentration for each phantom scan. CTA images obtained within 8 h from symptom onset were analyzed by two trained readers comparing the calibrated vs. uncalibrated density cutoffs for spot sign identification. ICH expansion was defined as hematoma volume growth >33%. A total of 90 subjects qualified for the study, of whom 17/83 (20.5%) experienced ICH expansion. The number of spot sign positive scans was higher in the calibrated analysis (67.8 vs 38.9% p spot signs identified in the non-calibrated analysis remained positive after calibration. Calibrated CTA images had higher sensitivity for ICH expansion (76 vs 52%) but inferior specificity (35 vs 63%) compared with uncalibrated images. Normalization of CTA images using phantom data is a feasible strategy to obtain consistent image quantification for spot sign analysis across different sites and may improve sensitivity for identification of ICH expansion.

  12. Oral anticoagulant re-initiation following intracerebral hemorrhage in non-valvular atrial fibrillation: Global survey of the practices of neurologists, neurosurgeons and thrombosis experts.

    Science.gov (United States)

    Xu, Yan; Shoamanesh, Ashkan; Schulman, Sam; Dowlatshahi, Dar; Al-Shahi Salman, Rustam; Moldovan, Ioana Doina; Wells, Philip Stephen; AlKherayf, Fahad

    2018-01-01

    While oral anticoagulants (OACs) are highly effective for ischemic stroke prevention in atrial fibrillation, intracerebral hemorrhage (ICH) remains the most feared complication of OAC. Clinical controversy remains regarding OAC resumption and its timing for ICH survivors with atrial fibrillation because the balance between risks and benefits has not been investigated in randomized trials. To survey the practice of stroke neurologists, thrombosis experts and neurosurgeons on OAC re-initiation following OAC-associated ICH. An online survey was distributed to members of the International Society for Thrombosis and Haemostasis, Canadian Stroke Consortium, NAVIGATE-ESUS trial investigators (Clinicatrials.gov identifier NCT02313909) and American Association of Neurological Surgeons. Demographic factors and 11 clinical scenarios were included. Two hundred twenty-eight participants from 38 countries completed the survey. Majority of participants were affiliated with academic centers, and >20% managed more than 15 OAC-associated ICH patients/year. Proportion of respondents suggesting OAC anticoagulant resumption varied from 30% (for cerebral amyloid angiopathy) to 98% (for traumatic ICH). Within this group, there was wide distribution in response for timing of resumption: 21.4% preferred to re-start OACs after 1-3 weeks of incident ICH, while 25.3% opted to start after 1-3 months. Neurosurgery respondents preferred earlier OAC resumption compared to stroke neurologists or thrombosis experts in 5 scenarios (p<0.05 by Kendall's tau). Wide variations in current practice exist among management of OAC-associated ICH, with decisions influenced by patient- and provider-related factors. As these variations likely reflect the lack of high quality evidence, randomized trials are direly needed in this population.

  13. Phantom-based standardization of CT angiography images for spot sign detection

    International Nuclear Information System (INIS)

    Morotti, Andrea; Rosand, Jonathan; Romero, Javier M.; Jessel, Michael J.; Vashkevich, Anastasia; Schwab, Kristin; Greenberg, Steven M.; Hernandez, Andrew M.; Boone, John M.; Burns, Joseph D.; Shah, Qaisar A.; Bergman, Thomas A.; Suri, M.F.K.; Ezzeddine, Mustapha; Kirmani, Jawad F.; Agarwal, Sachin; Hays Shapshak, Angela; Messe, Steven R.; Venkatasubramanian, Chitra; Palmieri, Katherine; Lewandowski, Christopher; Chang, Tiffany R.; Chang, Ira; Rose, David Z.; Smith, Wade; Hsu, Chung Y.; Liu, Chun-Lin; Lien, Li-Ming; Hsiao, Chen-Yu; Iwama, Toru; Afzal, Mohammad Rauf; Qureshi, Adnan I.; Cassarly, Christy; Hebert Martin, Renee; Goldstein, Joshua N.

    2017-01-01

    The CT angiography (CTA) spot sign is a strong predictor of hematoma expansion in intracerebral hemorrhage (ICH). However, CTA parameters vary widely across centers and may negatively impact spot sign accuracy in predicting ICH expansion. We developed a CT iodine calibration phantom that was scanned at different institutions in a large multicenter ICH clinical trial to determine the effect of image standardization on spot sign detection and performance. A custom phantom containing known concentrations of iodine was designed and scanned using the stroke CT protocol at each institution. Custom software was developed to read the CT volume datasets and calculate the Hounsfield unit as a function of iodine concentration for each phantom scan. CTA images obtained within 8 h from symptom onset were analyzed by two trained readers comparing the calibrated vs. uncalibrated density cutoffs for spot sign identification. ICH expansion was defined as hematoma volume growth >33%. A total of 90 subjects qualified for the study, of whom 17/83 (20.5%) experienced ICH expansion. The number of spot sign positive scans was higher in the calibrated analysis (67.8 vs 38.9% p < 0.001). All spot signs identified in the non-calibrated analysis remained positive after calibration. Calibrated CTA images had higher sensitivity for ICH expansion (76 vs 52%) but inferior specificity (35 vs 63%) compared with uncalibrated images. Normalization of CTA images using phantom data is a feasible strategy to obtain consistent image quantification for spot sign analysis across different sites and may improve sensitivity for identification of ICH expansion. (orig.)

  14. Hyperglycemia is associated with intracranial injury in children younger than 3 years of age.

    Science.gov (United States)

    Babbitt, Christopher J; Halpern, Rebekah; Liao, Eileen; Lai, Khanh

    2013-03-01

    The objective was to see if hyperglycemia in the emergency department predicted traumatic intracranial hemorrhage (ICH) for infants and young children. A 6-year retrospective chart review was performed on patients younger than 3 years. Patients identified from the pediatric intensive care unit (PICU) database with ICH on computer tomography were compared with those with a history of trauma without ICH identified from a radiology database. Subgroup analysis was performed on the ICH group comparing abusive head trauma (AHT) and accidental. Primary outcomes measured were initial serum glucose level, length of stay, length of ventilation, mortality, and disability on discharge. Fifty-three patients were admitted to the PICU with traumatic ICH with an overall mortality of 7.5%. The average initial glucose in the emergency department was significantly higher for the patients with ICH than those without (164 vs. 99 mg/dL, P < 0.0001). Combining elevated serum glucose with any abnormality in Glasgow Coma Scale score yielded sensitivity and specificity of 100%. The average presenting glucose was higher for AHT compared with accidental injury (190 vs. 133 mg/dL, P < 0.001). Patients with AHT had greater PICU and hospital length of stay and more severe disabilities on discharge (P < 0.001). Elevated serum glucose is a good marker of ICH in children younger than 3 years. When correlated with an abnormal neurological examination, it is highly sensitive and specific. Patients with AHT have further elevation of serum glucose at presentation. Emergency department physicians should consider measuring the serum glucose in children younger than 3 years with abnormal neurological examinations and obtaining a head computer tomography if it is elevated.

  15. Differential expression of circulating microRNAs in blood and haematoma samples from patients with intracerebral haemorrhage.

    Science.gov (United States)

    Wang, Jialu; Zhu, Ying; Jin, Feng; Tang, Ling; He, Zhenwei; He, Zhiyi

    2016-06-01

    To measure the differential expression of microRNAs (miRNAs) in peripheral blood samples from patients with intracerebral haemorrhage (ICH) and to measure the levels of hsa-miR-21-5p in peripheral blood and haematoma samples from patients with ICH. This case-control study enrolled individuals with ICH in the putamen treated by craniotomy and age- and sex-matched healthy control subjects. Serum miRNA expression profiles were determined in the patient and control groups using miRNA polymerase chain reaction (PCR) arrays. The ICH-related miRNA hsa-miR-21-5p was selected and its differential expression was assessed in peripheral blood and haematoma specimens from patients with ICH compared with peripheral blood samples controls using real-time PCR. Seven patients and five control subjects were included in the miRNA expression profile analysis; and 31 patients and 22 control subjects provided samples for the real-time PCR of hsa-miR-21-5p expression. A total of 59 miRNAs were significantly downregulated in patients with ICH. Relative hsa-miR-21-5p levels of 0.43 and 0.31 for peripheral blood and haematoma samples, respectively, were obtained in the patient group compared with the control subjects. Hsa-miR-21-5p levels were significantly reduced in both peripheral blood and haematoma samples in patients with ICH. © The Author(s) 2016.

  16. Phantom-based standardization of CT angiography images for spot sign detection

    Energy Technology Data Exchange (ETDEWEB)

    Morotti, Andrea; Rosand, Jonathan [Harvard Medical School, Division of Neurocritical Care and Emergency Neurology, Department of Neurology, Massachusetts General Hospital, Boston, MA (United States); Harvard Medical School, J. P. Kistler Stroke Research Center, Massachusetts General Hospital, Boston, MA (United States); Romero, Javier M. [Harvard Medical School, Division of Neurocritical Care and Emergency Neurology, Department of Neurology, Massachusetts General Hospital, Boston, MA (United States); Harvard Medical School, J. P. Kistler Stroke Research Center, Massachusetts General Hospital, Boston, MA (United States); Harvard Medical School, Neuroradiology Service, Department of Radiology, Massachusetts General Hospital, Boston, MA (United States); Jessel, Michael J.; Vashkevich, Anastasia; Schwab, Kristin; Greenberg, Steven M. [Harvard Medical School, J. P. Kistler Stroke Research Center, Massachusetts General Hospital, Boston, MA (United States); Hernandez, Andrew M.; Boone, John M. [University of California Davis, Department of Radiology, Sacramento, CA (United States); Burns, Joseph D. [Lahey Hospital and Medical Center, Department of Neurology, Burlington, MA (United States); Shah, Qaisar A. [Abington Memorial Hospital, Abington, PA (United States); Bergman, Thomas A. [Hennepin County Medical Center, Minneapolis, MN (United States); Suri, M.F.K. [St. Cloud Hospital, St. Cloud, MN (United States); Ezzeddine, Mustapha [University of Minnesota, Minneapolis, MN (United States); Kirmani, Jawad F. [JFK Medical Center, Stroke and Neurovascular Center, Edison, NJ (United States); Agarwal, Sachin [Columbia University Medical Center, New York, NY (United States); Hays Shapshak, Angela [University of Alabama at Birmingham, Birmingham, AL (United States); Messe, Steven R. [University of Pennsylvania, Philadelphia, PA (United States); Venkatasubramanian, Chitra [Stanford University, Stanford, CA (United States); Palmieri, Katherine [The University of Kansas Health System, Kansas City, KS (United States); Lewandowski, Christopher [Henry Ford Hospital, Detroit, MI (United States); Chang, Tiffany R. [University of Texas Medical School, Houston, TX (United States); Chang, Ira [Colorado Neurological Institute, Swedish Medical Center, Englewood, CO (United States); Rose, David Z. [Tampa General Hospital, University of South Florida College of Medicine, Tampa, FL (United States); Smith, Wade [UCSF Medical Center, San Francisco, CA (United States); Hsu, Chung Y.; Liu, Chun-Lin [China Medical University Hospital, Taichung (China); Lien, Li-Ming; Hsiao, Chen-Yu [Shin Kong Wu Ho-Su Memorial Hospital, Taipei (China); Iwama, Toru [Gifu University Hospital, Gifu (Japan); Afzal, Mohammad Rauf; Qureshi, Adnan I. [University of Minnesota, Zeenat Qureshi Stroke Research Center, Minneapolis, MN (United States); Cassarly, Christy; Hebert Martin, Renee [Medical University of South Carolina, Department of Public Health Sciences, Charleston, SC (United States); Goldstein, Joshua N. [Harvard Medical School, Division of Neurocritical Care and Emergency Neurology, Department of Neurology, Massachusetts General Hospital, Boston, MA (United States); Harvard Medical School, J. P. Kistler Stroke Research Center, Massachusetts General Hospital, Boston, MA (United States); Harvard Medical School, Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA (United States); Collaboration: ATACH-II and NETT Investigators

    2017-09-15

    The CT angiography (CTA) spot sign is a strong predictor of hematoma expansion in intracerebral hemorrhage (ICH). However, CTA parameters vary widely across centers and may negatively impact spot sign accuracy in predicting ICH expansion. We developed a CT iodine calibration phantom that was scanned at different institutions in a large multicenter ICH clinical trial to determine the effect of image standardization on spot sign detection and performance. A custom phantom containing known concentrations of iodine was designed and scanned using the stroke CT protocol at each institution. Custom software was developed to read the CT volume datasets and calculate the Hounsfield unit as a function of iodine concentration for each phantom scan. CTA images obtained within 8 h from symptom onset were analyzed by two trained readers comparing the calibrated vs. uncalibrated density cutoffs for spot sign identification. ICH expansion was defined as hematoma volume growth >33%. A total of 90 subjects qualified for the study, of whom 17/83 (20.5%) experienced ICH expansion. The number of spot sign positive scans was higher in the calibrated analysis (67.8 vs 38.9% p < 0.001). All spot signs identified in the non-calibrated analysis remained positive after calibration. Calibrated CTA images had higher sensitivity for ICH expansion (76 vs 52%) but inferior specificity (35 vs 63%) compared with uncalibrated images. Normalization of CTA images using phantom data is a feasible strategy to obtain consistent image quantification for spot sign analysis across different sites and may improve sensitivity for identification of ICH expansion. (orig.)

  17. Initial clinical experience with dual-layer detector spectral CT in patients with acute intracerebral haemorrhage: A single-centre pilot study.

    Directory of Open Access Journals (Sweden)

    Soo Buem Cho

    Full Text Available The purpose of this study was to investigate the clinical feasibility of spectral analyses using dual-layer detector spectral computed tomography (CT in acute intracerebral haemorrhage (ICH.We retrospectively reviewed patients with acute ICH who underwent CT angiography on a dual-layer detector spectral CT scanner. A spectral data analysis was performed to detect contrast enhancement in or adjacent to acute ICH by using spectral image reconstructions including monoenergetic (MonoE, virtual noncontrast (VNC, and iodine overlay fusion images. We also acquired a spectral plot to assess material differentiation within lesions.Among the 30 patients, the most common cause of acute ICH was chronic hypertension (18/30, 60% followed by trauma (5/30, 16.7%, brain tumour (3/30, 10%, Moyamoya disease (2/30, 6.7%, and haemorrhagic diathesis from anticoagulation therapy (2/30, 6.7%. Of 30 patients, 13 showed suboptimal iodine suppression in the subcalvarial spaces on VNC images compared with true noncontrast images. The CT angiographic spot sign within the acute ICH was detected in four patients (4/30, 13.3%. All three tumours were metastatic and included lung cancer (n = 2 and hepatocellular carcinoma (n = 1 which showed conspicuous delineation of an enhancing tumour portion in the spectral analysis. Spectral analyses allowed the discrimination of acute haemorrhage and iodine with enhanced lesion visualization on the MonoE images obtained at lower keVs (less than 70 keV and spectral plot.Even though the image quality of VNC is perceived to be inferior, it is feasible to evaluate acute ICH in clinical settings using dual-layer detector spectral CT. The MonoE images taken at lower keVs were useful for depicting contrast enhancing lesion, and spectral plot might be helpful for material differentiation in patients with acute ICH.

  18. Initial clinical experience with dual-layer detector spectral CT in patients with acute intracerebral haemorrhage: A single-centre pilot study.

    Science.gov (United States)

    Cho, Soo Buem; Baek, Hye Jin; Ryu, Kyeong Hwa; Moon, Jin Il; Choi, Bo Hwa; Park, Sung Eun; Bae, Kyungsoo; Jeon, Kyung Nyeo; Kim, Dong Wook

    2017-01-01

    The purpose of this study was to investigate the clinical feasibility of spectral analyses using dual-layer detector spectral computed tomography (CT) in acute intracerebral haemorrhage (ICH). We retrospectively reviewed patients with acute ICH who underwent CT angiography on a dual-layer detector spectral CT scanner. A spectral data analysis was performed to detect contrast enhancement in or adjacent to acute ICH by using spectral image reconstructions including monoenergetic (MonoE), virtual noncontrast (VNC), and iodine overlay fusion images. We also acquired a spectral plot to assess material differentiation within lesions. Among the 30 patients, the most common cause of acute ICH was chronic hypertension (18/30, 60%) followed by trauma (5/30, 16.7%), brain tumour (3/30, 10%), Moyamoya disease (2/30, 6.7%), and haemorrhagic diathesis from anticoagulation therapy (2/30, 6.7%). Of 30 patients, 13 showed suboptimal iodine suppression in the subcalvarial spaces on VNC images compared with true noncontrast images. The CT angiographic spot sign within the acute ICH was detected in four patients (4/30, 13.3%). All three tumours were metastatic and included lung cancer (n = 2) and hepatocellular carcinoma (n = 1) which showed conspicuous delineation of an enhancing tumour portion in the spectral analysis. Spectral analyses allowed the discrimination of acute haemorrhage and iodine with enhanced lesion visualization on the MonoE images obtained at lower keVs (less than 70 keV) and spectral plot. Even though the image quality of VNC is perceived to be inferior, it is feasible to evaluate acute ICH in clinical settings using dual-layer detector spectral CT. The MonoE images taken at lower keVs were useful for depicting contrast enhancing lesion, and spectral plot might be helpful for material differentiation in patients with acute ICH.

  19. Minocycline attenuates brain injury and iron overload after intracerebral hemorrhage in aged female rats.

    Science.gov (United States)

    Dai, Shuhui; Hua, Ya; Keep, Richard F; Novakovic, Nemanja; Fei, Zhou; Xi, Guohua

    2018-06-05

    Brain iron overload is involved in brain injury after intracerebral hemorrhage (ICH). There is evidence that systemic administration of minocycline reduces brain iron level and improves neurological outcome in experimental models of hemorrhagic and ischemic stroke. However, there is evidence in cerebral ischemia that minocycline is not protective in aged female animals. Since most ICH research has used male models, this study was designed to provide an overall view of ICH-induced iron deposits at different time points (1 to 28 days) in aged (18-month old) female Fischer 344 rat ICH model and to investigate the neuroprotective effects of minocycline in those rats. According to our previous studies, we used the following dosing regimen (20 mg/kg, i.p. at 2 and 12 h after ICH onset followed by 10 mg/kg, i.p., twice a day up to 7 days). T2-, T2 ⁎ -weighted and T2 ⁎ array MRI was performed at 1, 3, 7 and 28 days to measure brain iron content, ventricle volume, lesion volume and brain swelling. Immunohistochemistry was used to examine changes in iron handling proteins, neuronal loss and microglial activation. Behavioral testing was used to assess neurological deficits. In aged female rats, ICH induced long-term perihematomal iron overload with upregulated iron handling proteins, neuroinflammation, brain atrophy, neuronal loss and neurological deficits. Minocycline significantly reduced ICH-induced perihematomal iron overload and iron handling proteins. It further reduced brain swelling, neuroinflammation, neuronal loss, delayed brain atrophy and neurological deficits. These effects may be linked to the role of minocycline as an iron chelator as well as an inhibitor of neuroinflammation. Copyright © 2018 Elsevier Inc. All rights reserved.

  20. Effectiveness and Safety of Non-Vitamin K Antagonist Oral Anticoagulants in Asian Patients With Atrial Fibrillation.

    Science.gov (United States)

    Cha, Myung-Jin; Choi, Eue-Keun; Han, Kyung-Do; Lee, So-Ryoung; Lim, Woo-Hyun; Oh, Seil; Lip, Gregory Y H

    2017-11-01

    There are limited real-world data comparing the effectiveness and safety of non-vitamin K antagonist oral anticoagulants (NOACs) and warfarin in Asians with nonvalvular atrial fibrillation. We aimed to compare the effectiveness and safety between NOACs and warfarin users in the Korean atrial fibrillation population, with particular focus on high-risk patients. Using the Korean National Health Insurance Service database, we analyzed the risk of ischemic stroke, intracranial hemorrhage (ICH) events, and all-cause death in NOAC users (n=11 611 total, n=5681 taking rivaroxaban, n=3741 taking dabigatran, and n=2189 taking apixaban) compared with propensity score-matched warfarin users (n=23 222) among patients with high-risk atrial fibrillation (CHA 2 DS 2 -VASc score ≥2) between 2014 and 2015. NOAC treatment was associated with similar risk of ischemic stroke and lower risk of ICH and all-cause mortality compared with warfarin. All 3 NOACs were associated with a similar risk of ischemic stroke and a lower risk of ICH compared with warfarin. Dabigatran and apixaban were associated with a lower risk of total mortality and the composite net clinical outcome (ischemic stroke, ICH, and all-cause death) compared with warfarin, whereas this was nonsignificant for rivaroxaban. Among previously oral anticoagulant-naive patients (n=23 262), dabigatran and apixaban were superior to warfarin for ICH prevention, whereas rivaroxaban and warfarin were associated with similar risk of ICH. In real-world practice among a high-risk Asian atrial fibrillation population, all 3 NOACs demonstrated similar risk of ischemic stroke and lower risk of ICH compared with warfarin. All-cause mortality was significantly lower only with dabigatran and apixaban. © 2017 American Heart Association, Inc.

  1. Risk of Intracranial Hemorrhage From Statin Use in Asians: A Nationwide Cohort Study.

    Science.gov (United States)

    Chang, Chia-Hsuin; Lin, Chin-Hsien; Caffrey, James L; Lee, Yen-Chieh; Liu, Ying-Chun; Lin, Jou-Wei; Lai, Mei-Shu

    2015-06-09

    Reports of statin usage and increased risk of intracranial hemorrhage (ICH) have been inconsistent. This study examined potential associations between statin usage and the risk of ICH in subjects without a previous history of stroke. Patients initiating statin therapy between 2005 and 2009 without a previous history of ischemic or hemorrhagic stroke were identified from Taiwan's National Health Insurance database. Participants were stratified by advanced age (≥70 years), sex, and diagnosed hypertension. The outcome of interest was hospital admission for ICH (International Classification of Diseases, Ninth Revision, Clinical Modification codes 430, 431, 432). Cox regression models were applied to estimate the hazard ratio of ICH. The cumulative statin dosage stratified by quartile and adjusted for baseline disease risk score served as the primary variable using the lowest quartile of cumulative dosage as a reference. There were 1 096 547 statin initiators with an average follow-up of 3.3 years. The adjusted hazard ratio for ICH between the highest and the lowest quartile was nonsignificant at 1.06 with a 95% confidence interval spanning 1.00 (0.94-1.19). Similar nonsignificant results were found in sensitivity analyses using different outcome definitions or model adjustments, reinforcing the robustness of the study findings. Subgroup analysis identified an excess of ICH frequency in patients without diagnosed hypertension (adjusted hazard ratio 1.36 [1.11-1.67]). In general, no association was observed between cumulative statin use and the risk of ICH among subjects without a previous history of stroke. An increased risk was identified among the nonhypertensive cohort, but this finding should be interpreted with caution. © 2015 American Heart Association, Inc.

  2. Fetal and neonatal alloimmune thrombocytopenia: predictive factors of intracranial hemorrhage.

    Science.gov (United States)

    Delbos, Florent; Bertrand, Gérald; Croisille, Laure; Ansart-Pirenne, Hélène; Bierling, Philippe; Kaplan, Cécile

    2016-01-01

    In Caucasians, fetal/neonatal alloimmune thrombocytopenia (FNAIT) is most frequently caused by maternal alloimmunization against the human platelet antigen HPA-1a. The most serious complication of severe FNAIT is intracranial hemorrhage (ICH). ICH mainly occurs in utero; therefore, there is a need to identify noninvasive predictive factors of ICH to facilitate early identification of this condition and to determine response to maternal therapy. We studied gynecologic and immunogenetic variables of severe cases of anti-HPA-1a FNAIT within three groups: Group I, FNAIT without ICH; Group II, FNAIT with ICH; and Group III, suspected FNAIT cases without detectable maternal anti-HPA-1a alloantibodies. ICH was associated with a poor outcome because it led to death in 59% of cases. Multigravida (two or more pregnancies) was overrepresented in Group II, consistent with the high concentrations of maternal HPA-1a alloantibody and the frequent detection of a strong newborn-specific HLA class I antibody response at delivery. The proportion of HLA-DRB4*01:01P (*01:01 or *01:03) women was similar in Groups I and II, but this allele was overrepresented in Group III, in which FNAIT was less severe than in the other two groups. Finally, antenatal intravenous immunoglobulin therapy tended to be more effective in HLA-DRB3*01:01(+)/HLA-DRB4*01:01P(+) women than for HLA-DRB3*01:01(+)/HLA-DRB4*01:01P(-) women. The number of gestations is a predictive factor of ICH in anti-HPA-1a-alloimmunized women. Maternal immunogenetic variables should be investigated in the context of maternal immunization and may predict response to maternal therapy in subsequent pregnancies. © 2015 AABB.

  3. Electroacupuncture improves neurobehavioral function and brain injury in rat model of intracerebral hemorrhage.

    Science.gov (United States)

    Zhu, Yan; Deng, Li; Tang, Huajun; Gao, Xiaoqing; Wang, Youhua; Guo, Kan; Kong, Jiming; Yang, Chaoxian

    2017-05-01

    Acupuncture has been widely used as a treatment for stroke in China for a long time. Recently, studies have demonstrated that electroacupuncture (EA) can accelerate intracerebral hemorrhage (ICH)-induced angiogenesis in rats. In the present study, we investigated the effect of EA on neurobehavioral function and brain injury in ICH rats. ICH was induced by stereotactic injection of collagenase type I and heparin into the right caudate putamen. Adult ICH rats were randomly divided into the following three groups: model control group (MC), EA at non-acupoint points group (non-acupoint EA) and EA at Baihui and Dazhui acupoints group (EA). The neurobehavioral deficits of ICH rats were assessed by modified neurological severity score (mNSS) and gait analysis. The hemorrhage volume and glucose metabolism of hemorrhagic foci were detected by PET/CT. The expression levels of MBP, NSE and S100-B proteins in serum were tested by ELISA. The histopathological features were examined by haematoxylin-eosin (H&E) staining. Apoptosis-associated proteins in the perihematomal region were observed by immunohistochemistry. EA treatment significantly promoted the recovery of neurobehavioral function in ICH rats. Hemorrhage volume reduced in EA group at day 14 when compared with MC and non-acupoint EA groups. ELISA showed that the levels of MBP, NSE and S100-B in serum were all down-regulated by EA treatment. The brain tissue of ICH rat in the EA group was more intact and compact than that in the MC and non-acupoint groups. In the perihematomal regions, the expression of Bcl-2 protein increased and expressions of Caspase-3 and Bax proteins decreased in the EA group vs MC and non-acupoint EA groups. Our data suggest that EA treatment can improve neurobehavioral function and brain injury, which were likely connected with the absorption of hematoma and regulation of apoptosis-related proteins. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Intranasal delivery of hypoxia-preconditioned bone marrow-derived mesenchymal stem cells enhanced regenerative effects after intracerebral hemorrhagic stroke in mice.

    Science.gov (United States)

    Sun, Jinmei; Wei, Zheng Zachory; Gu, Xiaohuan; Zhang, James Ya; Zhang, Yongbo; Li, Jimei; Wei, Ling

    2015-10-01

    Intracerebral hemorrhagic stroke (ICH) causes high mortality and morbidity with very limited treatment options. Cell-based therapy has emerged as a novel approach to replace damaged brain tissues and promote regenerative processes. In this study we tested the hypothesis that intranasally delivered hypoxia-preconditioned BMSCs could reach the brain, promote tissue repair and improve functional recovery after ICH. Hemorrhagic stroke was induced in adult C57/B6 mice by injection of collagenase IV into the striatum. Animals were randomly divided into three groups: sham group, intranasal BMSC treatment group, and vehicle treatment group. BMSCs were pre-treated with hypoxic preconditioning (HP) and pre-labeled with Hoechst before transplantation. Behavior tests, including the mNSS score, rotarod test, adhesive removal test, and locomotor function evaluation were performed at varying days, up to 21days, after ICH to evaluate the therapeutic effects of BMSC transplantation. Western blots and immunohistochemistry were performed to analyze the neurotrophic effects. Intranasally delivered HP-BMSCs were identified in peri-injury regions. NeuN+/BrdU+ co-labeled cells were markedly increased around the hematoma region, and growth factors, including BDNF, GDNF, and VEGF were significantly upregulated in the ICH brain after BMSC treatment. The BMSC treatment group showed significant improvement in behavioral performance compared with the vehicle group. Our data also showed that intranasally delivered HP-BMSCs migrated to peri-injury regions and provided growth factors to increase neurogenesis after ICH. We conclude that intranasal administration of BMSC is an effective treatment for ICH, and that it enhanced neuroregenerative effects and promoted neurological functional recovery after ICH. Overall, the investigation supports the potential therapeutic strategy for BMSC transplantation therapy against hemorrhagic stroke. Copyright © 2015 Elsevier Inc. All rights reserved.

  5. Different utilization of intensive care services (ICSs) for patients dying of hemorrhagic and ischemic stroke, a hospital-based survey.

    Science.gov (United States)

    Wang, Vinchi; Hsieh, Chieh-Chao; Huang, Yen-Ling; Chen, Chia-Ping; Hsieh, Yi-Ting; Chao, Tzu-Hao

    2018-02-01

    The intensive care service (ICS) saves lives and rescues the neurological function of stroke patients. We wondered the different utilization of ICS for patients with ischemic and hemorrhagic stroke, especially those who died within 30 days after stroke.Sixty-seven patients died during 2011 to 2015 due to acute stroke (42 due to intracranial hemorrhage [ICH]; 25 due to cerebral infarct [CI]). The durations of hospital stay (hospital staying days [HSDs]) and ICS staying days (ISDs) and codes of the do-not-resuscitate (DNR) were surveyed among these medical records. Statistics included chi-square and descriptive analyses.In this study, CI patients had a longer HSD (mean 14.3 days), as compared with ICH patients (mean 8.3 days); however, the ICH patients had a higher percentage of early entry within the first 24 hours of admission into ICS than CI group (95.1% vs 60.0%, P = .003). A higher rate of CI patients died in holidays or weekends than those with ICH (44.0% vs 21.4%, P = .051). DNR, requested mainly from direct descendants (children or grandchildren), was coded in all 25 CI patients (100.0%) and 38 ICH patients (90.5%). More cases with early DNR coded within 24 hours after admission occurred in ICH group (47%, 12% in CI patients, P = .003). None of the stroke patient had living wills. Withhold of endotracheal intubation (ETI) occurred among CI patients, more than for ICH patients (76.0% vs 18.4%, P mortality within holidays or weekends, and higher ETI withhold; but less percentage of ICS utilization expressed by a lower ISD/HSD ratio. This ICS utilization is a key issue of medical quality for stroke care.

  6. Epidemiology of Mild Traumatic Brain Injury with Intracranial Hemorrhage: Focusing Predictive Models for Neurosurgical Intervention.

    Science.gov (United States)

    Orlando, Alessandro; Levy, A Stewart; Carrick, Matthew M; Tanner, Allen; Mains, Charles W; Bar-Or, David

    2017-11-01

    To outline differences in neurosurgical intervention (NI) rates between intracranial hemorrhage (ICH) types in mild traumatic brain injuries and help identify which ICH types are most likely to benefit from creation of predictive models for NI. A multicenter retrospective study of adult patients spanning 3 years at 4 U.S. trauma centers was performed. Patients were included if they presented with mild traumatic brain injury (Glasgow Coma Scale score 13-15) with head CT scan positive for ICH. Patients were excluded for skull fractures, "unspecified hemorrhage," or coagulopathy. Primary outcome was NI. Stepwise multivariable logistic regression models were built to analyze the independent association between ICH variables and outcome measures. The study comprised 1876 patients. NI rate was 6.7%. There was a significant difference in rate of NI by ICH type. Subdural hematomas had the highest rate of NI (15.5%) and accounted for 78% of all NIs. Isolated subarachnoid hemorrhages had the lowest, nonzero, NI rate (0.19%). Logistic regression models identified ICH type as the most influential independent variable when examining NI. A model predicting NI for isolated subarachnoid hemorrhages would require 26,928 patients, but a model predicting NI for isolated subdural hematomas would require only 328 patients. This study highlighted disparate NI rates among ICH types in patients with mild traumatic brain injury and identified mild, isolated subdural hematomas as most appropriate for construction of predictive NI models. Increased health care efficiency will be driven by accurate understanding of risk, which can come only from accurate predictive models. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. Prostaglandin E2 EP2 Receptor Deletion Attenuates Intracerebral Hemorrhage-Induced Brain Injury and Improves Functional Recovery

    Directory of Open Access Journals (Sweden)

    Jenna L. Leclerc

    2015-04-01

    Full Text Available Intracerebral hemorrhage (ICH is a devastating type of stroke characterized by bleeding into the brain parenchyma and secondary brain injury resulting from strong neuroinflammatory responses to blood components. Production of prostaglandin E2 (PGE2 is significantly upregulated following ICH and contributes to this inflammatory response in part through its E prostanoid receptor subtype 2 (EP2. Signaling through the EP2 receptor has been shown to affect outcomes of many acute and chronic neurological disorders; although, not yet explored in the context of ICH. Wildtype (WT and EP2 receptor knockout (EP2−/− mice were subjected to ICH, and various anatomical and functional outcomes were assessed by histology and neurobehavioral testing, respectively. When compared with age-matched WT controls, EP2−/− mice had 41.9 ± 4.7% smaller ICH-induced brain lesions and displayed significantly less ipsilateral hemispheric enlargement and incidence of intraventricular hemorrhage. Anatomical outcomes correlated with improved functional recovery as identified by neurological deficit scoring. Histological staining was performed to begin investigating the mechanisms involved in EP2-mediated neurotoxicity after ICH. EP2−/− mice exhibited 45.5 ± 5.8% and 41.4 ± 8.1% less blood and ferric iron accumulation, respectively. Furthermore, significantly less striatal and cortical microgliosis, striatal and cortical astrogliosis, blood–brain barrier breakdown, and peripheral neutrophil infiltration were seen in EP2−/− mice. This study is the first to suggest a deleterious role for the PGE2-EP2 signaling axis in modulating brain injury, inflammation, and functional recovery following ICH. Targeting the EP2 G protein-coupled receptor may represent a new therapeutic avenue for the treatment of hemorrhagic stroke.

  8. Landschaftsbereiche der Provinz Latina

    Directory of Open Access Journals (Sweden)

    Luigi Piemontese

    2012-08-01

    Full Text Available Das Konzept der Landschaft setz sich zusammen aus verschiedenen Bezugspunkten und Interpretationen, je nach dem Blickpunkt, und ihre Wahnehrung veraendert sich je nach der verschiedenartigen Brille mit der man sie sieht. Der Artikel, geht von der Definition der Landschaft aus, wie sie in der Eurpaischen Konvention zitiert ist :“ Ein Teil des Landes, wie es von seinen Volk gesehen ist, dessen Charakter geformt ist aus naturlichen und menschlichen Faktoren und deren Wechselverhaeltnis”. Er wird fortgefuehrt mit der Identifikation der Landschaftsbereiche der Provinz Latina, die angesehn werden sollen als klimatisch, litologisch und morphologisch aenliche Landschaftsportionen, in denen erstens die Merkmale der Flora und Fauna klar werden und an zweiter Stelle, durch den Gebrauch des Territoriums und die Veraendungen mit denen er es gezeichnet hat, das Tun des Menschen. Die Methodik ruht teilweise auf der Klassifizierung des Territoriums, ausgearbeitet von C.Blasio und dem Konkretfall angeglichen.

  9. Cyborg oder Göttin: Wie Technikforscherinnen ihr Verhältnis zu Technik sehen

    Directory of Open Access Journals (Sweden)

    Ulrike Kissmann

    2001-11-01

    Full Text Available Die Autorinnen haben für die Beiträge eigene auto/biographische Erlebnisse ausgewählt, in denen der mediale Charakter von Technik deutlich wird. Die Geschichten erzählen also von Technik, die soziale Ordnung und Bedeutung vermittelt und auf diese Weise dazu beiträgt, Geschlechtergrenzen und andere Grenzen wie die zwischen „bekannt“ und „fremd“ oder „normal“ und „anormal“ herzustellen. Die Auto/Biographien sind durch Technik einerseits fremdbestimmt, andererseits zeigen die Autorinnen auch, wie Selbstbestimmung über diese Grenzen hinweg möglich ist. Sie benutzen Donna Haraways Cyborg Metapher (1985, um das Selbst in der Verflechtung von Sozialem und Technischem auto/biographisch zu rekonstruieren.

  10. Zróżnicowanie parametrów geotechnicznych gruntów spoistych południowo-zachodniej Polski

    Directory of Open Access Journals (Sweden)

    Ewa Wojnicka-Janowska

    2017-09-01

    Full Text Available Podstawą w projektowaniu konstrukcji inżynierskiej lub jej elementów jest znajomość podłoża gruntowego, w szczególności jego parametrów geotechnicznych. Przedstawione opracowanie ma charakter analizy zmienności regionalnej parametrów geotechnicznych gruntów ilastych południowo-zachodniej Polski, pod względem stratygraficznym zaliczonych do utworów neogeńskich. W publikacji wykorzystano bieżące badania własne uzupełnione o archiwalne badania próbek gruntów ilastych pochodzących z Legnicy i Głogowa. Wyniki badań opracowano statystycznie oraz przedstawiono w formie tabelarycznej.

  11. Historyczność kultury. W poszukiwaniu myślowego fundamentu współczesnej historiografii.

    OpenAIRE

    Werner, Wiktor

    2009-01-01

    Pracę tę ma można uznać za studium z obszaru intelektualnej historii kultury europejskiej. W tym ujęciu dotyczy ona powstawania, w okresie od początku XVIII wieku do początku XX wieku, ważnych dyskursów opisujących i wyjaśniających świat: filozoficznego empiryzmu, ekonomii politycznej, społecznego darwinizmu i teologii naturalnej. Praca ta także ma charakter studium z historii idei, gdzie badanym zagadnieniem jest historyczność kultury czyli zbiór myślowych kategorii, których obecność w ró...

  12. Relational Resources As A Source Of Regional Competitive Advantage. Illustrated By The Examples Of The Lodzkie Voivodship And The Novosibirsk Oblast / Zasoby Relacyjne Jako Źródło Przewagi Konkurencyjnej Regionów Na Przykładzie Województwa Łódzkiego Oraz Obwodu Novosybirskiego

    Directory of Open Access Journals (Sweden)

    Rudolf Wawrzyniec

    2015-08-01

    Full Text Available Artykuł ma na celu pokazanie zasobów relacyjnych, jako nabierającego na znaczeniu czynnika konkurencyjności terytoriów. Autorzy starają się wykazać, że regiony chcące zwiększyć swoją przewagę konkurencyjną powinny podejmować działania, aby ułatwiać tworzenie bazy wiedzy oraz otoczenia instytucjonalnego. W artykule oparto się na teorii zależności od zasobów, wykorzystywanej zwłaszcza dla analizowania relacji pomiędzy organizacją a jej otoczeniem. Opracowanie ma charakter teoretyczny z wykorzystaniem metody desk research przy użyciu szerokiej, światowej literatury przedmiotu. Rozważania kończy prezentacja dwóch deskryptywnych studiów przypadku.

  13. Lifestyle and Health

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    Martyna Gorzelak

    2017-11-01

    Full Text Available Admission:  The World Health Organization defines lifestyle as a way of being associated with the interaction of man and the conditions, in which he lives, as well as individual behavior patterns, which have been determined by socio-cultural factors and personal characteristics charakter2. Aim: Aim of the study is to identify the impact of lifestyle on human health in every stage of life. Lifestyle is defined as all the characteristics of the behavior of a particular individual or community. It refers to behavior occurring in everyday life and those routinely repeated. The lifestyle behaviors include inter alia: attitudes to work and use, leisure, nutrition, clothing and relationships. Summary: Healthy lifestyle developed among people of all ages, will transfer into later adult health, their children, and the elderly. A healthy lifestyle improves the quality of life in every stage.

  14. Heidegeer a Kierkegaard: pojetí boha a posvátného

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    Jiří Olšovský

    2010-05-01

    Full Text Available Text je zaměřen zejména na posvátný charakter světa a přírody, jak se zračí v pojetí bytí a božského u Heideggera a Kierkegaarda. Bytí zde zůstává tématem, spolu se základní péčí a starostí o svět a věci v něm. Ukazuje se, že spodní proud Heideggerova myšlení je znovu-probuzení „zbožného myšlení“ a rezervovanost. Zejména článek chce upozornit na Heideggerovy odkazy k mysticismu a Kierkegaardův „pramen víry“. V úvahách nad Heideggerovým dílem je třeba se zamyslet, zda otázka Boha může být rozhodnuta jen v blízkosti bytí a svatosti. O noumenální charakter naší „zahrady“ je nezbytné znovu náležitě pečovat, a zaposlouchat se proto do řeči těch, kteří byli s to se přiblížit k bytí a božskému, k posvátnému pobývání na zemi.

  15. Outcomes Associated With Resuming Warfarin Treatment After Hemorrhagic Stroke or Traumatic Intracranial Hemorrhage in Patients With Atrial Fibrillation.

    Science.gov (United States)

    Nielsen, Peter Brønnum; Larsen, Torben Bjerregaard; Skjøth, Flemming; Lip, Gregory Y H

    2017-04-01

    The increase in the risk for bleeding associated with antithrombotic therapy causes a dilemma in patients with atrial fibrillation (AF) who sustain an intracranial hemorrhage (ICH). A thrombotic risk is present; however, a risk for serious harm associated with resumption of anticoagulation therapy also exists. To investigate the prognosis associated with resuming warfarin treatment stratified by the type of ICH (hemorrhagic stroke or traumatic ICH). This nationwide observational cohort study included patients with AF who sustained an incident ICH event during warfarin treatment from January 1, 1998, through February 28, 2016. Follow-up was completed April 30, 2016. Resumption of warfarin treatment was evaluated after hospital discharge. No oral anticoagulant treatment or resumption of warfarin treatment, included as a time-dependent exposure. One-year observed event rates per 100 person-years were calculated, and treatment strategies were compared using time-dependent Cox proportional hazards regression models with adjustment for age, sex, length of hospital stay, comorbidities, and concomitant medication use. A total of 2415 patients with AF in this cohort (1481 men [61.3%] and 934 women [38.7%]; mean [SD] age, 77.1 years [9.1 years]) sustained an ICH event. Of these events, 1325 were attributable to hemorrhagic stroke and 1090 were secondary to trauma. During the first year, 305 patients with a hemorrhagic stroke (23.0%) died, whereas 210 in the traumatic ICH group (19.3%) died. Among patients with hemorrhagic stroke, resuming warfarin therapy was associated with a lower rate of ischemic stroke or systemic embolism (SE) (adjusted hazard ratio [AHR], 0.49; 95% CI, 0.24-1.02) and an increased rate of recurrent ICH (AHR, 1.31; 95% CI, 0.68-2.50) compared with not resuming warfarin therapy, but these differences did not reach statistical significance. For patients with traumatic ICH, resuming warfarin therapy also was associated with a lower rate of ischemic stroke

  16. Relationship between alternation of cerebral blood flow and formation of brain edema around the hematoma after experimental intracerebral hemorrhage

    International Nuclear Information System (INIS)

    Zhou Jian; Gao Peiyi; Li Xiaoguang

    2005-01-01

    Objective: To investigate the mechanism of brain edema formation around the hematoma and the relationship between the formation of brain edema and the changes of regional cerebral blood flow after intracerebral hemorrhage (ICH) in rats, and to provide experimental basis for the clinical treatment of ICH . Methods: Seventy male Sprague-Dawley rats were randomly divided into ICH groups and sham-operated groups. ICH was produced by microinjection of 40 ul fresh autologous blood or saline into the right caudatum. Dynamic CT perfusion imaging was performed, and the parameters of regional cerebral blood flow (rCBF), regional cerebral blood volume (rCBV), and mean transit time (MTT) around the hematoma were calculated respectively. Then the rats were sacrificed, and the water content, sodium, potassium, and calcium concentrations were measured respectively. The correlative study between the water content and rCBF and rCBV were carried out. Results:The gradient of perihematomal hypoperfusion was revealed on CT perfusion maps in ICH groups. The alternation of rCBF around the hematomas were fluctuated, and rCBF reduction was most pronounced at 1 hour afer ICH, then the rCBF gradually returned, reaching the peaks at 6 hours and 24 hours after ICH, respectively. In the meantime, rCBV reduction around the hematoma was most pronounced at 1 hour after ICH. Then the rCBV gradually increased, and reaching the peak at 24 hours. The water contents were gradually increased in the ipsilateral basal ganglia in the animals sacrificed at 6, 24, and 72 hours. The accumulation of water was at its peak at 24 hours, and remained in the animals sacrificed at the 72 hours. The perihemorrhagic water contents correlated significantly with rCBV surrounding hematomas, r=0.372 (one-tailed), P<0.05. Conclusion: The perihemorrhagic brain edema results from the common effects of the blood-brain-barrier disruption, cytotoxic edema, and the accumulation of osmotically active substances. The r

  17. Increased Expression of T Cell Immunoglobulin and Mucin Domain 3 on CD14+ Monocytes Is Associated with Systemic Inflammatory Reaction and Brain Injury in Patients with Spontaneous Intracerebral Hemorrhage.

    Science.gov (United States)

    Xu, ChangJun; Ge, HaiTao; Wang, Tao; Qin, JianBing; Liu, De; Liu, YuGuang

    2018-05-01

    To study the expression of T cell immunoglobulin and mucin domain 3 (Tim-3) on peripheral blood immunocytes, and the relationship between Tim-3 and the systemic inflammatory response or brain injury in patients with intracerebral hemorrhage (ICH). According to the volume of hematoma at 12 hours after onset of ICH, 60 newly diagnosed patients with ICH were divided into the small (volume of hematoma <30 mL, 30 cases) and large (volume of hematoma ≥30 mL, 30 cases) ICH groups. The expression of Tim-3 on peripheral blood immunocytes was analyzed by flow cytometry. Real-time reverse transcriptase polymerase chain reaction was used to detect Tim-3 mRNA on peripheral blood mononuclear cells (PBMCs). Meanwhile, tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), and S-100B protein were measured by enzyme-linked immunosorbent assay. Glasgow outcome scale (GOS) score at Day 30 was used to estimate prognosis of patients. The leukocyte count, neutrophil count, monocyte count, TNF-α, IL-1β, and S-100B protein increased remarkably after ICH. However, all of them in the large ICH group increased more obviously, and there were significant differences when compared with those in the small ICH group (P < .01). The expression of Tim-3 mRNA on PBMCs in the large ICH group increased remarkably, peaked at Day 3, and was positively associated with the concentrations of TNF-α, IL-1β, and S-100B protein (P < .01). Tim-3 was predominantly expressed itself on CD14 + monocytes. There was a negative correlation between GOS score and Tim-3 mRNA, TNF-α, IL-1β, or S-100B protein. The expression of Tim-3 on CD14 + monocytes involves in systemic inflammatory reaction after ICH and may be a novel treatment target. Copyright © 2018 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  18. Heme activates TLR4-mediated inflammatory injury via MyD88/TRIF signaling pathway in intracerebral hemorrhage

    Directory of Open Access Journals (Sweden)

    Lin Sen

    2012-03-01

    Full Text Available Abstract Background Inflammatory injury plays a critical role in intracerebral hemorrhage (ICH-induced neurological deficits; however, the signaling pathways are not apparent by which the upstream cellular events trigger innate immune and inflammatory responses that contribute to neurological impairments. Toll-like receptor 4 (TLR4 plays a role in inflammatory damage caused by brain disorders. Methods In this study, we investigate the role of TLR4 signaling in ICH-induced inflammation. In the ICH model, a significant upregulation of TLR4 expression in reactive microglia has been demonstrated using real-time RT-PCR. Activation of microglia was detected by immunohistochemistry, cytokines were measured by ELISA, MyD88, TRIF and NF-κB were measured by Western blot and EMSA, animal behavior was evaluated by animal behavioristics. Results Compared to WT mice, TLR4−/− mice had restrained ICH-induced brain damage showing in reduced cerebral edema and lower neurological deficit scores. Quantification of cytokines including IL-6, TNF-α and IL-1β and assessment of macrophage infiltration in perihematoma tissues from TLR4−/−, MyD88−/− and TRIF−/− mice showed attenuated inflammatory damage after ICH. TLR4−/− mice also exhibited reduced MyD88 and TRIF expression which was accompanied by decreased NF-κB activity. This suggests that after ICH both MyD88 and TRIF pathways might be involved in TLR4-mediated inflammatory injury possibly via NF-κB activation. Exogenous hemin administration significantly increased TLR4 expression and microglial activation in cultures and also exacerbated brain injury in WT mice but not in TLR4−/− mice. Anti-TLR4 antibody administration suppressed hemin-induced microglial activation in cultures and in the mice model of ICH. Conclusions Our findings suggest that heme potentiates microglial activation via TLR4, in turn inducing NF-κB activation via the MyD88/TRIF signaling pathway, and ultimately

  19. Designated Stroke Center Status and Hospital Characteristics as Predictors of In-Hospital Mortality among Hemorrhagic Stroke Patients in New York, 2008-2012.

    Science.gov (United States)

    Gatollari, Hajere J; Colello, Anna; Eisenberg, Bonnie; Brissette, Ian; Luna, Jorge; Elkind, Mitchell S V; Willey, Joshua Z

    2017-01-01

    Although designated stroke centers (DSCs) improve the quality of care and clinical outcomes for ischemic stroke patients, less is known about the benefits of DSCs for patients with intracerebral hemorrhage (ICH) and subarachnoid hemorrhage (SAH). Compared to non-DSCs, hospitals with the DSC status have lower in-hospital mortality rates for hemorrhagic stroke patients. We believed these effects would sustain over a period of time after adjusting for hospital-level characteristics, including hospital size, urban location, and teaching status. We evaluated ICH (International Classification of Diseases, Ninth Revision; ICD-9: 431) and SAH (ICD-9: 430) hospitalizations documented in the 2008-2012 New York State Department of Health Statewide Planning and Research Cooperative System inpatient sample database. Generalized estimating equation logistic regression was used to evaluate the association between DSC status and in-hospital mortality. We calculated ORs and 95% CIs adjusted for clustering of patients within facilities, other hospital characteristics, and individual level characteristics. Planned secondary analyses explored other hospital characteristics associated with in-hospital mortality. In 6,352 ICH and 3,369 SAH patients in the study sample, in-hospital mortality was higher among those with ICH compared to SAH (23.7 vs. 18.5%). Unadjusted analyses revealed that DSC status was related with reduced mortality for both ICH (OR 0.7, 95% CI 0.5-0.8) and SAH patients (OR 0.4, 95% CI 0.3-0.7). DSC remained a significant predictor of lower in-hospital mortality for SAH patients (OR 0.6, 95% CI 0.3-0.9) but not for ICH patients (OR 0.8, 95% CI 0.6-1.0) after adjusting for patient demographic characteristics, comorbidities, hospital size, teaching status and location. Admission to a DSC was independently associated with reduced in-hospital mortality for SAH patients but not for those with ICH. Other patient and hospital characteristics may explain the benefits of DSC

  20. Antiplatelet Treatment After Transient Ischemic Attack and Ischemic Stroke in Patients With Cerebral Microbleeds in 2 Large Cohorts and an Updated Systematic Review.

    Science.gov (United States)

    Lau, Kui Kai; Lovelock, Caroline E; Li, Linxin; Simoni, Michela; Gutnikov, Sergei; Küker, Wilhelm; Mak, Henry Ka Fung; Rothwell, Peter M

    2018-06-01

    In patients with transient ischemic attack/ischemic stroke, microbleed burden predicts intracerebral hemorrhage (ICH), and ischemic stroke, but implications for antiplatelet treatment are uncertain. Previous cohort studies have had insufficient follow-up to assess the time course of risks, have not stratified risks by antithrombotic use, and have not reported extracranial bleeds or functional outcome of ICH versus ischemic stroke. In 2 independent prospective cohorts with transient ischemic attack/ischemic stroke (Oxford Vascular Study/mainly white; University of Hong Kong/mainly Chinese), antiplatelet treatment was started routinely irrespective of microbleed burden. Risks, time course and outcome of ICH, extracranial bleeds, and recurrent ischemic events were determined and stratified by microbleed burden (0 versus 1, 2-4, and ≥5), adjusting for age, sex, and vascular risk factors. Microbleeds were more frequent in the Chinese cohort (450 of 1003 versus 165 of 1080; P <0.0001), but risk associations were similar during 7433 patient-years of follow-up. Among 1811 patients on antiplatelet drugs, risk of major extracranial bleeds was unrelated to microbleed burden ( P trend =0.87), but the 5-year risk of ICH was steeply related ( P trend <0.0001), with 11 of 15 (73%) of ICH in 140 of 1811 (7.7%) patients with ≥5 microbleeds. However, risk of ischemic stroke also increased with microbleed burden ( P trend =0.013), such that risk of ischemic stroke and coronary events exceeded ICH and major extracranial bleeds during the first year, even among patients with ≥5 microbleeds (11.6% versus 3.9%). However, this ratio changed over time, with risk of hemorrhage (11.2%) matching that of ischemic events (12.0%) after 1 year. Moreover, whereas the association between microbleed burden and risk of ischemic stroke was due mainly to nondisabling events ( P trend =0.007), the association with ICH was accounted for ( P trend <0.0001) by disabling/fatal events (≥5 microbleeds

  1. Minimally Invasive Subcortical Parafascicular Transsulcal Access for Clot Evacuation (Mi SPACE for Intracerebral Hemorrhage

    Directory of Open Access Journals (Sweden)

    Benjamin Ritsma

    2014-01-01

    Full Text Available Background. Spontaneous intracerebral hemorrhage (ICH is common and causes significant mortality and morbidity. To date, optimal medical and surgical intervention remains uncertain. A lack of definitive benefit for operative management may be attributable to adverse surgical effect, collateral tissue injury. This is particularly relevant for ICH in dominant, eloquent cortex. Minimally invasive surgery (MIS offers the potential advantage of reduced collateral damage. MIS utilizing a parafascicular approach has demonstrated such benefit for intracranial tumor resection. Methods. We present a case of dominant hemisphere spontaneous ICH evacuated via the minimally invasive subcortical parafascicular transsulcal access clot evacuation (Mi SPACE model. We use this report to introduce Mi SPACE and to examine the application of this novel MIS paradigm. Case Presentation. The featured patient presented with a left temporal ICH and severe global aphasia. The hematoma was evacuated via the Mi SPACE approach. Postoperative reassessments showed significant improvement. At two months, bedside language testing was normal. MRI tractography confirmed limited collateral injury. Conclusions. This case illustrates successful application of the Mi SPACE model to ICH in dominant, eloquent cortex and subcortical regions. MRI tractography illustrates collateral tissue preservation. Safety and feasibility studies are required to further assess this promising new therapeutic paradigm.

  2. Severe bleeding complications other than intracranial hemorrhage in neonatal alloimmune thrombocytopenia: a case series and review of the literature.

    Science.gov (United States)

    Winkelhorst, Dian; Kamphuis, Marije M; de Kloet, Liselotte C; Zwaginga, Jaap Jan; Oepkes, Dick; Lopriore, Enrico

    2016-05-01

    The most feared bleeding complication in fetal and neonatal alloimmune thrombocytopenia (FNAIT) is an intracranial hemorrhage (ICH). However, FNAIT may also lead to other severe bleeding problems. The aim was to analyze this spectrum and evaluate the occurrence of severe hemorrhages other than ICH in fetuses or neonates with FNAIT. A retrospective chart analysis of cases of FNAIT presenting with severe bleeding complications other than ICH at our institution from 1990 to 2015 was conducted. Additionally, a review of the literature was performed to identify case reports and case series on FNAIT presenting with extracranial hemorrhage. Of 25 fetuses or neonates with severe bleeding due to FNAIT, three had isolated severe internal organ hemorrhage other than ICH, two pulmonary hemorrhages and one gastrointestinal hemorrhage. Two of these three neonates died due to this bleeding. Eighteen cases of extracranial bleeding complications as a first presentation of FNAIT were found in the literature, including ocular, gastrointestinal, spinal cord, pulmonary, renal, subgaleal, and genitourinary hemorrhages. Bleeding complications other than ICH may be more extensive, and the presentation of FNAIT may have a greater spectrum than previously described. A high index of suspicion on the possible diagnosis of FNAIT with any bleeding complication in a fetus or neonate may enable adequate diagnostics, adequate treatment, and appropriate follow-up in future pregnancies, as is especially relevant for FNAIT. © 2016 AABB.

  3. Intracranial hemorrhage after blunt head trauma in children with bleeding disorders.

    Science.gov (United States)

    Lee, Lois K; Dayan, Peter S; Gerardi, Michael J; Borgialli, Dominic A; Badawy, Mohamed K; Callahan, James M; Lillis, Kathleen A; Stanley, Rachel M; Gorelick, Marc H; Dong, Li; Zuspan, Sally Jo; Holmes, James F; Kuppermann, Nathan

    2011-06-01

    To determine computerized tomography (CT) use and prevalence of traumatic intracranial hemorrhage (ICH) in children with and without congenital and acquired bleeding disorders. We compared CT use and ICH prevalence in children with and without bleeding disorders in a multicenter cohort study of 43 904 children bleeding disorders; all had Glasgow Coma Scale (GCS) scores of 14 to 15. These children had higher CT rates than children without bleeding disorders and GCS scores of 14 to 15 (risk ratio, 2.29; 95% CI, 2.15 to 2.44). Of the children who underwent imaging with CT, 2 of 186 children with bleeding disorders had ICH (1.1%; 95% CI, 0.1 to 3.8) , compared with 655 of 14 969 children without bleeding disorders (4.4%; 95% CI, 4.1-4.7; rate ratio, 0.25; 95% CI, 0.06 to 0.98). Both children with bleeding disorders and ICHs had symptoms; none of the children required neurosurgery. In children with head trauma, CTs are obtained twice as often in children with bleeding disorders, although ICHs occurred in only 1.1%, and these patients had symptoms. Routine CT imaging after head trauma may not be required in children without symptoms who have congenital and acquired bleeding disorders. Copyright © 2011 Mosby, Inc. All rights reserved.

  4. Intracerebral Hemorrhage with Intraventricular Extension—Getting the Prognosis Right Early

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    Christoph Stretz

    2017-08-01

    Full Text Available BackgroundEarly accurate outcome prognostication for patients with intracerebral hemorrhage (ICH and accompanying intraventricular hemorrhage (IVH is often challenging (1. Acute hydrocephalus often contributes to a poor clinical exam (2 and can portend significant morbidity and mortality (3. Accordingly, the inpatient neurologist may feel inclined to recommend limitations of care for an ICH patient admitted with a large IVH burden and poor exam.Case presentationWe present a patient with significant IVH and minimal ICH who deteriorated rapidly to coma after presentation. Despite this exam, an initially non-functioning diversion of cerebrospinal fluid (CSF and temporary halt of further attempts of CSF diversion in the setting of an early “do not resuscitate order,” our patient gradually improved and, with supportive ICU care and rehabilitation, was able to communicate and ambulate with assistance at 12 weeks.ConclusionPatients with ICH with IVH do have the capacity to improve dramatically even with relatively conservative management. Unless previous limitations of care exist, we recommend that early judgments of prognosis for patients with ICH and/or IVH should be delayed for at least 72 h until the patient’s clinical trajectory over time is better understood.

  5. Current management of intracerebral haemorrhage in China: a national, multi-centre, hospital register study

    Directory of Open Access Journals (Sweden)

    Heeley Emma L

    2011-01-01

    Full Text Available Abstract Background We aimed to examine current practice of the management and secondary prevention of intracerebral haemorrhage (ICH in China where the disease is more common than in Western populations. Methods Data on baseline characteristics, management in-hospital and post-stroke, and outcome of ICH patients are from the ChinaQUEST (QUality Evaluation of Stroke Care and Treatment study, a multi-centre, prospective, 62 hospital registry in China during 2006-07. Results Nearly all ICH patients (n = 1572 received an intravenous haemodiluting agent such as mannitol (96% or a neuroprotectant (72%, and there was high use of intravenous traditional Chinese medicine (TCM (42%. Neurosurgery was undertaken in 137 (9% patients; being overweight, having a low Glasgow Coma Scale (GCS score on admission, and Total Anterior Circulation Syndrome (TACS clinical pattern on admission, were the only baseline factors associated with this intervention in multivariate analyses. Neurosurgery was associated with nearly three times higher risk of death/disability at 3 months post-stroke (odd ratio [OR] 2.60, p Conclusions The management of ICH in China is characterised by high rates of use of intravenous haemodiluting agents, neuroprotectants, and TCM, and of antihypertensives for secondary prevention. The controversial efficacy of these therapies, coupled with the current lack of treatments of proven benefit, is a call for action for more outcomes based research in ICH.

  6. Glial responses, neuron death and lesion resolution after intracerebral hemorrhage in young vs. aged rats.

    Science.gov (United States)

    Wasserman, Jason K; Yang, Helen; Schlichter, Lyanne C

    2008-10-01

    Intracerebral hemorrhage (ICH) usually affects older humans but almost no experimental studies have assessed aged animals. We address how aging alters inflammation, neuron death and lesion resolution after a hemorrhage in the rat striatum. In the normal aged brain, microglia displayed a 'dystrophic' phenotype, with shorter cellular processes and large gaps between adjacent cells, and there was more astrocyte reactivity. The ICH injury was monitored as hematoma volume and number of dying neurons at 1 and 3 days, and the volume of the residual lesion, ventricles and lost tissue at 28 days. Inflammation at 1 and 3 days was assessed from densities of microglia with resting vs. activated morphologies, or expressing the lysosomal marker ED1. Despite an initial delay in neuron death in aged animals, by 28 days, there was no difference in neuron density or volume of tissue lost. However, lesion resolution was impaired in aged animals and there was less compensatory ventricular expansion. At 1 day after ICH, there were fewer activated microglia/macrophages in the aged brain, but by 3 days there were more of these cells at the edge of the hematoma and in the surrounding parenchyma. In both age groups a glial limitans had developed by 3 days, but astrocyte reactivity and the spread of activated microglia/macrophages into the surrounding parenchyma was greater in the aged. These findings have important implications for efforts to reduce secondary injury after ICH and to develop anti-inflammatory therapies to treat ICH in aged humans.

  7. Utility of echo-planar gradient-echo T2*-weighted MR images in patients with primary intracerebral hemorrhage

    International Nuclear Information System (INIS)

    Yokoe, Toshio; Yoshida, Tazuka; Kobayashi, Nozomu; Nakamura, Yukihiro; Kubota, Kazuyuki

    2005-01-01

    Magnetic resonance imaging (MRI) has the potential to reveal residues of intracerabral hemorrhage (ICH) throughout life because of the high sensitivity for iron-containing compounds. Gradient-echo T2 * -weighted MR imaging (T2 * MRI) requiring short times for complete acquisition is known to detect small areas of signal loss without surrounding edema representing microbleeds (MBs). MBs in the basal ganglia including the thalami are suggested to be closely related to intracerebral atherosclerotic microangiopathy. We looked for more than 3 MBs in basal ganglia or thalamus of patients with and without episodes of previous ICH. Twelve patients with previous hemorrhagic stroke and 82 without were studied. Multiple MBs in those regions were significantly more frequent in patients with recurrent ICH. In addition, a 76-year-old woman with a history of hypertension was transferred to our hospital for treatment of head injury. She had multiple incidental old basal ganglionic and thalamic MBs. The patient had an asymptomatic primary ICH on computed tomography (CT) 3 months later. In conclusion, MR evidence of multiple MBs in the basal ganglia and thalamus might identify patients at a risk for new and recurrent ICH. Therefore, patients with multiple MBs in those regions should be treated for cerebrovascular risk factors, especially hypertension. Our results appear to confirm the utility of T2 * MRI in hemorrhagic stroke. (author)

  8. Neuroprotection of brain-permeable iron chelator VK-28 against intracerebral hemorrhage in mice.

    Science.gov (United States)

    Li, Qian; Wan, Jieru; Lan, Xi; Han, Xiaoning; Wang, Zhongyu; Wang, Jian

    2017-09-01

    Iron overload plays a key role in the secondary brain damage that develops after intracerebral hemorrhage (ICH). The significant increase in iron deposition is associated with the generation of reactive oxygen species (ROS), which leads to oxidative brain damage. In this study, we examined the protective effects of VK-28, a brain-permeable iron chelator, against hemoglobin toxicity in an ex vivo organotypic hippocampal slice culture (OHSC) model and in middle-aged mice subjected to an in vivo, collagenase-induced ICH model. We found that the effects of VK-28 were similar to those of deferoxamine (DFX), a well-studied iron chelator. Both decreased cell death and ROS production in OHSCs and in vivo, decreased iron-deposition and microglial activation around hematoma in vivo, and improved neurologic function. Moreover, compared with DFX, VK-28 polarized microglia to an M2-like phenotype, reduced brain water content, deceased white matter injury, improved neurobehavioral performance, and reduced overall death rate after ICH. The protection of VK-28 was confirmed in a blood-injection ICH model and in aged-male and young female mice. Our findings indicate that VK-28 is protective against iron toxicity after ICH and that, at the dosage tested, it has better efficacy and less toxicity than DFX does.

  9. Electric double-layer capacitor based on an ionic clathrate hydrate.

    Science.gov (United States)

    Lee, Wonhee; Kwon, Minchul; Park, Seongmin; Lim, Dongwook; Cha, Jong-Ho; Lee, Huen

    2013-07-01

    Herein, we suggest a new approach to an electric double-layer capacitor (EDLC) that is based on a proton-conducting ionic clathrate hydrate (ICH). The ice-like structures of clathrate hydrates, which are comprised of host water molecules and guest ions, make them suitable for applications in EDLC electrolytes, owing to their high proton conductivities and thermal stabilities. The carbon materials in the ICH Me4NOH⋅5 H2O show a high specific capacitance, reversible charge-discharge behavior, and a long cycle life. The ionic-hydrate complex provides the following advantages in comparison with conventional aqueous and polymer electrolytes: 1) The ICH does not cause leakage problems under normal EDLC operating conditions. 2) The hydrate material can be utilized itself, without requiring any pre-treatments or activation for proton conduction, thus shortening the preparation procedure of the EDLC. 3) The crystallization of the ICH makes it possible to tailor practical EDLC dimensions because of its fluidity as a liquid hydrate. 4) The hydrate solid electrolyte exhibits more-favorable electrochemical stability than aqueous and polymer electrolytes. Therefore, ICH materials are expected to find practical applications in versatile energy devices that incorporate electrochemical systems. Copyright © 2013 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  10. The Definition of a Prolonged Intensive Care Unit Stay for Spontaneous Intracerebral Hemorrhage Patients: An Application with National Health Insurance Research Database

    Directory of Open Access Journals (Sweden)

    Chien-Lung Chan

    2014-01-01

    Full Text Available Introduction. Length of stay (LOS in the intensive care unit (ICU of spontaneous intracerebral hemorrhage (sICH patients is one of the most important issues. The disease severity, psychosocial factors, and institutional factors will influence the length of ICU stay. This study is used in the Taiwan National Health Insurance Research Database (NHIRD to define the threshold of a prolonged ICU stay in sICH patients. Methods. This research collected the demographic data of sICH patients in the NHIRD from 2005 to 2009. The threshold of prolonged ICU stay was calculated using change point analysis. Results. There were 1599 sICH patients included. A prolonged ICU stay was defined as being equal to or longer than 10 days. There were 436 prolonged ICU stay cases and 1163 nonprolonged cases. Conclusion. This study showed that the threshold of a prolonged ICU stay is a good indicator of hospital utilization in ICH patients. Different hospitals have their own different care strategies that can be identified with a prolonged ICU stay. This indicator can be improved using quality control methods such as complications prevention and efficiency of ICU bed management. Patients’ stay in ICUs and in hospitals will be shorter if integrated care systems are established.

  11. Motor Skills Training Improves Sensorimotor Dysfunction and Increases Microtubule-Associated Protein 2 mRNA Expression in Rats with Intracerebral Hemorrhage.

    Science.gov (United States)

    Tamakoshi, Keigo; Kawanaka, Kentaro; Onishi, Hideaki; Takamatsu, Yasuyuki; Ishida, Kazuto

    2016-08-01

    In this study, we examined the effects of motor skills training on the sensorimotor function and the expression of genes associated with synaptic plasticity after intracerebral hemorrhage (ICH) in rats. Male Wistar rats were subjected to ICH or sham operation. ICH was caused by the injection of collagenase into the left striatum. Rats were randomly assigned to no training, acrobatic training, and sham groups. The acrobatic group performed 5 types of acrobatic tasks from 4 to 28 days after surgery. The forelimb sensorimotor function was evaluated over time using forepaw grasping, forelimb placing, and postural instability tests. At 14 and 29 days after the lesion, we analyzed the mRNA expression levels of microtubule-associated protein 2 (MAP2), brain-derived neurotrophic factor, and growth-associated protein 43 in the bilateral sensorimotor cortex (forelimb area) by real-time reverse transcription-polymerase chain reaction. Motor skills training in ICH rats improved the sensorimotor dysfunction significantly from the early phase. The mRNA expression level of MAP2 was upregulated in the ipsilesional sensorimotor cortex by motor skills training at 29 days after the lesion. Our results suggest that sensorimotor functional recovery following motor skills training after ICH is promoted by dendritic growth in the ipsilesional sensorimotor cortex. Copyright © 2016 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  12. Early Erythrolysis in the Hematoma After Experimental Intracerebral Hemorrhage

    Science.gov (United States)

    Dang, Ge; Yang, Yuefan; Wu, Gang; Hua, Ya; Keep, Richard F.; Xi, Guohua

    2016-01-01

    Erythrolysis occurs in the clot after intracerebral hemorrhage (ICH) and the release of hemoglobin causes brain injury but it is unclear when such lysis occurs. The present study examined early erythrolysis in rats. ICH rats had an intra-caudate injection of 100 µl autologous blood and sham rats had a needle insertion. All rats had T2 and T2* MRI scanning and brains were used for histology and CD163 (a hemoglobin scavenger receptor) and DARPP-32 (a neuronal marker) immunohistochemistry. There was marked heterogeneity within the hematoma on T2* MRI, with a hyper- or isointense core and a hypointense periphery. Hematoxylin and eosin staining in the same animals showed significant erythrolysis in the core with the formation of erythrocyte ghosts. The degree of erythrolysis correlated with the severity of perihematomal neuronal loss. Perihematomal CD163 was increased by day 1 after ICH and may be involved in clearing hemoglobin caused by early hemolysis. Furthermore, ICH resulted in more severe erythrolysis, neuronal loss and perihematomal CD163 upregulation in spontaneously hypertensive rats compared to Wistar Kyoto rats. In conclusions, T2*MRI detectable early erythrolysis occurred in the clot after ICH, and activated CD163. Hypertension is associated with enhanced erythrolysis in the hematoma. PMID:27783383

  13. Minocycline and matrix metalloproteinase inhibition in acute intracerebral hemorrhage: a pilot study.

    Science.gov (United States)

    Chang, J J; Kim-Tenser, M; Emanuel, B A; Jones, G M; Chapple, K; Alikhani, A; Sanossian, N; Mack, W J; Tsivgoulis, G; Alexandrov, A V; Pourmotabbed, T

    2017-11-01

    Intracerebral hemorrhage (ICH) is a devastating cerebrovascular disorder with high morbidity and mortality. Minocycline is a matrix metalloproteinase-9 (MMP-9) inhibitor that may attenuate secondary mechanisms of injury in ICH. The feasibility and safety of minocycline in ICH patients were evaluated in a pilot, double-blinded, placebo-controlled randomized clinical trial. Patients with acute onset (minocycline or placebo. The outcome events included adverse events, change in serial National Institutes of Health Stroke Scale score assessments, hematoma volume and MMP-9 measurements, 3-month functional outcome (modified Rankin score) and mortality. A total of 20 patients were randomized to minocycline (n = 10) or placebo (n = 10). The two groups did not differ in terms of baseline characteristics. No serious adverse events or complications were noted with minocycline infusion. The two groups did not differ in any of the clinical and radiological outcomes. Day 5 serum MMP-9 levels tended to be lower in the minocycline group (372 ± 216 ng/ml vs. 472 ± 235 ng/ml; P = 0.052). Multiple linear regression analysis showed that minocycline was associated with a 217.65 (95% confidence interval -425.21 to -10.10, P = 0.041) decrease in MMP-9 levels between days 1 and 5. High-dose intravenous minocycline can be safely administered to patients with ICH. Larger randomized clinical trials evaluating the efficacy of minocycline and MMP-9 inhibition in ICH patients are required. © 2017 EAN.

  14. Surgical Outcome in Patients with Spontaneous Supratentorial Intracerebral Hemorrhage

    Directory of Open Access Journals (Sweden)

    Rendevski Vladimir

    2017-12-01

    Full Text Available The aim of the paper was to evaluate the surgical outcome in patients with spontaneous supratentorial intracerebral hemorrhage (ICH after surgical intervention, in respect to the initial clinical conditions, age, sex, hemispheric side and anatomic localization of ICH. Thirty-eight surgically treated patients with spontaneous supratentorial intracerebral hemorrhage were included in the study. The surgical outcome was evaluated three months after the initial admission, according to the Glasgow Outcome Scale (GOS. The surgical treatment was successful in 14 patients (37%, whereas it was unsuccessful in 24 patients (63%. We have detected a significant negative correlation between the Glasgow Coma Scale (GCS scores on admission and the GOS scores after three months, suggesting worse neurological outcome in patients with initially lower GCS scores. The surgical outcome in patients with ICH was not affected by the sex, the hemispheric side and the anatomic localization of ICH, but the age of the patients was estimated as a significant factor for their functional outcome, with younger patients being more likely to be treated successfully. The surgical outcome is affected from the initial clinical state of the patients and their age. The treatment of ICH is still an unsolved clinical problem and the development of new surgical techniques with larger efficiency in the evacuation of the hematoma is necessary, thus making a minimal damage to the normal brain tissue, as well as decreasing the possibility of postoperative bleeding.

  15. Incidental intracranial hemorrhage after uncomplicated birth: MRI before and after neonatal heart surgery

    International Nuclear Information System (INIS)

    Tavani, F.; Zimmerman, R.A.; Clancy, R.R.; Licht, D.J.; Mahle, W.T.

    2003-01-01

    We investigated the prevalence of intracranial hemorrhage (ICH) before and after neonatal heart surgery. We carried out pre- and postoperative MRI looking for brain lesions in 24 full-term new-borns with known congenital heart disease. They underwent heart surgery with cardiopulmonary bypass (CPB), usually with deep hypothermic circulatory arrest (DHCA). The first MRI was 1-22 days after birth. There were 21 children born after uncomplicated vaginal delivery and three delivered by cesarean section (CS). ICH was seen in 13 (62%) of the vaginal delivery group but in none of the CS group. We saw subdural bleeding along the inferior surface of the tentorium in 11 (52%) and supratentorially in six (29%) of the 21 children with ICH. Small hemorrhages were present in the choroid plexus in seven (33%), in the parenchyma in one (5%) and in the occipital horn in one (5%). There were 26 foci of bleeding in these 21 patients (1.2 per patient). None was judged by formal neurologic examination to be symptomatic from the hemorrhage. Follow-up MRI after cardiac surgery was obtained in 23 children, showing 37 foci of ICH (1.6 per patient), but all appeared asymptomatic. Postoperatively, ICH had increased in 10 children (43%), was unchanged in seven (30%) and was less extensive in six (26%). (orig.)

  16. Incidental intracranial hemorrhage after uncomplicated birth: MRI before and after neonatal heart surgery

    Energy Technology Data Exchange (ETDEWEB)

    Tavani, F.; Zimmerman, R.A. [Neuroradiology Dept., The Children' s Hospital of Philadelphia, Philadelphia, PA (United States); Clancy, R.R.; Licht, D.J. [Dept. of Neurology, The Children' s Hospital of Philadelphia, Philadelphia, PA (United States); Mahle, W.T. [Children' s Heart Hospital, Atlanta, GA (United States)

    2003-04-01

    We investigated the prevalence of intracranial hemorrhage (ICH) before and after neonatal heart surgery. We carried out pre- and postoperative MRI looking for brain lesions in 24 full-term new-borns with known congenital heart disease. They underwent heart surgery with cardiopulmonary bypass (CPB), usually with deep hypothermic circulatory arrest (DHCA). The first MRI was 1-22 days after birth. There were 21 children born after uncomplicated vaginal delivery and three delivered by cesarean section (CS). ICH was seen in 13 (62%) of the vaginal delivery group but in none of the CS group. We saw subdural bleeding along the inferior surface of the tentorium in 11 (52%) and supratentorially in six (29%) of the 21 children with ICH. Small hemorrhages were present in the choroid plexus in seven (33%), in the parenchyma in one (5%) and in the occipital horn in one (5%). There were 26 foci of bleeding in these 21 patients (1.2 per patient). None was judged by formal neurologic examination to be symptomatic from the hemorrhage. Follow-up MRI after cardiac surgery was obtained in 23 children, showing 37 foci of ICH (1.6 per patient), but all appeared asymptomatic. Postoperatively, ICH had increased in 10 children (43%), was unchanged in seven (30%) and was less extensive in six (26%). (orig.)

  17. Cofilin Knockdown Attenuates Hemorrhagic Brain Injury-induced Oxidative Stress and Microglial Activation in Mice.

    Science.gov (United States)

    Alhadidi, Qasim; Nash, Kevin M; Alaqel, Saleh; Sayeed, Muhammad Shahdaat Bin; Shah, Zahoor A

    2018-05-08

    Intracerebral hemorrhage (ICH) resulting from the rupture of the blood vessels in the brain is associated with significantly higher mortality and morbidity. Clinical studies focused on alleviating the primary injury, hematoma formation and expansion, were largely ineffective, suggesting that secondary injury-induced inflammation and the formation of reactive species also contribute to the overall injury process. In this study, we explored the effects of cofilin knockdown in a mouse model of ICH. Animals given stereotaxic injections of cofilin siRNA, 72-h prior to induction of ICH by collagenase injection within the area of siRNA administration showed significantly decreased cofilin expression levels and lower hemorrhage volume and edema, and the animals performed significantly better in neurobehavioral tasks i.e., rotarod, grip strength and neurologic deficit scores. Cofilin siRNA knocked-down mice had reduced ICH-induced DNA fragmentation, blood-brain barrier disruption and microglial activation, with a concomitant increase in astrocyte activation. Increased expression of pro-survival proteins and decreased markers of oxidative stress were also observed in cofilin siRNA-treated mice possibly due to the reduced levels of cofilin. Our results suggest that cofilin plays a major role in ICH-induced secondary injury, and could become a potential therapeutic target. Copyright © 2018 IBRO. Published by Elsevier Ltd. All rights reserved.

  18. Rheological behavior of clay-nanoparticle hybrid-added bentonite suspensions: specific role of hybrid additives on the gelation of clay-based fluids.

    Science.gov (United States)

    Jung, Youngsoo; Son, You-Hwan; Lee, Jung-Kun; Phuoc, Tran X; Soong, Yee; Chyu, Minking K

    2011-09-01

    Two different types of clay nanoparticle hybrid, iron oxide nanoparticle clay hybrid (ICH) and Al(2)O(3)-SiO(2) nanoparticle clay hybrid (ASCH), were synthesized and their effects on the rheological properties of aqueous bentonite fluids in steady state and dynamic state were explored. When ICH particles were added, bentonite particles in the fluid cross-link to form relatively well-oriented porous structure. This is attributed to the development of positively charged edge surfaces in ICH that leads to strengthening of the gel structure of the bentonite susensions. The role of ASCH particles on the interparticle association of the bentonite fluids is different from that of ICH and sensitive to pH. As pH of ASCH-added bentonite suspensions increased, the viscosity, yield stress, storage modulus, and flow stress decreased. In contrast, at low pH, the clay suspensions containing ASCH additives were coagulated and their rheological properties become close to those of ICH added bentonite fluids. A correlation between the net surface charge of the hybrid additives and the rheological properties of the fluids indicates that the embedded nanoparticles within the interlayer space control the variable charge of the edge surfaces of the platelets and determine the particles association behavior of the clay fluids.

  19. Magnetic resonance imaging in the acute stage of cerebrovascular disease

    International Nuclear Information System (INIS)

    Tanaka, Tokutaro; Sakai, Tsuneo; Fujishima, Ichiro; Yamamoto, Takamichi; Uemura, Kenichi; Teramura, Atsushi.

    1988-01-01

    Thirty patients with acute cerebrovascular disease were evaluated by both computed tomography (CT) and magnetic resonance (MR) imaging. The 17 patients with cerebral infarction (CI) were evaluated within 24 hours and the 13 with intracerebral hemorrhage (ICH) within 6 hours of the onset of symptoms. All ICHs were detected in T2-weighted images and appeared as perifocal, ring-like areas of high signal intensity. T2-weighted images also demonstrated a ruptured aneurysm and an arteriovenous malformation. In T1-weighted images, all ICHs displayed high signal intensity, which paralleled the CT images and is characteristic of MR imaging with an ultra-low magnetic filed. These findings were obtained as early as 90 minutes from the onset of symptoms. In cases of CI, T2-weighted images obtained 3 - 7 hours after onset demonstrated the pathology more clearly than did CT. This study proved MR imaging useful in the evaluation of both ICH and CI in the acute stage. In addition, it was possible to differentiate ICH from CI in the acute stage by T2-weighted images alone. (author)

  20. Anemia on admission increases the risk of mortality at 6 months and 1 year in hemorrhagic stroke patients in China.

    Science.gov (United States)

    Zeng, Yi-Jun; Liu, Gai-Fen; Liu, Li-Ping; Wang, Chun-Xue; Zhao, Xing-Quan; Wang, Yong-Jun

    2014-07-01

    The relationship between anemia and intracerebral hemorrhage is not clear. We investigated the associations between anemia at the onset and mortality or dependency in patients with intracerebral hemorrhage (ICH) registered at the China National Stroke Registry (CNSR). The CNSR recruited consecutive patients with diagnoses of ICH in 2007-2008. Their vascular risk factors, clinical presentations, and outcomes were recorded. The mortality and dependency at 1, 3, and 6 months and at 1 year were compared between ICH patients with and without anemia. A favorable outcome was defined as a modified Rankin Scale (mRS) score of 2 or less and a poor outcome as an mRS score of 3 or more. Multivariable logistic regression was performed to analyze the association between anemia and the 2 outcomes after adjusting for age, gender, body mass index, history of smoking and heavy drinking, National Institutes of Health Stroke Scale score on admission, random glucose value on admission, and hematoma volume. Anemia was identified in 484 (19%) ICH patients. Compared with ICH patients without anemia, patients with anemia had no difference in mortality rate at discharge and at 1 month. The rate of mortality at 3 months, 6 months, 1 year, and dependency at 1 year were significantly higher for those patients with anemia than those without (Pmortality at 6 months and 1 year after the initial episode of intercerebral hemorrhage. Copyright © 2014 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  1. Hospitalized hemorrhagic stroke patients with renal insufficiency: clinical characteristics, care patterns, and outcomes.

    Science.gov (United States)

    Ovbiagele, Bruce; Schwamm, Lee H; Smith, Eric E; Grau-Sepulveda, Maria V; Saver, Jeffrey L; Bhatt, Deepak L; Hernandez, Adrian F; Peterson, Eric D; Fonarow, Gregg C

    2014-10-01

    There is a paucity of information on clinical characteristics, care patterns, and clinical outcomes for hospitalized intracerebral hemorrhage (ICH) patients with chronic kidney disease (CKD). We assessed characteristics, care processes, and in-hospital outcome among ICH patients with CKD in the Get With the Guidelines-Stroke (GWTG-Stroke) program. We analyzed 113,059 ICH patients hospitalized at 1472 US centers participating in the GWTG-Stroke program between January 2009 and December 2012. In-hospital mortality and use of 2 predefined ICH performance measures were examined based on glomerular filtration rate. Renal dysfunction was categorized as a dichotomous (+CKD = estimated glomerular filtration rate mortality was also higher for those with CKD (adjusted odds ratio [OR], 1.47; 95% confidence interval [CI], 1.42-1.52), mild dysfunction (adjusted OR, 1.12; 95% CI, 1.08-1.16), moderate dysfunction (adjusted OR, 1.46; 95% CI, 1.39-1.53), severe dysfunction (adjusted OR, 1.96; 95% CI, 1.81-2.12), and kidney failure (adjusted OR, 2.22; 95% CI, 2.04-2.43) relative to those with normal renal function. Chronic kidney disease is present in nearly a third of patients hospitalized with ICH and is associated with slightly worse care and substantially higher mortality than those with normal renal function. Copyright © 2014 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  2. Management of Acute Hypertensive Response in Intracerebral Hemorrhage Patients After ATACH-2 Trial.

    Science.gov (United States)

    Majidi, Shahram; Suarez, Jose I; Qureshi, Adnan I

    2017-10-01

    Acute hypertensive response is elevation of systolic blood pressure (SBP) in the first 24 h after symptom onset which is highly prevalent in patients with intracerebral hemorrhage (ICH). Observational studies suggested association between acute hypertensive response and hematoma expansion, peri-hematoma edema and death and disability, and possible reduction in these adverse outcomes with treatment of acute hypertensive response. Recent clinical trials have focused on determining the clinical efficacy of early intensive SBP reduction in ICH patients. The Antihypertensive Treatment of Acute Cerebral Hemorrhage (ATACH-2) trial was the latest phase 3 randomized controlled multicenter clinical trial aimed to study the efficacy of early intensive reduction of SBP in ICH patients. In this review article, we summarize the results of recent clinical trials, treatment principles based on the latest guidelines, and the anticipated interpretation and incorporation of ATACH-2 trial results in clinical practice.

  3. Intracranial hypotension - a look beyond “bilateral subdural hematomas”

    International Nuclear Information System (INIS)

    Penev, B.

    2015-01-01

    Full text: The intracranial hypotension (ICH) is a disorder due to spontaneous or iatrogenic CSF leak and a low intracranial pressure. The clinical presentation is characterized by drug resistant orthostatic headache, nausea, vomiting, dizziness, neck pain and etc. The intracranial hypotension is defined as a benign disorder and the treatment is predominantly conservative. Due to this fact it is very important to differentiate this entity from subdural hematomas and hygromas which are treated surgically. Magnetic resonance imaging has revolutionized the diagnosis of ICH. Nowadays there are a lot of clinical and imaging features of this disorder. Regardless of clinical varieties and atypical forms, MRI gives enough information for the correct or probable diagnosis in the vast majority of the cases. The initial imaging resemblance with posttraumatic subdural hematomas and hygromas can result in giving the wrong diagnosis and therefore performing unneeded surgical interventions. the aim of this presentation is to discuss the contemporary criteria, algorithm and imaging features of ICH

  4. Der Organismus der Mathematik - mikro-, makro- und mesoskopisch betrachtet

    Science.gov (United States)

    Winkler, Reinhard

    Meist enden ähnliche Gespräche über Mathematik etwa an diesem Punkt, ohne dass der Nichtmathematiker von der Sinnhaftigkeit mathematischer Forschung, ja mathematischer Tätigkeit generell überzeugt werden konnte. Ich glaube nicht, dass dem Laien Blindheit für die Großartigkeit unserer Wissenschaft vorzuwerfen ist, wenn hier keine befriedigendere Kommunikation zustande kommt. Ich sehe als Ursache eher ein stark verkürztes Bild von der Mathematik, welches auch Fachleute oft zeichnen, weil ihnen eine angemessenere Darstellung ihres Faches zu viel Mühe macht - und das obwohl Mathematik nur betreiben kann, wer geistige Mühen sonst keineswegs scheut. Ich will versuchen, den Ursachen dieses eigentümlichen Phänomens auf den Grund zu gehen.

  5. Alternative Evaluation of the Properties of the Silica Sands

    Directory of Open Access Journals (Sweden)

    Beňo J.

    2014-06-01

    Full Text Available Piaski kwarcowe stanowią podstawowe tworzywo na osnowę mas formierskich i rdzeniowych. Stąd istnieje bardzo wiele metod charakteryzujących ich jakość, co umożliwia poznanie ich zalet i wad. Mało jest jednak prac opisujących wpływ systemów transportowych odlewni oraz systemów suchej regeneracji mas na zmianę ich składu granulometrycznego oraz zawartości frakcji pylastych na właściwości mas. Celem niniejszej pracy jest ocena skłonności piasku kwarcowego do rozkruszania, (tworzenia frakcji pyłowych i zmianie granulometrii według nowo opracowanej metodyki uwzględniającej charakterystyczne cechy piasku wynikające z jego pochodzenia, kształty ziaren i charakteru powierzchni.

  6. Nietzsche ein Immanentist?

    Directory of Open Access Journals (Sweden)

    Andreas Urs Sommer

    2017-12-01

    Full Text Available Mein Artikel besteht aus drei Abschnitten: Der erste Teil beschäftigt sich mit Nietzsches Gebrauch des Begriffs der „Immanenz“; ich werde diesen Gebrauch nachzeichnen. Mein zweiter Punkt ist ein allgemeinerer: Ich möchte den Fokus auf die Frage legen, ob es für Nietzsche möglich ist, ein starkes Konzept von Immanenz zu vertreten, insbesondere wenn wir uns in Erinnerung rufen, dass Nietzsche eine deutliche Opposition zu allen Vorstellungen von Transzendenz formuliert. Soll hier irgendeine Art von Immanenz bewahrt werden? Der dritte Abschnitt beinhaltet eine eingehendere Untersuchung von zwei Passagen aus Jenseits von Gut und Böse (Abschnitte 2 und 6. Ich denke, dass sich in diesen Passagen wichtige Aspekte aufzeigen lassen, insbesondere mit Hinblick auf die Frage, ob Nietzsche irgendeine Art von Vorstellung oder ein Konzept der Immanenz vertritt.

  7. Continuing versus Stopping Prestroke Antihypertensive Therapy in Acute Intracerebral Hemorrhage

    DEFF Research Database (Denmark)

    Krishnan, Kailash; Scutt, Polly; Woodhouse, Lisa

    2016-01-01

    BACKGROUND AND PURPOSE: More than 50% of patients with acute intracerebral hemorrhage (ICH) are taking antihypertensive drugs before ictus. Although antihypertensive therapy should be given long term for secondary prevention, whether to continue or stop such treatment during the acute phase of ICH...... remains unclear, a question that was addressed in the Efficacy of Nitric Oxide in Stroke (ENOS) trial. METHODS: ENOS was an international multicenter, prospective, randomized, blinded endpoint trial. Among 629 patients with ICH and systolic blood pressure between 140 and 220 mmHg, 246 patients who were...... taking antihypertensive drugs were assigned to continue (n = 119) or to stop (n = 127) taking drugs temporarily for 7 days. The primary outcome was the modified Rankin Score at 90 days. Secondary outcomes included death, length of stay in hospital, discharge destination, activities of daily living, mood...

  8. Real-time imaging and detection of intracranial haemorrhage by electrical impedance tomography in a piglet model.

    Science.gov (United States)

    Xu, C H; Wang, L; Shi, X T; You, F S; Fu, F; Liu, R G; Dai, M; Zhao, Z W; Gao, G D; Dong, X Z

    2010-01-01

    The aim of this study was to use electrical impedance tomography (EIT) to detect and image acute intracranial haemorrhage (ICH) in an animal model. Blood was infused into the frontal lobe of the brains of anaesthetized piglets and impedance was measured using 16 electrodes placed in a circle on the scalp. The EIT images were constructed using a filtered back-projection algorithm. The mean of all the pixel intensities within a region of interest--the mean resistivity value (MRV)--was used to evaluate the relative impedance changes in the target region. A symmetrical index (SI), reflecting the relative impedance on both sides of the brain, was also calculated. Changes in MRV and SI were associated with the injection of blood, demonstrating that EIT can successfully detect ICH in this animal model. The unique features of EIT may be beneficial for diagnosing ICH early in patients after cranial surgery, thereby reducing the risk of complications and mortality.

  9. Depression following intracerebral hemorrhage and the evaluation of cerebral blood flow by single photon emission tomography

    International Nuclear Information System (INIS)

    Masada, Tetsuya; Makabe, Tetsuo; Kunishio, Katsuzo; Matsumoto, Akira

    2007-01-01

    The authors studied patients who presented depression and apathy following intracerebral hemorrhage (ICH). Twelve patients who were admitted in our hospital were divided into two groups according to the presence of post-stroke depression (PSD). Five patients with PSD are in group A, and another seven patients without PSD are in group B. Zung-self depression scale (SDS) and apathy scale were used for screening of depression and apathy. PSD was recognized in 5 (42%) of patients following ICH. Single photon emission tomography (SPECT) suggested the reduction of cerebral blood flow (CBF) in the frontal lobe in all patients of the group A (100%), whereas only 29% of patients of the group B. The reduction of CBF in the frontal lobe might be involved in the mechanism of depression following ICH in subacute stage. (author)

  10. Intracranial hemorrhage complicating thrombolytic therapy for acute myocardial infarction

    International Nuclear Information System (INIS)

    Uglietta, J.P.; Boyko, O.B.; O'Connor, C.M.; Aldrich, H.; Massey, E.W.; Heinz, E.R.

    1990-01-01

    This paper determines the incidence and types of intracranial hemorrhage (ICH) in 1,696 patients treated with thrombolytic therapy for acute myocardial infarction (AMI). Thirteen of 1,696 patients experienced ICH, and their nonenhanced brain CT scans were reviewed. Their mean age was 62 years (range, 53-74 years), and nine of 13 were male. Six patients received tissue plasminogen activator (tPA), four streptokinase, two urokinase, and one tPA and urokinase. The hemorrhages were classified according to CT location: intraparenchymal (IPH), subarachnoid (SAH), subdural (SDH), and intraventricular (IVH). The incidence of ICH was 0.76%. There were 31 hemorrhages in 13 patients. Twelve hemorrhages were IPH, 10 were SDH, seven were SAH, and two were IVH. Excluding IVH, 24 of 29 hemorrhages (83%) were supratentorial

  11. Uhlíkové elektrody pro superkondenzátory

    OpenAIRE

    Moncoľ, Maroš

    2010-01-01

    Diplomová práca sa zaoberá problematikou superkondenzátorov založených na princípe elektrickej dvojvrstvy a uhlíkovými materiálmi vhodnými pre tento typ superkondenzátorov. V teoretickej časti je popísaná podstata superkondenzátorov, ich vlastnosti a princípy. V ďalšej časti je popis uhlíkových materiálov, ich vlastnosti a použité elektrochemické metódy merania. V praktickej časti sú popísané prípravy uhlíkových elektród, postup, výsledky meraní a ich vyhodnotenie. This master thesis deals...

  12. Intracerebral hemorrhage with intraventricular extension and no hydrocephalus may not increase mortality or severe disability.

    Science.gov (United States)

    Mahta, Ali; Katz, Paul M; Kamel, Hooman; Azizi, S Ausim

    2016-08-01

    This paper aimed to test the hypothesis that intraventricular extension of spontaneous intracerebral hemorrhage (ICH) in the absence of hydrocephalus is not associated with increased mortality or severe disability. We performed a retrospective consecutive cohort study of patients with primary spontaneous ICH who were admitted to a single institution. Multivariate logistic regression analysis was used to assess the association of each variable with functional outcome as measured by the modified Rankin Scale (mRS). A total of 164 patients met our inclusion criteria and were included in the study. Only hydrocephalus (p=0.002) and hematoma volume (p=0.006) were significantly associated with mortality or poor functional outcome (mRS of 3 to 6). In contrast, the presence of intraventricular hematoma was not independently associated with poor functional outcome. The presence of intraventricular extension of ICH in the absence of hydrocephalus may not increase mortality or disability. Copyright © 2016 Elsevier Ltd. All rights reserved.

  13. Clinical Course and Outcomes of Small Supratentorial Intracerebral Hematomas.

    Science.gov (United States)

    Behrouz, Réza; Misra, Vivek; Godoy, Daniel A; Topel, Christopher H; Masotti, Luca; Klijn, Catharina J M; Smith, Craig J; Parry-Jones, Adrian R; Slevin, Mark A; Silver, Brian; Willey, Joshua Z; Masjuán Vallejo, Jaime; Nzwalo, Hipólito; Popa-Wagner, Aurel; Malek, Ali R; Hafeez, Shaheryar; Di Napoli, Mario

    2017-06-01

    Intracerebral hemorrhage (ICH) volume, particularly if ≥30 mL, is a major determinant of poor outcome. We used a multinational ICH data registry to study the characteristics, course, and outcomes of supratentorial hematomas with volumes hematoma expansion, Glasgow Outcome Scale (GOS), and in-hospital death. Poor outcome was defined as composite of in-hospital death and severe disability (GOS ≤ 3). Comparison was conducted based on hemorrhage location. Logistic regression using dichotomized outcome scales was applied to determine predictors of poor outcome. Among 375 cases of supratentorial ICH with volumes hematomas <30 mL expands, leading to END or death. Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  14. Rapid Blood Pressure Lowering According to Recovery at Different Time Intervals after Acute Intracerebral Hemorrhage: Pooled Analysis of the INTERACT Studies.

    Science.gov (United States)

    Wang, Xia; Arima, Hisatomi; Al-Shahi Salman, Rustam; Woodward, Mark; Heeley, Emma; Stapf, Christian; Lavados, Pablo M; Robinson, Thompson; Huang, Yining; Wang, Jiguang; Delcourt, Candice; Anderson, Craig S

    2015-01-01

    Early intensive blood pressure (BP) lowering has been shown to improve functional outcome in acute intracerebral hemorrhage (ICH), but the treatment effect is modest and without a clearly defined underlying explanatory mechanism. We aimed at more reliably quantifying the benefits of this treatment according to different time periods in the recovery of participants in the Intensive Blood Pressure Reduction in Acute Cerebral Hemorrhage Trial (INTERACT) studies. Pooled analysis of the pilot INTERACT1 (n = 404) and main INTERACT2 (n = 2,839) involving patients with spontaneous ICH (patient characteristic subgroups, with trends favoring those randomized early, and with higher SBP and milder neurological severity at baseline. Intensive BP lowering provides beneficial effects on physical functioning that manifests consistently through the early and later phases of recovery from ICH. © 2015 S. Karger AG, Basel.

  15. Current status and burning issues in immunotoxicity testing of drugs

    International Nuclear Information System (INIS)

    Laan, Jan Willem van der; Loveren, Henk van

    2005-01-01

    Besides pathology endpoints, additional immune function endpoints have been included in the Note for Guidance on Repeated Dose Toxicity by the European Union (July 2001), which concern the analysis of antibody responses to a T-cell-dependent antigen. Guidance papers of other regulatory authorities are published as well. The main issue is the need for functional immunotoxicity testing to detect unintended immunosuppression. The International Conference on Harmonization (ICH) has surveyed studies from the files of the pharmaceutical industry to find the proportion of compounds that can be detected by additional immunotoxicity testing. Preliminary analysis shows that 10-15% of the compounds in the survey only react positively to the additional tests. More data are requested from the pharmaceutical industry. The Expert Working Group of the ICH has decided to choose a cause-for-concern approach to immmunotoxicity rather than a routine-screening approach. The causes for concern are to be defined during ICH negotiations

  16. MR imaging of neonatal cerebral hemorrhage at 1.5 T

    International Nuclear Information System (INIS)

    McArdle, C.B.; Mehta, S.D.; Kulkarni, M.V.; Keeney, S.A.; Adcock, E.W. III.

    1987-01-01

    Twenty-three intracerebral hemorrhages (ICH) were seen in 60 neonates. Both T1- weighted (spin-echo, repetition time/echo time = 600-800/20 msec) and heavily T2- weighted sequences (SE = 2,500/80, 160) were necessary for detecting hemorrhage. MR imaging failed to disclose seven of ten IVH because of an irregular and full choroid, seen on US. US failed to show six ICH because of their small size (≤0.5 cm) or peripheral site. Twelve extracerebral hemorrhages were missed on US, and only one of three was seen on CT. In five other cases there were signal features of hemosidering from earlier hemorrhage. MR imaging is the best modality for visualizing ICH because of its high sensitivity, specificity, and the persistence of hemorrhagic signal for weeks to months longer than on US or CT

  17. Timing of intracranial hemorrhage and monitoring of indomethacin therapy in premature neonates by cranial sonography

    International Nuclear Information System (INIS)

    Ment, L.; Duncan, C.; Eherenkranz, R.; Taylor, K.J.W.

    1986-01-01

    Fourteen cranial US studies were performed in each of 31 premature neonates weighing 600-1,250 gm. The studies revealed a 61% incidence of intracranial hemorrhage (ICH). Forty-two percent had occurred by age 6 hours and 95% bu age 5 days. These control data were confirmed in patients given prophylactic indomethacin. Forty-eight infants weighing less than 1,250 gm were randomly assigned to treatment with indomethacin (0.5 mg/kg/12 hours given intravenously for five treatments) or a placebo at 6 hours of life. Cardiac US disclosed patent ductus arteriosus in 82% of patients at 6 hours, with subsequent closure in 84% of the treated group and in 60% of the controls. ICH occurred in 25% of the treated infant and in 58% of the controls. The authors conclude that indomethacin therapy can reduce the incidence of ICH, but requires careful sonographic monitoring by US

  18. The comparative method of language acquisition research: a Mayan case study.

    Science.gov (United States)

    Pye, Clifton; Pfeiler, Barbara

    2014-03-01

    This article demonstrates how the Comparative Method can be applied to cross-linguistic research on language acquisition. The Comparative Method provides a systematic procedure for organizing and interpreting acquisition data from different languages. The Comparative Method controls for cross-linguistic differences at all levels of the grammar and is especially useful in drawing attention to variation in contexts of use across languages. This article uses the Comparative Method to analyze the acquisition of verb suffixes in two Mayan languages: K'iche' and Yucatec. Mayan status suffixes simultaneously mark distinctions in verb transitivity, verb class, mood, and clause position. Two-year-old children acquiring K'iche' and Yucatec Maya accurately produce the status suffixes on verbs, in marked distinction to the verbal prefixes for aspect and agreement. We find evidence that the contexts of use for the suffixes differentially promote the children's production of cognate status suffixes in K'iche' and Yucatec.

  19. Mortality after hemorrhagic stroke

    DEFF Research Database (Denmark)

    González-Pérez, Antonio; Gaist, David; Wallander, Mari-Ann

    2013-01-01

    OBJECTIVE: To investigate short-term case fatality and long-term mortality after intracerebral hemorrhage (ICH) and subarachnoid hemorrhage (SAH) using data from The Health Improvement Network database. METHODS: Thirty-day case fatality was stratified by age, sex, and calendar year after ICH...... = 0.03). CONCLUSIONS: More than one-third of individuals die in the first month after hemorrhagic stroke, and patients younger than 50 years are more likely to die after ICH than SAH. Short-term case fatality has decreased over time. Patients who survive hemorrhagic stroke have a continuing elevated......, 54.6% for 80-89 years; SAH: 20.3% for 20-49 years, 56.7% for 80-89 years; both p-trend stroke patients...

  20. Podatność osiedli wielkopłytowych z drugiej połowy XX wieku we Wrocławiu na procesy rewitalizacyjne

    Directory of Open Access Journals (Sweden)

    Robert Masztalski

    2018-04-01

    Full Text Available W artykule prezentowana jest problematyka przekształceń wielkopłytowych osiedli z drugiej połowy XX wieku, wobec współczesnych potrzeb ich kompleksowej odnowy. Autorzy prezentują na wybranych przykładach, analizę urbanistyczną funkcjonujących kilkadziesiąt lat osiedli. Ulegają one stopniowej degradacji, zużyciu technicznemu, a ich zagospodarowanie przestrzenne odbiega od oczekiwań mieszkańców, zwłaszcza w dobie zmiany modelu społecznego. Analityczne podejście do problemu pozwoli ukazać stan zjawiska oraz predyspozycje, lub ich brak, do przekształceń w ramach działań rewitalizacyjnych.

  1. Neurosarcoidosis-related intracranial haemorrhage: three new cases and a systematic review of the literature.

    LENUS (Irish Health Repository)

    O'Dwyer, J P

    2012-06-09

    BACKGROUND AND PURPOSE: Intracranial haemorrhage in neurosarcoidosis (NS-ICH) is rare, poorly understood and the diagnosis of NS may not be immediately apparent. METHODS: The clinical features of three new NS-ICH cases are described including new neuropathological findings and collated with cases from a systematic literature review. RESULTS: Cases: (i) A 41-year-old man with headaches, hypoandrogenism and encephalopathy developed a cerebellar haemorrhage. He had neuropathological confirmation of NS with biopsy-proven angiocentric granulomata and venous disruption. He responded to immunosuppressive therapy. (ii) A 41-year-old man with no history of hypertension was found unconscious. A subsequently fatal pontine haemorrhage was diagnosed. Liver biopsy revealed sarcoid granulomas. (iii) A 36-year-old man with raised intracranial pressure headaches presented with a seizure and a frontal haemorrhage. Hilar lymph node biopsy confirmed sarcoidosis, and he was treated successfully. Systematic Review: Twelve other published cases were identified and collated with our cases. Average age was 36 years and M:F = 2.3:1; 46% presented with neurological symptoms and 31% had CNS-isolated disease. Immediate symptoms of ICH were acute\\/worsening headache or seizures (60%). ICH was supratentorial (62%), infratentorial (31%) or subarachnoid (7%). 40% had definite NS, 53% probable NS and 7% possible NS (Zajicek criteria). Antigranulomatous\\/immunosuppressive therapy regimens varied and 31% died. CONCLUSIONS: This series expands our knowledge of the pathology of NS-ICH, which may be of arterial or venous origin. One-third have isolated NS. Clinicians should consider NS in young-onset ICH because early aggressive antigranulomatous therapy may improve outcome.

  2. Black Hole Sign Predicts Poor Outcome in Patients with Intracerebral Hemorrhage.

    Science.gov (United States)

    Li, Qi; Yang, Wen-Song; Chen, Sheng-Li; Lv, Fu-Rong; Lv, Fa-Jin; Hu, Xi; Zhu, Dan; Cao, Du; Wang, Xing-Chen; Li, Rui; Yuan, Liang; Qin, Xin-Yue; Xie, Peng

    2018-01-01

    In spontaneous intracerebral hemorrhage (ICH), black hole sign has been proposed as a promising imaging marker that predicts hematoma expansion in patients with ICH. The aim of our study was to investigate whether admission CT black hole sign predicts hematoma growth in patients with ICH. From July 2011 till February 2016, patients with spontaneous ICH who underwent baseline CT scan within 6 h of symptoms onset and follow-up CT scan were recruited into the study. The presence of black hole sign on admission non-enhanced CT was independently assessed by 2 readers. The functional outcome was assessed using the modified Rankin Scale (mRS) at 90 days. Univariate and multivariable logistic regression analyses were performed to assess the association between the presence of the black hole sign and functional outcome. A total of 225 patients (67.6% male, mean age 60.3 years) were included in our study. Black hole sign was identified in 32 of 225 (14.2%) patients on admission CT scan. The multivariate logistic regression analysis demonstrated that age, intraventricular hemorrhage, baseline ICH volume, admission Glasgow Coma Scale score, and presence of black hole sign on baseline CT independently predict poor functional outcome at 90 days. There are significantly more patients with a poor functional outcome (defined as mRS ≥4) among patients with black hole sign than those without (84.4 vs. 32.1%, p black hole sign independently predicts poor outcome in patients with ICH. Early identification of black hole sign is useful in prognostic stratification and may serve as a potential therapeutic target for anti-expansion clinical trials. © 2018 S. Karger AG, Basel.

  3. CT angiography spot sign in intracerebral hemorrhage predicts active bleeding during surgery.

    Science.gov (United States)

    Brouwers, H Bart; Raffeld, Miriam R; van Nieuwenhuizen, Koen M; Falcone, Guido J; Ayres, Alison M; McNamara, Kristen A; Schwab, Kristin; Romero, Javier M; Velthuis, Birgitta K; Viswanathan, Anand; Greenberg, Steven M; Ogilvy, Christopher S; van der Zwan, Albert; Rinkel, Gabriel J E; Goldstein, Joshua N; Klijn, Catharina J M; Rosand, Jonathan

    2014-09-02

    To determine whether the CT angiography (CTA) spot sign marks bleeding complications during and after surgery for spontaneous intracerebral hemorrhage (ICH). In a 2-center study of consecutive spontaneous ICH patients who underwent CTA followed by surgical hematoma evacuation, 2 experienced readers (blinded to clinical and surgical data) reviewed CTAs for spot sign presence. Blinded raters assessed active intraoperative and postoperative bleeding. The association between spot sign and active intraoperative bleeding, postoperative rebleeding, and residual ICH volumes was evaluated using univariable and multivariable logistic regression. A total of 95 patients met inclusion criteria: 44 lobar, 17 deep, 33 cerebellar, and 1 brainstem ICH; ≥1 spot sign was identified in 32 patients (34%). The spot sign was the only independent marker of active bleeding during surgery (odds ratio [OR] 3.4; 95% confidence interval [CI] 1.3-9.0). Spot sign (OR 4.1; 95% CI 1.1-17), female sex (OR 6.9; 95% CI 1.7-37), and antiplatelet use (OR 4.6; 95% CI 1.2-21) were predictive of postoperative rebleeding. Larger residual hematomas and postoperative rebleeding were associated with higher discharge case fatality (OR 3.4; 95% CI 1.1-11) and a trend toward increased case fatality at 3 months (OR 2.9; 95% CI 0.9-8.8). The CTA spot sign is associated with more intraoperative bleeding, more postoperative rebleeding, and larger residual ICH volumes in patients undergoing hematoma evacuation for spontaneous ICH. The spot sign may therefore be useful to select patients for future surgical trials. © 2014 American Academy of Neurology.

  4. Acute intracerebral haemorrhage: grounds for optimism in management.

    Science.gov (United States)

    Delcourt, Candice; Anderson, Craig

    2012-12-01

    Spontaneous intracerebral haemorrhage (ICH) is one of the most devastating types of stroke, which has considerable disease burden in "non-white" ethnic groups where the population-attributable risks of elevated blood pressure are very high. Since the treatment of ICH remains largely supportive and expectant, nihilism and the early withdrawal of active therapy influence management decisions in clinical practice. However, approaches to management are now better defined on the basis of evidence that both survival and speed (and degree) of recovery are critically dependent on the location, size, and degree of expansion and extension into the intraventricular system of the haematoma of the ICH. Although no medical treatment has been shown to improve outcome in ICH, several promising avenues have emerged that include haemostatic therapy and intensive control of elevated blood pressure. Conversely, there is continued controversy over the role of evacuation of the haematoma of ICH via open craniotomy. Despite being an established practice for several decades, and having undergone evaluation in multiple randomised trials, there is uncertainty over which patients have the most to gain from an intervention with clear procedural risk. Minimally invasive surgery via local anaesthetic applied drill-puncture of the cranium and infusion of a thrombolytic agent is an attractive option for patients requiring critical management of the haematoma, not just in low resource settings but arguably also in specialist centres of western countries. With several ongoing clinical trials nearing completion, these treatments could enter routine practice within the next few years, further justifying the urgency of "time is brain" and that active management within well-organized, comprehensive acute stroke care units includes patients with ICH. Copyright © 2012 Elsevier Ltd. All rights reserved.

  5. Hyponatremia in Patients with Spontaneous Intracerebral Hemorrhage

    Directory of Open Access Journals (Sweden)

    Jaime Robenolt Gray

    2014-11-01

    Full Text Available Hyponatremia is the most frequently encountered electrolyte abnormality in critically ill patients. Hyponatremia on admission has been identified as an independent predictor of in-hospital mortality in patients with spontaneous intracerebral hemorrhage (sICH. However, the incidence and etiology of hyponatremia (HN during hospitalization in a neurointensive care unit following spontaneous intracerebral hemorrhage (sICH remains unknown. This was a retrospective analysis of consecutive patients admitted to Detroit Receiving Hospital for sICH between January 2006 and July 2009. All serum Na levels were recorded for patients during the ICU stay. HN was defined as Na <135 mmol/L. A total of 99 patients were analyzed with HN developing in 24% of sICH patients. Patients with HN had an average sodium nadir of 130 ± 3 mmol/L and an average time from admission to sodium <135 mmol/L of 3.9 ± 5.7 days. The most common cause of hyponatremia was syndrome of inappropriate antidiuretic hormone (90% of HN patients. Patients with HN were more likely to have fever (50% vs. 23%; p = 0.01, infection (58% vs. 28%; p = 0.007 as well as a longer hospital length of stay (14 (8–25 vs. 6 (3–9 days; p < 0.001. Of the patients who developed HN, fifteen (62.5% patients developed HN in the first week following sICH. This shows HN has a fairly high incidence following sICH. The presence of HN is associated with longer hospital length of stays and higher rates of patient complications, which may result in worse patient outcomes. Further study is necessary to characterize the clinical relevance and treatment of HN in this population.

  6. A Four-Year Experience of Symptomatic Intracranial Hemorrhage Following Intravenous Tissue Plasminogen Activator at a Comprehensive Stroke Center.

    Science.gov (United States)

    Orlando, Alessandro; Wagner, Jeffrey C; Fanale, Christopher V; Whaley, Michelle; McCarthy, Kathryn L; Bar-Or, David

    2016-04-01

    To describe the 4-year experience of symptomatic intracranial hemorrhage (sICH) rate at a high-volume comprehensive stroke center. All admitted adult (≥18 years) patients presenting with an ischemic stroke from 2010 to 2013 were included in this study. The primary outcome was sICH, defined as any hemorrhage with neurological deterioration (change in National Institutes of Health Stroke Scale score ≥4) within 36 hours of intravenous tissue plasminogen activator (IV-tPA) treatment, or any hemorrhage resulting in death. Secondary outcomes were in-hospital mortality and having a favorable modified Rankin Scale (mRS) score (≤2). A total of 1925 did not receive intravascular (IV) or intra-arterial (IA) therapy; only 451 received IV therapy; and 175 received both IV and IA therapies. In IV-only patients, the overall rate of sICH was 2.2%; in IV and IA patients, the rate was 5.7%; and in patients who received no therapy, the rate was .4%. The IV-only group had an sICH rate of .9% in 2013. There were no differences in the adjusted odds of dying in the hospital between the study groups. IV-only treatment offered significantly better odds of achieving a favorable functional outcome, compared to no therapy, among patients with moderate stroke severity, whereas IV and IA treatments offered significantly better odds among patients with severe strokes. The odds of achieving a favorable functional outcome by discharge were decreased by 97% if patients suffered an sICH (OR = .03, 95%CI = .004, .19). Despite an increased risk of sICH with IV-tPA, treatment with IV-tPA continues to be associated with increased odds of a favorable discharge mRS. Copyright © 2016 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  7. Low free triiodothyronine levels predict symptomatic intracranial hemorrhage and worse short-term outcome of thrombolysis in patients with acute ischemia stroke.

    Science.gov (United States)

    Qiu, Mingjing; Fang, Min; Liu, Xueyuan

    2017-11-01

    The aim of the study was to determine whether thyroid hormones level on admission in patients with ischemic stroke, treated with intravenous recombinant tissue type plasminogen activator (rtPA), was associated with symptomatic intracranial hemorrhage (sICH) and worse outcomes at 3 months.Patients with acute ischemic stroke (AIS) receiving intravenous rtPA thrombolytic treatment on our stroke unit between January 2015 and June 2016 were included in this study. Serum-free triiodothyronine (fT3), free thyroxine (fT4), total triiodothyronine (tT3), total thyroxine (tT4), and thyroid-stimulating hormone (TSH) were detected on admission. The endpoints were sICH, and poor functional outcomes at 3 and 6 months.In all, 159 patients (106 males; mean age 65.36 ± 10.02 years) were included. FT3 was independently associated with sICH (odds ratio [OR] 0.204, 95% confidence interval [CI] 0.065-0.642) and poor outcomes at 3 months (OR 0.396, 95% CI 0.180-1.764). The cut-off values of fT3 for sICH was 3.54 pg/mL (sensitivity 83%; specificity 83%; area under the curve 0.88). FT3 values ≤3.54 pg/mL increased risk for sICH by 3.16-fold (95% CI 0.75-1.0) compared with fT3 values >3.54 pg/mL.Low fT3 levels at admission were independently associated with sICH and worse outcomes at 3 months in AIS patients receiving rtPA thrombolytic therapy.

  8. Predictors of symptomatic intracranial haemorrhage in patients with an ischaemic stroke with neurological deterioration after intravenous thrombolysis.

    Science.gov (United States)

    James, Brandon; Chang, Andrew D; McTaggart, Ryan A; Hemendinger, Morgan; Mac Grory, Brian; Cutting, Shawna M; Burton, Tina M; Reznik, Michael E; Thompson, Bradford; Wendell, Linda; Mahta, Ali; Siket, Matthew; Madsen, Tracy E; Sheth, Kevin N; Nouh, Amre; Furie, Karen L; Jayaraman, Mahesh V; Khatri, Pooja; Yaghi, Shadi

    2018-02-27

    Early neurological deterioration prompting urgent brain imaging occurs in nearly 15% of patients with ischaemic stroke receiving intravenous tissue plasminogen activator (tPA). We aim to determine risk factors associated with symptomatic intracranial haemorrhage (sICH) in patients with ischaemic stroke undergoing emergent brain imaging for early neurological deterioration after receiving tPA. We abstracted data from our prospective stroke database and included all patients receiving tPA for ischaemic stroke between 1 March 2015 and 1 March 2017. We then identified patients with neurological deterioration who underwent urgent brain imaging prior to their per-protocol surveillance imaging and divided patients into two groups: those with and without sICH. We compared baseline demographics, clinical variables, in-hospital treatments and functional outcomes at 90 days between the two groups. We identified 511 patients who received tPA, of whom 108 (21.1%) had an emergent brain CT. Of these patients, 17.5% (19/108) had sICH; 21.3% (23/108) of emergent scans occurred while tPA was infusing, though only 4.3% of these scans (1/23) revealed sICH. On multivariable analyses, the only predictor of sICH was a change in level of consciousness (OR 6.62, 95% CI 1.64 to 26.70, P=0.008). Change in level of consciousness is associated with sICH among patients undergoing emergent brain imaging after receiving tPA. In this group of patients, preparation of tPA reversal agents while awaiting brain imaging may reduce reversal times. Future studies are needed to study the cost-effectiveness of this approach. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  9. Low Ambient Temperature and Intracerebral Hemorrhage: The INTERACT2 Study.

    Directory of Open Access Journals (Sweden)

    Danni Zheng

    Full Text Available Rates of acute intracerebral hemorrhage (ICH increase in winter months but the magnitude of risk is unknown. We aimed to quantify the association of ambient temperature with the risk of ICH in the Intensive Blood Pressure Reduction in Acute Cerebral Haemorrhage Trial (INTERACT2 participants on an hourly timescale.INTERACT2 was an international, open, blinded endpoint, randomized controlled trial of patients with spontaneous ICH (<6h of onset and elevated systolic blood pressure (SBP, 150-220 mmHg assigned to intensive (target SBP <140 mmHg or guideline-recommended (SBP <180 mmHg BP treatment. We linked individual level hourly temperature to baseline data of 1997 participants, and performed case-crossover analyses using a distributed lag non-linear model with 24h lag period to assess the association of ambient temperature and risk of ICH. Results were presented as overall cumulative odds ratios (ORs and 95% CI.Low ambient temperature (≤10°C was associated with increased risks of ICH: overall cumulative OR was 1.37 (0.99-1.91 for 10°C, 1.92 (1.31-2.81 for 0°C, 3.13 (1.89-5.19 for -10°C, and 5.76 (2.30-14.42 for -20°C, as compared with a reference temperature of 20°C.There was no clear relation of low temperature beyond three hours after exposure. Results were consistent in sensitivity analyses.Exposure to low ambient temperature within several hours increases the risk of ICH.ClinicalTrials.gov NCT00716079.

  10. Low Ambient Temperature and Intracerebral Hemorrhage: The INTERACT2 Study

    Science.gov (United States)

    Zheng, Danni; Arima, Hisatomi; Sato, Shoichiro; Gasparrini, Antonio; Heeley, Emma; Delcourt, Candice; Lo, Serigne; Huang, Yining; Wang, Jiguang; Stapf, Christian; Robinson, Thompson; Lavados, Pablo; Chalmers, John; Anderson, Craig S.

    2016-01-01

    Background Rates of acute intracerebral hemorrhage (ICH) increase in winter months but the magnitude of risk is unknown. We aimed to quantify the association of ambient temperature with the risk of ICH in the Intensive Blood Pressure Reduction in Acute Cerebral Haemorrhage Trial (INTERACT2) participants on an hourly timescale. Methods INTERACT2 was an international, open, blinded endpoint, randomized controlled trial of patients with spontaneous ICH (<6h of onset) and elevated systolic blood pressure (SBP, 150–220 mmHg) assigned to intensive (target SBP <140 mmHg) or guideline-recommended (SBP <180 mmHg) BP treatment. We linked individual level hourly temperature to baseline data of 1997 participants, and performed case-crossover analyses using a distributed lag non-linear model with 24h lag period to assess the association of ambient temperature and risk of ICH. Results were presented as overall cumulative odds ratios (ORs) and 95% CI. Results Low ambient temperature (≤10°C) was associated with increased risks of ICH: overall cumulative OR was 1.37 (0.99–1.91) for 10°C, 1.92 (1.31–2.81) for 0°C, 3.13 (1.89–5.19) for -10°C, and 5.76 (2.30–14.42) for -20°C, as compared with a reference temperature of 20°C.There was no clear relation of low temperature beyond three hours after exposure. Results were consistent in sensitivity analyses. Conclusions Exposure to low ambient temperature within several hours increases the risk of ICH. Trial Registration ClinicalTrials.gov NCT00716079 PMID:26859491

  11. Role for HIF-1α and Downstream Pathways in Regulating Neuronal Injury after Intracerebral Hemorrhage in Diabetes

    Directory of Open Access Journals (Sweden)

    Zhen Yu

    2015-08-01

    Full Text Available Background/Aims: HIF-1α is accumulated in the cellular nucleus and cytoplasm under conditions of oxygen deprivation and engaged in pathophysiologic changes of homeostasis by modulating the expression of several target genes. As an endogenous signaling protein, HIF-1α contributes to in neuroprotection, erythropoiesis, and apoptosis modulation. The purpose of this study was to examine the role played by HIF-1α in regulating neurological injury evoked by intracerebral hemorrhage (ICH through its downstream product, namely vascular endothelial growth factor (VEGF. In particular, we examined the effects of diabetic hyperglycemia on HIF-1α response in the processing of ICH. Methods: ELISA was used to measure HIF-1α and VEGF; and Western Blot analysis to examine the protein expression of VEGFR-2 and Caspase-3. Neurological Severity Score and brain water content were used to indicate neurological function and brain edema. Results: HIF-1α and VEGF were significantly increased in the brain after induction of ICH in non-diabetic control rats and diabetic rats; however, the amplified levels of HIF-1α and VEGF were attenuated in diabetic rats (Pvs. non-diabetic rats as compared with non-diabetic rats. Also, the protein expression of VEGF receptor subtype 2 was significantly less in the brain of diabetic rats (Pvs. non-diabetic rats. Further, cerebral infusion of HIF-1 activator stabilized VEGF levels, attenuated Caspase-3 and improved neurological deficits induced by ICH and the effects are smaller in diabetic animals. Conclusion: HIF-1α activated by ICH likely plays a beneficial role via VEGF mechanisms and response of HIF-1α is largely impaired in diabetes. This has pharmacological implications to target specific HIF-1α and VEGF pathway for neuronal dysfunction and vulnerability related to ICH.

  12. Electroacupuncture Exerts Neuroprotection through Caveolin-1 Mediated Molecular Pathway in Intracerebral Hemorrhage of Rats

    Directory of Open Access Journals (Sweden)

    Hui-Qin Li

    2016-01-01

    Full Text Available Spontaneous intracerebral hemorrhage (ICH is one of the most devastating types of stroke. Here, we aim to demonstrate that electroacupuncture on Baihui (GV20 exerts neuroprotection for acute ICH possibly via the caveolin-1/matrix metalloproteinase/blood-brain barrier permeability pathway. The model of ICH was established by using collagenase VII. Rats were randomly divided into three groups: Sham-operation group, Sham electroacupuncture group, and electroacupuncture group. Each group was further divided into 4 subgroups according to the time points of 6 h, 1 d, 3 d, and 7 d after ICH. The methods were used including examination of neurological deficit scores according to Longa’s scale, measurement of blood-brain barrier permeability through Evans Blue content, in situ immunofluorescent detection of caveolin-1 in brains, western blot analysis of caveolin-1 in brains, and in situ zymography for measuring matrix metalloproteinase-2/9 activity in brains. Compared with Sham electroacupuncture group, electroacupuncture group has resulted in a significant improvement in neurological deficit scores and in a reduction in Evans Blue content, expression of caveolin-1, and activity of matrix metalloproteinase-2/9 at 6 h, 1 d, 3 d, and 7 d after ICH (P<0.05. In conclusion, the present results suggested that electroacupuncture on GV20 can improve neurological deficit scores and reduce blood-brain barrier permeability after ICH, and the mechanism possibly targets caveolin-1/matrix metalloproteinase/blood-brain barrier permeability pathway.

  13. Local hemostatic matrix for endoscope-assisted removal of intracerebral hemorrhage is safe and effective.

    Science.gov (United States)

    Luh, Hui-Tzung; Huang, Abel Po-Hao; Yang, Shih-Hung; Chen, Chien-Ming; Cho, Der-Yang; Chen, Chun-Chung; Kuo, Lu-Ting; Li, Chieh-Hsun; Wang, Kuo-Chuan; Tseng, Wei-Lung; Hsing, Ming-Tai; Yang, Bing-Shiang; Lai, Dar-Ming; Tsai, Jui-Chang

    2018-01-01

    Minimally invasive endoscope-assisted (MIE) evacuation of spontaneous intracerebral hemorrhage (ICH) is simple and effective, but the limited working space may hinder meticulous hemostasis and might lead to rebleeding. Management of intraoperative hemorrhage is therefore a critical issue of this study. This study presents experience in the treatment of patients with various types of ICH by MIE evacuation followed by direct local injection of FloSeal Hemostatic Matrix (Baxter Healthcare Corp, Fremont, CA, USA) for hemostasis. The retrospective nonrandomized clinical and radiology-based analysis enrolled 42 patients treated with MIE evacuation of ICH followed by direct local injection of FloSeal Hemostatic Matrix. Rebleeding, morbidity, and mortality were the primary endpoints. The percentage of hematoma evacuated was calculated from the pre- and postoperative brain computed tomography (CT) scans. Extended Glasgow Outcome Scale (GOSE) was evaluated at 6 months postoperatively. Forty-two ICH patients were included in this study, among these, 23 patients were putaminal hemorrhage, 16 were thalamic ICH, and the other three were subcortical type. Surgery-related mortality was 2.4%. The average percentage of hematoma evacuated was 80.8%, and the rebleeding rate was 4.8%. The mean operative time was 102.7 minutes and the average blood loss was 84.9 mL. The mean postoperative GOSE score was 4.55 at 6-months' follow-up. This study shows that local application of FloSeal Hemostatic Matrix is safe and effective for hemostasis during MIE evacuation of ICH. In our experience, this shortens the operation time, especially in cases with intraoperative bleeding. A large, prospective, randomized trial is needed to confirm the findings. Copyright © 2017. Published by Elsevier B.V.

  14. Childhood Stature and Growth in Relation to First Ischemic Stroke or Intracerebral Hemorrhage.

    Science.gov (United States)

    Gjærde, Line Klingen; Truelsen, Thomas Clement; Baker, Jennifer Lyn

    2018-03-01

    Attained height, an indicator of genetic potential and childhood growth environment, is inversely associated with stroke, but the mechanisms are poorly understood. We investigated whether childhood height and growth are associated with ischemic stroke (IS) and intracerebral hemorrhage (ICH). In a cohort of Danish schoolchildren born 1930 to 1989, with measured height from 7 to 13 years, we investigated associations of childhood stature and growth with risks of adult IS and ICH. Cox proportional hazards regressions were performed to estimate hazard ratios (HRs) with CIs separately for women and men. Among 311 009 individuals, 10 412 were diagnosed with IS and 2546 with ICH. Height at 7 years was inversely and significantly associated with IS in both sexes (per z score, equivalent to ≈5.2 cm in women and 5.1 cm in men; women: HR=0.89 [95% CI: 0.87-0.92]; men: HR=0.90 [95% CI: 0.88-0.92]) and with ICH in men (HR=0.89 [95% CI: 0.84-0.94]) but not in women (HR=0.97 [95% CI: 0.91-1.04]). Associations were similar at older childhood ages and were stable throughout the study period. No statistically significant associations for growth from 7 to 13 years were observed for IS or ICH. Short stature at 7 to 13 years is significantly associated with increased risks of IS in both sexes and with ICH in men. Growth during this period of childhood is not significantly associated with either of these stroke subtypes, suggesting that underlying mechanisms linking height with risks of stroke may exert their influence already by early childhood. © 2018 American Heart Association, Inc.

  15. Systematic Review and Meta-Analysis: Is Pre-Injury Antiplatelet Therapy Associated with Traumatic Intracranial Hemorrhage?

    Science.gov (United States)

    van den Brand, Crispijn L; Tolido, Tanya; Rambach, Anna H; Hunink, Myriam G M; Patka, Peter; Jellema, Korné

    2017-01-01

    The objective of this systematic review and meta-analysis is to evaluate whether the pre-injury use of antiplatelet therapy (APT) is associated with increased risk of traumatic intracranial hemorrhage (tICH) on CT scan. PubMed, Medline, Embase, Cochrane Central, reference lists, and national guidelines on traumatic brain injury were used as data sources. Eligible studies were cohort studies and case-control studies that assessed the relationship between APT and tICH. Studies without control group were not included. The primary outcome of interest was tICH on CT. Two reviewers independently selected studies, assessed methodological quality, and extracted outcome data. This search resulted in 10 eligible studies with 20,247 patients with head injury that were included in the meta-analysis. The use of APT in patients with head injury was associated with significant increased risk of tICH compared with control (odds ratio [OR] 1.87, 95% confidence interval [CI]1.27-2.74). There was significant heterogeneity in the studies (I 2 84%), although almost all showed an association between APT use and tICH. This association could not be established for patients receiving aspirin monotherapy. When considering only patients with mild traumatic brain injury (mTBI), the OR is 2.72 (95% CI 1.92-3.85). The results were robust to sensitivity analysis on study quality. In summary, APT in patients with head injury is associated with increased risk of tICH; this association is most relevant in patients with mTBI. Whether this association is the result of a causal relationship and whether this relationship also exists for patients receiving aspirin monotherapy cannot be established with the current review and meta-analysis.

  16. Intraoperative imaging for patient safety and QA: detection of intracranial hemorrhage using C-arm cone-beam CT

    Science.gov (United States)

    Schafer, Sebastian; Wang, Adam; Otake, Yoshito; Stayman, J. W.; Zbijewski, Wojciech; Kleinszig, Gerhard; Xia, Xuewei; Gallia, Gary L.; Siewerdsen, Jeffrey H.

    2013-03-01

    Intraoperative imaging could improve patient safety and quality assurance (QA) via the detection of subtle complications that might otherwise only be found hours after surgery. Such capability could therefore reduce morbidity and the need for additional intervention. Among the severe adverse events that could be more quickly detected by high-quality intraoperative imaging is acute intracranial hemorrhage (ICH), conventionally assessed using post-operative CT. A mobile C-arm capable of high-quality cone-beam CT (CBCT) in combination with advanced image reconstruction techniques is reported as a means of detecting ICH in the operating room. The system employs an isocentric C-arm with a flat-panel detector in dual gain mode, correction of x-ray scatter and beam-hardening, and a penalized likelihood (PL) iterative reconstruction method. Performance in ICH detection was investigated using a quantitative phantom focusing on (non-contrast-enhanced) blood-brain contrast, an anthropomorphic head phantom, and a porcine model with injection of fresh blood bolus. The visibility of ICH was characterized in terms of contrast-to-noise ratio (CNR) and qualitative evaluation of images by a neurosurgeon. Across a range of size and contrast of the ICH as well as radiation dose from the CBCT scan, the CNR was found to increase from ~2.2-3.7 for conventional filtered backprojection (FBP) to ~3.9-5.4 for PL at equivalent spatial resolution. The porcine model demonstrated superior ICH detectability for PL. The results support the role of high-quality mobile C-arm CBCT employing advanced reconstruction algorithms for detecting subtle complications in the operating room at lower radiation dose and lower cost than intraoperative CT scanners and/or fixedroom C-arms. Such capability could present a potentially valuable aid to patient safety and QA.

  17. Intracerebral Hemorrhage; towards physiological imaging of hemorrhage risk in acute and chronic bleeding.

    Directory of Open Access Journals (Sweden)

    Raphael eJakubovic

    2012-05-01

    Full Text Available Despite improvements in management and prevention of intracerebral hemorrhage (ICH, there has been little improvement in mortality over the last 30 years. Hematoma expansion, primarily during the first few hours is highly predictive of neurological deterioration, poor functional outcome and mortality. For each 10% increase in ICH size, there is a 5% increase in mortality and an additional 16% chance of poorer functional outcome. As such, both the identification and prevention of hematoma expansion are attractive therapeutic targets in ICH. Previous studies suggest that contrast extravasation seen on CT Angiography (CTA, MRI, and digital subtraction angiography correlates with hematoma growth, indicating ongoing bleeding. Contrast extravasation on the arterial phase of a CTA has been coined the CTA Spot Sign. These easily identifiable foci of contrast enhancement have been identified as independent predictors of hematoma growth, mortality and clinical outcome in primary ICH. The Spot Sign score, developed to stratify risk of hematoma expansion, has shown high inter-observer agreement. Post-contrast leakage or delayed CTA Spot Sign, on post contrast CT following CTA or delayed CTA respectively are seen in an additional ~8% of patients and explain apparently false negative observations on early CTA imaging in patients subsequently undergoing hematoma expansion. CT perfusion provides an opportunity to acquire dynamic imaging and has been shown to quantify rates of contrast extravasation. Intravenous recombinant factor VIIa(rFVIIa within 4 hours of ICH onset has been shown to significantly reduce hematoma growth. However, clinical efficacy has yet to be proven. There is compelling evidence that cerebral amyloid angiopathy (CAA may precede the radiographic evidence of vascular disease and as such contribute to microbleeding. The interplay between microbleeding, CAA,CTA Spot Sign and genetic composition (ApoE genotype may be crucial in developing a

  18. Cognitive functioning over 2 years after intracerebral hemorrhage in school-aged children.

    Science.gov (United States)

    Murphy, Lexa K; Compas, Bruce E; Gindville, Melissa C; Reeslund, Kristen L; Jordan, Lori C

    2017-11-01

    Previous research investigating outcomes after pediatric intracerebral hemorrhage (ICH) has generally been limited to global and sensorimotor outcomes. This study examined cognitive outcomes after spontaneous ICH in school-aged children with serial assessments over 2 years after stroke. Seven children (age range 6-16y, median 13; six males, one female; 57% white, 43% black) presenting with spontaneous ICH (six arteriovenous malformations) were assessed at 3 months, 12 months, and 24 months after stroke. The Pediatric Stroke Outcome Measure (PSOM) quantified neurological outcome and Wechsler Intelligence Scales measured cognitive outcomes: verbal comprehension, perceptual reasoning, working memory, and processing speed. PSOM scales showed improved neurological function over the first 12 months, with mild to no sensorimotor deficits and moderate overall deficits at 1- and 2-year follow-ups (median 2-year sensorimotor PSOM=0.5, total PSOM=1.5). Changes in cognitive function indicated a different trajectory; verbal comprehension and perceptual reasoning improved over 24 months; low performance was sustained in processing speed and working memory. Age-normed centile scores decreased between 1- and 2-year follow-ups for working memory, suggesting emerging deficits compared with peers. Early and serial cognitive testing in children with ICH is needed to assess cognitive functioning and support children in school as they age and cognitive deficits become more apparent and important for function. In children with intracerebral hemorrhage (ICH), motor function improved between 3 months and 24 months. Improvements in cognitive function were variable between 3 months and 24 months. Working memory centiles declined, suggesting emerging deficits compared with peers. Processing speed improved but remained significantly below the 50th centile. Cognitive impact of ICH may increase with age in children. © 2017 Mac Keith Press.

  19. 30-Day Mortality and Readmission after Hemorrhagic Stroke among Medicare Beneficiaries in Joint Commission Primary Stroke Center Certified and Non-Certified Hospitals

    Science.gov (United States)

    Lichtman, Judith H.; Jones, Sara B.; Leifheit-Limson, Erica C.; Wang, Yun; Goldstein, Larry B.

    2012-01-01

    Background and Purpose Ischemic stroke patients treated at Joint Commission Primary Stroke Center (JC-PSC) certified hospitals have better outcomes. Data reflecting the impact of JC-PSC status on outcomes after hemorrhagic stroke are limited. We determined whether 30-day mortality and readmission rates after hemorrhagic stroke differed for patients treated at JC-PSC certified versus non-certified hospitals. Methods The study included all fee-for-service Medicare beneficiaries ≥65 years old with a primary discharge diagnosis of subarachnoid hemorrhage (SAH) or intracerebral hemorrhage (ICH) in 2006. Covariate-adjusted logistic and Cox proportional hazards regression assessed the effect of care at a JC-PSC certified hospital on 30-day mortality and readmission. Results There were 2,305 SAH and 8,708 ICH discharges from JC-PSC certified hospitals and 3,892 SAH and 22,564 ICH discharges from non-certified hospitals. Unadjusted in-hospital mortality (SAH: 27.5% vs. 33.2%, pmortality (SAH: 35.1% vs. 44.0%, pmortality was 34% lower (OR 0.66, 95% CI 0.58–0.76) after SAH and 14% lower (OR 0.86, 95% CI 0.80–0.92) after ICH for patients discharged from JC-PSC certified hospitals. There was no difference in 30-day risk-adjusted readmission rates for SAH or ICH based on JC-PSC status. Conclusions Patients treated at JC-PSC certified hospitals had lower risk-adjusted mortality rates for both SAH and ICH but similar 30-day readmission rates as compared with non-certified hospitals. PMID:22033986

  20. Intracranial hemorrhage in normotensive and hypertensive patients receiving streptokinase after decreasing elevated blood pressure

    Directory of Open Access Journals (Sweden)

    H Shemirani

    2005-09-01

    Full Text Available Background: Many patients with suspected acute myocardial infarction (AMI and eligible for thrombolytic therapy may not be treated because of association between hemorrhagic complications especially intracranial hemorrhage (ICH, and severe hypertension (HTN at presentation. Unfortunately, this leads to under use or delay in thrombolytic therapy. We assessed effect of decreasing elevated blood pressure before thrombolytic therapy in order to reduce the incidence of ICH without increasing mortality rate. Methods: This observational and analytical cohort study enrolled 293 patients (215males and 78 female with STsegment elevation (AMI that were hospitalized in emergency department of Noor hospital, Isfahan, Iran. Severe hypertension (blood pressure ≥180/110mmHg was diagnosed in 132 patients. All of them received 1.5 million units streptokinase within one hour intravenously. In the hypertensive group, elevated blood pressure was lowered to less than180/110mmhg before thrombolysis and they were observed to detect development of symptomatic ICH and they underwent Brain CT scan, if required. Results: The incidence of total stroke, ICH and death were 1.4%, 0.7% and 4.8%, respectively. The incidence of death and ICH in patients with severe hypertension was less than control group (P value=0.13 and 0.59, respectively Conclusion: Although we did not find any increase in ICH incidence in severe hypertensive patients treated be streptokinase due to AMI, but we recommend a multi-centric study with more cases and varied thrombolytic protocols. Key words: Acute myocardial infarction, Intracranial hemorrhage, Thrombolytic therapy

  1. 30-day mortality and readmission after hemorrhagic stroke among Medicare beneficiaries in Joint Commission primary stroke center-certified and noncertified hospitals.

    Science.gov (United States)

    Lichtman, Judith H; Jones, Sara B; Leifheit-Limson, Erica C; Wang, Yun; Goldstein, Larry B

    2011-12-01

    Ischemic stroke patients treated at Joint Commission Primary Stroke Center (JC-PSC)-certified hospitals have better outcomes. Data reflecting the impact of JC-PSC status on outcomes after hemorrhagic stroke are limited. We determined whether 30-day mortality and readmission rates after hemorrhagic stroke differed for patients treated at JC-PSC-certified versus noncertified hospitals. The study included all fee-for-service Medicare beneficiaries aged 65 years or older with a primary discharge diagnosis of subarachnoid hemorrhage (SAH) or intracerebral hemorrhage (ICH) in 2006. Covariate-adjusted logistic and Cox proportional hazards regression assessed the effect of care at a JC-PSC-certified hospital on 30-day mortality and readmission. There were 2305 SAH and 8708 ICH discharges from JC-PSC-certified hospitals and 3892 SAH and 22 564 ICH discharges from noncertified hospitals. Unadjusted in-hospital mortality (SAH: 27.5% versus 33.2%, Pmortality (SAH: 35.1% versus 44.0%, Pmortality was 34% lower (odds ratio, 0.66; 95% confidence interval, 0.58-0.76) after SAH and 14% lower (odds ratio, 0.86; 95% confidence interval, 0.80-0.92) after ICH for patients discharged from JC-PSC-certified hospitals. There was no difference in 30-day risk-adjusted readmission rates for SAH or ICH based on JC-PSC status. Patients treated at JC-PSC-certified hospitals had lower risk-adjusted mortality rates for both SAH and ICH but similar 30-day readmission rates as compared with noncertified hospitals.

  2. Transpersonale Aspekte von Musik und Imagination in der Traumatherapie

    DEFF Research Database (Denmark)

    Maack, Carola

    2013-01-01

    Guided Imagery and Music nach Helen Bonny (GIM) und ihre Modifikationen haben sich in der Traumatherapie als sehr effektiv herausgestellt. In meinem Vortrag werde ich die Methode und ihre Anwendungen in der Traumatherapie vorstellen. Dabei gehe ich auch auf die Abgrenzung von Imagination im...... personalen und traunspersonalen Raum und deren jeweilige Bedeutung für traumatisierte Menschen in der unterschiedlichen Phasen ihrer Therapie ein. [The Bonny Methode of Guided Imagery and Music (GIM) and its modifications have shown to be quite effective in trauma therapy. In my presentation I will give...

  3. MRI characteristics of spontaneous intracerebral hemorrhage; Das kernspintomographische Erscheinungsbild der spontanen intrazerebralen Blutung

    Energy Technology Data Exchange (ETDEWEB)

    Felber, S.; Schocke, M. [Innsbruck Univ. (Austria). Klinik fuer Radiologie; Innsbruck Univ. (Austria). Inst. fuer Magnetresonanztomographie und Spektroskopie; Auer, A.; Golaszewski, S.; Amort, B. [Innsbruck Univ. (Austria). Inst. fuer Magnetresonanztomographie und Spektroskopie; Nedden, D. zur [Innsbruck Univ. (Austria). Klinik fuer Radiologie

    1999-10-01

    We review the signal characteristics of intracerebral hematomas (ICH) on magnetic resonance imaging (MRI), with special emphasis on the diagnosis of intracerebral hemorrhage within the first hours after stroke. The detection of peracute ICH was evaluated in 42 patients of a prospective, MR randomized stroke trial. These patients underwent a protocol of T1 and T2 weighted sequences, diffusion weighted sequences and MR - angiography within 6 hours after onset of acute hemiparesis. The signal behaviour of ICH in any stage after bleeding was additionally reviewed in a retrospective series of 63 patients, who were submitted for MRI over a 12 months period because of known ICH. MRI correctly identified 4 hyperacute ICH in the prospective group and 4 hyperacute ICH in the retrospective group. These ICHs had high signal on T2 weighted images, were isointense in T1 weighted images and had signal voids on the diffusion weighted sequences. The signal intensities of acute, subacute and chronic ICHs correlated to previous experiences as reported in the literature. In conclusion, MRI reliably identified all hematomas even in the hyperacute stage. Diffusion weighted images were most sensitive to the presence of deoxyhemoglobine and helpful for the differentiation and characterization of acute ischemia. Therefore, MRI at 1.5 T can be employed as an alternative to CT for the emergency diagnosis of acute stroke. (orig.) [German] In dieser Uebersicht wird das kernspintomographische (KST) Erscheinungsbild der intrazerebralen Blutung (IZB) anhand eigener Erfahrungen und der Literatur diskutiert. Besonderes Gewicht wurde auf den KST Nachweis der hyperakuten IZB innerhalb der ersten Stunden gelegt. Es wurden einerseits die Befunde von 42 Patienten einer prospektiven, KST randomisierten Schlaganfallstudie ausgewertet, bei denen die KST als Erstuntersuchung innerhalb von 6 Stunden durchgefuehrt worden war. Andererseits werteten wir retrospektiv jene KST Untersuchungen aus, die im Jahr 1998

  4. Vom Referat bis zur Examensarbeit: Naturwissenschaftliche Texte perfekt verfassen und gestalten

    Science.gov (United States)

    Kremer, Bruno P.

    Welches Thema eignet sich für mein Referat oder meine Seminararbeit? Wie sammle ich Stoff? Wie gliedere ich den Text? Bruno P. Kremer beantwortet auf nur 200 Seiten alle wichtigen Fragen zur wissenschaftlichen Arbeit in den naturwissenschaftlichen Fächern. Dabei beschränkt er sich auf das für Studenten und Schüler wirklich notwendige Wissen und lässt jeglichen unnützen Ballast beiseite. Dieser praktische Ratgeber verhilft Ihnen zur erfolgreichen wissenschaftlichen Arbeit - vom Referat bis zur Examensarbeit.

  5. Not only the sugar, early infarct sign, hyperDense middle cerebral artery, age, neurologic deficit score but also atrial fibrillation is predictive for symptomatic intracranial hemorrhage after intravenous recombinant tissue plasminogen activator

    Directory of Open Access Journals (Sweden)

    Sombat Muengtaweepongsa

    2017-01-01

    Full Text Available Background: Symptomatic intracranial hemorrhage (sICH is the most unwanted adverse event in patients with acute ischemic stroke who received intravenous recombinant tissue plasminogen activator (i.v. rt-PA. Many tool scores are available to predict the probability of sICH. Among those scores, the Sugar, Early infarct sign, hyperDense middle cerebral artery, Age, Neurologic deficit (SEDAN gives the highest area under the curve-receiver operating characteristic value. Objective: We aimed to examine any factors other than the SEDAN score to predict the probability of sICH. Methods: Patients with acute ischemic stroke treated with i.v. rt-PA within 4.5 h time window from January 2010 to July 2012 were evaluated. Compiling demographic data, risk factors, and comorbidity (hypertension, diabetes mellitus, dyslipidemia, atrial fibrillation (AF, ischemic heart disease, valvular heart disease, previous stroke, gout, smoking cigarette, drinking alcoholic beverage, family history of stroke, and family history of ischemic heart disease, computed tomography scan of patients prior to treatment with rt-PA, and assessing the National Institutes of Health Stroke Scale (NIHSS score for the purpose of calculating SEDAN score were analyzed. Results: Of 314 patients treated with i.v. rt-PA, there were 46 ICH cases (14.6% with 14 sICH (4.4% and 32 asymptomatic intracranial hemorrhage cases (10.2%. The rate of sICH occurrence was increased in accordance with the increase in the SEDAN score and AF. Age over 75 years, early infarction, hyperdense cerebral artery, baseline blood sugar more than 12 mmol/l, NIHSS as 10 or more, and AF were the risk factors to develop sICH after treated with rt-PA at 1.535, 2.501, 1.093, 1.276, 1.253, and 2.492 times, respectively. Conclusions: Rather than the SEDAN score, AF should be a predictor of sICH in patients with acute ischemic stroke after i.v. rt-PA treatment in Thai population.

  6. International Conference on Harmonisation; guidance on Q10 Pharmaceutical Quality System; availability. Notice.

    Science.gov (United States)

    2009-04-08

    The Food and Drug Administration (FDA) is announcing the availability of a guidance entitled "Q10 Pharmaceutical Quality System." The guidance was prepared under the auspices of the International Conference on Harmonisation of Technical Requirements for Registration of Pharmaceuticals for Human Use (ICH). The guidance describes a model for an effective quality management system for the pharmaceutical industry, referred to as the Pharmaceutical Quality System. The guidance is intended to provide a comprehensive approach to an effective pharmaceutical quality system that is based on International Organization for Standardization (ISO) concepts, includes applicable good manufacturing practice (GMP) regulations and complements ICH guidances on "Q8 Pharmaceutical Development" and "Q9 Quality Risk Management."

  7. Association of prothrombin complex concentrate administration and hematoma enlargement in non-vitamin K antagonist oral anticoagulant-related intracerebral hemorrhage.

    Science.gov (United States)

    Gerner, Stefan T; Kuramatsu, Joji B; Sembill, Jochen A; Sprügel, Maximilian I; Endres, Matthias; Haeusler, Karl Georg; Vajkoczy, Peter; Ringleb, Peter A; Purrucker, Jan; Rizos, Timolaos; Erbguth, Frank; Schellinger, Peter D; Fink, Gereon R; Stetefeld, Henning; Schneider, Hauke; Neugebauer, Hermann; Röther, Joachim; Claßen, Joseph; Michalski, Dominik; Dörfler, Arnd; Schwab, Stefan; Huttner, Hagen B

    2018-01-01

    To investigate parameters associated with hematoma enlargement in non-vitamin K antagonist oral anticoagulant (NOAC)-related intracerebral hemorrhage (ICH). This retrospective cohort study includes individual patient data for 190 patients with NOAC-associated ICH over a 5-year period (2011-2015) at 19 departments of neurology across Germany. Primary outcome was the association of prothrombin complex concentrate (PCC) administration with hematoma enlargement. Subanalyses were calculated for blood pressure management and its association with the primary outcome. Secondary outcomes include associations with in-hospital mortality and functional outcome at 3 months assessed using the modified Rankin Scale. The study population for analysis of primary and secondary outcomes consisted of 146 NOAC-ICH patients with available follow-up imaging. Hematoma enlargement occurred in 49/146 (33.6%) patients with NOAC-related ICH. Parameters associated with hematoma enlargement were blood pressure ≥ 160mmHg within 4 hours and-in the case of factor Xa inhibitor ICH-anti-Xa levels on admission. PCC administration prior to follow-up imaging was not significantly associated with a reduced rate of hematoma enlargement either in overall NOAC-related ICH or in patients with factor Xa inhibitor intake (NOAC: risk ratio [RR] = 1.150, 95% confidence interval [CI] = 0.632-2.090; factor Xa inhibitor: RR = 1.057, 95% CI = 0.565-1.977), regardless of PCC dosage given or time interval until imaging or treatment. Systolic blood pressure levels < 160mmHg within 4 hours after admission were significantly associated with a reduction in the proportion of patients with hematoma enlargement (RR = 0.598, 95% CI = 0.365-0.978). PCC administration had no effect on mortality and functional outcome either at discharge or at 3 months. In contrast to blood pressure control, PCC administration was not associated with a reduced rate of hematoma enlargement in NOAC-related ICH

  8. Aspekte der Höflichkeit im Vergleich der Kulturen

    OpenAIRE

    Kotthoff, Helga

    2003-01-01

    Haben Sie schon gegessen? Sicher finden Sie diese Anrede höchst merkwürdig; völlig deplaziert erscheint es Ihnen vermutlich, Sie nach dem Essen zu fragen. Mir ging es ähnlich, als mir diese Frage bei meinem ersten China-Aufenthalt 1982 bei zufälligen Begegnungen auf dem Campus der Universität, an der ich gearbeitet habe, gestellt wurde. Ich habe sie in Richtung Vorbereitung auf eine kommende Essenseinladung oder zumindest auf den Vorschlag, jetzt gemeinsam essen zu gehen, interpretiert un...

  9. Representation and Dissemination of Intangible Cultural Heritage of Bangladesh through Social Media

    DEFF Research Database (Denmark)

    Khalid, Md. Saifuddin; Chowdhury, Md Saiful Alam

    2016-01-01

    Bangladesh is one of the next eleven countries and home to more than 160 million people. The country is experiencing an exponential growth of social media users due to the increase in affordability of smartphones, literacy rate, education level, and adoption of Internet services and applications...... of strategically representing and diffusing ICH through social media, this research explores the current roles of social media in the transmission of ICH in the virtual world. The research question is: How are Baul song and Jamdani weaving as intangible cultural heritage of Bangladesh represented and disseminated...... through social media platforms?...

  10. WE-EF-207-03: Design and Optimization of a CBCT Head Scanner for Detection of Acute Intracranial Hemorrhage

    Energy Technology Data Exchange (ETDEWEB)

    Xu, J; Sisniega, A; Zbijewski, W; Dang, H; Stayman, J; Aygun, N; Koliatsos, V; Siewerdsen, JH [Johns Hopkins University, Balitmore, MD (United States); Wang, X; Foos, DH [Carestream Health, Rochester, NY (United States)

    2015-06-15

    Purpose: To design a dedicated x-ray cone-beam CT (CBCT) system suitable to deployment at the point-of-care and offering reliable detection of acute intracranial hemorrhage (ICH), traumatic brain injury (TBI), stroke, and other head and neck injuries. Methods: A comprehensive task-based image quality model was developed to guide system design and optimization of a prototype head scanner suitable to imaging of acute TBI and ICH. Previously reported models were expanded to include the effects of x-ray scatter correction necessary for detection of low contrast ICH and the contribution of bit depth (digitization noise) to imaging performance. Task-based detectablity index provided the objective function for optimization of system geometry, x-ray source, detector type, anti-scatter grid, and technique at 10–25 mGy dose. Optimal characteristics were experimentally validated using a custom head phantom with 50 HU contrast ICH inserts imaged on a CBCT imaging bench allowing variation of system geometry, focal spot size, detector, grid selection, and x-ray technique. Results: The model guided selection of system geometry with a nominal source-detector distance 1100 mm and optimal magnification of 1.50. Focal spot size ∼0.6 mm was sufficient for spatial resolution requirements in ICH detection. Imaging at 90 kVp yielded the best tradeoff between noise and contrast. The model provided quantitation of tradeoffs between flat-panel and CMOS detectors with respect to electronic noise, field of view, and readout speed required for imaging of ICH. An anti-scatter grid was shown to provide modest benefit in conjunction with post-acquisition scatter correction. Images of the head phantom demonstrate visualization of millimeter-scale simulated ICH. Conclusions: Performance consistent with acute TBI and ICH detection is feasible with model-based system design and robust artifact correction in a dedicated head CBCT system. Further improvements can be achieved with incorporation of

  11. Reliability-Exploitation Analysis of Highway Transport Telematics Systems / Analiza Niezawodnościowo-Eksploatacyjna Autostradowych Systemów Telematyki Transportu

    Directory of Open Access Journals (Sweden)

    Siergiejczyk Mirosław

    2015-09-01

    Full Text Available W publikacji przedstawiono zagadnienia związane z autostradowymi systemami telematyki transportu. Zwrócono szczególna uwagę na autostradowe systemy łączności alarmowej. Opisano ich budowę oraz funkcjonowanie. Zaprezentowano także ich ogólny model niezawodnościowo-eksploatacyjny. Umożliwia on wyznaczenie wartości prawdopodobieństw przebywania systemu w wyróżnionych stanach eksploatacyjnych.

  12. Das Prinzip Bewegung - Herz und Gehirn als Metaphern des menschlichen Lebens

    Science.gov (United States)

    Otis, Laura

    In diesem Jahr, in dem wir Charles Darwins gedenken, möchte ich etwas riskieren und eine Frage erörtern, die für die Literatur ebenso wie für die Biologie zentral ist: Was ist das Leben? Die Antwort auf diese Frage finden wir nicht in der Bibliothek und nicht im Labor, zumindest nicht an diesen erkenntnisproduzierenden Stellen allein. Als Literaturwissenschaftlerin und ehemalige Naturwissenschaftlerin glaube ich, dass wir das Leben nur verstehen werden, wenn wir seinen Wirkungen überall nachforschen, inklusive in der Literatur.

  13. An update on surgical and medical management strategies for intracerebral hemorrhage.

    Science.gov (United States)

    Kreitzer, Natalie; Adeoye, Opeolu

    2013-11-01

    Intracerebral hemorrhage (ICH) accounts for ∼ 10 to 15% of all strokes and is one of the major causes of stroke-related death and disability. After the initial hemorrhage, further bleeding and edema contribute to secondary damage and worsened outcomes. As such, goals of previous and ongoing trials are to prevent continued bleeding, as well as mitigate the impact of cerebral edema. Although no trials have shown a definite functional outcome benefit with a given intervention, much progress has been made recently. This review focuses on recent developments that inform the acute management of ICH. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  14. Gospodynie domowe. Izolacja jako opresja

    Directory of Open Access Journals (Sweden)

    Dorothy Hobson

    2015-06-01

    Full Text Available Artykuł oparty jest na badaniach autorki nad kulturą młodych gospodyń domowych z klasy robotniczej, przebywających w domu z małymi dziećmi. W badaniach wykorzystano wywiady z tymi kobietami, skoncentrowane na ich roli jako gospodyń i matek oraz na ich rozumieniu tej roli względem do- świadczeń z wykonywanej wcześniej pracy zarobkowej. Autorka, analizując subiektywne relacje badanych, wskazuje m.in. na ujawniające się w nich poczucie opresji.

  15. Developing the Clarity and Openness in Reporting: E3-based (CORE) Reference user manual for creation of clinical study reports in the era of clinical trial transparency.

    Science.gov (United States)

    Hamilton, Samina; Bernstein, Aaron B; Blakey, Graham; Fagan, Vivien; Farrow, Tracy; Jordan, Debbie; Seiler, Walther; Shannon, Anna; Gertel, Art

    2016-01-01

    Interventional clinical studies conducted in the regulated drug research environment are reported using International Council for Harmonisation (ICH) regulatory guidance documents: ICH E3 on the structure and content of clinical study reports (CSRs) published in 1995 and ICH E3 supplementary Questions & Answers (Q & A) published in 2012.Since the ICH guidance documents were published, there has been heightened awareness of the importance of disclosure of clinical study results. The use of the CSR as a key source document to fulfil emerging obligations has resulted in a re-examination of how ICH guidelines are applied in CSR preparation. The dynamic regulatory and modern drug development environments create emerging reporting challenges. Regulatory medical writing and statistical professionals developed Clarity and Openness in Reporting: E3-based (CORE) Reference over a 2-year period. Stakeholders contributing expertise included a global industry association, regulatory agency, patient advocate, academic and Principal Investigator representatives. CORE Reference should help authors navigate relevant guidelines as they create CSR content relevant for today's studies. It offers practical suggestions for developing CSRs that will require minimum redaction and modification prior to public disclosure.CORE Reference comprises a Preface, followed by the actual resource. The Preface clarifies intended use and underlying principles that inform resource utility. The Preface lists references contributing to development of the resource, which broadly fall into 'regulatory' and 'public disclosure' categories. The resource includes ICH E3 guidance text, ICH E3 Q & A 2012-derived guidance text and CORE Reference text, distinguished from one another through the use of shading. Rationale comments are used throughout for clarification purposes.A separate mapping tool comparing ICH E3 sectional structure and CORE Reference sectional structure is also provided.Together, CORE Reference

  16. Hemorrhagic stroke and oral anticoagulants: What is to be done?

    Directory of Open Access Journals (Sweden)

    M. A. Domashenko

    2016-01-01

    Full Text Available Hemorrhagic stroke (HS is associated with high mortality and disability rates. Due to the introduction of the current guidelines for the prevention of systemic thromboembolic events in patients with atrial fibrillations and to an increase in the number of older patients, there has been a rise in the incidence of intracranial hemorrhage (ICH associated with the use of oral anticoagulants. The paper discusses medical treatment in patients with HS during therapy with vitamin K antagonists (warfarin and novel oral anticoagulants (dabigatran. rivaroxaban, apixaban, as well as an anticoagulant resumption policy after prior ICH in patients at high risk for thromboembolic events.

  17. Rehabilitation following hemorrhagic stroke: building the case for stroke-subtype specific recovery therapies [version 1; referees: 2 approved

    Directory of Open Access Journals (Sweden)

    Tomoko Kitago

    2017-11-01

    Full Text Available Intracerebral hemorrhage (ICH, a form of brain bleeding and minor subtype of stroke, leads to significant mortality and long-term disability. There are currently no validated approaches to promote functional recovery after ICH. Research in stroke recovery and rehabilitation has largely focused on ischemic stroke, but given the stark differences in the pathophysiology between ischemic and hemorrhagic stroke, it is possible that strategies to rehabilitate the brain in distinct stroke subtypes will be different. Here, we review our current understanding of recovery after primary intracerebral hemorrhage with the intent to provide a framework to promote novel, stroke-subtype specific approaches.

  18. The brain in acute liver failure. A tortuous path from hyperammonemia to cerebral edema

    DEFF Research Database (Denmark)

    Bjerring, Peter Nissen; Eefsen, Martin; Hansen, Bent Adel

    2008-01-01

    Acute liver failure (ALF) is a condition with an unfavourable prognosis. Multiorgan failure and circulatory collapse are frequent causes of death, but cerebral edema and intracranial hypertension (ICH) are also common complications with a high risk of fatal outcome. The underlying pathogenesis has...... been extensively studied and although the development of cerebral edema and ICH is of a complex and multifactorial nature, it is well established that ammonia plays a pivotal role. This review will focus on the effects of hyperammonemia on neurotransmission, mitochondrial function, oxidative stress...

  19. Influence of the Plow Filling and Thread Angle onto the Plow Head Efficiency / Wpływ Współczynnika Wypełnienia Organu Oraz Kąta Nawinięcia Płata Ślimaka Na Sprawność Ładowania Frezującymi Organami Ślimakowymi

    Science.gov (United States)

    Wydro, Tomasz

    2015-03-01

    Laboratory examinations on the plow heads at various filling rate and material grain-size, as well as various values of worm thread angle of the plow head have been executed. Influence of the worm thread angle and plow head filling onto optimal loading efficiency, has also been tested. Eksploatacja węgla kamiennego w Polsce odbywa się przy zastosowaniu kompleksów ścianowych kombajnowych jak również kompleksów strugowych. Ten drugi z kompleksów jest znacznie mniej rozpowszechniony w Polsce i stosowany do pokładów o miąższości poniżej 1,5 m. Do głównych maszyn i urządzeń ścianowego kompleksu kombajnowego należy zaliczyć maszynę urabiająco - ładującą jaką jest kombajn ścianowy, obudowę zmechanizowaną oraz przenośnik ścianowy. Elementami roboczymi w kombajnie ścianowym są frezujące organy ślimakowe, które mocowane są na ramionach kombajnu. Zadaniem frezujących organów ślimakowych jest realizacja jednocześnie dwóch procesów. Pierwszym z procesów jest frezowanie czyli oddzielanie kawałków węgla od calizny. Drugi proces to proces ładowania urobku, polegający na ciągłym odprowadzaniu urobku na przenośnik ścianowy. Równoległość realizacji pracy tych dwóch procesów, uniemożliwia w warunkach rzeczywistych przeprowadzenie obserwacji procesu ładowania i dokonania jakichkolwiek pomiarów i analiz. Dlatego też, przeprowadzane badania i pomiary opisywane w literaturze zwykle miały charakter modelowy lub stanowiskowy, gdyż tylko takie warunki umożliwiały rozdział tych funkcji organu (Chodura, 1992; Hyong Jong Gol, 1990; Jaszczuk & Tomaszewski, 2004; Krauze, 1997). W związku z powyższym, chcąc bliżej poznać prawa rządzące procesem ładowania, zdecydowano się na rozdzielenie tych dwóch procesów i przeprowadzenie badań laboratoryjnych. Przedmiotowe badania zostały przeprowadzone w laboratorium Katedry Maszyn Górniczych, Przeróbczych i Transportowych AGH. W badaniach uwzględniono wpływ jednego z

  20. Historik jiné moderny: Té horší

    Czech Academy of Sciences Publication Activity Database

    Hlavačka, Milan

    2017-01-01

    Roč. 30, 24. 6. (2017), s. 22 ISSN 0862-5921 Institutional support: RVO:67985963 Keywords : Bedřich Loewenstein * historian * modern civilisation OBOR OECD: History (history of science and technology to be 6.3, history of specific sciences to be under the respective headings)

  1. Die politische Quacksalberei des libertären Paternalismus

    Directory of Open Access Journals (Sweden)

    Schramme Thomas

    2016-07-01

    Full Text Available Der libertäre Paternalismus befürwortet Eingriffe in die Entscheidungsfindung von Bürgern, ohne ihnen Optionen völlig nehmen zu wollen. Vielmehr soll die Lenkung des Willens durch Schubser (nudges geschehen. Im folgenden Beitrag möchte ich zeigen, dass der libertäre Paternalismus auf tönernen Füßen steht. Ich bediene mich dabei des polemischen Bilds von Quacksalbern. Dieses Bild passt zu meinem argumentativen Vorgehen, da ich erstens zeigen will, dass der libertäre Paternalismus falsche Diagnosen über vermeintliche Krankheiten der Willensbildung stellt, und zweitens, dass er die falsche Therapie empfiehlt. Im ersten Teil des Artikels kritisiere ich die Diagnose des libertären Paternalismus, wonach Menschen in ihrer Entscheidungsfindung systematisch fehlschlagen. Die Auswirkungen der zugrundeliegenden psychologischen Forschung werden missinterpretiert und damit vielen menschlichen Entscheidungen eine Art Defekt zugeschrieben. Der zweite Teil des Beitrags hinterfragt die Therapie des libertären Paternalismus. Für entsprechende Interventionen in die Wahlarchitektonik muss Wissen erlangt werden über die Richtung, in welche die Menschen jeweils geschubst werden sollten. Die hier genannte epistemische Aufgabe kann mit den theoretischen Mitteln des libertären Paternalismus nicht gelöst werden.

  2. Management of intracranial hemorrhage in adult patients on extracorporeal membrane oxygenation (ECMO)

    DEFF Research Database (Denmark)

    Fletcher-Sandersjöö, Alexander; Thelin, Eric Peter; Bartek, Jiri

    2017-01-01

    : We conducted a retrospective review of adult patients (≥18 years) who developed an ICH during ECMO treatment at the Karolinska University Hospital (Stockholm, Sweden) between September 2005 and May 2017. Outcome was assessed by 30-day mortality and Glasgow Outcome Scale (GOS) after 6 months...

  3. Interleukin-4 ameliorates the functional recovery of intracerebral hemorrhage through the alternative activation of microglia/macrophage

    Directory of Open Access Journals (Sweden)

    Jianjing eYang

    2016-03-01

    Full Text Available Neuro-inflammation plays an important role in the recovery of brain injury after stroke. Microglia/macrophage is the major executor in the neuro-inflammation, which can be polarized into two distinct phenotypes: injurious/toxic classical activation (M1 phenotype and protective alternative activation (M2 phenotype. Here, we investigated whether intracerebral administration of interleukin-4 (IL-4 at an early stage could affect the activation of microglia/macrophage and the corresponding outcome after intracerebral hemorrhage (ICH. The neuro-behavior was recorded between different groups in the rat ICH model. The M1 and M2 markers were then determined by qRT-PCR, western blotting, ELISA and immunofluorescence, respectively. We observed aberrant activation of microglia/macrophage after ICH. After intracerebral injection of IL-4, M1 activation was greatly inhibited while M2 activation was enhanced, along with improving neurobehavioral recovery from deficits after ICH. Our study showed that early intracerebral injection of IL-4 potentially promotes neuro-functional recovery, probably through enhancing the alternative activation of microglia/macrophage.

  4. Local hemostatic matrix for endoscope-assisted removal of intracerebral hemorrhage is safe and effective

    Directory of Open Access Journals (Sweden)

    Hui-Tzung Luh

    2018-01-01

    Conclusion: This study shows that local application of FloSeal Hemostatic Matrix is safe and effective for hemostasis during MIE evacuation of ICH. In our experience, this shortens the operation time, especially in cases with intraoperative bleeding. A large, prospective, randomized trial is needed to confirm the findings.

  5. A method for normalizing pathology images to improve feature extraction for quantitative pathology

    International Nuclear Information System (INIS)

    Tam, Allison; Barker, Jocelyn; Rubin, Daniel

    2016-01-01

    Purpose: With the advent of digital slide scanning technologies and the potential proliferation of large repositories of digital pathology images, many research studies can leverage these data for biomedical discovery and to develop clinical applications. However, quantitative analysis of digital pathology images is impeded by batch effects generated by varied staining protocols and staining conditions of pathological slides. Methods: To overcome this problem, this paper proposes a novel, fully automated stain normalization method to reduce batch effects and thus aid research in digital pathology applications. Their method, intensity centering and histogram equalization (ICHE), normalizes a diverse set of pathology images by first scaling the centroids of the intensity histograms to a common point and then applying a modified version of contrast-limited adaptive histogram equalization. Normalization was performed on two datasets of digitized hematoxylin and eosin (H&E) slides of different tissue slices from the same lung tumor, and one immunohistochemistry dataset of digitized slides created by restaining one of the H&E datasets. Results: The ICHE method was evaluated based on image intensity values, quantitative features, and the effect on downstream applications, such as a computer aided diagnosis. For comparison, three methods from the literature were reimplemented and evaluated using the same criteria. The authors found that ICHE not only improved performance compared with un-normalized images, but in most cases showed improvement compared with previous methods for correcting batch effects in the literature. Conclusions: ICHE may be a useful preprocessing step a digital pathology image processing pipeline

  6. Louisiana Coastal Area, Louisiana. Freshwater Diversion to Barataria and Breton Sound Basins. Feasibility Study. Volume 1. Draft Main Report. Draft Environmental Impact Statement.

    Science.gov (United States)

    1984-09-01

    and fresh marshes. 5.2.8.3. The study arca saipports r ich popula tions of phytoplankton, zooplankton, bent hos, macroinvertebrates , and numerous small...Foundation and consists primarily of saline marsh with a net-work of bayous, ditches, and lagoons . Rabbit hunting is considered excellent in the area

  7. Mini-craniotomy under local anaesthesia and sedation as a less ...

    African Journals Online (AJOL)

    Mini-craniotomy under local anaesthesia and sedation as a less invasive procedure for spontaneous intracerebral haemorrhage in a developing country. ... The ICH showed evidence of significant mass effect on brain computed tomography (CT) scan in 95% and was associated with intraventricular haemorrhage in 43%.

  8. Meta-Analysis of Predictive Significance of the Black Hole Sign for Hematoma Expansion in Intracerebral Hemorrhage.

    Science.gov (United States)

    Zheng, Jun; Yu, Zhiyuan; Guo, Rui; Li, Hao; You, Chao; Ma, Lu

    2018-04-27

    Hematoma expansion is related to unfavorable prognosis in intracerebral hemorrhage (ICH). The black hole sign is a novel marker on non-contrast computed tomography for predicting hematoma expansion. However, its predictive values are different in previous studies. Thus, this meta-analysis was conducted to evaluate the predictive significance of the black hole sign for hematoma expansion in ICH. A systematic literature search was performed. Original researches on the association between the black hole sign and hematoma expansion in ICH were included. Sensitivity and specificity were pooled to assess the predictive accuracy. Summary receiver operating characteristics curve (SROC) was developed. Deeks' funnel plot asymmetry test was used to assess the publication bias. Five studies with a total of 1495 patients were included in this study. The pooled sensitivity and specificity of the black hole sign for predicting hematoma expansion were 0.30 and 0.91, respectively. The area under the curve was 0.78 in SROC curve. There was no significant publication bias. This meta-analysis shows that the black hole sign is a helpful imaging marker for predicting hematoma expansion in ICH. Although the black hole sign has a relatively low sensitivity, its specificity is relatively high. Copyright © 2018 Elsevier Inc. All rights reserved.

  9. Interdisciplinarity in pragmatics and linguistics

    DEFF Research Database (Denmark)

    Mey, Jacob L.

    2017-01-01

    At the Second International Conference ‘Zeichen und System der Sprache’ (Magdeburg, September 1964), a certain East German professor took the floor during a discussion of one of the linguistic presentations. He started his comments by saying: ‘Als Mathematiker weiß ich zwar von der Sache nichts...

  10. Differences in Spontaneous Intracerebral Hemorrhage Cases between Urban and Rural Regions of Taiwan: Big Data Analytics of Government Open Data.

    Science.gov (United States)

    Ting, Hsien-Wei; Chien, Ting-Ying; Lai, K Robert; Pan, Ren-Hao; Wu, Kuan-Hsien; Chen, Jun-Min; Chan, Chien-Lung

    2017-12-10

    This study evaluated the differences in spontaneous intracerebral hemorrhage (sICH) between rural and urban areas of Taiwan with big data analysis. We used big data analytics and visualization tools to examine government open data, which included the residents' health medical administrative data, economic status, educational status, and relevant information. The study subjects included sICH patients of Taipei region (29,741 cases) and Eastern Taiwan (4565 cases). The incidence of sICH per 100,000 population per year in Eastern Taiwan (71.3 cases) was significantly higher than that of the Taipei region (42.3 cases). The mean coverage area per hospital in Eastern Taiwan (452.4 km²) was significantly larger than the Taipei region (24 km²). The residents educational level in the Taipei region was significantly higher than that in Eastern Taiwan. The mean hospital length of stay in the Taipei region (17.9 days) was significantly greater than that in Eastern Taiwan (16.3 days) ( p < 0.001). There were no significant differences in other medical profiles between two areas. Distance and educational barriers were two possible reasons for the higher incidence of sICH in the rural area of Eastern Taiwan. Further studies are necessary in order to understand these phenomena in greater depth.

  11. Added value of delayed computed tomography angiography in primary intracranial hemorrhage and hematoma size for predicting spot sign.

    Science.gov (United States)

    Wu, Te Chang; Chen, Tai Yuan; Shiue, Yow Ling; Chen, Jeon Hor; Hsieh, Tsyh-Jyi; Ko, Ching Chung; Lin, Ching Po

    2018-04-01

    Background The computed tomography angiography (CTA) spot sign represents active contrast extravasation within acute primary intracerebral hemorrhage (ICH) and is an independent predictor of hematoma expansion (HE) and poor clinical outcomes. The spot sign could be detected on first-pass CTA (fpCTA) or delayed CTA (dCTA). Purpose To investigate the additional benefits of dCTA spot sign in primary ICH and hematoma size for predicting spot sign. Material and Methods This is a retrospective study of 100 patients who underwent non-contrast CT (NCCT) and CTA within 24 h of onset of primary ICH. The presence of spot sign on fpCTA or dCTA, and hematoma size on NCCT were recorded. The spot sign on fpCTA or dCTA for predicting significant HE, in-hospital mortality, and poor clinical outcomes (mRS ≥ 4) are calculated. The hematoma size for prediction of CTA spot sign was also analyzed. Results Only the spot sign on dCTA could predict high risk of significant HE and poor clinical outcomes as on fpCTA ( P spot sign on fpCTA or dCTA in the absence of intraventricular and subarachnoid hemorrhage. Conclusion This study clarifies that dCTA imaging could improve predictive performance of CTA in primary ICH. Furthermore, the XY value is the best predictor for CTA spot sign.

  12. 75 FR 41871 - International Conference on Harmonisation; Draft Guidance on Q4B Evaluation and Recommendation of...

    Science.gov (United States)

    2010-07-19

    ... Pharmaceutical Industries Associations; the Japanese Ministry of Health, Labour, and Welfare; the Japanese... and Research, FDA; and the Pharmaceutical Research and Manufacturers of America. The ICH Secretariat... the Q4B process entitled ``Q4B Evaluation and Recommendation of Pharmaceutical Texts for Use in the...

  13. A method for normalizing pathology images to improve feature extraction for quantitative pathology

    Energy Technology Data Exchange (ETDEWEB)

    Tam, Allison [Stanford Institutes of Medical Research Program, Stanford University School of Medicine, Stanford, California 94305 (United States); Barker, Jocelyn [Department of Radiology, Stanford University School of Medicine, Stanford, California 94305 (United States); Rubin, Daniel [Department of Radiology, Stanford University School of Medicine, Stanford, California 94305 and Department of Medicine (Biomedical Informatics Research), Stanford University School of Medicine, Stanford, California 94305 (United States)

    2016-01-15

    Purpose: With the advent of digital slide scanning technologies and the potential proliferation of large repositories of digital pathology images, many research studies can leverage these data for biomedical discovery and to develop clinical applications. However, quantitative analysis of digital pathology images is impeded by batch effects generated by varied staining protocols and staining conditions of pathological slides. Methods: To overcome this problem, this paper proposes a novel, fully automated stain normalization method to reduce batch effects and thus aid research in digital pathology applications. Their method, intensity centering and histogram equalization (ICHE), normalizes a diverse set of pathology images by first scaling the centroids of the intensity histograms to a common point and then applying a modified version of contrast-limited adaptive histogram equalization. Normalization was performed on two datasets of digitized hematoxylin and eosin (H&E) slides of different tissue slices from the same lung tumor, and one immunohistochemistry dataset of digitized slides created by restaining one of the H&E datasets. Results: The ICHE method was evaluated based on image intensity values, quantitative features, and the effect on downstream applications, such as a computer aided diagnosis. For comparison, three methods from the literature were reimplemented and evaluated using the same criteria. The authors found that ICHE not only improved performance compared with un-normalized images, but in most cases showed improvement compared with previous methods for correcting batch effects in the literature. Conclusions: ICHE may be a useful preprocessing step a digital pathology image processing pipeline.

  14. Střed

    Czech Academy of Sciences Publication Activity Database

    Hruška, Petr

    2014-01-01

    Roč. 25, č. 39 (2014), s. 59 ISSN 0862-6545 Institutional support: RVO:68378068 Keywords : literary scholar * Czech writers * Czech literature * Pokorný, Jindřich * Jirous, Ivan Martin * translator Subject RIV: AJ - Letters, Mass-media, Audiovision

  15. CROWN initiative and preterm birth prevention: researchers and editors commit to implement core outcome sets

    NARCIS (Netherlands)

    van 't Hooft, J.; Alfirevic, Z.; Asztalos, E. V.; Biggio, J. R.; Dugoff, L.; Hoffman, M.; Lee, G.; Mol, B. W.; Pacagnella, R. C.; Pajkrt, E.; Saade, G. R.; Shennan, A. H.; Vayssière, C.; Khan, K. S.

    2018-01-01

    The emphasis on research quality has taken great strides in recent years. Publication of clinical trial protocols (i.e. SPIRIT guideline), prospective registration (e.g. ClinicalTrials. gov, WHO registry), high standards in research conduct (i.e. ICH-Good Clinical Practice guidelines) and

  16. Circumventing Therapeutic Resistance and the Emergence of Disseminated Breast Cancer Cells Through Non-Invasive Optical Imaging

    Science.gov (United States)

    2015-06-01

    Investigator (1992-1994); National Science Foundation Young Investigator (1993-1998); E. I. DuPont de Nemours Young Faculty Award (1995-1997); Alfred P. Sloan...address of the Funding Agency’s Procuring Contracting/Grants Officer: Amber Stilh·ich U.S . Almy Medical Resem·ch Acquisition Activity, 820 Chandler

  17. MR findings of cerebral arteriovenous malformations associated with hemorrhage

    Energy Technology Data Exchange (ETDEWEB)

    Tsuchiya, Kazuhiro (National Defence Medical Coll., Tokorozawa, Saitama (Japan))

    1990-10-01

    This study was developed to assess the role of magnetic resonance (MR) imaging in the diagnosis of cerebral arteriovenous malformations (AVMs) associated with hemorrhage. MR images were retrospectively reviewed in 10 patients (age 8 to 60 years) who had an AVM with intracerebral or intraventricular hemorrhage. MR imaging was performed at 1.5 T obtaining T{sub 1}- and T{sub 2}-weighted spin-echo images with a slice thickness of 5 mm, and a slice interval of 0-5 mm. The AVM was detected on MR in seven patients (70%), while enhanced CT was positive in six of eight patients (75%). In six patients in whom both the AVM and intracerebral hematoma (ICH) were depicted on MR, the nidi were located not inside but adjacent to the ICH. In three patients, MR disclosed a thin subdural hematoma (SDH) which was not noted on CT. There is little difference in the detectability of AVMs by MR and enhanced CT. However, MR clearly demonstrates the anatomic relationship to associated ICH. A non-traumatic SDH with an ICH demonstrated on MR may indicate the presence of an AVM even when the AVM itself is not apparent. (author).

  18. Correlation between subacute sensorimotor deficits and brain edema in two mouse models of intracerebral hemorrhage.

    Science.gov (United States)

    Krafft, Paul R; McBride, Devin W; Lekic, Tim; Rolland, William B; Mansell, Charles E; Ma, Qingyi; Tang, Jiping; Zhang, John H

    2014-05-01

    Formation of brain edema after intracerebral hemorrhage (ICH) is highly associated with its poor outcome. However, the relationship between cerebral edema and behavioral deficits has not been thoroughly examined in the preclinical setting. Hence, this study aimed to evaluate the ability of common sensorimotor tests to predict the extent of brain edema in two mouse models of ICH. One hundred male CD-1 mice were subjected to sham surgery or ICH induction via intrastriatal injection of either autologous blood (30 μL) or bacterial collagenase (0.0375U or 0.075U). At 24 and 72 h after surgery, animals underwent a battery of behavioral tests, including the modified Garcia neuroscore (Neuroscore), corner turn test (CTT), forelimb placing test (FPT), wire hang task (WHT) and beam walking (BW). Brain edema was evaluated via the wet weight/dry weight method. Intrastriatal injection of autologous blood or bacterial collagenase resulted in a significant increase in brain water content and associated sensorimotor deficits (p<0.05). A significant correlation between brain edema and sensorimotor deficits was observed for all behavioral tests except for WHT and BW. Based on these findings, we recommend implementing the Neuroscore, CTT and/or FPT in preclinical studies of unilateral ICH in mice. Copyright © 2014 Elsevier B.V. All rights reserved.

  19. Genetic variants in CETP increase risk of intracerebral hemorrhage

    NARCIS (Netherlands)

    Anderson, C.D.; Falcone, G.J.; Phuah, C.L.; Radmanesh, F.; Brouwers, H.B.; Battey, T.W.; Biffi, A.; Peloso, G.M.; Liu, D.J.; Ayres, A.M.; Goldstein, J.N.; Viswanathan, A.; Greenberg, S.M.; Selim, M.; Meschia, J.F.; Brown, D.L.; Worrall, B.B.; Silliman, S.L.; Tirschwell, D.L.; Flaherty, M.L.; Kraft, P.; Jagiella, J.M.; Schmidt, H.; Hansen, B.M.; Jimenez-Conde, J.; Giralt-Steinhauer, E.; Elosua, R.; Cuadrado-Godia, E.; Soriano, C.; Nieuwenhuizen, K.M. van; Klijn, C.J.M.; Rannikmae, K.; Samarasekera, N.; Salman, R.A.; Sudlow, C.L.; Deary, I.J.; Morotti, A.; Pezzini, A.; Pera, J.; Urbanik, A.; Pichler, A.; Enzinger, C.; Norrving, B.; Montaner, J.; Fernandez-Cadenas, I.; Delgado, P.; Roquer, J.; Lindgren, A.; Slowik, A.; Schmidt, R.; Kidwell, C.S.; Kittner, S.J.; Waddy, S.P.; Langefeld, C.D.; Abecasis, G.; Willer, C.J.; Kathiresan, S.; Woo, D.; Rosand, J.

    2016-01-01

    OBJECTIVE: In observational epidemiologic studies, higher plasma high-density lipoprotein cholesterol (HDL-C) has been associated with increased risk of intracerebral hemorrhage (ICH). DNA sequence variants that decrease cholesteryl ester transfer protein (CETP) gene activity increase plasma HDL-C;

  20. Genetic variants in CETP increase risk of intracerebral hemorrhage

    NARCIS (Netherlands)

    Anderson, Christopher D.; Falcone, Guido J.; Phuah, Chia Ling; Radmanesh, Farid; Brouwers, H. Bart; Battey, Thomas W K; Biffi, Alessandro; Peloso, Gina M.; Liu, Dajiang J.; Ayres, Alison M.; Goldstein, Joshua N.; Viswanathan, Anand; Greenberg, Steven M.; Selim, Magdy; Meschia, James F.; Brown, Devin L.; Worrall, Bradford B.; Silliman, Scott L.; Tirschwell, David L.; Flaherty, Matthew L.; Kraft, Peter; Jagiella, Jeremiasz M.; Schmidt, Helena; Hansen, Björn M.; Jimenez-Conde, Jordi; Giralt-Steinhauer, Eva; Elosua, Roberto; Cuadrado-Godia, Elisa; Soriano, Carolina; van Nieuwenhuizen, Koen M.; Klijn, Catharina J M; Rannikmae, Kristiina; Samarasekera, Neshika; Salman, Rustam Al Shahi; Sudlow, Catherine L.; Deary, Ian J.; Morotti, Andrea; Pezzini, Alessandro; Pera, Joanna; Urbanik, Andrzej; Pichler, Alexander; Enzinger, Christian; Norrving, Bo; Montaner, Joan; Fernandez-Cadenas, Israel; Delgado, Pilar; Roquer, Jaume; Lindgren, Arne; Slowik, Agnieszka; Schmidt, Reinhold; Kidwell, Chelsea S.; Kittner, Steven J.; Waddy, Salina P.; Langefeld, Carl D.; Abecasis, Goncalo; Willer, Cristen J.; Kathiresan, Sekar; Woo, Daniel; Rosand, Jonathan

    2016-01-01

    Objective: In observational epidemiologic studies, higher plasma high-density lipoprotein cholesterol (HDL-C) has been associated with increased risk of intracerebral hemorrhage (ICH). DNA sequence variants that decrease cholesteryl ester transfer protein (CETP) gene activity increase plasma HDL-C;