Mark, A.S.; Andrews, B.; Sanches, J.; Manelfe, C.; Norman, D.; Newton, T.H.
Arachnoid adhesions have been recognized as a cause of syringomyelia. Ten patients with surgically proven syringomyelia secondary to arachnoid adhesions (seven postraumatic, two postinfectious, one post-Pantopaque) were examined by MR imaging using sagittal and axial T1-weighted and sagittal T2-weighted sequences. A syrinx with loss of the sharp edge between the cord and the subarachnoid space as compared with the sharp interface seen in syringomyelia associated with Chiari I, was demonstrated on T1-weighted sequences in all patients. Intradural arachnoid cysts were found in nine patients. After surgical fenestration of the cyst, four patients improved and five remained unchanged. In one patient the syrinx decreased after fenestration of the cyst. Early detection and fesestration of these cavities may improve the patients' outcome
Okamoto, Junji; Matsumoto, Keizo
Craniotomy and an examination of the maximal extent of extirpation of the cystic membrane were performed under an operative microscope in a series of 30 consecutive cases of intracranial arachnoid cysts. From these clinical features and a histological examination of the membrane, the etiologies of the arachnoid cysts may be divided into three fundamental categories: arachnoid cysts due to local brain atrophy or malformation (Category I), arachnoid cysts due to a malformation of the local arachnoid membrane itself (Category II), and arachnoid cysts due to acquired etiology (Category III). The postoperative reduction rates were investigated by means of a serial CT examination over a follow-up period of from 1 month to 6.5 years (average 2 years) in 27 cases. The postoperative reduction rates of 5 cases were less than 20% (Group A), 15 cases had rates from 30 to 80% (Group B), and 7 cases had rates of more than 90% (Group C). Cases of females, large cysts, round-shaped cysts, and cases with positive mass signs and poorly communicating cysts are revealed by metrizamide CT examination seemed to have a tendency for cystic cavity to be reduced well, judging from the postoperative analysis of the clinical findings. Furthermore, from the standpoint of our hypothesis concerning the etiology of the arachnoid cysts, Group A fit in almost all cases in Category I, though a few cases of Group A who had severe secondary local brain damage were in Category II. Group C fit in Category III in almost all cases, though a few cases of Group C who had minimal local brain damage were in Category II. Cases of Group B were considered to show some changes in the local cerebrum of various degrees in the cases of Categories II and III. (J.P.N.)
Full Text Available Arachnoid cysts are rare, usually benign, space-occupying central nervous system lesion. They are the results of an accumulation of cerebrospinal-like fluid between the cerebral meninges and diagnosed prenatally as a unilocular, simple, echolucent area within the fetal head. They may be primary (congenital (maldevelopment of the meninges or secondary (acquired (result of infection trauma, or hemorrhage. The primary ones typically dont communicate with the subarachnoid space whereas acquired forms usually communicate. In recent years, with the development of radiological techniques, the clinical detectability of arachnoid cysts seems to have increased. We report a case of primary arachnoid cyst that were diagnosed prenatally by using ultrasonography and magnetic resonance imaging . [Cukurova Med J 2016; 41(4.000: 792-795
Sharma, Rajesh; Gupta, Puneet; Mahajan, Manik; Sharma, Poonam; Gupta, Anchal; Khurana, Arti
Intradiploic arachnoid cysts have scarcely been reported in the literature, most reported cases being secondary to trauma. Non traumatic arachnoid cysts are quite rare and have been reported mostly in adults. Here, we report the case of a 16-year-old male presenting with a slowly growing mass in the occipital region and intermittent headaches. On the basis of the findings of X-rays, computed tomography scans, and magnetic resonance imaging scans of the head, the mass was diagnosed as a giant intradiploic arachnoid cyst. Keywords: Arachnoid cysts; Cerebrospinal fluid; Headache/diagnosis. (author)
Sharma, Rajesh [Department of Radiodiagnosis and Imaging, ASCOMS Hospital, Sidhra, Jammu (India); Gupta, Puneet; Mahajan, Manik, E-mail: email@example.com [Department of Radiodiagnosis and Imaging, Lady Hardinge Medical College, New Delhi (India); Sharma, Poonam [Department of Pathology, GMC, Jammu (India); Gupta, Anchal; Khurana, Arti [Department of Radiodiagnosis and Imaging, GMC, Jammu (J and K) (India)
Intradiploic arachnoid cysts have scarcely been reported in the literature, most reported cases being secondary to trauma. Non traumatic arachnoid cysts are quite rare and have been reported mostly in adults. Here, we report the case of a 16-year-old male presenting with a slowly growing mass in the occipital region and intermittent headaches. On the basis of the findings of X-rays, computed tomography scans, and magnetic resonance imaging scans of the head, the mass was diagnosed as a giant intradiploic arachnoid cyst. Keywords: Arachnoid cysts; Cerebrospinal fluid; Headache/diagnosis. (author)
Martin-Vaquero, Paula; da Costa, Ronaldo C; Daniels, Joshua B
A 5-year-old castrated male domestic longhair cat was presented with neurological signs consistent with a central vestibular lesion and left Horner's syndrome. Computed tomography images revealed hyperattenuating, moderately contrast-enhancing material within the left tympanic bulla, most consistent with left otitis media/interna. Marked neutrophilic pleocytosis was identified on cerebrospinal fluid analysis. Streptococcus equi subspecies zooepidemicus (SEZ) was isolated from the cerebrospinal fluid. Intracranial extension of otitis media/interna is relatively infrequent in small animals. There are no reports of otitis media/interna caused by SEZ in dogs or cats. This is the first report of otitis media/interna and presumptive secondary meningoencephalitis caused by SEZ in a cat. Copyright © 2011 ISFM and AAFP. Published by Elsevier Ltd. All rights reserved.
Spinal arachnoiditis describes inflammation of the meninges, subarachnoid space and, in most cases, also involve the pial layer. The vast majority of cases described are secondary and are preceded by a known event, for example,. trauma, infections or irritative substances. Here, we present the case of primary spinal arachnoiditis. A 35-year-old lady was referred to the neurosurgical services in Dublin, Ireland with a 15-month history of progressive, right lower limb weakness. Magnetic resonance imaging revealed cystic distortion of the lumbar spinal canal extending up to the conus. Initially, an L2-L4 laminectomy was performed revealing thickened and adherent arachnoid with a large cyst in the spinal canal. Four months after initial operation, the patient represented with bilateral lower limb weakness and loss of detrusor function. Repeat magnetic resonance imaging was performed, which showed the development of a syrinx in the patient\\'s thoracic spine. We then performed a T9-T10 laminectomy, midline myelotomy and insertion of a syringe-arachnoid shunt. Post-operative imaging showed resolution of the syrinx and a vast improvement in lower limb power. The patient also regained bladder control. In conclusion, spinal arachnoiditis is a clearly defined pathological and radiological entity with a highly variable clinical presentation. It is exceedingly difficult to treat as there is no recognised treatment currently, with most interventions aimed at symptomatic relief.
Puijlaert, J.B.C.M.; Vielvoye, G.J.; Dulken, H. van
Two cases of spinal arachnoid cysts are reported. One is extradurally located, the other intradurally. The first is only documented with myelography, the second also by subsequent CT scanning. Some clinical and diagnostic aspects of the lesion are discussed. The aim of this report is to add two new cases to the literature and to emphasize the role of high-resolution CT scanning in the diagnosis of these lesions.
García-Conde, Mario; Martín-Viota, Lucia
There is still great controversy surrounding the origin of the arachnoid cyst. The most accepted theory in the case of congenital cysts explains how they are formed from an anomalous development of the arachnoid membrane, which is unfolded allowing the accumulation of cerebrospinal fluid inside and creating a cyst. This theory seems to explain the origin of convexity and sylvian cistern arachnoid cysts, whereas those in other locations might be due to other mechanisms. In the anatomopathological analysis, the arachnoid cyst wall can be seen as having few differences from normal, although thickened due to an increase quantity of collagenous material. A description of the embryological development of the arachnoid layer and cyst formation is presented, describing the main anatomopathological findings. Copyright © 2015 Sociedad Española de Neurocirugía. Published by Elsevier España. All rights reserved.
The Madagascar spider tortoise (Pyxis arachnoides spp.) is faced with the threat of habitat destruction as well as the international pet trade. Habitat requirements and population structure of this species are largely unknown. Detailed studies have so far concentrated on the subspecies Pyxis arachnoides arachnoides.
Guerra, Alice; Luppi, Barbara; Parisi, Francesco
This paper is about the incentive effects of legal presumptions. We analyze three interrelated effects of legal presumptions in a tort setting: (1) incentives to invest in evidence technology; (2) incentives to invest in care-type precautions; and (3) incentives to mitigate excessive activity lev...
Holst, Anders Vedel; Danielsen, Patricia L; Juhler, Marianne
The best surgical treatment of cerebral arachnoid cysts is yet to be established. Treatment options are shunting, endoscopic fenestration or microsurgical fenestration through craniotomy.Data from 69 patients with cerebral arachnoid cysts treated in our institution between 1997 and 2007 were...
Full Text Available The purpose of this study was to investigate using light microscopy the fibro-cellular components of arachnoid granulations affected by mild and severe subarachnoid hemorrage. The erythrocytes were in the channels delimitated by collagenous and elastic bundles and arachnoid cells, showing their tortuous and intercommunicating row from the pedicle to the fibrous capsule. The core portion of the pedicle and the center represented a principal route to the bulk outflow of cerebrospinal fluid and erythrocytes. In the severe hemorrhage, the fibrocellular components are desorganized, increasing the extracellular channels. We could see arachnoid granulations without erythrocytes, which cells showed big round nucleous suggesting their transformation into phagocytic cells.
Sep 2, 2005 ... C/O Division of Neurosurgery, Department of Neurosciences,. University of the Witwatersrand, 7 York Rd. Parktown 2193,. Johannesburg, South Africa email: firstname.lastname@example.org. Visual deterioration 1½ years after wrapping an un-clippable anterior communicating artery aneurysm: report of a case and.
Strahle, Jennifer; Selzer, Béla J; Geh, Ndi; Srinivasan, Dushyanth; Strahle, MaryKathryn; Martinez-Sosa, Meleine; Muraszko, Karin M; Garton, Hugh J L; Maher, Cormac O
OBJECT There is currently no consensus on the safety of sports participation for patients with an intracranial arachnoid cyst (AC). The authors' goal was to define the risk of sports participation for children with this imaging finding. METHODS A survey was prospectively administered to 185 patients with ACs during a 46-month period at a single institution. Cyst size and location, treatment, sports participation, and any injuries were recorded. Eighty patients completed at least 1 subsequent survey following their initial entry into the registry, and these patients were included in a prospective registry with a mean prospective follow-up interval of 15.9 ± 8.8 months. RESULTS A total 112 patients with ACs participated in 261 sports for a cumulative duration of 4410 months or 1470 seasons. Of these, 94 patients participated in 190 contact sports for a cumulative duration of 2818 months or 939 seasons. There were no serious or catastrophic neurological injuries. Two patients presented with symptomatic subdural hygromas following minor sports injuries. In the prospective cohort, there were no neurological injuries CONCLUSIONS Permanent or catastrophic neurological injuries are very unusual in AC patients who participate in athletic activities. In most cases, sports participation by these patients is safe.
Gelabert González, Miguel; Serramito-García, Ramón; Liñares Paz, Mercedes; Aran-Echabe, Eduardo; García-Allut, Alfredo
Arachnoid cysts are very common lesions in paediatric patients, with treatment depending on their location and symptomatology. They are usually solitary cysts but may be associated with other central nervous system diseases such as tumours and congenital deformities. We describe the case of a neonate diagnosed with an arachnoid cyst of the quadrigeminal cistern treated by endoscopy. After the operation, the child's condition worsened; a CT scan revealed a midline posterior fossa tumour not visible in the preoperative neuroradiological tests. The tumour, a medulloblastoma, was partially removed. Given the child's age and the poor prognosis, oncological treatment was not undertaken. The association between medulloblastoma and arachnoid cyst is very rare, and we could find only one such case in the literature. Copyright © 2012 Sociedad Española de Neurocirugía. Published by Elsevier España. All rights reserved.
Takahashi, Ryosuke; Kusaka, Hirofumi; Sadashima, Hiromichi
A 39-year-old woman developed progressive difficulty in walking and urination over one year and 9 months. Her past history included a hystero-oophorectomy because of ''infection;'' the operation had been done under lumbar anesthesia. At the time of admission to our hospital, her legs were markedly spastic, with increased knee and ankle jerks as well as bilateral Babinski signs. Sensation to pain was slightly decreased bilaterally at and below Th4. Myelography through a suboccipital tap and CT myelography demonstrated a block of the CSF space at Th6. The spinal cord was displaced and became thin at and below Th1, secondary to an enlarged CSF space. Horizontal MRI demonstrated similar findings; however, sagittal MRI showed that the cord had been displaced and had collapsed; in addition, an abnormally enlarged CSF space indicated a subdural arachnoid cyst. MRI has thus been shown to be a very useful tool in the diagnosis of a spinal arachnoid cyst as well as other spinal-cord diseases. (author)
Kiroglu, Yilmaz; Yaqci, Baki; Cirak, Bayram; Karabulut, Nevzat [Pamukkale University, Department of Radiology, School of Medicine, Denizli (Turkey)
We report magnetic resonance (MR), computed tomography (CT) and angiographic imaging of an unusual giant arachnoid granulation in the superior sagittal sinus in a man with headache and vertigo. Intrasinus pressure measurements revealed a significant pressure gradient across the lesion. MR imaging is useful to identify giant arachnoid granulation and dural sinus thrombosis, whereas dural sinus pressure measurement in certain cases of giant arachnoid granulations can be used to evaluate the lesion as the cause of the patient's symptoms. (orig.)
Kiroglu, Yilmaz; Yaqci, Baki; Cirak, Bayram; Karabulut, Nevzat
We report magnetic resonance (MR), computed tomography (CT) and angiographic imaging of an unusual giant arachnoid granulation in the superior sagittal sinus in a man with headache and vertigo. Intrasinus pressure measurements revealed a significant pressure gradient across the lesion. MR imaging is useful to identify giant arachnoid granulation and dural sinus thrombosis, whereas dural sinus pressure measurement in certain cases of giant arachnoid granulations can be used to evaluate the lesion as the cause of the patient's symptoms. (orig.)
Sharma, Anand; Sharma, Achal; Mittal, Radhey S; Gandhi, Ashok
Bilateral cerebellopontine angle (CPA) arachnoid cysts (ACs) are very rare: only one case is reported in literature. Pathogenesis of those cysts is unknown; they are thought to be congenital. The presenting symptoms of CPA AC are frequently nonspecific or otological. The management of ACs of the CPA is controversial. We are reporting two cases of bilateral CPA AC with their pathophysiology and review of literature.
Sharif, Salman; Afsar, Afifa; Qadeer, Mohsin
Intradural arachnoid cysts are a rare cause of spinal cord and nerve root compression. Primarily, they are present in the thoracic region posteriorly. We report a 25-year-old man who had an intradural arachnoid cyst at the level of conus medullaris presenting with cauda equina syndrome, which is very rare.
Raveenthiran, Venkatachalam; Reshma, Khajamohideen B
Sixth cranial nerve palsy is an extremely rare complication of an arachnoid cyst. A 4-year-old boy who presented with left abducens palsy and a subdural hygroma complicating arachnoid cyst is discussed. Comprehensive review of the world literature revealed only 12 additional cases. Copyright 2014, SLACK Incorporated.
Intracranial arachnoid cysts have been found in 0.3% of computed tomography (CT) scans and in 0.1% of brain autopsy specimens, more often in children than in adults. Intracranial arachnoid cysts occur prevalently in males, on the left side, and in the temporal fossa. Their occasional association
HIMALAIA (Hypertension Induction in the Management of AneurysmaL subArachnoid haemorrhage with secondary IschaemiA): a randomized single-blind controlled trial of induced hypertension vs. no induced hypertension in the treatment of delayed cerebral ischemia after subarachnoid hemorrhage.
Gathier, C S; van den Bergh, W M; Slooter, A J C
Delayed cerebral ischemia (DCI) is a major complication after aneurysmal subarachnoid hemorrhage (SAH). One option to treat delayed cerebral ischemia is to use induced hypertension, but its efficacy on the eventual outcome has not been proven in a randomized clinical trial. This article describes the design of the HIMALAIA trial (Hypertension Induction in the Management of AneurysmaL subArachnoid haemorrhage with secondary IschaemiA), designed to assess the effectiveness of induced hypertension on neurological outcome in patients with DCI after SAH. To investigate whether induced hypertension improves the functional outcome in patients with delayed cerebral ischemia after SAH. The HIMALAIA trial is a multicenter, singe-blinded, randomized controlled trial in patients with DCI after a recent SAH. Eligible patients will be randomized to either induced hypertension (n = 120) or to no induced hypertension (n = 120). In selected centers, the efficacy of induced hypertension in augmenting cerebral blood flow will be measured by means of cerebral perfusion computerized tomography scanning. Follow-up assessments will be performed at 3 and 12 months after randomization by trial nurses who are blinded to the treatment allocation and management. We will include patients during five years. The primary outcome is the proportion of subarachnoid hemorrhage patients with delayed cerebral ischemia with poor outcome three-months after randomization, defined as a modified Rankin scale of more than 3. Secondary outcome measures are related to treatment failure, functional outcome, adverse events, and cerebral hemodynamics. The HIMALAIA trial is registered at clinicaltrials.gov under identifier NCT01613235. © 2013 The Authors. International Journal of Stroke © 2013 World Stroke Organization.
Hernández-León, O; Pérez-Nogueira, F R; Corrales, N
Extradural arachnoid spinal cysts are unfrequent lesions that are associated with spinal trauma, surgery and less frequently with congenital anomalies. The clinical manifestations are similar to those seen with other compressive spinal cord lesions. Magnetic resonance techniques allow to diagnose correctly this pathology and to define its thopographic situation. The pathologic history of the patient is essencial to establish the ethiology. Surgery is the elective treatment in most cases. The patient is a 35 years old man who has a medical history of penetrating spinal trauma two years ago. In that instance he suffered an unilateral spinal cord section at D2-D3 level with the corresponding Brown Sequard syndrome. A small wound was detected at the skin dorsal level and it was closed without difficulties. At the beginning, he improved his motor right leg function with rehabilitation and vitamins. After two years of good recovery he came to our hospital suffering a neurological deterioration of six months of evolution. The physical examination revealed an spastic paraparesis. Magnetic resonance was performed demonstrating a cystic extradural collection compressing the spinal cord at D3-D4 level. Surgical decompressive treatment allowed to excise the cyst and it was possible to define a dural tear that was closed successfully. The outcome was good with restoration of the initial motor function that he had after the spinal trauma. Surgical management of postraumatic epidural arachnoid spinal cyst allows to detect the meningeal tear and to close it, which is highly effective on these kinds of lesions.
Full Text Available Several types of intraspinal cyst develop within the spinal canal from the craniovertebral junction to the sacrum. These lesions occur in both children and adults. Arachnoid cysts are one of them and are more frequent in the paediatric population, being a relatively uncommon lesion in adults. The arachnoid cyst may be located intradurally or extradurally. The intradural type may be congenital or from spinal trauma, infection or spondylosis. Although intradural arachnoid cysts are often asymptomatic, they may give early symptoms when they exist with synchronous pathologies constricting the spinal canal gradually as in cervical spondylosis. In this report, a 60-year-old man with an arachnoid cyst of the cervicothoracic spine is presented. His cyst remained undiagnosed because of the nonspecific nature of the symptoms. It was only when he developed right hemiparesis that a posterior fluid collection compressing the spinal cord was found in Magnetic resonance imaginig. An intradural extramedullary cyst was removed with successful surgery and cord compression and symptoms were reversed. We discuss radiological diagnosis and surgical treatment of an arachnoid cyst in this report.
Lam, Cornelius H; Romanova, Liudmila; Hubel, Allison; Janson, Christopher; Hansen, Eric A
Fibroblast is pervasive in the setting of injury. Its invasion into the arachnoid tissue causes scarring, cortical adhesion of the brain, and obstruction of cerebrospinal fluid outflow. The purpose of this study is to determine the phenotypic and physiologic effects of fibroblasts on arachnoid in culture. We studied the effects of fibroblast on the arachnoid cell growth, motility, phenotypic changes, and transport properties. Immortalized rat (Rattus norvegicus, Sprague Dawley breed) arachnoid cells were grown with fibroblast on opposite sides of polyethylene membranes or co-cultured in plastic wells. Arachnoid cell growth rate and DNA content, morphology, transport physiology, and extracellular matriceal content were determined in the presence of normal and irradiated fibroblast cells. When arachnoid cells were grown in the presence of fibroblasts, mannitol permeability increased and transepithelial electrical resistance (TEER) decreased. Arachnoid cell growth rate also significantly decreased. When arachnoid cells were grown in close proximity (i.e. on the same monolayer) with fibroblasts, the arachnoid cells were overrun by day 2, yet when physically separated, no significant change was seen in growth. Apoptosis increased markedly in arachnoid cultures in the presence of fibroblast. Fibroblast caused arachnoid cell to exhibit avoidance behavior, and irradiated fibroblast induced arachnoidal cells to move faster and exhibited greater directional changes. Subcellular glycosaminoglycan (GAG) content was significantly altered by fibroblast. Fibroblasts influence arachnoid cell's mannitol transport likely via soluble factors. While the arachnoid cells did not change morphologically, cell growth was influenced. Over time, the cells had profound changes in transport and motility. The immortalized arachnoid cell/fibroblast culture system provides a unique model mimicking the pathologic event of leptomeningeal scarring. Published by Elsevier B.V.
Peters, S.A.; Heyer, C.M.; Frombach, E.
Full text: We present a case of intense, rapidly evolving headache clinically mimicking meningitis, subarachnoid haemorrhage or venous sinus thrombosis. Clinical examination, standard blood work and central nervous system studies were non-contributory and effectively ruled out these diagnoses. Cranial multidetector CT studies before and after application of intravenous contrast medium performed prior to lumbar tap disclosed a non-enhancing ovoid mass filling the superior sagittal sinus. This lesion posed a differential to venous sinus thrombosis, but ultimately fulfilled the criteria of a giant arachnoid granulation. The imaging characteristics and differential diagnosis of giant arachnoid granulations are discussed
Blackshaw S, Bowen RC. A case of atypical psychosis associated with alexithymia and a left fronto-temporal lesion: possible correlations. Can J Psychiatry 1987; 32: 688–692. 11. Gupta R, Vaishya S, Mehta VS. Arachnoid cyst presenting as subdural hygroma. J Clin Neuroscience 2004; 11 (3): 317-318. Figure1: CT scan of ...
fossa arachnoid cysts presenting with a psychiatric disorder. One of them presented with drop attacks ... schizophrenia like presentation has been reported in association with temporal lobe cysts.4-7 Whilst there ... and personal care and remained self absorbed most of the time. His sleep was reduced to two to three hours at ...
Groot, T.L.C.M.; Quadackers, L.M.; Wright, A.
Although skepticism is widely viewed as essential to audit quality, there is a debate about what form is optimal. The two prevailing perspectives that have surfaced are "neutrality" and "presumptive doubt." With neutrality, auditors neither believe nor disbelieve client management. With presumptive
Awaji, M. [Niigata University, Department of Radiology, Faculty of Medicine, Niigata (Japan); Okamoto, K. [Niigata University, Center for Integrated Human Brain Science, Brain Research Institute, Niigata (Japan); Nishiyama, K. [Niigata University, Department of Neurosurgery, Brain Research Institute, Niigata (Japan)
With a high likelihood of clinical improvement and low rates of complications, minimally invasive neuroendoscopic surgery is becoming the treatment of choice for symptomatic or growing arachnoid cysts. In neuroendoscopic surgery, visualization of anatomical landmarks is essential in achieving successful fenestration without complications. Because of the restricted visual field in neuroendoscopic surgery, preoperative anatomical assessment is very helpful. Magnetic resonance cisternography (MRC) with high spatial resolution and contrast, using for example 3-D Fourier transformation constructive interference in steady state (CISS) or fast imaging employing steady-state acquisition (FIESTA) sequences, is able to detect the arachnoid cyst wall and neighboring anatomical structures as the anatomical landmarks. We retrospectively reviewed T2-weighted (T2-W) fast spin-echo images, and the MRC and intraoperative findings. Axial and coronal T2-W images (6 and 3 mm thickness, respectively) and axial and coronal 0.8 mm thick MRC images with CISS or FIESTA were obtained from four patients with arachnoid cysts treated by neuroendoscopic surgery. Intraoperative findings were reviewed on videotape recorded during the procedures. At the brain surface, the arachnoid cyst wall could be detected clearly in any of the four patients on MRC images, and was only partly seen in the fourth patient T2-W images. Adjacent important anatomical structures including vessels and cranial nerves, and an enough space for cystocisternostomy were identified on MRC images, and the findings were consistent with the findings during neuroendoscopic surgery. Preoperative identification of the arachnoid cyst wall and surrounding anatomical structures by MRC may help avoid complications and allow safer neuroendoscopic surgery. (orig.)
Sasaji, Tatsuro; Horaguchi, Kiyoshi; Yamada, Noboru; Iwai, Kazuo
Intradural extra-arachnoid lumbar disc herniation is a rare disease. Few MRI findings have been reported. We experienced an intradural extra-arachnoid lumbar disc herniation. We reviewed the preoperative MRI findings. Lumbar spine T2-weighted sagittal MRI showed that one line of the ventral dura was divided into two by a disc herniation. We speculated that the two lines comprised the dura and arachnoid and that a disc herniation existed between them. We believe that division of the ventral du...
Casazza, Krista; Fontaine, Kevin R; Astrup, Arne
Many beliefs about obesity persist in the absence of supporting scientific evidence (presumptions); some persist despite contradicting evidence (myths). The promulgation of unsupported beliefs may yield poorly informed policy decisions, inaccurate clinical and public health recommendations...
U.S. Department of Health & Human Services — Health care providers and Head Start programs can play a major role in finding and enrolling uninsured children through presumptive eligibility. States can authorize...
... conformity with the Department's present enforcement policy, is in compliance with those provisions of the FCPA. Such a presumption may be rebutted by a preponderance of the evidence. In considering the...
Adeeb, Nimer; Deep, Aman; Griessenauer, Christoph J; Mortazavi, Martin M; Watanabe, Koichi; Loukas, Marios; Tubbs, R Shane; Cohen-Gadol, Aaron A
The arachnoid mater is a delicate and avascular layer that lies in direct contact with the dura and is separated from the pia mater by the cerebrospinal fluid-filled subarachnoid space. The subarachnoid space is divided into cisterns named according to surrounding brain structures. The medical literature on this meningeal layer was reviewed in regard to historical aspects, etymology, embryology, histology, and anatomy with special emphasis on the arachnoid cisterns. Cerebrospinal fluid dynamics are discussed along with a section devoted to arachnoid cysts. Knowledge on the arachnoid mater and cerebrospinal fluid dynamics has evolved over time and is of great significance to the neurosurgeon in clinical practice.
Apel, K; Sgouros, S
Spinal extradural arachnoid cysts are an uncommon cause of neural compression in children. Even more uncommon is the association of such cysts with spina bifida occulta. Two girls, 12 and 8-years-old, presented with left leg pain, deteriorating gait, clinical signs of left L5 and S1 root compression, without bladder or bowel symptoms. The first patient had left foot drop. The second patient had muscle wasting and smaller left foot with pes cavus. Radiographs showed spina bifida occulta of S1 in both. MRI revealed an extradural cyst at the S1 level, indenting the thecal sac and the L5 and S1 roots. At operation in both patients a large arachnoid cyst arising from a small dural defect in the axilla of the left S1 root was compressing and displacing it and the dural sac. It was removed and the defect was repaired. The first patient improved with complete recovery of the foot drop. An MRI at 12 months showed no cyst recurrence. The second patient made good recovery initially, but at 10 months developed recurrent symptoms. An MRI scan showed recurrence of the cyst with root compression. On repeat exploration a different dural defect was identified in a more anterior position and was repaired. The coexistence of extradural arachnoid cyst and corresponding bifid spinal segment has not been described previously. It raises the suspicion that the dural defect giving rise to the arachnoid cyst may be due to segmental dural dysgenesis in the context of the dysrhaphic neuroectodermal malformation.
Rahimizadeh, Abolfazl; Soufiani, Housain
Intramedullary spinal arachnoid cysts are considered to be very rare, and only 11 cases have been reported previously. Development of such a cyst in association with marked cervical spondylosis has not been reported until recently. Brief review of reported cases and debate on likely treatment strategy when such a cyst is associated with symptomatic spondylosis. To report the first example of a cervicothoracic intramedullary arachnoid cyst along with a symptomatic cervical spondylosis. Evaluation of quadriparesis in a 58-year-old female resulted in detection of a cervical spondylotic stenosis that was accompanied with an intramedullary cystic lesion. Parallel management of both pathologies was through a wide laminectomy extending from the lower edge of C3 to T2 with subsequent fenestration and partial resection of the cyst wall via an appropriate dorsal entry root zone myelotomy. Cervicothoracic instrumentation from C3 down to T2 was done to prevent postlaminectomy deformity. Histopathological findings were consistent with the diagnosis of arachnoid cyst. Postoperatively, the patient exhibited marked improvement in neurologic status. Through the review of the current case, first example from the literature, we concluded that surgery should target toward the proper management of both pathologies in a single-stage operation. Copyright © 2013 Elsevier Inc. All rights reserved.
Full Text Available Intradural extra-arachnoid lumbar disc herniation is a rare disease. Few MRI findings have been reported. We experienced an intradural extra-arachnoid lumbar disc herniation. We reviewed the preoperative MRI findings. Lumbar spine T2-weighted sagittal MRI showed that one line of the ventral dura was divided into two by a disc herniation. We speculated that the two lines comprised the dura and arachnoid and that a disc herniation existed between them. We believe that division of the ventral dural line on T2-weighted sagittal images is a characteristic finding of intradural extra-arachnoid lumbar disc herniation. The division of ventral dural line seemed to be a “Y,” and, thus, we called it the “Y sign.” The “Y sign” may be useful for diagnosing intradural extra-arachnoid lumbar disc herniation.
Sasaji, Tatsuro; Horaguchi, Kiyoshi; Yamada, Noboru; Iwai, Kazuo
Intradural extra-arachnoid lumbar disc herniation is a rare disease. Few MRI findings have been reported. We experienced an intradural extra-arachnoid lumbar disc herniation. We reviewed the preoperative MRI findings. Lumbar spine T2-weighted sagittal MRI showed that one line of the ventral dura was divided into two by a disc herniation. We speculated that the two lines comprised the dura and arachnoid and that a disc herniation existed between them. We believe that division of the ventral dural line on T2-weighted sagittal images is a characteristic finding of intradural extra-arachnoid lumbar disc herniation. The division of ventral dural line seemed to be a “Y,” and, thus, we called it the “Y sign.” The “Y sign” may be useful for diagnosing intradural extra-arachnoid lumbar disc herniation. PMID:22431932
Yokoyama, K.; Tonami, N.; Kimura, M.; Kinoshita, A.; Aburano, T.; Hisada, K.
An arachnoid cyst found to have a communication to an associated subdural hematoma was demonstrated with the Tc-99m DTPA brain scintigraphy. Although arachnoid cysts are known to be silent, when a patient with an arachnoid cyst develops signs of increased intracranial pressure or neurological deficits, the presence of a complication, including subdural hematoma, intracystic hemorrhage or subdural hygroma, is highly suspected. In the present case, the patient with an arachnoid cyst had a subdural hematoma following minor head injury. Tc-99m DTPA brain scintigraphy showed abnormal accumulation of the tracer not only in the hematoma but in the arachnoid cyst. This observation suggested communication of the two lesions, which was confirmed at surgery.
Simanjuntak, Herbert P.; Pereyra, Pedro
We analyze different examples to show that the so-called generalized Hartman effect is an erroneous presumption. The results obtained for electron tunneling and transmission of electromagnetic waves through superlattices and Bragg gratings show clearly the resonant character of the phase time behavior where a generalized Hartman effect is expected. A reinterpretation of the experimental results in double Bragg gratings is proposed. (author)
Mar 2, 2010 ... diagnostic test in the management of children with this overlap, but this has not been evaluated. Therefore, the objective of this study was to compare the clinical outcome of presumptive versus malaria rapid diagnostic test - ... the rain forest belt of Nigeria, an area with perennial malaria trans mission.
Three hundred and fifteen blood samples were obtained from presumptively diagnosed typhoid patients who were referred for Widal Serological test at four diagnostic centres. The blood samples were subjected to bacteriological investigations. Salmonella and non-Salmonella organisms isolated were identified according ...
...) NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION, DEPARTMENT OF COMMERCE OIL POLLUTION ACT REGULATIONS... assessment of damages to natural resources made by a Federal, State, or Indian trustee in accordance with this part shall have the force and effect of a rebuttable presumption on behalf of the trustee in any...
Cemil, Berker; Kurt, Gokhan; Aydın, Cansel; Akyurek, Nalan; Erdogan, Bulent; Ceviker, Necdet
Post laminectomy arachnoiditis has been shown by experiments with rats and post operative radiological imaging in humans. The purpose of this experimental study was to determine the efficacy of tenoxicam in preventing arachnoiditis in rats. Twenty-four Wistar rats were divided into two groups, and L3 laminectomy was performed. In the tenoxicam group, 0.5 mg/kg tenoxicam was applied intraperitoneally. Normal saline was applied intraperitoneally in the control group. Later, the rats were killed at weeks 3 and 6, and the laminectomy sites were evaluated pathologically for arachnoiditis. The results showed that 6 weeks after surgery, the tenoxicam group showed lowest arachnoiditis grades. However, statistically significant difference was not found in arachnoiditis between the control group and the tenoxicam group. Based on these findings it is concluded that application of the tenoxicam after lumbar laminectomy did not effectively reduce arachnoiditis. Performing the most effective surgical technique without damage around tissue in a small surgical wound and having meticulous hemostasis in surgery seem to be the key for preventing arachnoiditis effectively.
Zara, Gabriella; Ponza, Isabella; Citton, Valentina; Manara, Renzo
We present a patient who showed MRI evidence of a giant temporo-sylvian arachnoidal cyst of the left hemisphere and an extreme pneumatization of the sphenoid and frontal sinuses. No sign of mass effect or cerebral atrophy was detected. This patient presented a deficit of memory and control functions, but quality of life was not affected. Surgery was not performed. Arachnoidal cyst and anatomic variants of the sinus region have not a common etiology. This is the first report that describes a giant temporo-sylvian arachnoidal cyst with anatomic variants of the paranasal sinuses. Copyright © 2010 Elsevier B.V. All rights reserved.
Takashi Kobayashi, MD, PhD
Full Text Available We herein present a case involving an asymptomatic cervical intradural arachnoid cyst that was suspected to be the cause of the patient's radicular pain. Magnetic resonance imaging showed a small, round intradural mass beside the cervical nerve root. An arachnoid cyst of this shape has not been previously reported. Intraoperative examination revealed that the cyst was not compressing the nerve root and was asymptomatic. Intradural spinal surgery is sometimes associated with serious complications. The knowledge that arachnoid cysts of this shape are asymptomatic can help to avoid unnecessary surgery.
Inoue, Tooru; Matsushima, Toshio; Nakagaki, Hiroyuki; Fukui, Masashi; Hasuo, Kanehiro; Fukushima, Takeo; Kuromatsu, Chiharu; Takagi, Tosuke; Koga, Toshihiko
Twenty intracranial arachnoid cysts and one low-grade glioma were evaluated by magnetic resonance imaging (MRI). Six arachnoid cysts were examined by metrizamide CT cisternography. All arachnoid cysts showed a CSF-like pattern on MRI images. In the spin echo image (SE 2000/80), the cysts showed a similar signal intensity as the surrounding normal brain, and separation was difficult. There were no MRI difference between communicating and noncommunicating cysts. One low-grade glioma showing a well-defined low density area without contrast enhancement on X-CT scans had a signal intensity higher than that of the surrounding normal brain in spin echo images (SE 2000/80). It seems easy to differentiate a low-grade glioma from an arachnoid cyst, which showed normal signal intensity in spin echo images (SE 2000/80).
Full Text Available Presence of an arachnoid cyst at craniospinal junction is not very common. This is a very rare anatomic site, with only seven other cases reported in the literature. We report a case of large intradural craniospinal arachnoid cyst presenting with obstructive hydrocephalus and cranial nerve palsy. A 39-year-old male presented with 8-month history of neck pain, headache, vomiting, visual disturbances, diminished taste sensation, and numbness of face. He had bilateral papilledema on ophthalmoscopy. Magnetic resonance imaging (MRI revealed a posterior fossa arachnoid cyst extending down to the lower border of C5 vertebra. Posterior decompression was done through C5 laminectomy. He made a full recovery and was asymptomatic at 6-month follow-up examination. The clinical features, diagnosis, and management of these rare craniospinal arachnoid cysts are discussed.
Casazza, Krista; Fontaine, Kevin R.; Astrup, Arne; Birch, Leann L.; Brown, Andrew W.; Bohan Brown, Michelle M.; Durant, Nefertiti; Dutton, Gareth; Foster, E. Michael; Heymsfield, Steven B.; McIver, Kerry; Mehta, Tapan; Menachemi, Nir; Newby, P.K.; Pate, Russell; Rolls, Barbara J.; Sen, Bisakha; Smith, Daniel L.; Thomas, Diana M.; Allison, David B.
BACKGROUND Many beliefs about obesity persist in the absence of supporting scientific evidence (presumptions); some persist despite contradicting evidence (myths). The promulgation of unsupported beliefs may yield poorly informed policy decisions, inaccurate clinical and public health recommendations, and an unproductive allocation of research resources and may divert attention away from useful, evidence-based information. METHODS Using Internet searches of popular media and scientific literature, we identified, reviewed, and classified obesity-related myths and presumptions. We also examined facts that are well supported by evidence, with an emphasis on those that have practical implications for public health, policy, or clinical recommendations. RESULTS We identified seven obesity-related myths concerning the effects of small sustained increases in energy intake or expenditure, establishment of realistic goals for weight loss, rapid weight loss, weight-loss readiness, physical-education classes, breast-feeding, and energy expended during sexual activity. We also identified six presumptions about the purported effects of regularly eating breakfast, early childhood experiences, eating fruits and vegetables, weight cycling, snacking, and the built (i.e., human-made) environment. Finally, we identified nine evidence-supported facts that are relevant for the formulation of sound public health, policy, or clinical recommendations. CONCLUSIONS False and scientifically unsupported beliefs about obesity are pervasive in both scientific literature and the popular press. (Funded by the National Institutes of Health.) PMID:23363498
Adams, R J; Garosi, L; Matiasek, K; Lowrie, M
A one-year-old, female entire, domestic, shorthair cat presented with acute onset non-ambulatory tetraparesis. Magnetic resonance imaging was consistent with a C3-C4 acute non-compressive nucleus pulposus extrusion and the cat was treated conservatively. The cat was able to walk after 10 days and was normal 2 months after presentation. The cat was referred five and a half years later for investigation of an insidious onset 3-month history of ataxia and tetraparesis. Magnetic resonance imaging of the cervical spine was repeated, demonstrating a spinal arachnoid diverticulum at C3 causing marked focal compression of the spinal cord. This was treated surgically with hemilaminectomy and durectomy. The cat improved uneventfully and was discharged 12 days later. © 2014 British Small Animal Veterinary Association.
Tomii, Masato; Mizuno, Junichi; Takeda, Masaaki; Matsushima, Tadao; Itoh, Yasunobu; Numazawa, Shinichi; Matsuoka, Hidenori; Watanabe, Kazuo
Three cases of symptomatic extradural arachnoid cyst were treated by surgery. Total excision of the cyst followed by tight closure of the fistula by suture was achieved in all 3 cases. Surgery improved the neurological deficits but urinary incontinence persisted in all three patients. Obliteration of the fistula is considered to be important at surgery from the etiological perspective of the cyst. There are many surgical options, but surgical removal of the cyst and obliteration of the communication usually leads to prompt improvement in neurological deficits. Instability, malalignment, and worsening scoliosis are well-recognized postoperative complications of excessive laminotomy, but the exposure should be wide enough to cover the cyst completely at the operation. Wide exposure of the entire cyst is preferable to avoid missing the fistula and to identify any adhesions or fistula between the cyst and the dura. Identification of the fistula location based on preoperative imaging studies is also important.
Eidlitz-Markus, Tal; Zeharia, Avi; Cohen, Yishai Haimi; Konen, Osnat
Arachnoid cysts are generally identified incidentally on brain imaging, although they occasionally cause symptoms because of expansion or bleeding. This study aims to describe patients in whom an arachnoid cyst was identified on magnetic resonance imaging (MRI) study performed for the evaluation of headache in a pediatric headache clinic and to highlight the clinical dilemma posed by this finding. A retrospective descriptive study design was used. The electronic database of a tertiary pediatric headache clinic was searched for all newly admitted patients with headache who underwent MRI evaluation in 2008-2013. The indications for imaging were based on clinical practice parameters recommended by the Subcommittee of the American Academy of Neurology. Clinical and imaging parameters were collected from the files. Findings were compared between patients with and without an arachnoid cyst. Of the 250 (31%) of 800 patients who met the inclusion criteria, 11 (4.4%) had an arachnoid cyst. Two patients had a ruptured cyst with midline shifting and a large subdural collection. Both presented with headache, vomiting, phonophobia, and photophobia. In the other 9 asymptomtic patients with an arachnoid cyst, imaging showed only a mild mass effect without midline shifting; their symptoms were considered unrelated to the cyst. The patients with a symptomatic arachnoid cyst were referred for surgery, with good outcome. Arachnoid cysts are found in a small percentage of brain scans performed for evaluation of headache in the setting of a hospital-based pediatric headache clinic. For the long run in these clinical settings, most of the cysts are asymptomatic. Precise anamnesis, neurologic examination, and imaging performed according to accepted practice guidelines may help clinicians determine if the headache and symptoms are caused by the cyst or if they should seek primary headache diagnosis with overlapping symptoms. The clinical distinction between symptomatic and asymptomatic
Nomura, M.; Kanazawa Univ. School of Medicine; Tachibana, O.; Hasegawa, M.; Kohda, Y.; Nakada, M.; Yamashima, T.; Yamashita, J.; Suzuki, M.
We recently encountered two large intrasellar arachnoid cysts extending to the suprasellar region. The intensity of the cyst contents was identical to that of the cerebrospinal fluid on both T1- and T2-weighted MRI. On contrast-enhanced MRI, the pituitary gland was compressed posteroinferiorly and flattened in the sella turcica. In this report of rare intrasellar arachnoid cysts the discussion is focused on dislocation of the pituitary gland. (orig.)
Rimmelin, A.; Clouet, P.L.; Salatino, S.; Kehrli, P.; Maitrot, D.; Stephan, M.; Dietemann, J.L.
Extradural arachnoid cysts are uncommon expanding lesions in the spinal canal which may communicate with the subarachnoid space. Usually in the lower thoracic spine, they may cause symptoms by compressing the spinal cord or nerve roots. We report cases of thoracic and lumbar arachnoid cysts studied by cystography, myelography, CT and MRI. These techniques showed extradural cystic lesions containing cerebrospinal fluid, with variable communication with the subarachnoid space, causing anterior displacement and flattening of the spinal cord. (orig.)
Kollam Chandra Sekhar
Full Text Available BACKGROUND Arachnoid cysts of spinal cord are relatively uncommon lesions. Most of them arise dorsal to the cord, and anteriorly placed intradural arachnoid cyst is a rare cause of cervical cord compression. To the best of our knowledge, only 30 cases were reported in the literature. We present a case of anterior cervical intradural arachnoid cyst with review of literature. METHODS We performed a literature search for anteriorly placed intradural arachnoid cysts in the cervical spinal cord through http://pubmed.com, a well-known worldwide internet medical address. To the best of our knowledge, only 30 cases were reported in the literature. We reviewed the literature with illustration of our case. We present a case of a 40-year-old male patient who presented with insidious onset of radicular pain. MRI cervical spine demonstrated cervical intradural cystic lesion extending from C2 to upper border of C4, lying anteriorly with compression over the cord. Cervical laminectomy followed by wide cyst fenestration and subtotal excision of cyst was done. Histopathological diagnosis was arachnoid cyst. RESULTS Patient totally recovered from his pain and sensory symptoms within a week and motor symptoms improved gradually over a period of six to eight weeks. With two years followup, patient had no further complaints. CONCLUSION Anterior cervical intradural arachnoid cysts are rare. These are amenable to resection through posterior approach safely with good postoperative recovery.
Full Text Available Introduction: Arachnoid cysts in children are incidental or symptomatic findings which can have associated neurological pathologies in children. Epileptic seizures and headache are by far the most common symptoms associated to arachnoid cysts but they can also associate cerebral palsy or facial dwarfism. Objectives: In the era of globalisation we want to highlight the importance of modern diagnostic procedures and long term strategic management of children with arachnoid cysts in order to rise their social competence and have a better quality of life. Material and methods: We searched the most important theories in the literature and the new methods in the management of the arachnoid cysts. Results: Even if surgical is necessary just in few cases, medication is needed for epileptic seizures. Many children receive neuroprotective agents while other receive antiepileptic drugs for the concomitant or associated epilepsy. For speech difficulties and movement disorders speech therapy, physical therapy and other further support is needed. Discussions and conclusions: The EEG patterns are not mandatory identic to the site of the cyst. Facial dwarfism and other genetic hallmarks need to be further investigated for rare syndromes associated to cerebral arachnoid cysts. The arachnoid cyst could be a hallmark that children brain can be more sensitive to seizures.
Oi, Shizuo; Shose, Yoshiteru; Okuda, Yasuhiro; Yamada, Hiroshi; Ijichi, Akihiro; Matsumoto, Satoshi.
The natural history and pathophysiology of intracranial arachnoid cysts are still obscure. The purpose of this paper is to analyze the characteristics of the fluid dynamics of arachnoid cysts by utilizing the quantitative analysis method of metrizamide CT cisternography (CTCG). These results are then compared with those of intracystic pressure dynamics. We discuss the pathophysiology of and the operative indication for intracranial arachnoid cysts. The patterns of fluid dynamics in arachnoid cysts in the major pathway of CSF circulation are various. It is not possible to classify 3 or 4 types of cyst-CSF circulation patterns, as has been done in many previous reports, with just this quantitative analysis method, namely, CTCG. There was no close correlation between the type of fluid communication and either clinical symptoms or intracystic pressure dynamics. From these points of view, it was suggested that the operative or therapeutic goal in treating arachnoid cysts is to normalize the pressure dynamics, which are likely to damage the regional brain function with its expansile ballooning pressure in non-communicating cysts or stagnating fluid force in communicating cysts. We hereby propose a new concept of ''localized hydrocephalus'' with regard to intracranial arachnoid cysts. (author)
Cokluk, C; Senel, A; Celik, F; Ergür, H
We report two children with asymptomatic arachnoid cysts which resolved spontaneously without any surgical intervention and history of major head and body trauma. The first child was a 10-year-old boy with an arachnoid cyst in the right sylvian fissure. The second child was a 1-year-old girl with a right cerebral convexity arachnoid cyst. Both of them were asymptomatic. Arachnoid cysts spontaneously disappeared within 2 years following initial diagnosing. There was no major head and body trauma except usual home, school and sports activity. We speculated that the cysts ruptured into cerebrospinal fluid circulation by the mechanical effects of some forced activities to the brain tissue and cyst, such as excessive breathing, coughing and sport activities. These factors may change the balance between intracystic and pericystic pressure and facilitate the rupturing of the cyst into subdural, subarachnoid and intraventricular spaces. These cases demonstrate that neurosurgical intervention of asymptomatic arachnoid cysts is not absolutely indicated in the paediatric age group. Close follow up with computerized tomography (CT) and magnetic resonance imaging (MRI) is a treatment option in the patient with arachnoid cysts located in the middle cranial fossa and cerebral convexity.
Wang, Chao; Han, Guoqiang; You, Chao; Liu, Chuangxi; Wang, Jun; Xiong, Yunbiao
Intracranial arachnoid cysts (IAC) are benign congenital cystic lesions filled with cerebrospinal fluid (CSF). This study evaluated microsurgical craniotomy and endoscopy in the surgical treatment of IAC. Eight-one consecutive pediatric patients with IAC were surgically treated between January 2004 and January 2011. The surgical procedures included microsurgical craniotomy and endoscopy. Symptoms at presentation, location of IAC, surgical treatment options, and effectiveness were evaluated. There were 43 males and 38 females and the mean age was 8.7 years (range between 1 month and 14 years) at the time of surgery. The cyst location was supratentorial in 72 patients and infratentorial in 9 patients, arachnoid cyst were identified. Follow-up period ranged between 2 and 8 years. Of the 49 patients with headache 83.67% of patients had cure and 10.2% had significant improvement. Of the eight patients with hydrocephalus and gait disturbances, six (75%) had complete total relief of symptoms and two (25%) patients had significant improvement. Four of the six patients with cognitive decline and weakness showed improvement. Of the 18 patients with epilepsy seizure freedom was: Engle class I grade I in 14 (77.78%) patients; class II in 2 (11.11%) patients; and class III in 2 (11.11%) patients. Follow-up studies from 2 to 8 years showed that headache was cured in 41 of the 49 cases (83.67%), significantly improved in 5 cases (10.20%), and showed no variation in 3 cases (6.12%). Hydrocephalus and gait disturbances were controlled in six of the eight cases (75.00%) and significantly improved in two cases (25.00%). Cognitive decline and weakness were obviously improved in four of the six cases (66.67%) and exhibited no variation in two cases (33.33%). According to the Engle standard, the following results were obtained from 18 patients with epilepsy: Grade I in 14 cases (77.78%); grade II in 2 cases (11.11%); and grade III in 2 cases (11.11%). Eleven cases with local or general
Hansen, Eric A; Romanova, Liudmila; Janson, Christopher; Lam, Cornelius H
After traumatic brain injury (TBI), large amounts of red blood cells and hemolytic products are deposited intracranially creating debris in the cerebrospinal fluid (CSF). This debris, which includes heme and bilirubin, is cleared via the arachnoid granulations and lymphatic systems. However, the mechanisms by which erythrocytes and their breakdown products interfere with normal CSF dynamics remain poorly defined. The purpose of this study was to model in vitro how blood breakdown products affect arachnoid cells at the CSF-blood barrier, and the extent to which the resorption of CSF into the venous drainage system is mechanically impaired following TBI. Arachnoid cells were grown to confluency on permeable membranes. Rates of growth and apoptosis were measured in the presence of blood and lysed blood, changes in transepithelial electrical resistance (TEER) was measured in the presence of blood and hemoglobin, and small molecule permeability was determined in the presence of blood, lysed blood, bilirubin, and biliverdin. These results were directly compared with an established rat brain endothelial cell line (RBEC4) co-cultured with rat brain astrocytes. We found that arachnoid cells grown in the presence of whole or lysed erythrocytes had significantly slower growth rates than controls. Bilirubin and biliverdin, despite their low solubilities, altered the paracellular transport of arachnoid cells more than the acute blood breakdown components of whole and lysed blood. Mannitol permeability was up to four times higher in biliverdin treatments than controls, and arachnoid membranes demonstrated significantly decreased small molecule permeabilities in the presence of whole and lysed blood. We conclude that short-term (5 days) arachnoid cell viability are affected by blood and blood breakdown products, with important consequences for CSF flow and blood clearance after TBI.
Todeschi, J; Chibbaro, S; Gubian, A; Pop, R; Proust, F; Cebula, H
The rupture of an isolated spinal aneurysm is an exceptional occurrence. It might be responsible for a spinal subarachnoid haemorrhage (SSAH) that in rare cases can be complicated by arachnoiditis. Among the former the adhesive type is the most severe leading to the formation of a cyst and/or a syrinx. The literature review was performed via a PubMed search using the following keywords. Adhesive arachnoiditis; spinal subarachnoid haemorrhage; spinal arachnoiditis; spinal arachnoid cyst; arachnoid cyst .Thesearch yielded 24 articles. Given the fact that only a few studies had been reported on the subject, we decided to include all studies regarding adhesive arachnoiditis after SAH leading to a descriptive literature review. Furthermore, a case illustration of a 57 year old man harbouring this type of rare pathology is described. Twenty-four case reports were found regarding spinal adhesive arachnoiditis (SAA) following SSAH. Posterior cerebral circulation bleeding (66.7%) most often occurred followed by spinal (9.1%) and anterior cerebral circulation (9.1%) respectively. The mean time between the haemorrhage and the SAA onset was 10 months. A higher predominance of symptomatic thoracic SAA was found. Including the present case, 80% of patients had a laminectomy, 72% had a micro adhesiolysis, and 56% a shunt placement. Cervical and upper thoracic involvement appeared to have a better outcome. Although most authors suggested surgical treatment, the long-term outcome remains unclear. Early stage diagnosis and management of this rare and disabling pathology may lead to a better outcome. Larger co-operative studies remain essential to obtain a better understanding of such a rare and complex disease. Copyright © 2018 Elsevier Masson SAS. All rights reserved.
Full Text Available Spinal epidural arachnoid cyst (EAC is a rare, usually asymptomatic condition of unknown origin, which typically involves the lower thoracic spine. We report a case of posttraumatic symptomatic EAC with lumbar disc herniation. A 22-year-old man experienced back pain and sciatica after a traffic accident. Neurological examination revealed a right L5 radiculopathy. Magnetic resonance imaging demonstrated a cystic lesion at the L3 to L5 level and an L4-5 disc herniation; computed tomography myelography showed that the right L5 root was sandwiched between the cyst and the herniation. A dural defect was identified during surgery. The cyst was excised completely and the defect was repaired. A herniation was excised beside the dural sac. Histology showed that the cyst wall consisted of collagen and meningothelial cells. Postoperatively the symptoms resolved. Lumbar spinal EACs are rare; such cysts may arise from a congenital dural crack and grow gradually. The 6 cases of symptomatic lumbar EAC reported in the literature were not associated with disc herniation or trauma. In this case, the comorbid disc herniation was involved in symptom progression. Although many EACs are asymptomatic, comorbid spinal disorders such as disc herniation or trauma can result in symptom progression.
... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Presumption relating to respirable disease... Pneumoconiosis § 410.462 Presumption relating to respirable disease. (a) Even though the existence of... was employed for 10 years or more in the Nation's coal mines and died from a respirable disease, it...
Full Text Available A 14-year-old boy underwent emergency debridement surgery of right foot under spinal anaesthesia. Four hours after the surgery, the patient developed symptoms of cauda equina syndrome (CES. Postoperative magnetic resonance imaging of the patient′s spine suggested underlying tubercular arachnoiditis. The boy was started on intravenous methylprednisolone and antitubercular therapy. He responded to the therapy and recovered completely in 2 weeks without any residual neurological deficits. We suggest that underlying pathological changes in the subarachnoid space due to tubercular arachnoiditis contributed to maldistribution of the local anaesthetic drug leading to CES.
Haaland Øystein A
Full Text Available Abstract Background Arachnoid cyst (AC fluid has not previously been compared with cerebrospinal fluid (CSF from the same patient. ACs are commonly referred to as containing "CSF-like fluid". The objective of this study was to characterize AC fluid by clinical chemistry and to compare AC fluid to CSF drawn from the same patient. Such comparative analysis can shed further light on the mechanisms for filling and sustaining of ACs. Methods Cyst fluid from 15 adult patients with unilateral temporal AC (9 female, 6 male, age 22-77y was compared with CSF from the same patients by clinical chemical analysis. Results AC fluid and CSF had the same osmolarity. There were no significant differences in the concentrations of sodium, potassium, chloride, calcium, magnesium or glucose. We found significant elevated concentration of phosphate in AC fluid (0.39 versus 0.35 mmol/L in CSF; p = 0.02, and significantly reduced concentrations of total protein (0.30 versus 0.41 g/L; p = 0.004, of ferritin (7.8 versus 25.5 ug/L; p = 0.001 and of lactate dehydrogenase (17.9 versus 35.6 U/L; p = 0.002 in AC fluid relative to CSF. Conclusions AC fluid is not identical to CSF. The differential composition of AC fluid relative to CSF supports secretion or active transport as the mechanism underlying cyst filling. Oncotic pressure gradients or slit-valves as mechanisms for generating fluid in temporal ACs are not supported by these results.
Stowe, LA; Go, KG; Pruim, J; den Dunnen, W; Meiners, LC; Paans, AMJ
We investigated whether left-hemisphere arachnoid cysts lead to reorganization of the language function using PET. A group analysis demonstrated that patients showed no more right-hemisphere activation than a matched control group. Several patients had clear language localizations in the left
Full Text Available Background: Although adhesive arachnoiditis of the spinal cord can cause progressive symptoms associated with syringomyelia or myelomalacia, its surgical resolution based on the imaging diagnosis is not well characterized. This study aims to describe the use of imaging for the diagnosis of focal adhesive arachnoiditis of the spinal cord and its surgical resolution using microsurgical arachnoidolysis. Materials and Methods: Four consecutive patients with symptomatic syringomyelia or myelomalacia caused by focal adhesive arachnoiditis underwent microsurgical arachnoidolysis. Comprehensive imaging evaluation using constructive interference in steady-state (CISS magnetic resonance imaging (MRI or myelographic MR imaging using true fast imaging with steady-state precession (TrueFISP sequences was included before surgery to determine the surgical indication. Results: In all four patients a focal adhesion was identified at the cervical or thoracic level of the spinal cord, a consequence of infection or trauma. Three patients showed modest or minor improvement in neurological function, and one patient was unchanged after surgery. The syringomyelia or myelomalacia resolved after surgery and no recurrence was noted within the follow-up period, which ranged from 5 months to 30 months. Conclusions: MRI diagnosis of focal adhesive arachnoiditis is critical to determine the surgical indication. Microsurgical arachnoidolysis appears to be a straightforward method for stabilizing the progressive symptoms, though the procedure is technically demanding.
Jordi Ferrer Beltrán
Full Text Available The article aims to address the multiple faces that the presumption of innocence incorporates in modern legal systems from a critical perspective. In this sense, an analytical methodology seeks to demonstrate that some of these faces overlap with other legal rights and institutes, which, far from increasing the guarantees of citizens, leads to confusion and lack of controllability of judicial decisions. Thus, it is defended the conceptual and practical convenience of thinking the presumption of innocence avoiding overlaps with other legal rights or concepts, as standards of proof or burden of proof rules. Hence the reference to a minimalist and guarantistic conception of the presumption of innocence and, and, as will be seen, the defense of the presumption of innocence as a second order rule whose application would make sense in contexts of uncertainty about the satisfaction of the standard of proof.
Ferry de Jong
Full Text Available This article’s primary aim is to highlight the essentially critical potential of the presumption of innocence, as well as the need for this critical potential to be duly recognized. It is argued that the essential meaning of the presumption of innocence is best understood when approached from what is referred to as its counterfactual status. As a first step, the different values and functions that are attributed to the presumption of innocence in contemporary legal literature are discussed, in order to provide an outline of the central ideas it contains or is supposed to contain. Subsequently, the concept of ‘counterfactuality’ is introduced and it is argued that a counterfactual perspective can further clarify the nature of the presumption of innocence. Next, a number of fundamental shifts in society and criminal justice are discussed that affect the presumption of innocence and that lend a large measure of urgency to disclosing its essence and critical potential. The conclusion argues that today’s threats to the presumption of innocence are of a fundamental nature, and that attempts to preserve the principle’s efficacy should focus on the value attached to its counterfactual and critical nature.
Bharath, A.; Uhiara, O.; Botchu, Rajesh; Davies, A.M.; James, S.L. [The Royal Orthopedic Hospital, Department of Musculoskeletal Radiology, Birmingham (United Kingdom)
We present a case series of symptomatic post-operative spinal subdural extra-arachnoid collections that displace the cauda equina roots anteriorly. This is described as the ''rising root sign''. (orig.)
To describe three cases of delayed development of intracranial hypertension (IH) after surgical treatment of intracranial arachnoid cyst, including the pathogenesis of IH and a review of the literature.
M. M. Martins
Lianas as a food resource for brown howlers (Alouatta guariba) and southern muriquis (Brachyteles arachnoides) in a forest fragment.— Lianas, woody vines, are abundant and diverse in tropical forests, but their relative contribution as a source of food for herbivores has been neglected. I compared feeding rates on lianas and trees of two sympatric primates, A. guariba and B. arachnoides, in Southeastern Brazil. Availability of liana foods was gathered in parallel with primate behavioral data ...
Mehta Bhavya C
Full Text Available Abstract Background The arachnoid granulations (AGs are projections of the arachnoid membrane into the dural venous sinuses. They function, along with the extracranial lymphatics, to circulate the cerebrospinal fluid (CSF to the systemic venous circulation. Disruption of normal CSF dynamics may result in increased intracranial pressures causing many problems including headaches and visual loss, as in idiopathic intracranial hypertension and hydrocephalus. To study the role of AGs in CSF egress, we have grown cells from human AG tissue in vitro and have characterized their expression of those cytoskeletal and junctional proteins that may function in the regulation of CSF outflow. Methods Human AG tissue was obtained at autopsy, and explanted to cell culture dishes coated with fibronectin. Typically, cells migrated from the explanted tissue after 7–10 days in vitro. Second or third passage cells were seeded onto fibronectin-coated coverslips at confluent densities and grown to confluency for 7–10 days. Arachnoidal cells were tested using immunocytochemical methods for the expression of several common cytoskeletal and junctional proteins. Second and third passage cultures were also labeled with the common endothelial markers CD-31 or VE-cadherin (CD144 and their expression was quantified using flow cytometry analysis. Results Confluent cultures of arachnoidal cells expressed the intermediate filament protein vimentin. Cytokeratin intermediate filaments were expressed variably in a subpopulation of cells. The cultures also expressed the junctional proteins connexin43, desmoplakin 1 and 2, E-cadherin, and zonula occludens-1. Flow cytometry analysis indicated that second and third passage cultures failed to express the endothelial cell markers CD31 or VE-cadherin in significant quantities, thereby showing that these cultures did not consist of endothelial cells from the venous sinus wall. Conclusion To our knowledge, this is the first report of
Luciano Sousa Pereira
Full Text Available Gliomas are the most common infiltrative neoplasms of the optic nerve and can present as two distinct growth patterns: intraneural glial proliferation and perineural arachnoidal gliomatosis (PAG. It has been suggested that perineural arachnoidal gliomatosis is seen almost exclusively in the setting of neurofibromatosis type 1 (NF1. We describe a child with perineural arachnoidal gliomatosis occurring without neurofibromatosis type 1, supported by both radiographic and histological findings. A 4-year-old female without neurofibromatosis type 1 presented with rapidly progressive right-sided proptosis. Magnetic resonance imaging (MRI revealed an enhancing fusiform intraconal lesion, which was hypointense on T1 and hyperintense on T2-weighted images: characteristic of perineural arachnoidal gliomatosis, the optic nerve was visualized coursing the tumor. Histopathologic study was consistent with perineural arachnoidal gliomatosis. Perineural arachnoidal gliomatosis can develop independent of neurofibromatosis type 1, as demonstrated by this case.Gliomas são as neoplasias infiltrativas mais freqüentes do nervo óptico e podem se apresentar através de dois padrões distintos de crescimento: proliferação glial intraneural e gliomatose aracnoidal perineural. Existem evidências de que a gliomatose aracnoidal perineural é vista quase exclusivamente em pacientes com neurofibromatose tipo 1. Descrevemos um caso de gliomatose aracnoidal perineural ocorrendo em criança sem neurofibromatose tipo 1, comprovado tanto por achados radiológicos quanto histológicos. Uma criança de quatro anos de idade, do sexo feminino, sem evidências de neurofibromatose tipo 1, apresentou quadro de proptose à direita rapidamente progressiva. Ressonância magnética revelou lesão intraconal fusiforme hipointensa em T1 e hiperintensa em T2 - característico de gliomatose aracnoidal perineural, o nervo óptico pôde ser observado atravessando o tumor. O estudo histol
Martins, Milene Moura
Fruit is an important food resource for neotropical primates. In this study I compare the fruit diet of sympatric brown howlers (Alouatta guariba) and southern muriquis (Brachyteles arachnoides). Feeding behavior was studied over 12 months and fruit species consumed were identified and assigned to the categories fruit type, fruit color, and seed size. Observed-fruit feeding records were compared with expected records determined from local availability of the fruit of the tree species. I also determined dietary overlap. Fruit consumption occupied 8 and 12% of the feeding time of A. guariba and B. arachnoides, respectively. Fruit from eight tree species were consumed by the former and fruit from twenty-two species by the latter. Patterns of fruit selection of A. guariba and B. arachnoides varied widely. Although howlers and muriquis converge behaviorally by selecting fruit with common attributes (fleshy/unprotected, violet and brown/black-colored), unlike A. guariba, B. arachnoides fed on immature seeds of fleshy/protected and dry fruit. Large seeds were ingested, and defecated intact, by B. arachnoides only. There was little overlap of fruit diet even within categories that had been selected by both, suggesting that dietary divergence is occurring at the interspecific level. Different resource exploitation probably mediates the coexistence of A. guariba and B. arachnoides in low diversity, semideciduous forests, where the environment imposes narrow limits on primate food choices.
Roy-Gash, F; Engrand, N; Lecarpentier, E; Bonnet, M P
We present a case of arachnoiditis and an intrathecal hematoma after an epidural blood patch. A 24-year-old parturient underwent an epidural blood patch three days after an accidental dural puncture during epidural labor analgesia. Four days later, the patient developed severe lower back pain, bilateral leg pain, persistent headache and fever. Bacterial meningitis was initially suspected and antibiotics started. Lumbar magnetic resonance imaging was performed and showed an intrathecal hematoma, with no blood in the epidural space. This report briefly reviews the few cases in the literature of arachnoiditis caused by an intrathecal hematoma and discusses the mechanism which resulted in blood in the subarachnoid space. Copyright © 2017 Elsevier Ltd. All rights reserved.
Mami Ishikawa, MD, PhD
Conclusions: Straightening the trigeminal nerve axis by complete dissection of the arachnoidal adhesion around the trigeminal nerve was effective for typical trigeminal neuralgia without neurovascular compression.
Lee, Kyung Soo; Choi, Hyung Sik; Kim, Myung Joon; Yang, Seoung Oh; Kim, Chang Jin
Cysts overlying the temporal lobes have been well described in literature. These are often associated with agenesis of the temporal lobes, and of major neurosurgical interest due to their frequent association with subdural hematoma, a combination that is rarely seen with cysts in other regions. Full features of plain, angiographic, and CT findings of arachnoid cyst with temporal lobe agenesis accompanying isodense subdural hematoma are presented, being very rare in radiologic literature
Mendes,Francisco D.C.; Ades,César
Sequential exchanges of vocalizations (staccatos and neighs) emitted by Northern Muriquis Brachyteles arachnoides hypoxanthus were recorded at the Biological Station of Caratinga, Minas Gerais State, Brazil. Staccatos and neighs containing larger proportion of short elements were preferentially produced during short-range exchanges; neighs, produced by a larger number of participants, were typical of long-range exchanges. Staccatos emitted by animals feeding in a dispersed manner contained a ...
Kamikawa, Shuji; Kuwamura, Keiichi [Hyogo Prefectural Awaji Hospital, Sumoto (Japan); Tamaki, Norihiko
The treatment of intracranial arachnoid cysts is controversial regarding its surgical indication and operative procedures. Conventional surgical approaches such as fenestration, membranectomy, and shunting operation are invasive. Also CT cisternography and/or RI cisternography are invasive, when it has been performed to evaluate the possible CSF communications between the arachnoid cyst and subarachnoid space. Between July 1994 and February 1997, 10 patients with intracranial middle fossa arachnoid cysts were treated with a newly developed ventriculofiberscope which is characterized by splendid mechanical flexibility and high resolution. The cine-MRI, which is a non-invasive diagnostic tool, is used to evaluate the CSF circulation around the cyst fenestration. The patients` ages ranged from 4 months to 10 years, with a mean of 4.46 years. The cyst locations were left middle fossa (9), and right (1). Eight patients presented with macrocrania, 4 with developmental delay, three with seizure, two with headache, and one with subdural hematoma. The patients were preoperatively evaluated by means of MRI and cine-MR images. In all patients ventriculofiberscopic procedures including cyst fenestration, membranous dissection, cyst puncture and shriveling were successfully performed. Postoperative MR and cine-MR studies have shown reduction of the cyst size and appropriate CSF circulation. Neuroendoscopic procedures seem to be the first choice for children with arachnoid cysts and the ventriculofiberscope proved to be very useful not only for cyst fenestration but also for cyst dissection. In addition, the non-invasive cine-MR studies are useful for long follow-up at OPD. (author)
Tsutsumi, Satoshi; Ono, Hideo; Yasumoto, Yukimasa
Arachnoid granulations (AGs) occasionally appear to protrude into the calvarial convexity, lying close to the bridging veins (BVs). This study aims to characterize such AGs and BVs using magnetic resonance imaging (MRI). Ninety-five patients were enrolled in this study. Initially, stepwise frontal craniotomy was performed in an injected cadaver head. Next, examinations with contrast MRI were performed involving the whole cranial vault. In cadaveric dissection, the AGs located in the parasagittal regions appeared as outward protrusions through the dura mater and in contact with the diploic veins. Forming tent-shaped sleeves, these AGs and the continuous arachnoid membranes suspended the BVs coursing just below. A total of 237 AGs were identified on contrast MRI that protruded into the skull, lying close to the BVs. Among them, 78 % were located in parasagittal regions as AG-BV pairs. These pairs were most frequently found in the middle third of the calvarial hemisphere, followed by the anterior and posterior thirds. In 34 %, the BV segments were lodged in the AGs. Some AGs located in the parasagittal regions and cerebral convexity pass through the dura mater and pile drive into the skull, which contribute to forming hanging-type arachnoid sleeves suspending the BVs. These structures may underpin the predisposition of BVs to injury following mechanical impacts.
Komori, Mika; Kosa, Peter; Khan, Omar; Hammoud, Dima A.; Rosen, Lindsey B.; Browne, Sarah K.; Lin, Yen-Chih; Romm, Elena; Ramaprasad, Charu; Fries, Bettina C.; Bennett, John E.; Bielekova, Bibiana; Williamson, Peter R.
Background. Cryptococcus can cause meningoencephalitis (CM) among previously healthy non-HIV adults. Spinal arachnoiditis is under-recognized, since diagnosis is difficult with concomitant central nervous system (CNS) pathology. Methods. We describe 6 cases of spinal arachnoiditis among 26 consecutively recruited CM patients with normal CD4 counts who achieved microbiologic control. We performed detailed neurological exams, cerebrospinal fluid (CSF) immunophenotyping and biomarker analysis before and after adjunctive immunomodulatory intervention with high dose pulse corticosteroids, affording causal inference into pathophysiology. Results. All 6 exhibited severe lower motor neuron involvement in addition to cognitive changes and gait disturbances from meningoencephalitis. Spinal involvement was associated with asymmetric weakness and urinary retention. Diagnostic specificity was improved by MRI imaging which demonstrated lumbar spinal nerve root enhancement and clumping or lesions. Despite negative fungal cultures, CSF inflammatory biomarkers, sCD27 and sCD21, as well as the neuronal damage biomarker, neurofilament light chain (NFL), were elevated compared to healthy donor (HD) controls. Elevations in these biomarkers were associated with clinical symptoms and showed improvement with adjunctive high dose pulse corticosteroids. Conclusions. These data suggest that a post-infectious spinal arachnoiditis is an important complication of CM in previously healthy individuals, requiring heightened clinician awareness. Despite microbiological control, this syndrome causes significant pathology likely due to increased inflammation and may be amenable to suppressive therapeutics. PMID:28011613
First, 50 children with malaria-pneumonia symptom overlap were consecutively enrolled and treated presumptively with antibiotics and antimalarials irrespective of malaria test result (control arm).Then, another 50 eligible children were enrolled and treated with antibiotics with/out antimalarials based on rapid diagnostic test ...
Background: Intermittent presumptive treatment of malaria in pregnancy (IPTp) is one of the recommended interventions by World Health Organization to mitigate the impact of malaria in pregnancy in malaria stable transmission zones such as Sub Saharan regions so as to ensure the best outcome for both the mother and ...
Chanda-Kapata, Pascalina; Kapata, Nathan; Masiye, Felix; Maboshe, Mwendaweli; Klinkenberg, Eveline; Cobelens, Frank; Grobusch, Martin P.
Tuberculosis (TB) prevalence surveys offer a unique opportunity to study health seeking behaviour at the population level because they identify individuals with symptoms that should ideally prompt a health consultation. To assess the health-seeking behaviour among individuals who were presumptive TB
“Although presumption is not evidence and has no weight as such, it does make a ..... intelligence to appreciate the difficulties of the subject-matter has approached .... facts exists. This envisages the existence of another fact or aggregate of facts, called the presumed fact or fact(s) that must be assumed in the absence of.
... 47 Telecommunication 4 2010-10-01 2010-10-01 false Presumption of no effective competition. 76.906... competition. In the absence of a demonstration to the contrary, cable systems are presumed not to be subject to effective competition. ...
Bucuk, Mira; Gasparovic, Iva; Sonnenschein, Ivan; Perkovic, Olivio
Myasthenia gravis is a chronic autoimmune disease characterized by weakening of voluntary muscles during the day and a marked restitution of function during the night and after rest. The symptoms may worsen over days or weeks, sometimes even in a few hours, and are usually well controlled by appropriate therapy. Arachnoid cysts are congenital or acquired deformities of the arachnoid membrane and are usually too small to cause distinct clinical symptomatology. We describe a case of a 76-year-old myasthenia gravis patient with an arachnoid cyst. To the best of our knowledge this is the first reported case of these two comorbidities together.
Mendes, Francisco D C; Ades, César
Sequential exchanges of vocalizations (staccatos and neighs) emitted by Northern Muriquis Brachyteles arachnoides hypoxanthus were recorded at the Biological Station of Caratinga, Minas Gerais State, Brazil. Staccatos and neighs containing larger proportion of short elements were preferentially produced during short-range exchanges; neighs, produced by a larger number of participants, were typical of long-range exchanges. Staccatos emitted by animals feeding in a dispersed manner contained a larger proportion of tonal elements than those emitted by muriquis feeding in a cohesive manner. Sequential exchanges seem thus to be constituted by two inter-related subsystems of calls that aid muriquis to coordinate intragroup spacing, despite the poor visibility of the habitat.
Full Text Available Lateral sphenoid encephalocele, especially within the lateral aspect of the sphenoid sinus, when the sphenoid sinus has pneumatized extensively into the pterygoid recess, are considered exceedingly rare. We report a rare case of lateral intrasphenoidal encephalocele with spontaneous cerebral spinal fluid (CSF rhinorrhea. Computed tomography demonstrated bilateral arachnoid pit, extensive sphenoid sinus pneumatization, and a defect in the superior wall of the left lateral recess of the sphenoid sinus. Magnetic resonance imaging demonstrated anteromedial temporal lobe herniating through the bony defect.
Walker, Lisa; Gholamrezanezhad, Ali; Bucklan, Daniel; Faulhaber, Peter F; O'Donnell, James K
A 59-year-old man with history of multiple sclerosis and residual sensory and motor dysfunction presented with progressive lower-extremity weakness, ataxic gait, and intermittent urinary incontinence. Brain MRI demonstrated volume loss with disproportionate ventricular dilatation, but no evidence of infarction or abnormal enhancement. Radionuclide cisternography showed early and persistent ventricular reflux, poor progression of radiopharmaceutical over convexities, and delayed clearance in a pattern consistent with normal pressure hydrocephalus. Asymmetric activity in the right parietal region was also identified. Fused SPECT/CT, as well as fusion of the SPECT with a previous brain MRI, demonstrated a communicating arachnoidal cyst.
Leka, Stavroula; Van Wassenhove, Wim; Jain, Aditya Kailash
This paper tackles a much debated and often misunderstood issue in the modern world of work, psychosocial risks. Although the prevalence and impact of psychosocial risks is now widely acknowledged as a priority in health and safety in Europe, there remains resistance by key stakeholders in prioritizing psychosocial risk management both in business and policy making. This paper explores why this is still the case by discussing three presumptions in relation to the current state of the art in t...
Istvan, Stephanie A; Walker, Julie M; Hansen, Bernard D; Hanel, Rita M; Marks, Steven L
To describe the clinical features, diagnostic findings, treatment, and outcome of a dog with acute abdominal pain and hemoperitoneum secondary to a presumptive intraperitoneal (IP) snakebite. A 10-month-old castrated male mixed-breed dog was evaluated for suspected snake envenomation. The dog presented recumbent and tachycardic with signs of severe abdominal pain. Two cutaneous puncture wounds and hemoperitoneum were discovered during evaluation. Ultrasonographic examination revealed communication of the wounds with the peritoneal cavity. The dog was treated with supportive care, parenteral analgesia, packed red blood cell and fresh frozen plasma transfusions, crotalid antivenom, and placement of an IP catheter to provide local analgesia. The dog recovered fully and was discharged 5 days after initial presentation. To our knowledge, this is the first report of IP envenomation accompanied by hemorrhage treated with continuous IP analgesia in the veterinary literature. © Veterinary Emergency and Critical Care Society 2015.
Full Text Available This study aims to focus on a rare presentation of spinal hydatid cyst as cauda equine syndrome and misdiagnosed as intradural extramedullary (IDEM benign lesion on magnetic resonance imaging. In this article, we report a case of spinal hydatid cyst masquerading as IDEM tumor, and intraoperatively, we accidently find clumped granuloma with severe arachnoiditis and hydatid cyst in lumber region, which was present as bilateral S1 radiculopathy with cauda equina syndrome. An 11 year old boy who presented with symptoms and signs of cauda equina syndrome and planned for surgical excision. His radiological impression was IDEM possibly neurofibroma. To our surprise, we found multiple intradural cystic lesions with arachnoiditis. Dissecting in plane cyst was flushed out, and surgical cavity was irrigated with 3% saline. Postoperatively histopathology and serum tests confirmed the diagnosis of hydatid cyst. Hydatid disease is rare cause of cauda equine syndrome which can be miss diagnosed on radiological investigations. A high index of suspicion should be kept especially in a young patient from the Indian subcontinent.
Abderrahmen, K; Saadaoui, K; Bouhoula, A; Boubaker, A; Jemel, H
Subdural effusions are uncommon but known complications of arachnoid cysts of the middle cranial fossa. They mainly occur after minor head traumas in young patients. Here, we report eight cases of arachnoid cyst of the middle cranial fossa associated with subdural hematoma in five cases and hygroma in three cases. Major symptoms are signs of raised intracranial pressure. CT scan and MRI showed the cyst and the subdural effusion. An excellent therapeutic result was achieved with evacuation of the subdural fluid via burr holes in the five cases of subdural hematoma while in the two cases of hygroma a subduro-peritoneal shunt was necessary. In the last case, a temporal craniotomy was performed with evacuation of the hygroma and fenestration of the cyst. We suggest treating only the complicating event in the case of a subdural hematoma via burr holes evacuation. Whereas, in the case of hygroma we think that craniotomy with fenestration of the cyst or the use of a subdural shunt are more often needed. Copyright © 2012 Elsevier Masson SAS. All rights reserved.
M. M. Martins
Full Text Available Lianas as a food resource for brown howlers (Alouatta guariba and southern muriquis (Brachyteles arachnoides in a forest fragment.— Lianas, woody vines, are abundant and diverse in tropical forests, but their relative contribution as a source of food for herbivores has been neglected. I compared feeding rates on lianas and trees of two sympatric primates, A. guariba and B. arachnoides, in Southeastern Brazil. Availability of liana foods was gathered in parallel with primate behavioral data collection. Liana represented 33.9% and 27.3% of food sources for A. guariba and B. arachnoides, respectively. Foods coming from trees, rather than from lianas, were significantly more consumed by B. arachnoides. However, both species took advantage of the continuously renewable and ephemeral food resources provided by liana. Availability of liana flowers correlated positively with A. guariba feeding proportions. The nutritional supply provided by lianas is apparently beneficial, or at least unharmful, but experiments comparing primate choices in forests with different liana abundances will help to shed light on their possible negative effect on communities.
Shanbhag, Nagesh C.; Duyff, Ruurd F.; Groen, Rob J. M.
BACKGROUND: Spinal extradural arachnoid cysts (SEACs) are relatively rare and usually asymptomatic. They preferentially are situated in the thoracic extradural space and almost always dorsal. SEACs may present with back pain and/or cord compression symptoms. Needle aspiration, needle fenestration,
Sellors, J; Howard, M; Pickard, L; Jang, D; Mahony, J; Chernesky, M
To test the recommendation from the Canadian guidelines for sexually transmitted diseases (STDs) that mucopurulent endocervical discharge and 10 or more polymorphonuclear leukocytes (PMNs) per high-power field of a Gram-stained endocervical smear or, when Gram staining is not possible, the presence of endocervical discharge and one of edema, erythema or induced mucosal bleeding of the cervix can be considered diagnostic for chlamydial cervicitis. A total of 596 consecutive women attending 2 family planning clinics for routine care underwent vaginal speculum examination and were tested for Chlamydia trachomatis and Neisseria gonorrhoeae. PMN counts from Gram-stained endocervical smears and the presence or absence of putative indicators of chlamydial infection were recorded. The prevalence of chlamydial cervicitis was 6.2% (37/596), and no women tested positive for N. gonorrhoeae. Presumptive diagnosis of chlamydial cervicitis based on the guidelines criteria of mucopurulent endocervical discharge and 10 or more PMN per high-power microscopic field had a sensitivity and specificity of 18.9% and 97.0% respectively, a positive predictive value of 29.2% and a positive likelihood ratio (LR) of 6.2 (p = 0.003). Presumptive diagnosis based on endocervical discharge with edema, erythema or induced mucosal bleeding of the cervix had a sensitivity and specificity of 43.2% and 80.0% respectively, a positive predictive value of 12.5% and a positive LR of 2.2 (p = 0.002). In the presence of bacterial vaginosis or vaginitis, the LR for the criteria of mucopurulent endocervical discharge and 10 or more PMN per high-power field was 5.4 (p = 0.04), whereas the LR was 4.3 (p = 0.10) if bacterial vaginosis and vaginitis were absent. In this setting, the practice of making a presumptive diagnosis of chlamydial cervicitis on the basis of the criteria given in the Canadian STD guidelines was not supported.
Chanda-Kapata, Pascalina; Kapata, Nathan; Masiye, Felix; Maboshe, Mwendaweli; Klinkenberg, Eveline; Cobelens, Frank; Grobusch, Martin P
Tuberculosis (TB) prevalence surveys offer a unique opportunity to study health seeking behaviour at the population level because they identify individuals with symptoms that should ideally prompt a health consultation. To assess the health-seeking behaviour among individuals who were presumptive TB cases in a national population based TB prevalence survey. A cross sectional survey was conducted between 2013 and 2014 among 66 survey clusters in Zambia. Clusters were census supervisory areas (CSAs). Participants (presumptive TB cases) were individuals aged 15 years and above; having either cough, fever or chest pain for 2 weeks or more; and/or having an abnormal or inconclusive chest x-ray image. All survey participants were interviewed about symptoms and had a chest X-ray taken. An in-depth interview was conducted to collect information on health seeking behaviour and previous TB treatment. Of the 6,708 participants, the majority reported at least a history of chest pain (3,426; 51.1%) followed by cough (2,405; 35.9%), and fever (1,030; 15.4%) for two weeks or more. Only 34.9% (2,340) had sought care for their symptoms, mainly (92%) at government health facilities. Of those who sought care, 13.9% (326) and 12.1% (283) had chest x-ray and sputum examinations, respectively. Those ever treated for TB were 9.6% (644); while 1.7% (114) was currently on treatment. The average time (in weeks) from onset of symptoms to first care-seeking was 3 for the presumptive TB cases. Males, urban dwellers and individuals in the highest wealth quintile were less likely to seek care for their symptoms. The likelihood of having ever been treated for TB was highest among males, urban dwellers; respondents aged 35-64 years, individuals in the highest wealth quintile, or HIV positive. Some presumptive TB patients delay care-seeking for their symptoms. The health system misses opportunities to diagnose TB among those who seek care. Improving health-seeking behaviour among males, urban
Stéfanie Vanessa Santos
O gênero Brachyteles, endêmico do Brasil, é constituído por duas espécies, B. arachnoides e B. hypoxantus, e estudos recentes demonstraram que suas populações selvagens podem estar seriamente reduzidas. Na tentativa de reverter a situação atual, esforços têm sito realizados visando a conservação dos muriquis, no entanto, dados relativos à condição sanitária de Brachyteles são extremamente escassos. Sabe-se, que o estabelecimento de protocolos adequados de manejo é condição necessária para a m...
Strier, K B
Data were collected on one group of muriquis, or woolly spider monkeys (Brachyteles arachnoides) during a 14-month study at Fazenda Montes Claros, Minas Gerais, Brazil to examine the effects of food patch size on muriqui feeding associations. Muriqui food patches were larger than expected from the availability of patch sizes in the forest; fruit patches were significantly larger than leaf patches. Feeding aggregate size, the maximum number of simultaneous occupants, and patch occupancy time were positively related to the size of fruit patches. However, a greater number of individuals fed at leaf sources than expected from the size of these patches. Adult females tended to feed alone in patches more often than males, whereas males tended to feed in single-sexed groups more often than females. Yet in neither case were these differences statistically significant.
Eguchi, Takahiko; Nikaido, Yuji; Shiomi, Kazuaki; Fujimoto, Takatoshi; Otsuka, Hiroyuki; Takeuchi, Hiroshi; Taoka, Toshiaki.
Cine-magnetic resonance (MR) imaging examinations were performed in 10 patients with middle cranial fossa arachnoid cysts to evaluate communication between the cysts and the normal cerebrospinal fluid (CSF) space. Eight of 10 patients were evaluated by time of flight cine-MR imaging, and two by phase contrast cine-MR imaging. Two patients underwent membranectomy of the cysts, and were evaluated both pre-and postoperatively. Computed tomography cisternography was used to confirm communication between the cysts and the surrounding cisterns. Pulsatile fluid motion within the cysts was present in all patients. However, marked fluid motion and jet flow between the cysts and the surrounding cisterns were only observed in communicating cysts. In the two patients who underwent membranectomy, postoperative examination found greater fluid motion and jet flow not previously present. Cine-MR imaging demonstration of marked pulsatile fluid motion accompanied by jet flow suggests that a cyst communicates with the normal CSF space. (author)
de Carvalho, Oswaldo; Ferrari, Stephen F; Strier, Karen B
The feeding behaviour of a group of free-ranging muriquis (Brachyteles arachnoides) was monitored in the 380 km(2) Carlos Botelho State Park (PECB), between February 1992 and November 1993. Scan sample data indicated that 59.1% of feeding time was devoted to fruit, 33.2% to leaves, 4.1% to flowers, and 3.6% to other items (twigs, stem and bark). Little seasonal variation was recorded. These results contrast with those of all previous studies of Brachyteles, in which the consumption of leaves was generally double that of fruit. One key difference in comparison with previous studies is that the PECB is part of the largest remaining continuous area of primary Atlantic forest, in the Serra do Mar coastal range. Such intraspecific differences in ecology may have important implications for the conservation of the species.
Mendes Francisco D.C.
Full Text Available Sequential exchanges of vocalizations (staccatos and neighs emitted by Northern Muriquis Brachyteles arachnoides hypoxanthus were recorded at the Biological Station of Caratinga, Minas Gerais State, Brazil. Staccatos and neighs containing larger proportion of short elements were preferentially produced during short-range exchanges; neighs, produced by a larger number of participants, were typical of long-range exchanges. Staccatos emitted by animals feeding in a dispersed manner contained a larger proportion of tonal elements than those emitted by muriquis feeding in a cohesive manner. Sequential exchanges seem thus to be constituted by two inter-related subsystems of calls that aid muriquis to coordinate intragroup spacing, despite the poor visibility of the habitat.
Vijay P Joshi
Full Text Available Acquired cerebellar tonsillar herniation and syringomyelia associated with posterior fossa mass lesions is an exception rather than the rule. In the present article, we describe the neuroimaging findings in a case of 28-year-old female patient presented with a history of paraesthesia involving right upper limb of 8-month duration. Magnetic resonance imaging showed a giant retrocerebellar arachnoid causing tonsillar herniation with cervical syringomyelia. The findings in the present case supports that the one of the primary mechanism for the development of syringomyelia may be the obstruction to the flow of cerebrospinal fluid causing alterations in the passage of extracellular fluid in the spinal cord and leading to syringomyelia.
Watane, Gaurav Vishwasrao; Patel, Bhumi; Brown, Derek; Taheri, M Reza
The aim of this article was to study the significance of arachnoid granulations (AGs) in patients with idiopathic intracranial hypertension (IIH). In an institutional review board-approved retrospective chart review study, 79 patients with clinical diagnosis of idiopathic increased intracranial pressure were compared with 63 patients with a diagnosis of multiple sclerosis. Inclusion criteria also included available magnetic resonance imaging (MRI) of the brain, older than 18 years, and female sex. Patients with elevated intracranial pressure due to other causes were excluded. The electronic medical records were mined for presence of the following: body mass index, age, headache, vision changes, tinnitus, and vertigo. The MRI of the brain was reviewed for the presence of the following features: empty sella, prominent cerebrospinal fluid space in the optic sheaths, tortuosity of the optic nerves and enlarged Meckel cave. In addition, the number, size, and location of AGs associated with major venous drainage sinuses were documented in all patients. Using statistical analysis, association between various imaging and clinical signs were evaluated. The association between AG and various imaging and clinical signs were evaluated. The percentage of patients with AG were significantly higher in patients with IIH. Patients with IIH tended to have 0 to 3 AG. The most common imaging findings observed in MRI of the brain of patients with IIH were empty sella and prominent cerebrospinal fluid space in the optic sheaths. The prevalence of these MRI findings in patients with IIH was inversely proportional to the number of AG. A similar inverse trend was also noted with the opening pressure of patients with IIH and number of AG. The study establishes that there is a relationship between presence of AG and IIH. Arachnoid granulation seems to act in a compensatory mechanism in patients with IIH.
Dislich, Mathias; Wohlsein, Peter; Croukamp, Anna Sophie; Neumann, Ulrich
Snake bites represent a serious public health risk in many regions of the globe, especially in tropical areas. Clinical signs and postmortem changes are well described in human and other mammalian species. However, detailed case reports about venomous snake attacks in avian species are limited. This report describes presumptive fatal envenomations in three psittacines caused by pit vipers in a Brazilian zoo. In one case, a Brazilian lancehead (Bothrops moojeni) was captured in the aviary. In all three cases the dermis around the suspected snake bite area exhibited hemorrhages and edema. Histologically, degeneration and necrosis of subcutaneous musculature were observed. Lung, heart, and kidneys displayed focal hemorrhages. The local changes are similar to those described for mammalian patients including humans. However, except for the parenchymatous hemorrhages, additional external and internal gross and histopathological lesions were missing. After ruling out other causes, such as aggression and dicoumarinic intoxication, the presumptive diagnosis of snake envenomation was made. The smaller size and variabilities of pathophysiological effects of the venom in parrots might explain the different lesion patterns observed, compared with mammals. Possibly, the birds may have reacted differently to envenomation by pit vipers and died before the venom could cause macroscopic and histological changes often observed in mammals.
Full Text Available In Mexico, increasing demands for public safety coupled with the need for a more effective criminal justice system resulted in the security and justice constitutional reform of 2008. The outcome was a constitutional framework with provisions based on the highest standards of human rights on the one hand, and on the other, exceptional measures that restrict rights in an attempt to improve public safety. Unfortunately, the crime rate and incidence of unreported crime have changed little. When public safety is demanded, a clear, rational and concrete response is required. Limiting the alternatives to pre-trial detention or increasing penalties is rarely the appropriate response. This paper focuses on pre-trial detention and non-custodial measures supported by the new criminal justice system, how they relate to the principle of the presumption of innocence and the tension between this and the punitive demands for increased imprisonment. In addition, this study discusses a technical solution, found in pre-trial services, which seeks to balance the presumption of innocence and the right to personal liberty with public safety.
Lee, Jun Seok; Song, Geun Sung; Son, Dong Wuk
Syringomyelia associated with tuberculous meningitis is an extremely rare condition. Only a few studies have reported clinical experience with syringomyelia as a late complication of tuberculous meningitis. Twenty-six years after a tuberculous meningitis episode, a 44-year-old man presented with progressively worsening spastic paresis of the lower limbs and impaired urinary function for 2 years. Radiological examination revealed syringomyelia extending from the level of C2 to T9 and arachnoiditis with atrophy of the spinal cord between C2 and T3. We performed laminectomy from C7 to T1, dissected the arachnoid adhesion and placed a syringo-pleural shunt via keyhole myelotomy. One year after the operation, his neurological condition improved. The postoperative control magnetic resonance imaging revealed the correctly located shunt and significantly diminished syringomyelia cavities. We aim to discuss the mechanism of syrinx formation following tuberculous meningitis and to share our surgical therapeutic experience with this rare disease entity.
... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Irrebuttable presumption of death due to... FEDERAL COAL MINE HEALTH AND SAFETY ACT OF 1969, TITLE IV-BLACK LUNG BENEFITS (1969- ) Total Disability or Death Due to Pneumoconiosis § 410.458 Irrebuttable presumption of death due to pneumoconiosis—survivor's...
... Acquisition Regulation Supplement; Presumption of Development at Private Expense AGENCY: Defense Acquisition... the presumption of development at private expense for major systems; and section 815(a)(2) of the NDAA... Expense--Technical Data The validation of asserted restrictions on technical data is based on statutory...
Santos, Stéfanie Vanessa; Pena, Hilda F J; Talebi, Mauricio G; Teixeira, Rodrigo H F; Kanamura, Cristina T; Diaz-Delgado, Josué; Gennari, Solange M; Catão-Dias, José Luiz
We report the pathological, immunohistochemical, and molecular features of fatal acute systemic toxoplasmosis in an adult, female, free-living southern muriqui (Brachyteles arachnoides) from São Paulo state, Brazil. PCR-RFLP genotyping analysis identified the #21 genotype of Toxoplasma gondii. This represents the first report of acute toxoplasmosis involving this genotype in humans and animals. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Full Text Available The actuality of this article is determined by the necessity of implementing fiscal simplicity for increasing tax compliance through fiscal education of small business representatives. In many developing and transition countries, micro and small enterprises are the most rapidly growing business segment. Tax compliance attitude within this sector varies significantly because high conformation costs and difficult formalization procedures can determine many small enterprises to operate in the informal economy. Thus tax regulation of small enterprises is crucial in the process of small entrepreneurs fiscal education and tax simplification of SMEs in many countries becomes one of the most efficient instruments. The main research methods were systemic analysis and logic synthesis. The main results obtained in article, as a result of research, are identification, analysis and systematization of foreign countries’ practices in implementing presumptive tax design and elaboration of some recommendations on fiscal simplicity.
Mullin, C M; Arkans, M A; Sammarco, C D; Vail, D M; Britton, B M; Vickery, K R; Risbon, R E; Lachowicz, J; Burgess, K E; Manley, C A; Clifford, C A
Sixty-four dogs were treated with single-agent doxorubicin (DOX) for presumptive cardiac hemangiosarcoma (cHSA). The objective response rate (CR + PR) was 41%, and the biologic response rate (CR + PR + SD), or clinical benefit, was 68%. The median progression-free survival (PFS) for treated dogs was 66 days. The median survival time (MST) for this group was 116 days and was significantly improved compared to a MST of 12 days for untreated control dogs (P = 0.0001). Biologic response was significantly associated with improved PFS (P < 0.0001) and OS (P < 0.0001). Univariate analysis identified larger tumour size as a variable negatively associated with PFS. The high rate of clinical benefit and improved MST suggest that DOX has activity in canine cHSA. © 2014 John Wiley & Sons Ltd.
Pérez-Roca, F; Alfaro Juárez, A; Sánchez Merino, C; Navarro Mingorance, A
We present the case of an 11-year-old boy with acute diplopia in near vision secondary to transient convergence palsy, possibly in relation to amoxicillin. Convergence palsy is an uncommon eye disorder. The causes are reviewed, and amoxicilin is identified as presumptive etiologic agent. This is the first case reported. Copyright Â© 2016 Sociedad Española de Oftalmología. Publicado por Elsevier España, S.L.U. All rights reserved.
... establishing presumptions of service connection for former prisoners of war. 1.18 Section 1.18 Pensions... Guidelines for establishing presumptions of service connection for former prisoners of war. (a) Purpose. The Secretary of Veterans Affairs will establish presumptions of service connection for former prisoners of war...
Elkins, Kelly M
Human body fluids and materials were evaluated using attenuated total reflectance Fourier transform infrared spectroscopy. Purified proteins, cosmetics, and foodstuffs were also assayed with the method. The results of this study show that the sampled fluids and materials vary in the fingerprint region and locations of the amide I peaks because of the secondary structure of the composite proteins although the C = O stretch is always present. The distinct 1016 cm(-1) peak serves as a signature for semen. The lipid-containing materials (e.g., fingerprints, earwax, tears, and skin) can also be easily separated from the aqueous materials because of the strong CH(3) asymmetric stretch of the former. Blood-saliva and blood-urine mixtures were also successfully differentiated using combinations of peaks. Crime scene investigators employing rapid, portable, or handheld infrared spectroscopic instruments may be able to reduce their need for invasive, destructive, and consumptive presumptive test reagents in evaluating trace evidence. © 2011 American Academy of Forensic Sciences.
Hermann, G.; Gilbert, M.
A case has been presented of a 72-year-old man on whom an excretory urogram showed the incidental findings of two soft tissue masses in the abdomen containing considerable deposits of calcium. The history was interesting in that the patient was classic hemophiliac with Factor VIII level less than 1%, who first developed symptoms and signs of multiple hemarthroses affecting the knees, ankles, elbows, and shoulders at the age of nine years. Secondary hemophilic arthropathy followed, particularly advanced in the right elbow. Total knee replacements were performed within the last 10 years. A mass within the muscles of the right chest wall, superficial to the ribs, was surgically removed. The abdominal masses in this case were studied with CT and showed considerable calcification with a fibrous wall. Surgical removal of pseudotumors is usually undertaken following diagnosis because the natural history includes continuous enlargement and destruction of the adjacent tissues. Because of the age of the patient and the significant cardiac history, it was considered inappropriate to undertake surgery for the masses in the abdomen which were considered presumptively to be pseudotumors. The clinical, radiological, and pathological aspects of pseudotumor of hemophilia were reviewed. In this case, besides the masses in the abdomen, hemophilic arthropathy of an elbow was illustrated and a soft tissue mass in the right chest wall was demonstrated radiologically and the pathological specimen shown after surgical excision. (orig.)
Strier, K B; Ziegler, T E; Wittwer, D J
Fecal testosterone and cortisol levels were analyzed from six wild male muriquis (Brachyteles arachnoides) over a 19-month period at the Estação Biológica de Caratinga in Minas Gerais, Brazil, to investigate the hormonal correlates of seasonal sexual behavior and environmental conditions. Group mean testosterone levels based on weekly samples from the six males did not differ between copulatory and noncopulatory periods or between rainy and dry seasons. Cortisol levels did change with copulatory periods, and were significantly higher during the second dry season, when mating continued following an exceptionally heavy rainy season, than during the first dry season, when mating ceased. Males exhibited individual variation in the timing of their hormone shifts relative to their sexual activity, but neither hormone levels nor sexual activity were related to male age. Despite individual differences in the timing of testosterone fluctuations around the onset and offset of the copulatory season, all males exhibited elevated cortisol concentrations following a slight increase in testosterone at the beginning of the copulatory season. Both the lack of significant changes in testosterone levels with the onset of the rainy and copulatory season and the lack of prebreeding increases in cortisol may be related to the low levels of overt aggression displayed by male muriquis over access to mates. Copyright 1999 Academic Press.
Ziegler, T E; Santos, C V; Pissinatti, A; Strier, K B
Urine, feces, and copulation frequency were collected from two captive muriqui females, Brachyteles arachnoides, at the Centro de Primatologia do Rio de Janeiro following the resumption of postpartum ovarian cycles. Fecal steroid profiles from seven wild muriqui females at the Estação Biologica de Caratinga, Minas Gerais, Brazil, were compared to the captive females to determine the approximate patterns of steroid excretion relative to the urinary LH peak. Hormonal profiles from one of the captive female muriquis revealed a discrete urinary LH peak. For this female, fecal progesterone increased on the same day as the urinary LH peak, while fecal estradiol increased 6 days later and urinary steroids increased 5 days later. For both captive females, the onset of fecal progesterone increase was preceded by the onset of copulations, which occurred during at least a 5-day period. The complete fecal hormonal profiles of the one captive female for which continuos data were available were similar to those found in wild muriqui monkeys, with the onset of an increase in sustained progesterone levels occurring several days prior to the onset of sustained estradiol increase. These patterns suggest that fecal progesterone may be excreted rapidly in this species. The onset of sustained increase in fecal progesterone levels, together with the consistent delay in the onset of the sustained increase in estradiol, may provide the best indicators of the periovulatory period for muriqui females.
Strier, K B; Ziegler, T E
The analysis of fecal ovarian steroids provides a powerful noninvasive method to obtain insights into ovulatory cycles, gestation length, and the timing of sexual interactions relative to the periovulatory period in wild primates. Techniques developed to collect and assay feces from free-ranging muriqui monkeys (Brachyteles arachnoides) for estradiol and progesterone yield the first explicit reproductive data on this species, and provide the first opportunity to evaluate the timing of observed copulations with muriqui ovarian cycles. Hormonal profiles from seven females indicate average cycle lengths of 21.0 +/- 5.4 days (n = 20). Females conceived after 3-6 ovulatory cycles. Gestation length averaged 216.4 +/- 1.5 days for the five females for which conception cycles were sampled. Discrete copulation periods spanned an average of 2.1 +/- 1.2 days (n = 29), with intervals between these concentrated periods of copulations averaging 15.6 +/- 6.7 days (n = 20). There were no significant differences among females in cycle lengths, copulation period lengths, or copulation interval lengths. Ejaculation was visible following 71.8 +/- 26.7% of copulations during the females preovulatory periods. All females copulated outside the periovulatory period. The proportion of copulation days outside the periovulatory period was slightly greater (p = 0.08) for primiparous females (64.8 +/- 28.3%) than for multiparous females (28.7 +/- 19.7%).
Strier, Karen B; Lynch, Jessica W; Ziegler, Toni E
We investigated hormonal and behavioral changes in wild male and female northern muriquis (Brachyteles arachnoides hypoxanthus) at the Estação Biológica de Caratinga, Minas Gerais, Brazil, during a 6-mo period that encompassed the onset of the 1998-1999 mating and conception seasons. Individual females resumed mating with the resumption of ovarian cycling, which was not synchronized among them or related to their cortisol levels. Females experienced two to seven cycles prior to conceiving, and the first conception occurred 2 mo after the onset of the group's mating season. There were no differences in female cortisol levels across their premating, mating, and conception conditions. Cortisol levels were significantly higher in females than in males prior to the conception season, consistent with the prediction that energy reserves may be associated with breeding readiness in females, but not males, in this species. The sustained elevation in male cortisol occurred after the peak in their sexual activity, which resulted in the first conception of the year. Male cortisol levels were positively correlated between years that were similar in rainfall, but differed in the timing of sexual and reproductive events. The timing of cortisol elevations in males appears to be generally regulated by environmental cues, but is responsive to fine-tuning by social and behavioral cues related to the unpredictable timing of reproductive opportunities within their extended mating season. Copyright 2003 Wiley-Liss, Inc.
Cha, Young Deog; Yang, Chun Woo; Han, Jung Uk; Song, Jang Ho; Na, WonJu; Oh, Sora; Kim, Byung-Gun
Abstract Background: Coccygodynia is a pain in the region of the coccyx that radiates to the sacral, perineal area. The cause of the pain is often unknown. Coccygodynia is diagnosed through the patient's past history, a physical examination, and dynamic radiographic study, but the injection of local anesthetics or a diagnostic nerve blockade are needed to distinguish between somatic, neuropathic, and combined pain. Ganglion impar is a single retroperitoneal structure made of both paravertebral sympathetic ganglions. Although there are no standard guidelines for the treatment of coccygodynia, ganglion impar blockade is one of the effective options for treatment. Methods: Here, we report a 42-year-old female patient presenting with severe pain in the coccygeal area after spinal arachnoid cyst removal. Results: Treatment involved neurolysis with absolute alcohol on the ganglion impar through the transsacrococcygeal junction. Pain was relieved without any complications. Conclusion: Our case report offers the ganglion impar blockade using the transsacrococcygeal approach with absolute alcohol can improve intractable coccydynia. PMID:27684866
Bilello, John A; Tennant, Forest S
To use biomarkers to gain insight into and gauge the residual (post-treatment) level of inflammation in two groups of intensively treated patients with severe chronic pain. Three study groups were analyzed, and included: (i) patients (n = 90) with chronic intractable pain (CIP), (ii) patients (n = 26) with chronic pain and MRI-documented arachnoiditis (ARC) and (iii) normal subjects without a diagnosis of chronic pain (n = 86). We determined and compared the serum concentrations of Alpha-1 Antitrypsin (A1AT), Myeloperoxidase (MPO) and soluble Tumor Necrosis Factor receptor type 2 (sTNFR2) in each of the patient populations studied. Patients treated for ARC or CIP had higher serum levels of A1AT and MPO than normal untreated subjects without a diagnosis of chronic pain. ARC patients had an A1AT mean serum concentration of 167.9 ± 41.9 mg/dL as compared to 148.9 ± 35.2 mg/dL for normal subjects (p = 0.023). CIP patients had the highest mean serum A1AT level 183.6 ± 39.2 mg/dL with p values of pain, sites of neuroinflammation elaborate MPO and other inflammatory factors which may not be completely cleared from the system despite extensive and complex treatment regimens.
Kraft, S.L.; Mussman, J.M.; Smith, T.; Biller, D.S.; Hoskinson, J.J.
three-year-old male Boxer dog had hyperesthesia, symmetrical epaxial, gluteal and hind limb muscular atrophy and rear limb ataxia. Neurological deficits included decreased conscious proprioception of the left hind limb, decreased withdrawal and increased patellar reflexes of both hind limbs. The dog had a urinary tract infection with positive culture for Staphylococcus intermedius. On survey radiography of the lumbosacral spine there was active bone proliferation spanning the L7 S1 intervertebral disc space with an epidural filling defect at the ventral aspect of the vertebral canal on epidurography. On magnetic resonance imaging (MRI), findings were similar to those described for human diskospondylitis including altered signal intensity and nonuniform contrast enhancement of the L7-S1 intervertebral disc, adjacent vertebral end plates and epidural and sublumbar soft tissues. Although skeletal radiography is usually sufficient to reach a diagnosis of discospondylitis, MRI of this patient made it possible to reach a presumptive diagnosis of discospondylitis prior to development of definitive radiographic abnormalities
Sriskandarajah, Srishamanthi; Carter-Storch, Rasmus; Frydkjær-Olsen, Ulrik; Mogensen, Christian Backer
In Denmark, patients referred from the general practitioner (GP) to the emergency department (ED) can be referred with either specific symptoms or with a presumptive diagnosis. The aim of the present study was to evaluate the diagnostic accuracy for various presumptive diagnoses made by the GP in a population acutely referred to an ED. This was a retrospective cohort study of all registered acute referrals for admission to Kolding ED in 2010. Eight presumptive diagnoses were selected for further studies: meningitis, acute coronary syndrome (ACS), pulmonary embolism, pneumonia, pancreatitis, deep venous thrombosis (DVT), pyelonephritis and intestinal obstruction. The presumptive diagnoses were compared with the final diagnosis on discharge. Sensitivity, specificity, predictive values and likelihood ratios were calculated. A total of 8,841 patients were enrolled. The highest and lowest sensitivities were seen for DVT (90%) and meningitis (36%), respectively; and the highest and lowest values for specificity were observed for meningitis (99%) and ACS (30%), respectively. The positive predictive value had a wide range with the lowest value for ACS (9%) and the highest for pneumonia (59%). For pyelonephritis, meningitis and pancreatitis, the likelihood ratio of a positive test was above 10. The likelihood ratio of a negative test was above 0.1 for all diagnoses. Patients referred with the presumptive diagnoses pyelonephritis, meningitis and pancreatitis had a high likelihood of having the disease in question. It is important not to discard any of the included presumptive diagnoses even if the GPs fail to suggest them on admission. none. none.
Martins, Waldney P; Strier, Karen B
Female northern muriquis ( Brachyteles arachnoides hypoxanthus or B. hypoxanthus) at the Estação Biológica de Caratinga/RPPN-FMA, Minas Gerais, Brazil typically disperse from their natal groups at an average age of 6.1+/-0.6 years (median =6.0 years, range =5.3-7.8 years, n =22), prior to the onset of puberty and sexual activity. Immigrants do not conceive until at least their second mating season, and the minimum interval from immigration to first reproduction has been 2.0 years. Age at first reproduction in dispersing females, previously estimated at 8.9 years, has now been documented at 9.0 and 9.25 years for two females whose birth dates are known. This is older than the 7.5 years at which the only female previously known to have reproduced in her natal group gave birth. Here, we present new data from a second female that reproduced in her natal group. This female (BA) was first observed to copulate at 5.5 years, and gave birth to her first infant at 7.25 years of age. Her 1.75-year cycling-to-first conception delay was only slightly shorter than the minimum recorded for immigrant females, and thus was not responsible for her young age at first reproduction compared to dispersing females. Although our sample size is small, our findings suggest that early puberty may permit females to reproduce in their natal group, implying a possible link between life history trade-offs and dispersal patterns. Because the only two females that have reproduced in their natal group were maternal sisters, it is also possible that maternal effects on age at puberty can impact dispersal patterns, particularly in small populations of primates.
Talebi, M G; Beltrão-Mendes, R; Lee, P C
We report on the first evidence of intra-community coalitionary lethal aggression in muriquis (Brachyteles). The event occurred in southern muriquis (Brachyteles arachnoides) during a long-term study (>15 years) of two social groups inhabiting mostly pristine Atlantic forest habitat in the Parque Estadual Carlos Botelho, southern São Paulo State, Brazil. The attack took place deep in the core area of the Group Caetê home range. Tense agonistic behaviors and vocalizations preceded the lethal coalitionary attack, and the tension increased over a 36-48 hr period. One adult female and two unidentified individuals also took part in a coalition led by six adult males. The members of the coalition collectively approached, embraced, immobilized and repeatedly bit the entire body of an adult male, resulting in severe bleeding injuries and the victim's death in less than 1 hr after the attack commenced. Combined ecological, behavioral and spatial data related to the event indicate that this was an intra-community attack and suggest social tensions related to mating competition as the proximate trigger of the coalitionary killing. The attack resembled those reported for chimpanzees, with clear numeric superiority and a low risk of injury to aggressors, resulting in the death of a lone conspecific victim. This observation (n=1) is suggestive of a capacity for escalated aggression in muriquis and reinforces arguments for the potential adaptive significance of intra-community aggression in male philopatric societies, as reported for spider monkeys and chimpanzees. These characteristics challenge the view of the muriquis as a peaceful primate and support the general hypothesis that imbalances of power contribute to intra-specific killing in primates, such as chimpanzees and humans.
Background Hydrocephalus following spontaneous aneurysmal sub-arachnoid hemorrhage (SAH) is often associated with unfavorable outcome. This study aimed to determine the potential risk factors and outcomes of shunt-dependent hydrocephalus in aneurysmal SAH patients but without hydrocephalus upon arrival at the hospital. Methods One hundred and sixty-eight aneurysmal SAH patients were evaluated. Using functional scores, those without hydrocephalus upon arrival at the hospital were compared to those already with hydrocephalus on admission, those who developed it during hospitalization, and those who did not develop it throughout their hospital stay. The Glasgow Coma Score, modified Fisher SAH grade, and World Federation of Neurosurgical Societies grade were determined at the emergency room. Therapeutic outcomes immediately after discharge and 18 months after were assessed using the Glasgow Outcome Score. Results Hydrocephalus accounted for 61.9% (104/168) of all episodes, including 82 with initial hydrocephalus on admission and 22 with subsequent hydrocephalus. Both the presence of intra-ventricular hemorrhage on admission and post-operative intra-cerebral hemorrhage were independently associated with shunt-dependent hydrocephalus in patients without hydrocephalus on admission. After a minimum 1.5 years of follow-up, the mean Glasgow outcome score was 3.33 ± 1.40 for patients with shunt-dependent hydrocephalus and 4.21 ± 1.19 for those without. Conclusions The presence of intra-ventricular hemorrhage, lower mean Glasgow Coma Scale score, and higher mean scores of the modified Fisher SAH and World Federation of Neurosurgical grading on admission imply risk of shunt-dependent hydrocephalus in patients without initial hydrocephalus. These patients have worse short- and long-term outcomes and longer hospitalization. PMID:22765765
Full Text Available Abstract Background Hydrocephalus following spontaneous aneurysmal sub-arachnoid hemorrhage (SAH is often associated with unfavorable outcome. This study aimed to determine the potential risk factors and outcomes of shunt-dependent hydrocephalus in aneurysmal SAH patients but without hydrocephalus upon arrival at the hospital. Methods One hundred and sixty-eight aneurysmal SAH patients were evaluated. Using functional scores, those without hydrocephalus upon arrival at the hospital were compared to those already with hydrocephalus on admission, those who developed it during hospitalization, and those who did not develop it throughout their hospital stay. The Glasgow Coma Score, modified Fisher SAH grade, and World Federation of Neurosurgical Societies grade were determined at the emergency room. Therapeutic outcomes immediately after discharge and 18 months after were assessed using the Glasgow Outcome Score. Results Hydrocephalus accounted for 61.9% (104/168 of all episodes, including 82 with initial hydrocephalus on admission and 22 with subsequent hydrocephalus. Both the presence of intra-ventricular hemorrhage on admission and post-operative intra-cerebral hemorrhage were independently associated with shunt-dependent hydrocephalus in patients without hydrocephalus on admission. After a minimum 1.5 years of follow-up, the mean Glasgow outcome score was 3.33 ± 1.40 for patients with shunt-dependent hydrocephalus and 4.21 ± 1.19 for those without. Conclusions The presence of intra-ventricular hemorrhage, lower mean Glasgow Coma Scale score, and higher mean scores of the modified Fisher SAH and World Federation of Neurosurgical grading on admission imply risk of shunt-dependent hydrocephalus in patients without initial hydrocephalus. These patients have worse short- and long-term outcomes and longer hospitalization.
Kim, Jae-Hyun; Kim, Chang-Hyun; Lee, Chang-Young
We aimed to elucidate the effects of arachnoid plasty (ARP) on chronic subdural hematoma (CSDH) occurrence following clipping surgery. In total 217 patients (ARP, n = 97; non-ARP, n = 120) who had undergone unruptured intracranial aneurysm (UIA) surgical clipping via the pterional approach were retrospectively assessed. Predisposing factors for CSDH development following the surgery were investigated. Thickness and volume of the subdural fluid collection (SDFC) were measured to determine whether ARP affects postoperative SDFC. The occurrence of postoperative CSDH was higher in patients without ARP compared to those with ARP (12.5 vs. 3.1%; P = 0.01). In multivariate analyses, having an SDFC volume ≥15 mL on postoperative day (POD) 8, (odds ratio [OR] = 15.113; range = 3.159-72.290), and male sex (OR = 4.274; range = 1.291-14.148) were identified as independent predictive factors. Having had ARP (OR = 0.228; range = 0.056-0.927) was, as an independent variable, negatively correlated with the occurrence of CSDH (P < 0.05). Moreover, SDFC volume ≥15 ml on POD 8 was significantly less common in the ARP group compared with the non-ARP group (P = 0.03). Patients who underwent ARPs developed fewer CSDHs following UIA clipping surgery. The factors that predicted the development of CSDH included male sex, SDFC volume on POD 8, and ARP. In addition, the ARP patients had lower SDFC volumes (<15 mL). These findings suggested that ARP reduced the incidence of CSDHs after surgical clippings in patients with unruptured aneurysms. Copyright © 2017 Elsevier Inc. All rights reserved.
Salcedo-Villanueva, G; Rueda-Villa, A; Hernández-Ábrego, M P
A 45-year-old woman with a history of seizures, headaches, nausea, vomiting, and decreased visual acuity of 5 years. Visual field detected a bitemporal heteronymous hemianopia. Magnetic resonance imaging revealed basal cistern arachnoiditis and supratentorial hydrocephalus. Cranial computed tomography revealed supratentorial calcifications, scolex in the left occipital region, and hydrocephalus secondary to entrapment of the fourth ventricle. Neurocysticercosis can cause bitemporal hemianopsia due to chiasmatic compression secondary to obstructive hydrocephalus. The positivity of anti-cysticercus antibodies determined by ELISA evidence active disease. However patients with hydrocephalus and negative antigen may have sequelae of infection with non-living parasites. Copyright © 2011 Sociedad Española de Oftalmología. Published by Elsevier Espana. All rights reserved.
de Oliveira, EHC; Neusser, M.; Pieczarka, J. C.; Nagamachi, C.; Sbalqueiro, I. J.; Müller, Stefan
We performed multi-directional chromosome painting in a comparative cytogenetic study of the three Atelinae species Brachyteles arachnoides, Ateles paniscus paniscus and Ateles belzebuth marginatus, in order to reconstruct phylogenetic relationships within this Platyrrhini subfamily. Comparative chromosome maps between these species were established by multi-color fluorescence in situ hybridization ( FISH) employing human, Saguinus oedipus and Lagothrix lagothricha chromosome-specific probes....
Santos, S V; Strefezzi, R F; Pissinatti, A; Kanamura, C T; Takakura, C F H; Duarte, M I S; Catão-Dias, J L
Toxoplasmosis led to the death of two Brachyteles arachnoides, an endangered atelid. The diagnosis was established by necropsy, histopathological, immunohistochemical and ultrastructural changes. The analysis confirms the presence of Toxoplasma gondii. This report contributes to the development of protocols for health surveillance on maintenance and conservation of southern muriquis.
Nakashima, Hiroaki; Imagama, Shiro; Yagi, Hideki; Kato, Fumihiko; Kanemura, Tokumi; Sato, Koji; Kawakami, Noriaki; Kamiya, Mitsuhiro; Yoshihara, Hisatake; Ito, Kenyu; Matsuyama, Yukihiro; Nishida, Yoshihiro; Ishiguro, Naoki
A retrospective, multicenter, case-controlled study. The aim of this study was to investigate the clinical and radiographical differences between thoracic idiopathic spinal cord herniation (ISCH) and spinal arachnoid cyst (SAC). ISCH and SAC are relatively rare diseases. Preoperative misdiagnose was frequently reported in both; however, these clinical and radiographical differences remain unclear. Of 30,469 patients who underwent spinal surgery, 18 (0.059%) and 22 (0.072%) patients were diagnosed as ISCH or SAC at nine hospitals, respectively, and their clinical and radiographical data were retrospectively evaluated. The spinal cord kink angle was measured on magnetic resonance or computed tomography myelography sagittal images; the kink angle was the exterior angle formed between the two tangents to the dorsal-side inflection points at the maximally affected level. There were no significant differences in age, gender, and duration of symptoms. Preoperative motor deficit was significantly higher (94.4%) and severer (manual muscle testing: 3.1 ± 1.1) in ISCH. Brown-Séquard syndrome was observed in 38.9% of ISCH, while no patients in SAC. In addition, leg sensory disorder and bladder rectal disorder were significantly more common in ISCH, while back pain was significantly frequent in SAC. With respect to radiographical findings, the length of disease (5.1 ± 2.7 levels) and altered cerebrospinal flow (CSF) (81.8%) in the lesion was significantly longer and more common in SAC. On the contrary, the kink angle was significantly greater in ISCH (54.0 ± 23.1°) than in SAC (14.1 ± 12.0°) (P < 0.001). The cut-off value of the kink angle to distinguish ISCH and SAC was 32.8°. Patients with ISCH commonly had severe preoperative neurological deficit, Brown-Séquard syndrome, and higher kink angle, while patients with SAC had back pain, longer length of disease, and altered CSF in the lesion. 4.
The Department of Veterans Affairs (VA) is amending its adjudication regulations to establish a presumption of service connection for osteoporosis for former Prisoners of War (POWs) who were detained or interned for at least 30 days and whose osteoporosis is at least 10 percent disabling. The amendment implements a decision by the Secretary to establish such a presumption based on scientific studies. VA is additionally amending its adjudication regulations to establish a presumption of service connection for osteoporosis for POWs who were detained or interned for any period of time, have a diagnosis of posttraumatic stress disorder (PTSD), and whose osteoporosis is at least 10 percent disabling. This amendment reflects statutory provisions of the Veterans' Benefits Improvement Act of 2008.
Sriskandarajah, Srishamanthi; Carter-Storch, Rasmus; Frydkjær-Olsen, Ulrik
by the GP in a population acutely referred to an ED. METHODS: This was a retrospective cohort study of all registered acute referrals for admission to Kolding ED in 2010. Eight presumptive diagnoses were selected for further studies: meningitis, acute coronary syndrome (ACS), pulmonary embolism, pneumonia......, pancreatitis, deep venous thrombosis (DVT), pyelonephritis and intestinal obstruction. The presumptive diagnoses were compared with the final diagnosis on discharge. Sensitivity, specificity, predictive values and likelihood ratios were calculated. RESULTS: A total of 8,841 patients were enrolled. The highest...... for pneumonia (59%). For pyelonephritis, meningitis and pancreatitis, the likelihood ratio of a positive test was above 10. The likelihood ratio of a negative test was above 0.1 for all diagnoses. CONCLUSIONS: Patients referred with the presumptive diagnoses pyelonephritis, meningitis and pancreatitis had...
Hoorfar, Jeffrey; Baggesen, Dorte Lau; Porting, P.H.
The purpose of the present study was to investigate the application of ready-to-go Salmonella PCR tests, based on dry chemistry, for final identification of rough presumptive Salmonella isolates. The results were compared with two different biotyping methods performed at two different laboratorie...... (serogroup D). In conclusion, rough presumptive Salmonella isolates can be conveniently confirmed to the serogroup-revel, using the pre-mixed PCR tests. The system can be easily implemented in accredited laboratories with limited experience in molecular biology....
Oswaldo Loayza, A.
Cerabral cysticercosis is a grave public health problem in Ecuador and is caused by a tapeworm, which is parasite of man. The larvae of this tapeworm lodge in various tissues, notably in the brain, causing blockage of the sub-arachnoid space and leading to epileptic seizures and to mental deterioration. The present investigation on 115 patients has compared clinical and radiological findings with those from radionuclide cisternography, performed with a gamma camera after injection of 15-200μCi 131 I-albumin into the cerebro-spinal fluid. The results from 86 patients have been selected for detailed analysis. Radiological techniques such as pneumoencephalography were in general found to be more precise in determining the site of obstruction than cisternography
Full Text Available 【Abstract】The association of chronic subdural hematoma (CSDH and arachnoid cyst (AC is uncommon. We reported 2 juvenile athletes with CSDH associated with AC which occurred in their daily sports activities and re- viewed the literature. Both of them were treated surgically, with satisfactory outcome. AC is a common predisposing factor in young patients with CSDH. The complication of intracranial bleeding is an indication for surgical management. Though there are still controversies in the treatment of asymptomatic AC, it is the consensus that the patients with AC should avoid violent sports so as to re- duce the incidence of intracranial hemorrhage resulted from head injuries. Key words: Hematoma, subdural, chronic; Arach- noid cysts; Adolescent; Athletes
... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Death due to pneumoconiosis, including... COAL MINE HEALTH AND SAFETY ACT OF 1969, TITLE IV-BLACK LUNG BENEFITS (1969- ) Total Disability or Death Due to Pneumoconiosis § 410.450 Death due to pneumoconiosis, including statutory presumption...
... FEDERAL COAL MINE HEALTH AND SAFETY ACT OF 1969, TITLE IV-BLACK LUNG BENEFITS (1969- ) Total Disability or Death Due to Pneumoconiosis § 410.418 Irrebuttable presumption of total disability due to pneumoconiosis... miner was totally disabled due to pneumoconiosis at the time of his death, if he is suffering or...
Examines the conflict between individualism and communitarianism (and its implications for rhetorical theory) by examining the historical debate between liberals and conservatives during and after the French Revolution. Shows how Richard Whately's notions of "presumption" and "burden of proof" (further developed by Mill and…
The administration of the criminal justice system tries to strike a balance between the search for truth and the fairness of the process. To this end, the law should protect individual rights and impose various legal burdens on the state. One such tool is the principle of the presumption of innocence until proven guilty. This is a ...
Galetta, Antonella; de Hert, Paul; Wright, D.; Kreissl, R.
This contribution focuses on the impact of surveillance on the rule of law, due process and the presumption of innocence, key values and principles of a democratic order. It illustrates how they are implemented and enforced in contemporary surveillance societies, while referring to European law and
Given advances in the science of fertility preservation and the link between fertility choices and wellbeing, it is time to reframe our ethical thinking around fertility preservation procedures for children and young people with cancer. The current framing of fertility preservation as a possible offer may no longer be universally appropriate. There is an increasingly pressing need to discuss the ethics of failing to preserve fertility, particularly for patient groups for whom established techniques exist. I argue that the starting point for deliberating about a particular patient should be a rebuttable presumption that fertility preservation ought to be attempted. Consideration of the harms applicable to that specific patient may then override this presumption. I outline the benefits of attempting fertility preservation; these justify a presumption in favour of the treatment. I then discuss the potential harms associated with fertility preservation procedures, which may justify failing to attempt fertility preservation in an individual patient's particular case. Moving from a framework of offer to one of rebuttable presumption in favour of fertility preservation would have significant implications for medical practice, healthcare organizations and the state. © 2015 John Wiley & Sons Ltd.
Self-diagnosis of influenza, yellow fever, typhoid, and pneumonia was also common. Conclusion: Self-diagnosis and presumptive treatment with antimalarial drugs and other antibiotic medications that are readily available without a prescription may compromise health outcomes for febrile adults and children. Key words: ...
...; Presumptive Eligibility for Psychosis and Other Mental Illness AGENCY: Department of Veterans Affairs. ACTION... psychosis within specified time periods and for Persian Gulf War veterans who developed a mental illness other than psychosis within two years after service and within two years after the end of the Persian...
...; Presumptive Eligibility for Psychosis and Other Mental Illness AGENCY: Department of Veterans Affairs. ACTION... care eligibility for veterans of certain wars and conflicts who developed psychosis within specified time periods and for Persian Gulf War veterans who developed a mental illness other than psychosis...
... during the Vietnam War. After careful review of the IOM report, the Secretary determines that the... served in deep-water naval vessels off the coast of Vietnam during the Vietnam War are referred to as... DEPARTMENT OF VETERANS AFFAIRS Presumption of Exposure to Herbicides for Blue Water Navy Vietnam...
... 47 Telecommunication 3 2010-10-01 2010-10-01 false Presumption of acceptability for deployment of an advanced services loop technology. 51.230 Section 51.230 Telecommunication FEDERAL COMMUNICATIONS... following circumstances, where the technology: (1) Complies with existing industry standards; or (2) Is...
Pinhata, Juliana Maira Watanabe; Felippe, Isis Moreira; Gallo, Juliana Failde; Chimara, Erica; Ferrazoli, Lucilaine; de Oliveira, Rosangela Siqueira
We evaluated the microscopic and macroscopic characteristics of mycobacteria growth indicator tube (MGIT) cultures for the presumptive identification of the Mycobacterium tuberculosis complex (MTBC) and assessed the reliability of this strategy for correctly directing isolates to drug susceptibility testing (DST) or species identification. A total of 1526 isolates of mycobacteria received at the Instituto Adolfo Lutz were prospectively subjected to presumptive identification by the observation of growth characteristics along with cord formation detection via microscopy. The presumptive identification showed a sensitivity, specificity and accuracy of 98.8, 92.5 and 97.9 %, respectively. Macroscopic analysis of MTBC isolates that would have been erroneously classified as non-tuberculous mycobacteria based solely on microscopic morphology enabled us to direct them rapidly to DST, representing a substantial gain to patients. In conclusion, the growth characteristics of mycobacteria in MGIT, when considered along with cord formation, increased the reliability of the presumptive identification, which has a great impact on the laboratory budget and turnaround times.
Full Text Available The objective of the study was to isolate potential Bacillus cereus sensu lato (B. cereus s.l. from a range of farm environments. Samples of tap water, milking equipment rinse water, milk sediment filter, grass, soil and bulk tank milk were collected from 63 farms. In addition, milk liners were swabbed at the start and the end of milking, and swabs were taken from cows’ teats prior to milking. The samples were plated on mannitol egg yolk polymyxin agar (MYP and presumptive B. cereus s.l. colonies were isolated and stored in nutrient broth with 20% glycerol and frozen at -80 °C. These isolates were then plated on chromogenic medium (BACARA and colonies identified as presumptive B. cereus s.l. on this medium were subjected to 16S ribosomal RNA (rRNA sequencing. Of the 507 isolates presumed to be B. cereus s.l. on the basis of growth on MYP, only 177 showed growth typical of B. cereus s.l. on BACARA agar. The use of 16S rRNA sequencing to identify isolates that grew on BACARA confirmed that the majority of isolates belonged to B. cereus s.l. A total of 81 of the 98 isolates sequenced were tentatively identified as presumptive B. cereus s.l. Pulsed-field gel electrophoresis was carried out on milk and soil isolates from seven farms that were identified as having presumptive B. cereus s.l. No pulsotype was shared by isolates from soil and milk on the same farm. Presumptive B. cereus s.l. was widely distributed within the dairy farm environment.
Nicolaas I. Bohnen
Full Text Available Motor speech apraxia is a speech disorder of impaired syllable sequencing which, when seen with advancing age, is suggestive of a neurodegenerative process affecting cortical structures in the left frontal lobe. Arachnoid cysts can be associated with neurologic symptoms due to compression of underlying brain structures though indications for surgical intervention are unclear. We present the case of a 70-year-old man who presented with a two-year history of speech changes along with decreased initiation and talkativeness, shorter utterances, and dysnomia. [18F]Fluorodeoxyglucose (FDG Positron Emission and Computed Tomography (PET-CT and magnetic resonance imaging (MRI showed very focal left frontal cortical hypometabolism immediately adjacent to an arachnoid cyst but no specific evidence of a neurodegenerative process.
Ingberman, Bianca; Kaminski, Nicholas; Fusco-Costa, Roberto; Monteiro-Filho, Emygdio
The endangered southern muriqui or mono [Brachyteles arachnoides (É. Geoffroy, 1806)], is a primate endemic to the Atlantic Forest of Brazil. One known extant population is found at the southern limit of its distribution, in the state of Paraná, where it is regionally classified as Critically Endangered. Here, we report on a new population in southern Brazil. Additionally, we express our concern about the conservation status of this species in Paraná, because both populations are in small, is...
Ajay M.V. Kumar
Full Text Available For certain subgroups within people living with the human immunodeficiency virus (HIV [active tuberculosis (TB, pregnant women, children <5 years old, and serodiscordant couples], the World Health Organization recommends antiretroviral therapy (ART irrespective of CD4 count. Another subgroup which has received increased attention is “HIV-infected presumptive TB patients without TB”. In this study, we assess the proportion of HIV-infected presumptive TB patients eligible for ART in Karnataka State (population 60 million, India. This was a cross-sectional analysis of data of HIV-infected presumptive TB patients diagnosed in May 2015 abstracted from national TB and HIV program records. Of 42,585 presumptive TB patients, 28,964 (68% were tested for HIV and 2262 (8% were HIV positive. Of the latter, 377 (17% had active TB. Of 1885 “presumptive TB patients without active TB”, 1100 (58% were already receiving ART. Of the remaining 785 who were not receiving ART, 617 (79% were assessed for ART eligibility and of those, 548 (89% were eligible for ART. About 90% of “HIV-infected presumptive TB patients without TB” were eligible for ART. This evidence supports a public health approach of starting all “HIV-infected presumptive TB patients without TB” on ART irrespective of CD4 count in line with global thinking about ‘test and treat’.
Holman David W
Full Text Available Abstract Background The arachnoid granulations (AGs are herniations of the arachnoid membrane into the dural venous sinuses on the surface of the brain. Previous morphological studies of AGs have been limited in scope and only one has mentioned surface area measurements. The purpose of this study was to investigate the topographic distribution of AGs on the superior surface of the cerebral cortex. Methods En face images were taken of the superior surface of 35 formalin-fixed human brains. AGs were manually identified using Adobe Photoshop, with a pixel location containing an AG defined as 'positive'. A set of 25 standard fiducial points was marked on each hemisphere for a total of 50 points on each image. The points were connected on each hemisphere to create a segmented image. A standard template was created for each hemisphere by calculating the average position of the 25 fiducial points from all brains. Each segmented image was mapped to the standard template using a linear transformation. A topographic distribution map was produced by calculating the proportion of AG positive images at each pixel in the standard template. The AG surface area was calculated for each hemisphere and for the total brain superior surface. To adjust for different brain sizes, the proportional involvement of AGs was calculated by dividing the AG area by the total area. Results The total brain average surface area of AGs was 78.53 ± 13.13 mm2 (n = 35 and average AG proportional involvement was 57.71 × 10-4 ± 7.65 × 10-4. Regression analysis confirmed the reproducibility of AG identification between independent researchers with r2 = 0.97. The surface AGs were localized in the parasagittal planes that coincide with the region of the lateral lacunae. Conclusion The data obtained on the spatial distribution and en face surface area of AGs will be used in an in vitro model of CSF outflow. With an increase in the number of samples, this analysis technique can be used
Rehman, H.; Hafizullah, M.; Shah, S.T.; Khan, S.B.; Hadi, A.; Ahmad, F.; Shah, I.; Gul, A.M.
Objective: To know the sensitivity of polymerase chain reaction (PCR) in pericardial fluid and response to antituberculous treatment (ATT) in PCR positive patients who were presumptively diagnosed and treated as tuberculous pericardial effusion. Methodology: This was a descriptive cross sectional study carried out from June 1, 2009 to 31 May 2010 at Cardiology Department, Lady Reading Hospital, Peshawar. Patients with presumptive diagnosis and receiving treatment for tuberculous pericardial effusion were included. Pericardial fluid sample was aspirated under fluoroscopy for the routine work up. The specimens were subjected to PCR detection of mycobacterium tuberculous DNA. Results: During 12 month study period, a total of 54 patients with large pericardial effusion presented to Cardiology department, Lady Reading Hospital, Peshawar. Of them, 46 patients fulfilled the criteria for presumptive diagnosis of tuberculous pericardial effusion. PCR for mycobacterium tuberculous DNA in pericardial fluid was positive in 45.7%(21). Patients were followed for three months. In PCR positive group, 01 patient while in PCR negative group 3 patients were lost to follow up. Among PCR positive patients 17(85%) while in PCR negative group 11(47.82%) patient responded to ATT both clinically and echo-cardio graphically. We found that patients who were PCR positive responded better to therapy than those who were PCR negative and this finding was statistically significant (p=0.035). Conclusion: PCR, with all its limitations, is potentially a useful diagnostic test in patients with presumptively diagnosed tuberculous pericardial effusion. A PCR positive patient responds better to therapy as compared to PCR negative patient. (author)
Hartman, L C; Natiella, J R; Meenaghan, M A
Routine histochemistry, special stains, and energy dispersive x-ray microanalysis (EDX) were used to analyze 15 cases of presumptive amalgam tattoo. Histologically, the fine, spherical, golden brown granules of amalgam were remarkably similar to hemosiderin and melanin granules, and routine and special stains were not always reliable in differentiating one from the others. EDX provided a simple, fast, inexpensive, and reliable method for identifying the precise elemental composition of the pigmented material.
Colotelo, Alison HA; Smokorowski, Karen; Haxton, Tim; Cooke, Steven J.
Current methods of fish epithelial injury detection are limited to gross macroscopic examination that has a subjective bias as well as an inability to reliably quantify the degree of injury. Fluorescein, a presumptive test for blood, has been shown to have the capability to detect and quantify fish epithelial injury. However, there are several other presumptive tests for blood (Bluestar*, phenolphthalein, and HemastixH) that may have benefits over the use of fluorescein, particularly for field research on wild fish. This study investigated the capabilities of these four tests to detect and quantify a variety of injuries commonly encountered by fish (abrasion, cuts, fin frays, and punctures) using the freshwater bluegill Lepomis macrochirus as a model. Fluorescein was consistently found to be the most reliable (i.e., detected the highest proportion of true positive results and rarely detected false positive reactions) of the four presumptive tests for blood compared. Further testing was conducted to examine the reliability of fluorescein. By 24 h after an injury was inflicted, the injury was no longer detectable by fluorescein, and when fluorescein was applied to an injured fish, the fluorescein was no longer detectable 3 h after application. In a comparison of two common anaesthetics used in fisheries research, there was no significant difference in the proportion of injury detected when 3- aminobenzoic acid ethyl ester methanesulfate (tricaine) was used compared with a clove oil and ethanol (1:9) solution. In summary, fluorescein was the most reliable presumptive test for blood examined in this study for the detection and quantification of recent (hours) fish epithelial injury.
... situations in which there may be a risk that the divestiture will not result in the complete termination of a... the kinds of indebtedness that, standing alone, support a presumption that the creditor is able to...
Strier, K B; Mendes, S L; Santos, R R
We monitored the birth patterns of sympatric brown howler monkeys (Alouatta fusca clamitans) and northern muriquis (Brachyteles arachnoides hypoxanthus) during a 4-yr period from October 1996 to August 2000 at the Estação Biológica de Caratinga, Minas Gerais, Brazil. Brown howler monkey births (n = 34) occurred throughout the year, and birth frequencies did not differ between rainy and dry season months. The aseasonal birth patterns of the howler monkeys differed significantly from the dry season concentration and dry month peak in muriqui births (n = 23). We found no effects of infant sex or the number of females on interbirth intervals (IBIs) in our 10 howler monkey study troops. IBIs of brown howler monkeys averaged 21.2 +/- 2.5 mo (n = 8, median = 21.0 mo), and were significantly shorter following dry season births than rainy season births. Their IBIs and yearling survivorship (74%) were similar to those reported for other species of howler monkeys, but yearling survivorship was much lower than that of muriquis (94%), whose IBIs were more than 12 mo longer than those of the howler monkeys. Our study extends comparative knowledge of birth patterns in Alouatta to a poorly known species, and provides insights into the different ways in which diet and life history may affect the timing of births in large-bodied platyrrhines under the same seasonal ecological conditions. Copyright 2001 Wiley-Liss, Inc.
JOSÉ CORREIA DE FARIAS BRITO
Full Text Available Análise de nove casos de cisto aracnóideo intracraniano operados no período de 1974 a 1995. Os procedimentos cirúrgicos consistiram de derivação cistoperitoneal em sete pacientes e craniotomia com membranectomia nos outros dois casos. Complicações pós-cirúrgicas, do tipo infecção bacteriana e falha no sistema de drenagem, ocorreram em três casos, as quais foram debeladas e corrigidas, respectivamente. Baseados em revisão de literatura, alguns aspectos fisiopatológicos, diagnósticos e terapêuticos são discutidos.Analysis of nine patients with intracranial arachnoid cysts surgically treated from 1974 to 1995. The treatment consisted of cystoperitoneal shunt in seven patients and craniotomy with excision of cyst membrane in the other two cases. After surgery, bacterial meningitis and failure shunt device were observed in three cases. Both the infectious process and the shunt device were respectively treated and corrected at once. It has been observed total clinical improvement in all nine cases. A review of the literature has been made and some pathophysiological, diagnostic and therapeutic aspects are discussed.
A. O. Adejumo
Full Text Available Abstract Background Engagement of communities and civil society organizations is a critical part of the Post-2015 End TB Strategy. Since 2007, many models of community referral have been implemented to boost TB case detection in Nigeria. Yet clear insights into the comparative TB yield from particular approaches have been limited. Methods We compared four models of active case finding in three Nigerian states. Data on presumptive TB case referral by community workers (CWs, TB diagnoses among referred clients, active case finding model characteristics, and CWs compensation details for 2012 were obtained from implementers and CWs via interviews and log book review. Self-reported performance data were triangulated against routine surveillance data to assess concordance. Analysis focused on assessing the predictors of presumptive TB referral. Results CWs referred 4–22 % of presumptive TB clients tested, and 4–24 % of the total TB cases detected. The annual median referral per CW ranged widely among the models from 1 to 48 clients, with an overall average of 13.4 referrals per CW. The highest median referrals (48 per CW/yr and mean TB diagnoses (7.1/yr per CW (H =70.850, p < 0.001 was obtained by the model with training supervision, and $80/quarterly payments (Comprehensive Quotas-Oriented model. The model with irregularly supervised, trained, and compensated CWs contributed the least to TB case detection with a median of 13 referrals per CW/yr and mean of 0.53 TB diagnoses per CW/yr. Hours spent weekly on presumptive TB referral made the strongest unique contribution (Beta = 0.514, p < 0.001 to explaining presumptive TB referral after controlling for other variables. Conclusion All community based TB case-finding projects studied referred a relative low number of symptomatic individuals. The study shows that incentivized referral, appropriate selection of CWs, supportive supervision, leveraged treatment support roles, and a
Pereira, Luiz Cezar Machado
O presente estudo foi realizado na Fazenda Lagoa Alegre, Castro, Estado do Paraná, onde um grupo de Brachyteles arachnoides (E. Geoffroy, 1806), (mono-carvoeiro) composto por 24 indivíduos foi acompanhado entre janeiro de 2002 a outubro de 2005. O uso do habitat por Brachyteles arachnoides foi estudado numa área fragmentada de 370 hectares de Floresta Ombrófila Densa ecótono com a Floresta Ombrófila Mista (área de tensão ecológica). Ao estudo da área de vida, também foi efetivado uma breve de...
Li, Ye; Zhao, Yining; Zhang, Jiashu; Zhang, Zhizhong; Dong, Guojun; Wang, Qun; Liu, Lei; Yu, Xinguang; Xu, Bainan; Chen, Xiaolei
To investigate the feasibility and reliability of virtual endoscopy (VE) as a rapid, low-cost, and interactive tool for the diagnosis and surgical planning of suprasellar arachnoid cysts (SACs). Eighteen patients with SACs treated with endoscopic ventriculocystostomy were recruited, and 18 endoscopic patients treated with third ventriculostomy were randomly selected as a VE reconstruction control group. After loading their DICOM data into free 3D Slicer software, VE reconstruction was independently performed by 3 blinded clinicians and the time required for each reconstruction was recorded. Another 3 blinded senior neurosurgeons interactively graded the visibility of VE by watching video recordings of the endoscopic procedures. Based on the visibility scores, receiver operating characteristic curve analysis was used to investigate the reliability of VE to diagnose SACs, and Bland-Altman plots were used to assess the reliability of VE for surgical planning. In addition, the intraclass correlation coefficient was calculated to estimate the consistency among the results of 3 reconstruction performers. All 3 independent reconstructing performers successfully completed VE simulation for all cases, and the average reconstruction time was 10.2 ± 9.7 minutes. The area under the receiver operating characteristic curve of the cyst visibility score was 0.96, implying its diagnostic value for SACs. The Bland-Altman plot indicated good agreement between VE and intraoperative viewings, suggesting the anatomic accuracy of the VE for surgical planning. In addition, the intraclass correlation coefficient was 0.81, which revealed excellent interperformer consistency of our simulation method. This study substantiated the feasibility and reliability of VE as a rapid, low-cost, and interactive modality for diagnosis and surgical planning of SACs. Copyright © 2016 Elsevier Inc. All rights reserved.
Ernst, S. [Inst. und Poliklinik fuer Radiologische Diagnostik, Univ. Koeln (Germany); Lanfermann, H. [Inst. und Poliklinik fuer Radiologische Diagnostik, Univ. Koeln (Germany); Heindel, W. [Inst. und Poliklinik fuer Radiologische Diagnostik, Univ. Koeln (Germany); Hildebrandt, G. [Klinik und Poliklinik fuer Neurochirurgie, Univ. Koeln (Germany); Lackner, K. [Inst. und Poliklinik fuer Radiologische Diagnostik, Univ. Koeln (Germany)
To determine which appearances on CT or MRI are indications for surgical treatment of intracranial arachnoid cysts. The images obtained from 26 patients treated either by surgery or conservatively were compared retrospectively. The features evaluated were the size of the cyst, evidence of a space-occupying lesion, cerebral abnormalities near the cyst and skull deformities. In 6 patients (23%), surgical treatment was indicated because of the presence of obstructive hydrocephalus. The presence of all other radiological findings did not differ significantly between the two analysed groups. 92% of the patients treated surgically benefited from the treatment. Fenestration and shunting produced similar results in respect to reduction in size of the cyst and the clinical and neurological symptoms. The only indication for surgery is the presence of obstructive hydrocephalus. The other features were seen equally amongst the patients treated conservatively and the surgical patients and had no influence on the decision to operate. (orig.) [Deutsch] Gibt es mit der CT oder MRT bildmorphologisch fassbare Befunde, die die Indikation zur Entlastung intrakranieller Arachnoidalzysten stuetzen? Die Schnittbilduntersuchungen von je 26 Patienten mit operativ oder konservativ behandelten Arachnoidalzysten wurden vergleichend retrospektiv beurteilt. Auswerteparameter waren Zystengroesse, Raumforderungszeichen, zystenbenachbarte Hirnparenchymdefekte und Kalottendeformierungen. Bei 6 Patienten (23%) war eine operative Entlastung aufgrund eines Hydrocephalus occlusus indiziert. Bei den uebrigen Parametern unterschieden sich die beiden Kollektive nur geringgradig. 92% der operierten Patienten profitierten von der Therapie. Fensterung und Shuntimplantation lieferten vergleichbare Ergebnisse bezueglich der Zystengroessenreduktion und der klinisch-neurologischen Symptomatik. Nur der durch eine Arachnoidalzyste bedingte Hydrocephalus occlusus stellt eine Indikation zur Operation dar. Die
York, Sloane; Lichtenberg, E Steve
Disseminated intravascular coagulation (DIC) is a serious and relatively uncommon complication of induced or spontaneous abortion or delivery. Occasionally, it has been reported in the absence of predisposing conditions. Little information in the literature describing idiopathic DIC or the treatment of patients with DIC exists. From 2002 through 2008, 24 cases of presumptive idiopathic DIC occurred following dilation and evacuation (D&E) abortion between 13 5/7 and 23 6/7 weeks' estimated gestational age at a Midwestern ambulatory surgical center. The characteristics of each patient, their pregnancies and surgical experiences were examined and compared with a temporally matched control group of D&E patients. We explored whether the index cases had a predominance of any historical, clinical or reproductive characteristics compared with controls matched for demographic and reproductive landmarks. Overall incidence of presumptive idiopathic DIC was 1.8 per 1000 D&E cases. Compared with matched controls, there was a greater likelihood of DIC with more advanced gestation (p=.009); no case of DIC was under 17 weeks' gestational age. Increased bleeding occurred at a mean time of 153 min after completion of surgery (range, 55-491 min; median, 131 min). Nineteen of 24 cases were successfully treated at the surgical center after receiving 6 to 8 units of fresh-frozen plasma (FFP); 5 cases were transferred to a hospital for further treatment. The abnormal bleeding of presumptive DIC typically begins to appear within 2 h after uncomplicated D&E and is more likely to occur at 17 weeks' estimated gestational age and more. With rapid diagnosis and treatment, most patients were able to be treated in an outpatient setting with up to 6 to 8 units of FFP and rehydration. Copyright © 2012 Elsevier Inc. All rights reserved.
McKenzie, R K; Gibson, I R; Ritmeester, A
Three weanling Thoroughbred fillies were presented during autumn with depression, muscle rigidity and, in one case, colic symptoms and cardiovascular shock. All fillies had abnormal physical examinations that included elevated heart rates and respiratory rates coupled with muscle rigidity through the back and rump. Biochemistry revealed markedly elevated creatinine kinase and aspartate aminotransferase which indicated a myopathy. All three horses were diagnosed with presumptive equine atypical myopathy. The horses received supportive therapy as per the literature available at the time regarding this condition; two responded to supportive therapy and survived, and one was euthanased due to a rapid deterioration in clinical status. Following post mortem of one case, histology of the trapezius muscle demonstrated an acute, severe myofibre degeneration. Atypical myopathy and a very similar disorder termed seasonal pasture myopathy in North America are potentially fatal, pasture-related syndromes that have been described in Europe and America but have not been previously described in New Zealand. This report describes three presumptive cases of this unique syndrome in New Zealand for the first time; it outlines the characteristics of the condition; and includes recently published information regarding diagnosis and treatment.
Bauters, T G; Peleman, R; Moerman, M; Vermeersch, H; de Looze, D; Noens, L; Nelis, H J
A rapid enzymatic two-step test for the presumptive differentiation of four Candida species commonly occurring in various clinical samples is described. The technique involves membrane filtration of a liquid sample, followed by preincubation of the membrane filter on Sabouraud glucose agar supplemented with ticarcillin-clavulanic acid to yield microcolonies. In a separate assay step, parts of the filter are placed on absorbent pads impregnated with fluorogenic 4-methylumbelliferyl (4-MU) enzyme substrates (4-MU-N-acetyl-beta-D-galactosaminide, 4-MU-phosphate, 4-MU-pyrophosphate, and 4-MU-beta-D-galactoside) in combination with 0.1% digitonin acting as a membrane permeabilizer. The membrane filter in contact with the assay medium is incubated to allow cleavage of the enzyme substrate, resulting in fluorescent microcolonies under long-wavelength UV light. This approach, tested on 301 clinical samples, is able to presumptively differentiate C. albicans, C. glabrata, C. krusei, and C. tropicalis and to distinguish them from other Candida spp. in about 9 to 11 h. Overall agreement with the conventional methods of 94.4% (one Candida species present in the sample) to 83.8% (multiple Candida spp. present) was obtained. The false-negative rates with reference to identification by traditional methods were 1.3% (single species) and 3.8% (multiple species).
Anholt, H; Himsworth, C; Britton, A
Two 4-year-old spayed female Siamese cats were seized by the British Columbia Society for the Prevention of Cruelty to Animals after confinement to an abandoned housing unit without food for 9 weeks. One cat was found dead, and the second was euthanized within 24 hours due to neurologic deterioration despite therapy. Polioencephalomalacia of the caudal colliculus, hepatic lipidosis, cachexia, and congestive heart failure with cardiomyocyte atrophy were identified in both cats through postmortem examination and attributed to a prolonged period of starvation. Brain lesions were likely the result of thiamine deficiency (Chastek paralysis), which can be associated with both malnutrition and liver disease. This case highlights the importance of thiamine supplementation during realimentation of cats with hepatic lipidosis. Heart failure resulting from cachexia may have contributed to the death of the first cat and the morbidity of the second cat. © The Author(s) 2016.
van Ginkel, Willem G; van Vliet, Danique; Burgerhof, Johannes G M; de Blaauw, Pim; Rubio Gozalbo, M Estela; Heiner-Fokkema, M Rebecca; van Spronsen, Francjan J
Hereditary Tyrosinemia type 1 (HT1) is a rare metabolic disease caused by a defect in the tyrosine degradation pathway. Current treatment consists of 2-(2-nitro-4-trifluoromethylbenoyl)-1,3-cyclohexanedione (NTBC) and a tyrosine and phenylalanine restricted diet. Recently, neuropsychological deficits have been seen in HT1 patients. These deficits are possibly associated with low blood phenylalanine concentrations and/or high blood tyrosine concentrations. Therefore, the aim of the present study was threefold. Firstly, we aimed to calculate how the plasma amino acid profile in HT1 patients may influence the presumptive brain influx of all large neutral amino acids (LNAA). Secondly, we aimed to investigate the effect of phenylalanine supplementation on presumptive brain phenylalanine and tyrosine influx. Thirdly, we aimed to theoretically determine minimal target plasma phenylalanine concentrations in HT1 patient to ensure adequate presumptive brain phenylalanine influx. Data of plasma LNAA concentrations were obtained. In total, 239 samples of 9 HT1 children, treated with NTBC, diet, and partly with phenylalanine supplementation were collected together with 596 samples of independent control children. Presumptive brain influx of all LNAA was calculated, using Michaelis-Menten parameters (Km) and Vmax-values obtained from earlier articles. In HT1 patients, plasma concentrations and presumptive brain influx of tyrosine were higher. However, plasma and especially brain influx of phenylalanine were lower in HT1 patients. Phenylalanine supplementation did not only tend to increase plasma phenylalanine concentrations, but also presumptive brain phenylalanine influx, despite increased plasma tyrosine concentrations. However, to ensure sufficient brain phenylalanine influx in HT1 patients, minimal plasma phenylalanine concentrations may need to be higher than considered thus far. This study clearly suggests a role for disturbed brain LNAA biochemistry, which is not well
A novel five-category multimodal T1-weighted and T2-weighted magnetic resonance imaging-based stratification system for the selection of spinal arachnoid cyst treatment: a 15-year experience of 81 cases
Full Text Available Ji Qi, Jun Yang, Guihuai Wang Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, People's Republic of China Background: Idiopathic spinal arachnoid cysts are rare cystic masses of the spinal canal generally classified as intra- or extradural, based on anatomical presentation. However, this system may not effectively indicate treatment. Objective: To investigate the incidence, resection modality, and prognosis of spinal arachnoid cyst in a 15-year case series. Patients and methods: A retrospective study was conducted in 81 spinal arachnoid cyst patients (male:female 34:47, mean age 36.5 years, age range 6–66 years classified using a novel five-category T1-weighted and T2-weighted magnetic resonance imaging (MRI classification system (intramedullary, subdural extramedullary, subdural/epidural, intraspinal epidural, or intraspinal/extraspinal. Conservative treatment failed in all patients. They underwent spinal surgery between January 1995 and December 2010 and were followed up for 69 (range 3–187 months. Performance outcomes were assessed using the Fugl-Meyer (FM scale 90 days after operation. Recurrences and deaths were recorded. Results: Subdural/epidural and intraspinal epidural cysts accounted for 66.7% (54 of 81 of patients, but exhibited relatively lower rates of postsurgical improvement using FM, with only 66.7% (36 of 54 of patients showing improvements. Excellent outcomes using the FM scale were reached in 100% (eight of eight of intramedullary, intraspinal/extraspinal, and subdural extramedullary cyst patients, 86.7% (13 of 15 of subdural extramedullary cyst patients, and 66.7% (36 of 54 of epidural intraspinal cyst patients. Conclusion: The proposed five-category multimodal MRI-based stratification system for spinal arachnoid cyst patients may more effectively allow clinicians to select the appropriate surgical intervention, and may help to predict outcomes. Keywords: spinal arachnoid cyst
Stepanović, S; Vuković, D; Radonjić, I; Dimitrijević, V; Svabić-Vlahović, M
The study compared ground red hot pepper agar (GRHP) and Guizotia abyssinica creatinine agar (GACA), a medium routinely used for isolation of Cryptococcus neoformans. In order to confirm the capacity of GRHP to support the Cr. neoformans growth and pigment production, 15 strains were inoculated onto GRHP and GACA. No significant differences in the growth and pigmentation of the tested strains on the two media were noted. As heavily contaminated specimens, 50 samples of pigeon droppings were examined by plating on GRHP and GACA, which resulted in the isolation of 14 and nine Cr. neoformans strains, respectively. The results indicate that GRHP, as a result of its superior selectivity and significant reduction of contaminant growth, provides better conditions than GACA for isolation and presumptive identification of Cr. neoformans from heavily contaminated specimens.
Paschal Awingura Apanga
Full Text Available Rabies remains endemic in Ghana and continues to pose a major public health threat to humans and animals with nearly hundred percent (100% case fatality rate in humans. We report of a presumptive case of human rabies whose survival was a rare occurrence in rural Ghana. Lessons from this case study provides a critically needed focus in helping improve rabies surveillance and case management in Ghana. We report of the survival of a 36 year old man who developed clinical rabies three weeks after he was bitten by his dog while restraining the dog with a chain. Prior to this he did not observe any abnormal or rabid behaviour in the dog. Following the bite, he did not immediately resort to hospital treatment, but rather to traditional application of herbs to the laceration he sustained after the bite. Reason given for not seeking immediate hospital treatment was that the dog was not rabid and lack of funds to seek hospital care. However, he began to show symptoms consistent with rabies virus infection after 10 days and was subsequently rushed to the hospital by relatives. At the hospital, he was administered human immune tetanus immunoglobulin, diazepam, ceftriaxone, paracetamol and intravenous fluids. No rabies vaccine was administered. Six days after commencing treatment patient became well, showed no signs of confused state of mind, hydrophobia nor photophobia. He was discharged home after 13 days of commencing treatment. This study provides insight on a presumptive case of Human rabies case that survived despite non-administration of rabies vaccine during esposure. It also exposes the weaknesses in the health and veterinary systems in rural Ghana regarding rabies surveillance and case management.
... presumptions as to the most advantageous method of transportation? 301-10.5 Section 301-10.5 Public Contracts... most advantageous method of transportation? (a) Common carrier. Travel by common carrier is presumed to be the most advantageous method of transportation and must be used when reasonably available. (b...
Akter, Laila; Haque, Rezwana; Salam, Md Abdus
Urine is the most frequent specimen received for culture/sensitivity by clinical laboratories. The microbiological performance of HiCrome UTI agar medium was compared with Blood agar and MacConkey agar for isolation and presumptive identification of bacteria from urine culture. A total of 443 consecutively collected midstream and/or catheter-catch urine samples from patients attending the Islami Bank Medical College Hospital, Rajshahi, Bangladesh during January to December, 2012 were cultured. Urine samples showing pus cells ≥ 5/HPF were inoculated on to Blood agar (BA), MacConkey agar (MAC) and HiCrome UTI agar (CA) media simultaneously and incubated overnight aerobically at 37(0)C. Rate of isolation and presumptive identification of bacterial species were compared for different media. Culture yielded a total of 199 bacterial isolates from 189 (42.67%) positive plates including 179 (40.40%) unimicrobial and 10 (2.26%) polymicrobial (mixed growth of pair of bacteria) growths. Both HiCrome UTI agar and Blood agar media supported 100% growths while 151 (75.88%) growths were observed on MacConkey agar. The rate of presumptive identification was found significantly higher on HiCrome UTI agar (97.49%) than MAC agar (67.34%) (P<0.001) as primary urine culture medium. Of 199 isolates, E. coli was found to be the leading uropathogen isolated from 118 (59.30%) samples with its presumptive identification rate of 95.76%, 93.22% and 5.93% on CA, MAC and BA respectively. All 10 (100%) polymicrobial growths were demonstrated distinctly on CA against only 01(10%) on each BA and MAC. HiCrome UTI agar was found to be more useful as primary urine culture medium in both higher rate of isolation and presumptive identification of uropathogens in comparison to conventional media. Its inherent characteristics in demonstrating polymicrobial growth and ease of rapid identification by distinct colony colour are unique.
de Oliveira, E H C; Neusser, M; Pieczarka, J C; Nagamachi, C; Sbalqueiro, I J; Müller, S
We performed multi-directional chromosome painting in a comparative cytogenetic study of the three Atelinae species Brachyteles arachnoides, Ateles paniscus paniscus and Ateles belzebuth marginatus, in order to reconstruct phylogenetic relationships within this Platyrrhini subfamily. Comparative chromosome maps between these species were established by multi-color fluorescence in situ hybridization (FISH) employing human, Saguinus oedipus and Lagothrix lagothricha chromosome-specific probes. The three species included in this study and four previously analyzed species from all four Atelinae genera were subjected to a phylogenetic analysis on the basis of a data matrix comprised of 82 discrete chromosome characters. The results confirmed that Atelinae represent a monophyletic clade with a putative ancestral karyotype of 2n = 62 chromosomes. Phylogenetic analysis revealed an evolutionary branching sequence [Alouatta [Brachyteles [Lagothrix and Ateles
Reyes, Laura D; Stimpson, Cheryl D; Gupta, Kanika; Raghanti, Mary Ann; Hof, Patrick R; Reep, Roger L; Sherwood, Chet C
Within afrotherians, sirenians are unusual due to their aquatic lifestyle, large body size and relatively large lissencephalic brain. However, little is known about the neuron type distributions of the cerebral cortex in sirenians within the context of other afrotherians and aquatic mammals. The present study investigated two cortical regions, dorsolateral cortex area 1 (DL1) and cluster cortex area 2 (CL2), in the presumptive primary somatosensory cortex (S1) in Florida manatees (Trichechus manatus latirostris) to characterize cyto- and chemoarchitecture. The mean neuron density for both cortical regions was 35,617 neurons/mm(3) and fell within the 95% prediction intervals relative to brain mass based on a reference group of afrotherians and xenarthrans. Densities of inhibitory interneuron subtypes labeled against calcium-binding proteins and neuropeptide Y were relatively low compared to afrotherians and xenarthrans and also formed a small percentage of the overall population of inhibitory interneurons as revealed by GAD67 immunoreactivity. Nonphosphorylated neurofilament protein-immunoreactive (NPNFP-ir) neurons comprised a mean of 60% of neurons in layer V across DL1 and CL2. DL1 contained a higher percentage of NPNFP-ir neurons than CL2, although CL2 had a higher variety of morphological types. The mean percentage of NPNFP-ir neurons in the two regions of the presumptive S1 were low compared to other afrotherians and xenarthrans but were within the 95% prediction intervals relative to brain mass, and their morphologies were comparable to those found in other afrotherians and xenarthrans. Although this specific pattern of neuron types and densities sets the manatee apart from other afrotherians and xenarthrans, the manatee isocortex does not appear to be explicitly adapted for an aquatic habitat. Many of the features that are shared between manatees and cetaceans are also shared with a diverse array of terrestrial mammals and likely represent highly conserved
Full Text Available Current guidelines recommend that all fever episodes in African children be treated presumptively with antimalarial drugs. But declining malarial transmission in parts of sub-Saharan Africa, declining proportions of fevers due to malaria, and the availability of rapid diagnostic tests mean it may be time for this policy to change. This debate examines whether enough evidence exists to support abandoning presumptive treatment and whether African health systems have the capacity to support a shift toward laboratory-confirmed rather than presumptive diagnosis and treatment of malaria in children under five.
Fleming, W H; Hopkins, J M; Land, G A
A new medium composed of Tween 80, oxgall, caffeic acid, and Davis agar (TOC) that provides for the rapid presumptive identification of Candida albicans and Cryptococcus neoformans is described herein. C. albicans is differentiated from other yeasts by the sequential production of germ tubes and chlamydospores. In a comparison with cormeal agar control plates, there was an increase of chlamydospore-forming strains of C. albicans (97.1% versus 87.2%) and a decrease in the time required for chlamydospore formation (24 h versus 48 h). C. neoformans produced a brown pigment of TOC, which is specific for its identification, thus differentiating it from the other yeasts. A comparison of 24-h pigment production by C. neoformans on TOC with that of birdseed agar showed a dark, coffee brown color in the former cultures and a light brown color in the latter. The change in pigmentation of C. neoformans, as well as morphological changes in C. albicans, can be induced within 3 to 12 h and in not more than 24 h on the TOC medium.
Waikar, S; Pathak, A; Ghule, V; Kapoor, A; Sagili, K; Babu, E R; Chadha, S
Setting: Sputum smear microscopy, the primary diagnostic tool used for diagnosis of tuberculosis (TB) in India's Revised National TB Control Programme (RNTCP), has low sensitivity, resulting in a significant number of TB cases reported as sputum-negative. As the revised guidelines pose challenges in implementation, sputum-negative presumptive TB (SNPT) patients are subjected to 2 weeks of antibiotics, followed by chest X-ray (CXR), resulting in significant loss to care among these cases. Objective: To determine whether reducing delays in CXR would yield additional TB cases and reduce initial loss to follow-up for diagnosis among SNPT cases. Methods: In an ongoing intervention in five districts of Maharashtra, SNPT patients were offered upfront CXR. Results: Of 119 male and 116 female SNPT patients with a mean age of 45 years who were tested by CXR, 32 (14%) were reported with CXR suggestive of TB. Administering upfront CXR in SNPT patients yielded twice as many additional cases, doubling the proportion of cases detected among all those tested as against administering CXR 2 weeks after smear examination. Conclusion: Our interventional study showed that the yield of TB cases was significantly greater when upfront CXR examination was undertaken without waiting for a 2-week antibiotic trial.
Cummings, F O; Rizzo, S A
The objective of this study was to compare hospitalisation duration, survival times, adverse events and cost of therapy in dogs with presumptive primary immune-mediated thrombocytopenia undergoing therapy with mycophenolate mofetil and corticosteroids versus cyclosporine and corticosteroids. A retrospective study of medical case records of dogs with presumed primary immune-mediated thrombocytopenia was conducted. Data collected included signalment, presenting complaints, haematologic and biochemical profiles, vector-borne disease testing, thoracic and abdominal radiographs, abdominal ultrasound, medications administered, duration of hospitalisation, 30- and 60-day survival, adverse events and cost of therapy. Variables were compared between dogs treated solely with mycophenolate mofetil and corticosteroids or cyclosporine and corticosteroids. A total of 55 dogs with primary immune-mediated thrombocytopenia were identified. Eighteen were excluded because multiple immunosuppressive medications were used during treatment. Hospitalisation times, 30-day survival and 60-day survival times were similar between both groups. Dogs in the mycophenolate mofetil/corticosteroid group experienced fewer adverse events than the cyclosporine/corticosteroid group. Therapy with mycophenolate mofetil was less expensive than that with cyclosporine. These results suggest that using the combination of mycophenolate mofetil and corticosteroids appears to be as effective as cyclosporine and corticosteroids in the treatment of presumed primary immune-mediated thrombocytopenia in dogs. Adverse events were less common and cost of therapy was lower in the mycophenolate mofetil group. Additional larger prospective, controlled, double-masked, outcome-based, multi-institutional studies are required to substantiate these preliminary findings. © 2017 British Small Animal Veterinary Association.
Grice, Karen T; Day, Sarah A
Pharmacotherapy challenges in a case of late latent syphilis complicated by end-stage renal disease and presumptive penicillin allergy are described. A 58-year-old white woman was admitted to the hospital for symptoms including altered mental status, shortness of breath, and chest pain. The initial workup isolated syphilis immunoglobulin G antibody. A treponemal test was reactive, and a nontreponemal test was nonreactive; analysis of cerebrospinal fluid did not indicate neurosyphilis. The patient was diagnosed as having late latent syphilis of unknown duration, for which the standard treatment is intramuscular penicillin G benzathine 2.4 million units once weekly for three weeks. Given the patient's advanced renal disease and other serious comorbidities, there were concerns about the potential need for renal dosage adjustment and repeated desensitization. However, given the slow absorption and long half-life of penicillin G and published data indicating its safe use in the context of hemodialysis, the treating clinicians decided to proceed with penicillin G therapy at the usual dose after an oral penicillin desensitization protocol; repeat desensitization before two subsequent injections was not performed. The patient completed the full course of penicillin G without incident. Notably, skin testing was not performed to definitively establish penicillin allergy. Microbiological testing to determine a cure of syphilis was not performed. After the completion of an oral desensitization protocol, the standard three-dose regimen of intramuscular penicillin G for late latent syphilis was safely administered to a hemodialysis patient without dosage adjustment or repeated desensitization.
Full Text Available We report a case of isolated homonymous hemianopsia due to presumptive cerebral tubercular abscess as the initial manifestation of human immunodeficiency virus (HIV infection. A 30-year-old man presented to our outpatient department with sudden loss of visibility in his left visual field. He had no other systemic symptoms. Perimetry showed left-sided incongruous homonymous hemianopsia denser above the horizontal meridian. Magnetic resonance imaging revealed irregular well-marginated lobulated lesions right temporo-occipital cerebral hemisphere and left high fronto-parietal cerebral hemisphere suggestive of brain tubercular abscess. Serological tests for HIV were reactive, and the patient was started only on anti-tubercular drugs with the presumptive diagnosis of cerebral tubercular abscess. Therapeutic response confirmed the diagnosis. Atypical ophthalmic manifestations may be the initial presenting feature in patients with HIV infection. This highlights the need for increased index of suspicion for HIV infection in young patients with atypical ophthalmic manifestations.
Brogan, O; Malone, J; Fox, C; Whyte, A S
AIM: To evaluate Lancefield grouping and caramel smell for presumptive identification of the Streptococcus milleri group, and to find whether Lancefield group, species, or protein profile correlated with virulence or infection site. METHODS: Prospective studies were made of 100 consecutive streptococcal isolates in blood cultures or pus from 100 patients in whom the severity of infection was categorised as serious, moderate, or not significant. The usefulness of Lancefield group and the caram...
Shewade, Hemant Deepak; Kokane, Arun M; Singh, Akash Ranjan; Verma, Manoj; Parmar, Malik; Chauhan, Ashish; Chahar, Sanjay Singh; Tiwari, Manoj; Khan, Sheeba Naz; Gupta, Vivek; Tripathy, Jaya Prasad; Nagar, Mukesh; Singh, Sanjai Kumar; Mehra, Pradeep Kumar; Kumar, Ajay Mv
Pre-diagnosis attrition needs to be addressed urgently if we are to make progress in improving MDR-TB case detection and achieve universal access to MDR-TB care. We report the pre-diagnosis attrition, along with factors associated, and turnaround times related to the diagnostic pathway among patient with presumptive MDR-TB in Bhopal district, central India (2014). Study was conducted under the Revised National Tuberculosis Control Programme setting. It was a retrospective cohort study involving record review of all registered TB cases in Bhopal district that met the presumptive MDR-TB criteria (eligible for DST) in 2014. In quarter 1, Line Probe Assay (LPA) was used if sample was smear/culture positive. Quarter 2 onwards, LPA and Cartridge-based Nucleic Acid Amplification Test (CbNAAT) was used for smear positive and smear negative samples respectively. Pre-diagnosis attrition was defined as failure to undergo DST among patients with presumptive MDR-TB (as defined by the programme). Of 770 patients eligible for DST, 311 underwent DST and 20 patients were diagnosed as having MDR-TB. Pre-diagnosis attrition was 60% (459/770). Among those with pre-diagnosis attrition, 91% (417/459) were not identified as 'presumptive MDR-TB' by the programme. TAT [median (IQR)] to undergo DST after eligibility was 4 (0, 10) days. Attrition was more than 40% across all subgroups. Age more than 64 years; those from a medical college; those eligible in quarter 1; patients with presumptive criteria 'previously treated - recurrent TB', 'treatment after loss-to-follow-up' and 'previously treated-others'; and patients with extra-pulmonary TB were independent risk factors for not undergoing DST. High pre-diagnosis attrition was contributed by failure to identify and refer patients. Attrition reduced modestly with time and one factor that might have contributed to this was introduction of CbNAAT in quarter 2 of 2014. General health system strengthening which includes improvement in
Zhang, Zhengyu; Tachikawa, Masanori; Uchida, Yasuo; Terasaki, Tetsuya
Although arachnoid mater epithelial cells form the blood-arachnoid barrier (BAB), acting as a blood-CSF interface, it has been generally considered that the BAB is impermeable to water-soluble substances and plays a largely passive role. Here, we aimed to clarify the function of transporters at the BAB in regulating CSF clearance of water-soluble organic anion drugs based on quantitative targeted absolute proteomics (QTAP) and in vivo analyses. Protein expression levels of 61 molecules, including 19 ATP-binding-cassette (ABC) transporters and 32 solute-carrier (SLC) transporters, were measured in plasma membrane fraction of rat leptomeninges using QTAP. Thirty-three proteins were detected; others were under the quantification limits. Expression levels of multidrug resistance protein 1 (Mdr1a/P-gp/Abcb1a) and breast cancer resistance protein (Bcrp/Abcg2) were 16.6 and 3.27 fmol/μg protein (51.9- and 9.82-fold greater than in choroid plexus, respectively). Among those organic anion transporters detected only at leptomeninges, not choroid plexus, organic anion transporter 1 (oat1/Slc22a6) showed the greatest expression (2.73 fmol/μg protein). On the other hand, the protein expression level of oat3 at leptomeninges was 6.65 fmol/μg protein, and the difference from choroid plexus was within two-fold. To investigate oat1's role, we injected para-aminohippuric acid (PAH) with or without oat1 inhibitors into cisterna magna (to minimize the contribution of choroid plexus function) of rats. A bulk flow marker, FITC-inulin, was not taken up from CSF up to 15 min, whereas uptake clearance of PAH was 26.5 μL/min. PAH uptake was completely blocked by 3 mM cephalothin (inhibits both oat1 and oat3), while 17% of PAH uptake was inhibited by 0.2 mM cephalothin (selectively inhibits oat3). These results indicate that oat1 and oat3 at the BAB provide a distinct clearance pathway of organic anion drugs from CSF independently of choroid plexus.
Full Text Available The aortic-pulmonary regions (APR of seven adult marmosets (Callithrix jacchus and the region of the right subclavian artery of a further three marmosets were diffusion-fixed with 10% buffered formol-saline solution. In both regions serial 5-µm sections were cut and stained by the Martius yellow, brilliant crystal scarlet and soluble blue method. Presumptive thoracic paraganglionic (PTP tissue was only observed in the APR. PTP tissue was composed of small groups of cells that varied in size and number. The distribution of the groups of cells was extremely variable, so much so that it would be misleading to attempt to classify their position; they were not circumscribed by a connective tissue capsule, but were always related to the thoracic branches of the left vagus nerve. The cells lay in loose areolar tissue characteristic of this part of the mediastinum and received their blood supply from small adjacent connective tissue arterioles. Unlike the paraganglionic tissue found in the carotid body the cells in the thorax did not appear to have a profuse capillary blood supply. There was, however, a close cellular-neural relationship. The cells, 10-15 µm in diameter, were oval or rounded in appearance and possessed a central nucleus and clear cytoplasm. No evidence was found that these cells possessed a 'companion' cell reminiscent of the arrangement of type 1 and type 2 cells in the carotid body. In conclusion, we found evidence of presumed paraganglionic tissue in the APR of the marmoset which, however, did not show the characteristic histological features of the aortic body chemoreceptors that have been described in some non-primate mammals. A survey of the mediastina of other non-human primates is required to establish whether this finding is atypical for these animals.
Yao, Lawrence; Stanczak, Jeffrey; Boutin, Robert D.
MRI detects subchondral marrow findings in painful knees which bear resemblance to spontaneous osteonecrosis of the knee (SONK). Gathering evidence suggests that the primary or predominant pathogenesis of these lesions is physical stress. This study analyzes the patient characteristics and meniscal pathology associated with these lesions - herein referred to as ''presumptive subarticular stress related'' (PSSR) lesions. All patients were scanned using a standardized imaging protocol. The criterion for a PSSR lesion was a subchondral marrow edema pattern encompassing a more focal, low-signal zone adjacent to or contiguous with the subchondral cortex. Patients were identified using an electronic database search of cases reported by one experienced musculoskeletal radiologist. Twenty-five PSSR lesions were identified among 1,948 MRI evaluations of the knee. Twenty-one PSSR lesions occurred in the medial compartment, and four occurred in the lateral compartment. There was no sex predilection. Patients with PSSR lesions were older than other patients undergoing MRI evaluation (mean 66 years versus 52 years, P<0.001). Meniscal tears occurred more commonly in cases with PSSR lesions than in the group as a whole (76% versus 45%, P<0.001). Radial and posterior root tears were more common in knees with PSSR lesions than in other knees with meniscal tears (53% versus 26%, P<0.01). PSSR lesions are associated with meniscal tears and, more specifically, with meniscal tear patterns that dramatically increase contact forces across the knee joint. This observation supports the hypothesis that mechanical stress is important in the pathogenesis of these subarticular lesions that are detected by MRI. (orig.)
Yao, Lawrence [Diagnostic Radiology Department, National Institutes of Health, Building 10, Room 1C640, 10 Center Drive, MSC 1182, MD 20892-1182, Bethesda (United States); Stanczak, Jeffrey [Fairfax Radiological Consultants, PC, 2722 Merrilee Drive, Suite 230, VA 22031, Fairfax (United States); Boutin, Robert D. [MedTel International, 1430 Spring Hill Road, State 500, VA 22102, Mclean (United States)
MRI detects subchondral marrow findings in painful knees which bear resemblance to spontaneous osteonecrosis of the knee (SONK). Gathering evidence suggests that the primary or predominant pathogenesis of these lesions is physical stress. This study analyzes the patient characteristics and meniscal pathology associated with these lesions - herein referred to as ''presumptive subarticular stress related'' (PSSR) lesions. All patients were scanned using a standardized imaging protocol. The criterion for a PSSR lesion was a subchondral marrow edema pattern encompassing a more focal, low-signal zone adjacent to or contiguous with the subchondral cortex. Patients were identified using an electronic database search of cases reported by one experienced musculoskeletal radiologist. Twenty-five PSSR lesions were identified among 1,948 MRI evaluations of the knee. Twenty-one PSSR lesions occurred in the medial compartment, and four occurred in the lateral compartment. There was no sex predilection. Patients with PSSR lesions were older than other patients undergoing MRI evaluation (mean 66 years versus 52 years, P<0.001). Meniscal tears occurred more commonly in cases with PSSR lesions than in the group as a whole (76% versus 45%, P<0.001). Radial and posterior root tears were more common in knees with PSSR lesions than in other knees with meniscal tears (53% versus 26%, P<0.01). PSSR lesions are associated with meniscal tears and, more specifically, with meniscal tear patterns that dramatically increase contact forces across the knee joint. This observation supports the hypothesis that mechanical stress is important in the pathogenesis of these subarticular lesions that are detected by MRI. (orig.)
Tawde, S N; Puschner, B; Albin, T; Stump, S; Poppenga, R H
A 4-year-old, 37 kg, male German shepherd developed hyperthermia, tachycardia, and agitation following consumption of ground meat found in the backyard of its owner. When presented to a veterinary clinic, plasma ethylene glycol (EG) testing was positive, and the dog was given ethanol and lactated Ringer's solution intravenously. Approximately 11 h postexposure the dog died. Among tissues submitted for toxicological analysis, urine was negative for EG, ground meat was negative for certain drugs of abuse, and gastric contents were negative for zinc/aluminum phosphide and metaldehyde. Analysis of gastric contents by gas chromatography-mass spectrometry confirmed the presence of caffeine. Caffeine concentration in the ground meat was estimated at 1 %. Caffeine is a methylxanthine alkaloid with a reported canine oral median lethal dose (MLD(50)) of 140 mg/kg (range 120-200 mg/kg). A commercially available 200-mg tablet formulation of caffeine was considered to be a possible source but this was not confirmed. By conservative estimates, the dog would need to ingest approximately 500-550 g of the meat to reach the MLD(50). Acute intoxication affects the cardiovascular, pulmonary, neurologic, gastrointestinal, and metabolic systems. Although no tablet remnants were observed in the bait, tablets could have been crushed and/or dissolved. Other potential caffeine sources include guarana, brewed and concentrated coffee, and caffeine-containing beverages. Based on the history, clinical signs, and the detection of caffeine in the gastric contents and meat, a presumptive diagnosis of malicious caffeine poisoning was made. A suggested treatment regimen for caffeine intoxication in dogs is described. While few cases of accidental ingestion of caffeine by dogs have been described, the intentional use of a concentrated caffeine source to cause mortality in a dog has not been previously reported.
Amenorrhea - secondary; No periods - secondary; Absent periods - secondary; Absent menses - secondary; Absence of periods - secondary ... Secondary amenorrhea can occur due to natural changes in the body. For example, the most common cause of secondary ...
Liége M. Petroni
Full Text Available ABSTRACT The present study aimed to compare the plant food diet of woolly spider monkeys (Brachyteles arachnoides inhabiting Intervales State Park in São Paulo, Brazil, with medicinal plant species used by humans in the surrounding areas of the park. The diet of a group of woolly spider monkeys living in an Atlantic forest area was recorded during 43 months of fieldwork. Fifty-three species (87 food items were recorded. Plant specimens were collected and identified at the University of São Paulo and the Botanical Institute of São Paulo State. Using semi-structured interviews, ethnomedicinal data were also collected from four preselected respondents regarding the human therapeutic value of these plants. The study showed that 24.5% (13/53 of these species are used by residents around the park for medicinal purposes. Of these thirteen, seven species also have validated pharmacological properties, and three are utilized by local residents for similar medicinal purposes. Overlap in the plant food/medicinal diet of woolly spider monkey populations elsewhere were also noted, suggesting potential overlap in their medicinal value for humans and primates. The similarities between the ingestion of plants by primates and their medicinal use by humans provide a bio-rational for the search of bioactive plants in the primate diet. Further detailed investigation of their pharmacological and phytochemical value is warranted.
Giza, Elżbieta Gabriela; Płonek, Marta; Nicpoń, Józef Marian; Wrzosek, Marcin Adam
Peripheral neuropathy is the most common neurological manifestation of canine hypothyroidism. Data concerning electrodiagnostic studies in hypothyroid associated polyneuropathy in dogs are very limited and usually lack a reevaluation after hormone replacement therapy. The objective of this study was to perform a detailed, retrospective analysis of electromyographic (EMG), motor nerve conduction velocity (MNCV), F-wave and brainstem auditory evoked response (BAER) findings in 24 dogs with presumptive primary hypothyroidism and polyneuropathy with a comparison of the results before and after initiation of levothyroxine treatment with the assessment of the clinical outcome. The results obtained from hypothyroid dogs showed a significant reduction in MNCV at a proximal-distal and middle-distal stimulation, decreased amplitudes of compound muscle action potentials (CMAP), an increased CMAP duration and a prolonged distal latency prior to treatment. Fifty percent of the dogs had an increased F-wave latency. A normal BAER recording was found in 78 % of the hypothyroid patients without vestibular impairment. Bilaterally increased peak V latencies and increased interpeak I-V latencies were found in the remaining individuals. Dogs with concurrent vestibular impairment had ipsilaterally increased peak latencies with normal interpeak latencies and decreased amplitudes of wave I and II. A comparison of the findings before and after 2 months of treatment revealed a decrease in the pathological activity on EMG, an improvement of proximal, middle and distal CMAP amplitudes and an increase in the proximal-distal conduction velocity in all dogs. F-wave latency improved in 38 % of dogs. The BAER reexamination revealed a persistent prolongation of peak I, II, III and V latencies and decreased wave I amplitude on the affected side in all dogs manifesting vestibular signs. Conversely, in dogs without vestibular signs, the peak V and interpeak I-V latencies decreased to normal values
Fenn, Joe; Drees, Randi; Volk, Holger A; De Decker, Steven
OBJECTIVE To compare clinical signs and outcomes between dogs with presumptive ischemic myelopathy and dogs with presumptive acute noncompressive nucleus pulposus extrusion (ANNPE). DESIGN Retrospective study. ANIMALS 51 dogs with ischemic myelopathy and 42 dogs with ANNPE examined at 1 referral hospital. PROCEDURES Medical records and MRI sequences were reviewed for dogs with a presumptive antemortem diagnosis of ischemic myelopathy or ANNPE. Information regarding signalment, clinical signs at initial examination, and short-term outcome was retrospectively retrieved from patient records. Long-term outcome information was obtained by telephone communication with referring or primary-care veterinarians and owners. RESULTS Compared with the hospital population, English Staffordshire Bull Terriers and Border Collies were overrepresented in the ischemic myelopathy and ANNPE groups, respectively. Dogs with ANNPE were significantly older at disease onset and were more likely to have a history of vocalization at onset of clinical signs, have spinal hyperesthesia during initial examination, have a lesion at C1-C5 spinal cord segments, and be ambulatory at hospital discharge, compared with dogs with ischemic myelopathy. Dogs with ischemic myelopathy were more likely to have a lesion at L4-S3 spinal cord segments and have long-term fecal incontinence, compared with dogs with ANNPE. However, long-term quality of life and outcome did not differ between dogs with ischemic myelopathy and dogs with ANNPE. CONCLUSIONS AND CLINICAL RELEVANCE Results revealed differences in clinical signs at initial examination between dogs with ischemic myelopathy and dogs with ANNPE that may aid clinicians in differentiating the 2 conditions.
Kato, Hideki; Fujii, Shigehisa; Shirakawa, Seiji; Suzuki, Yusuke; Nishii, Yoshio
A presumption calculating formula of the X-ray spectrum generated from a molybdenum target X-ray tube is presented. The calculation procedure is to add an amount of characteristic X-ray photons that corresponds to the ratio of characteristic photons and bremsstrahlung photons to the bremsstrahlung spectrum obtained using semiempirical calculation. The bremsstrahlung spectrum was calculated by using a corrected Tucker's formula. The corrected content was a formula for calculating the self-absorption length in the target that originated in the difference of the incident angle to the target of the electron and the mass stopping power data. The measured spectrum was separated into the bremsstrahlung component and the characteristic photon component, and the ratio of the characteristic photons and bremsstrahlung photons was obtained. The regression was derived from the function of the tube voltage. Based on this calculation procedure, computer software was constructed that can calculate an X-ray spectrum in arbitrary exposure conditions. The X-ray spectrum obtained from this presumption calculating formula and the measured X-ray spectrum corresponded well. This formula is very useful for analyzing various problems related to mammography by means of Monte Carlo simulations.
Hughes, Kevin A.
Factors affecting fecal microorganism survival and distribution in the Antarctic marine environment include solar radiation, water salinity, temperature, sea ice conditions, and fecal input by humans and local wildlife populations. This study assessed the influence of these factors on the distribution of presumptive fecal coliforms around Rothera Point, Adelaide Island, Antarctic Peninsula during the austral summer and winter of February 1999 to September 1999. Each factor had a different degree of influence depending on the time of year. In summer (February), although the station population was high, presumptive fecal coliform concentrations were low, probably due to the biologically damaging effects of solar radiation. However, summer algal blooms reduced penetration of solar radiation into the water column. By early winter (April), fecal coliform concentrations were high, due to increased fecal input by migrant wildlife, while solar radiation doses were low. By late winter (September), fecal coliform concentrations were high near the station sewage outfall, as sea ice formation limited solar radiation penetration into the sea and prevented wind-driven water circulation near the outfall. During this study, environmental factors masked the effect of station population numbers on sewage plume size. If sewage production increases throughout the Antarctic, environmental factors may become less significant and effective sewage waste management will become increasingly important. These findings highlight the need for year-round monitoring of fecal coliform distribution in Antarctic waters near research stations to produce realistic evaluations of sewage pollution persistence and dispersal. PMID:12902283
Ana Flávia Belchior Andrade
Full Text Available Blood is the most common body fluid found at crime scenes. One-step presumptive tests have been designed as a rapid immunological test for the qualitative detection of human hemoglobin in stool samples (faecal occult blood their usefulness for forensic purposes has been demonstrated before. In this study we compare Hexagon OBTI kit and FOB One-step Bioeasy kit sensitivity in the analysis of diluted blood samples. With Hexagon OBTI, positive test results are achieved in whole blood dilutions up to 1:1.000. Sensitivity decreased with aged samples, if samples were not stored under low temperatures regardless of which presumptive test is used. Whole blood tests must take into consideration that “hook” effect may interfere. Comparing both tests, OBTI Hexagon Kit is more sensible to detect diluted blood, showing a wider detection window in all conditions. This is interesting when analyzing forensic samples as forensic analysts usually do not know about the history of the analyzed sample before its collection.
metabolism of lipoprotein particles, most often the triglyceride (TG)-rich particles. Under normal metabolic conditions these patients may be entirely normal, but when exposed to one of the secondary causes this 'excessive metabolic load' precipitates an ever-worsening cycle of impairment in lipoprotein metabolism.
Yvens B. Fernandes
disabilities. On physical examination he exhibited mild eunuchoid aspect, 162 cm height (z score = -2,17, pubertal development on stage G II, P II, and 4 cm5 testis. Laboratory investigation revealed pre-pubertal levels of testosterone and normal results of the combined test of anterior pituitary function, except for in GnRH acute and prolonged test. Brain CT showed an arachnoid cyst on left middle fossa with expansion to suprasellar cisterna. He was diagnosed as having hypogonadotrophic hypogonadism secondary to compression by the cyst, and a cyst-peritoneal derivation was performed. After surgery there was no improvement of the pubertal state and bilateral anosmia was discovered, so Kallmann's syndrome was then diagnosed and was confirmed by MRI, even though the hormonal results are not totally matched with the refered syndrome. We did not find in the literature any description of the association between Kallmann's syndrome and arachnoid cyst and we believe that in this case the results of the hormonal measurement may be due to such association that provoked an additional hypophysis dysfunction.
The Qualified Presumption of Safety (QPS) approach, initially developed for the assessment of microorganisms referred to EFSA and added to the food chain is equally applicable to the assessment of botanicals or botanical preparations. Using the principles to establish the suitability of a botanical...... preparation for QPS status, it has been possible to develop a structured assessment scheme that provides a practical method for assessing botanicals and botanical preparations for which an adequate body of knowledge exists and therefore without the need for further testing. Reiterative applications...... of the assessment scheme to related botanicals or different botanical preparations obtained from the same plant variety can allow a QPS status to be derived for specific groupings. However, the particularity of botanicals that may be presented in a wide variety of forms or whose morphology and chemical composition...
Ikenishi, K.; Okuda, T.; Nakazato, S.
A single blastomere containing the ''germ plasm'' of 32-cell stage Xenopus embryos was cultured with (/sup 3/H)thymidine until the control embryos developed to the neurula stage. The explants, showing a spherical mass in which the nuclei of all cells were labeled, were implanted into the prospective place of presumptive primordial germ cells (pPGCs) in the endodermal cell mass of unlabeled host embryos of the neurula stage. Labeled PGCs as well as unlabeled, host PGCs were found in the genital ridges of experimental tadpoles. This indicates that the precursor of germ cells, corresponding to pPGCs in normal embryos of the neurula stage, in the explants migrated to genital ridges just at the right moment to become PGCs, and suggests that the developmental process progressed normally, even in the explants, as far as the differentiation of pPGCs is concerned.
Shats, Kathy; Faunce, Thomas
Health Care Complaints Commission v Wingate  NSWCA 326 concerns an appeal from the New South Wales Medical Tribunal regarding its findings on professional misconduct outside the practice of medicine in relation to a doctor convicted of possessing child pornography. The latest in a number of cases on this issue in Australia, it highlights the complexity of such decisions before medical tribunals and boards, as well as the diversity of approaches taken. Considering both this case and the recent Medical Practitioners Board of Victoria case of Re Stephanopoulos  MPBV 12, this column argues that Australian tribunals and medical boards may not yet have achieved the right balance here in terms of protecting public safety and the reputation of the profession as a whole. It makes the case for a position statement from Australian professional bodies to create a presumption of a lifetime prohibition on paediatric practice after a medical professional has been convicted of accessing child pornography.
Coleman, D J; McGhie, D; Tebbutt, G M
The reliability of the bacitracin inhibition test to differentiate between 125 Lancefield group A and 122 non-group A beta-haemolytic streptococci was studied. Bacitracin discs containing 0-02, 0-04, or 0-1 international units and the conditions recommended by both the Association of Clinical Pathologists and the Federal Drug Administration for routine sensitivity testing were used. The results suggest that the presence or absence of a zone of inhibition around a 0-04 unit disc can be used routinely for the presumptive identification of group A streptococci and that a specific zone size can be used for reading the test only with a 0-1 unit disc. PMID:325019
Brogan, O; Malone, J; Fox, C; Whyte, A S
To evaluate Lancefield grouping and caramel smell for presumptive identification of the Streptococcus milleri group, and to find whether Lancefield group, species, or protein profile correlated with virulence or infection site. Prospective studies were made of 100 consecutive streptococcal isolates in blood cultures or pus from 100 patients in whom the severity of infection was categorised as serious, moderate, or not significant. The usefulness of Lancefield group and the caramel smell for presumptive identification was examined, and the relation of the S milleri species, Lancefield group, and SDS-PAGE protein analysis to severity of infection and infection site was investigated. Lower respiratory tract and genital tract specimens, strict anaerobes, group D streptococci, and strains identified as Streptococcus pneumoniae, Streptococcus pyogenes, or Streptococcus agalactiae were excluded. Most streptococci occurring in pure or significant growth density were S milleri group (87/100; 87%, 95% confidence interval 0.81-0.93). Of these, 89.7% (78/87; 0.84-0.96) were associated with infection. Lancefield group F antigen predominated (41/87; 47.1%, 0.38-0.56). Lancefield group F alone or accompanied by the caramel smell had a specificity of 100%, but a sensitivity of only 47.3% for group F alone, and 19.5% for group F accompanied by the caramel smell. There was no significant association between species, Lancefield group, and severity of infection, site of infection, or pathogenicity. SDS-PAGE analysis failed to discriminate between strains. Neither species nor Lancefield antigen was related to the site of infection. The presence of Lancefield group F antigen alone or accompanied by a caramel smell was a useful indicator for the S milleri group when present, but was too insensitive to use as a screening test. Most streptococci occurring in pure culture or in significant growth density were of clinical importance. Such organisms should be identified to species level to
7 October 2005 This Mars Global Surveyor (MGS) Mars Orbiter Camera (MOC) image shows a cluster of craters in far western Arabia Terra. The crater cluster is oriented along a line that runs nearly east-west (left-right) across the scene. Clusters of craters positioned along a line like this are secondary craters -- that is, they formed as the result of a much larger meteor, asteroid, or cometary impact somewhere else in the region. These craters do not form from the object that impacted Mars to form the larger, primary crater; these are the product of the impact of the rocks and debris thrown out by the larger impact. Location near: 14.9oN, 19.3oW Image width: width: 3 km (1.9 mi) Illumination from: lower left Season: Northern Autumn
Nicola Di Daniele
Full Text Available Brown tumour represents a serious complication of hyperparathyroidism. Differential diagnosis, based on histological examination, is only presumptive and clinical, radiological and laboratory data are necessary for definitive diagnosis. Here we describe a case of a brown tumour localised in the maxilla due to secondary hyperparathyroidism in a young women with chronic renal failure. Hemodialysis and pharmacological treatment were unsuccessful in controlling secondary hyperparathyroidism making it necessary to proceed with a subtotal parathyroidectomy. The proper timing of the parathyroidectomy and its favourable effect on regression of the brown tumor made it possible to avoid a potentially disfiguring surgical removal of the brown tumor.
Dunyo, S K; Afari, E A; Koram, K A; Ahorlu, C K; Abubakar, I; Nkrumah, F K
A study was conducted in 1997 to compare the accuracy of presumptive diagnosis of malaria in children aged 1-9 years performed by caretakers of the children to that of health centre staff in 2 ecological zones in southern Ghana. Similar symptoms were reported in the children at home and at the health centre. In the home setting, symptoms were reported the same day that they occurred, 77.6% of the children with a report of fever were febrile (axillary temperature > or = 37.5 degrees C) and 64.7% of the reports of malaria were parasitologically confirmed. In the health centre, the median duration of symptoms before a child was seen was 3 days (range 1-14 days), 58.5% of the children with a report of fever were febrile and 62.6% of the clinically diagnosed cases were parasitologically confirmed. In the 2 settings almost all the infections were due to Plasmodium falciparum. Parasite density was 3 times higher in the health centre cases compared to the home-diagnosed cases. Early and appropriate treatment of malaria detected in children by caretakers may prevent complications that arise as a result of persistence of symptoms and attainment of high parasitaemic levels.
Last, G.V.; Bagaasen, L.M.; Josephson, G.B.; Lanigan, D.C.; Liikala, T.L.; Newcomer, D.R.; Pearson, A.W.; Teel, S.S.
A Remedial Investigation/Feasibility Study (RI/FS) is in progress at the Laboratory for Energy Related Health Research (LEHR) at the University of California, Davis. The purpose of the RI/FS is to gather sufficient information to support an informed risk management decision regarding the most appropriate remedial actions for impacted areas of the facility. In an effort to expedite remediation of the LEHR facility, the remedial project managers requested a more detailed evaluation of a selected set of remedial actions. In particular, they requested information on both characterization and remedial action costs. The US Department of Energy -- Oakland Office requested the assistance of the Pacific Northwest National Laboratory to prepare order-of-magnitude cost estimates for presumptive remedial actions being considered for the five source term operable units. The cost estimates presented in this report include characterization costs, capital costs, and annual operation and maintenance (O ampersand M) costs. These cost estimates are intended to aid planning and direction of future environmental remediation efforts
Nadeem, Sayyada Ghufrana; Hakim, Shazia Tabassum; Kazmi, Shahana Urooj
Introduction Identification of yeast isolated from clinical specimens to the species level has become increasingly important. Ever-increasing numbers of immuno-suppressed patients, a widening range of recognized pathogens, and the discovery of resistance to antifungal drugs are contributing factors to this necessity. Material and methods A total of 487 yeast strains were studied for the primary isolation and presumptive identification, directly from clinical specimen. Efficacy of CHROMagar Candida has been evaluated with conventional methods including morphology on Corn meal–tween 80 agar and biochemical methods by using API 20 C AUX. Results The result of this study shows that CHROMagar Candida can easily identify three species of Candida on the basis of colonial color and morphology, and accurately differentiate between them i.e. Candida albicans, Candida tropicalis, and Candida krusei. The specificity and sensitivity of CHROMagar Candida for C. albicans calculated as 99%, for C. tropicalis calculated as 98%, and C. krusei it is 100%. Conclusion The data presented supports the use of CHROMagar Candida for the rapid identification of Candida species directly from clinical specimens in resource-limited settings, which could be very helpful in developing appropriate therapeutic strategy and management of patients. PMID:21483597
Contreras Martínez, Orfa Inés; Aycardi Morinelli, María Paulina; Alarcón Furnieles, Jany Luz; Jaraba Ramos, Aparicio Manuel
the members of the Cryptococcus neoformans species complex are responsible for cryptococcosis in animals and humans. Human infection is thought to be acquired by inhalation of airborne propagules from an environmental source; therefore it is greatly important to study their habitat. to determine the ecological relationship of Cryptococcus gattii with Terminalia catappa trees present in urban areas of Montería city in Colombia. a total of 163 Terminalia catappa trees were selected; some samples were taken from the bark, the leaves, the flowers, the fruits of these trees and from the surrounding soil. The yeast was isolated using the Guizotia abyssinica seed agar medium; it was identified thanks to biochemical and morphologic tests whereas the right variety was determined by L-canavanine-glycine-bromothymol blue (CGB), D-proline and D-tryptophan tests. there was obtained 9.050 CFU/g isolate of Cryptococcus spp., 5.795 CFU/g of which were presumptively identified as Cryptococcus gattii. The highest percentage of isolates was found in flowers, followed by bark and fruits, presenting small cellular and capsular sizes. These isolates were more frequent in the south of the city, followed by the center zone and the lowest percentage in the northern zone. these findings confirmed the close relationship of Cryptococcus gattii and Terminalia catappa, being this the first study conducted in Monteria city. These results give us meaningful information for understanding and analyzing the epidemiology of cryptococcosis in Monteria city, Colombia.
Reyes, Laura D; Harland, Tessa; Reep, Roger L; Sherwood, Chet C; Jacobs, Bob
The current study investigates neuron morphology in presumptive primary somatosensory (S1) and primary visual (V1) cortices of the Florida manatee (Trichechus manatus latirostris) as revealed by Golgi impregnation. Sirenians, including manatees, have an aquatic lifestyle, a large body size, and a relatively large lissencephalic brain. The present study examines neuron morphology in 3 cortical areas: in S1, dorsolateral cortex area 1 (DL1) and cluster cortex area 2 (CL2) and in V1, dorsolateral cortex area 4 (DL4). Neurons exhibited a variety of morphological types, with pyramidal neurons being the most common. The large variety of neuron types present in the manatee cortex was comparable to that seen in other eutherian mammals, except for rodents and primates, where pyramid-shaped neurons predominate. A comparison between pyramidal neurons in S1 and V1 indicated relatively greater dendritic branching in S1. Across all 3 areas, the dendritic arborization pattern of pyramidal neurons was also similar to that observed previously in the afrotherian rock hyrax, cetartiodactyls, opossums, and echidnas but did not resemble the widely bifurcated dendrites seen in the large-brained African elephant. Despite adaptations for an aquatic environment, manatees did not share specific neuron types such as tritufted and star-like neurons that have been found in cetaceans. Manatees exhibit an evolutionarily primitive pattern of cortical neuron morphology shared with most other mammals and do not appear to have neuronal specializations for an aquatic niche. © 2016 S. Karger AG, Basel.
Donachie, Gillian E; Dawnay, Nick; Ahmed, Romana; Naif, Sarah; Duxbury, Nicola J; Tribble, Nicholas D
The rise of DNA evidence to the forefront of forensic science has led to high sample numbers being submitted for profiling by investigators to casework laboratories: bottleneck effects are often seen resulting in slow turnaround times and sample backlog. The ParaDNA(®) Screening and Intelligence Tests have been designed to guide investigators on the viability of potential sources of DNA allowing them to determine which samples should be sent for full DNA analysis. Both tests are designed to augment the arsenal of available forensic tests for end users and be used concurrently to those commonly available. Therefore, assessing the impact that common forensic tests have on such novel technology is important to measure. The systems were tested against various potential inhibitors to which samples may be exposed as part of the investigative process. Presumptive test agents for biological materials (blood, semen and saliva) and those used as fingerprint enhancement agents were both used. The Screening Test showed a drop in performance following application of aluminium powder and cyanoacrylate (CNA) on fingerprints samples; however this drop in performance was not replicated with high template DNA. No significant effect was observed for any agent using the Intelligence Test. Therefore, both tests stand up well to the chemical agents applied and can be used by investigators with confidence that system performance will be maintained. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
Full Text Available It is known that the caudal dislocation of the cerebellar tonsils may occur associated with clinical conditions such as an intracranial mass lesion or Chiari I and II malformation. It may also be acquired after repeated lumbar punctures or lumboperitoneostomy. The occurrence of cerebellar herniation after derivation of intracranial arachnoid cyst is extremely rare, and there are only three cases reported in the medical literature. We present the case of a 9-year-old boy with precocious puberty and suprasellar arachnoid cyst who developed a symptomatic herniation of the cerebellar tonsils three years after a cystoperitoneostomy. The patient underwent a suboccipital craniectomy with duraplasty and partial tonsilectomy, showing afterwards, remission of the symptoms. We discussed the pathogenesis suggested in the literature.Sabe-se que o deslocamento caudal das tonsilas cerebelares pode ocorrer em associação com condições clínicas tais como: lesão expansiva intracraniana ou malformação de Chiari I e II. Pode ainda ser adquirido após repetidas punções lombares ou lomboperitoniostomia. A ocorrência de herniação cerebelar após derivação de cisto aracnóide intracraniano é evento extremamente raro, existindo apenas três casos relatados na literatura médica. O caso de menino de 9 anos de idade, com puberdade precoce e cisto aracnóide supra-selar, que desenvolveu herniação sintomática das tonsilas cerebelares três anos após cistoperitoniostomia. O paciente foi submetido a craniectomia suboccipital com plástica dural e tonsilectomia parcial, apresentando remissão dos sintomas. Discutimos a patogênese sugerida na literatura.
Full Text Available Resumen: Es bien conocido que las presunciones juegan un papel de gran importancia en el campo del Derecho. Ahora bien, tal vez no lo es tanto que presunción es una noción que se estudia con un valor en cierta medida diferente más allá de las fronteras de esta disciplina, en campos como la Teoría de la Argumentación, la Epistemología y la Pragmática. En este artículo nos proponemos, de un lado, ofrecer una visión general de qué se entiende por presunción en dichos campos de estudio y, de otro, dar unas pinceladas acerca de su vinculación con la noción jurídica.Abstract: It is common knowledge that presumptions play a paramount role within the field of Law. Nonetheless, it may not be widely known that presumption is a notion that is studied with a partly different meaning beyond the boundaries of this subject, in fields of knowledge such as Argumentation Theory, Epistemology and Pragmatics. In this paper we aim to briefly present what presumption stands for in these fields of knowledge and give some hints on the way in which these uses are related to the legal notion.
Full Text Available Leptomeningeal carcinomatosis (LMC is a diffuse or multifocal malignant infiltration of the pia matter and arachnoid membrane. The most commonly reported cancers associated with LMC are breast, lung, and hematological malignancies. Patients with LMC commonly present with multifocal neurological symptoms. We report a case of LMC secondary to gastroesophageal junction cancer present initially with cauda equina syndrome. A 51-year-old male patient with treated adenocarcinoma of the gastroesophageal junction presented with left leg pain, mild weakness, and saddle area numbness. Initial radiological examinations were unremarkable. Subsequently, he had worsening of his leg weakness, fecal incontinence, and urine retention. Two days later, he developed rapidly progressive cranial neuropathies including facial diplegia, sensorineural hearing loss, dysarthria, and dysphagia. MRI with and without contrast showed diffuse enhancement of leptomeninges surrounding the brain, spinal cord, and cauda equina extending to the nerve roots. Cerebrospinal fluid cytology was positive for malignant cells. The patient died within 10 days from the second presentation. In cancer patients with cauda equina syndrome and absence of structural lesion on imaging, LMC should be considered. To our knowledge, this is the first case of LMC secondary to gastroesophageal cancer presenting with cauda equina syndrome.
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Moussa, Husseiny Sh; Bayoumi, Faten Sayed; Mohamed, Ahmed Mohamed Ali
Gene Xpert(GX) is a novel real time polymerase chain reaction (RT-PCR) assay which was endorsed by the World Health Organization (WHO) in 2011 for tuberculosis (TB) diagnosis and susceptibility to refampicin(RIF). To evaluate GX for direct diagnosis of TB in stool samples from children with suspected pulmonary Tuberculosis (PTB). Children older than one year and younger than 16 years with presumptive PTB were enrolled and classified to five clinical categories based on clinical, radiological, and laboratory findings: confirmed TB, probable TB, possible TB, Unlikely TB, and not TB. Two stool samples were collected from each child and tested for the presence of Mycobacterium tuberculosis (MTB) by GX and the obtained results were compared to Lowenstien-Jensen (LJ) culture as a gold standard. In total, 115 children were enrolled. 36 had been confirmed with TB, 61 probably TB, 10 possible TB, 5 unlikely TB, and 3 not TB. GX had a sensitivity of 83.33 and 80.56 % and specificity of 98.73 and 99.36 % by patients and samples respectively. GX was positive in 83.3% of confirmed TB as well as 1.6 and 0.8% of probable TB cases by patients and samples respectively. GX provided timely results with quit acceptable sensitivity and good specificity compared to LJ culture. In this study, sensitivity calculations take into account only children with confirmed TB. GX could not detect TB in children with probable TB, so it should not be used alone for TB diagnosis. Further studies for GX stool protocol optimization and assessment is required. © 2016 by the Association of Clinical Scientists, Inc.
Hamilton da Cunha Iribure Júnior
Full Text Available The article aims to analyze the breach of the presumption of innocence with the anticipation of the sentence before the final judgment of conviction, in a recent decision of the Supreme Court. Adopted documentary analytical methodology. Assumes that fundamental rights are not absolute and must be relativized. Deals with the constitutional jurisdiction in this perspective and the limits of the judicial role in the exercise of interpretation of the law. One of the conclusions is that the relativization of fundamental rights in Brazil follows tendency to give in proceedings other than the Constitutional Court.
Tawiah, Theresa; Hansen, Kristian Schultz; Baiden, Frank
(ACT) in all suspected malaria patients. The use of malaria rapid diagnostic tests (mRDTs) would make it possible for prescribers to diagnose malaria at point-of-care and better target the use of antimalarials. Therefore, a cost-effectiveness analysis was performed on the introduction of m......RDTs for management of malaria in under-five children in a high transmission area in Ghana where presumptive diagnosis was the norm in public health centres. Methods: A cluster-randomised controlled trial where thirty-two health centres were randomised into test-based diagnosis of malaria using mRDTs (intervention...
Thompson, Kara; McDougall, Rosalind
As assisted reproductive technologies (ART) become increasingly popular, debate has intensified over the ethical justification for restricting access to ART based on various medical and non-medical factors. In 2010, the Australian state of Victoria enacted world-first legislation that denies access to ART for all patients with certain criminal or child protection histories. Patients and their partners are identified via a compulsory police and child protection check prior to commencing ART and, if found to have a previous relevant conviction or child protection order, are given a "presumption against treatment." This article reviews the legislation and identifies arguments that may be used to justify restricting access to ART for various reasons. The arguments reviewed include limitations of reproductive rights, inheriting undesirable genetic traits, distributive justice, and the welfare of the future child. We show that none of these arguments justifies restricting access to ART in the context of past criminal history. We show that a "presumption against treatment" is an unjustified infringement on reproductive freedom and that it creates various inconsistencies in current social, medical, and legal policy. We argue that a state-enforced policy of restricting access to ART based on the non-medical factor of past criminal history is an example of unjust discrimination and cannot be ethically justified, with one important exception: in cases where ART treatment may be considered futile on the basis that the parents are not expected to raise the resulting child.
Full Text Available Abstract Background Acute myocarditis may mimic myocardial infarction, since affected patients complain of "typical" chest pain, the ECG changes are identical to those observed in acute coronary syndromes, and serum markers are increased. We describe a case series of presumptive myocarditis with ST segment elevation on admission ECG. Methods and Results From 1998 to 2009, 21 patients (20 males; age 17-42 years were admitted with chest pain, persistent ST segment elevation, serum enzyme and troponine release. All but one patients had fever and flu-like symptoms prior to admission. No abnormal Q wave appeared in any ECG tracing, and angiography did not show significant coronary artery disease. Patients remained asymptomatic at long term follow-up, except 2 who experienced a late relapse, with the same clinical, electrocardiographic and serum findings as in the first clinical presentation. Conclusion Presumptive myocarditis of possible viral origin characterized by ST elevation mimicking myocardial infarction, good short term prognosis and some risk for recurrence is relatively frequent in young males and appears as a distinct clinical condition.
O'Connor, Sarah E
Secondary (specialized) metabolites, produced by bacteria, fungi, plants, and other organisms, exhibit enormous structural variation, and consequently display a wide range of biological activities. Secondary metabolism improves and modulates the phenotype of the host producer. Furthermore, these biological activities have resulted in the use of secondary metabolites in a variety of industrial and pharmaceutical applications. Metabolic engineering presents a powerful strategy to improve access to these valuable molecules. A critical overview of engineering approaches in secondary metabolism is presented, both in heterologous and native hosts. The recognition of the increasing role of compartmentalization in metabolic engineering is highlighted. Engineering approaches to modify the structure of key secondary metabolite classes are also critically evaluated.
Baiden, Frank; Bruce, Jane; Webster, Jayne; Tivura, Mathilda; Delmini, Rupert; Amengo-Etego, Seeba; Owusu-Agyei, Seth; Chandramohan, Daniel
Malaria-endemic countries in sub-Saharan Africa are shifting from the presumptive approach that is based on clinical judgement (CJ) to the test-based approach that is based on confirmation through test with rapid diagnostic tests (RDT). It has been suggested that the loss of the prophylactic effect of presumptive-administered ACT in children who do not have malaria will result in increase in their risk of malaria and anaemia. We undertook a cluster-randomized controlled trial to compare the effects of the presumptive approach using clinical judgment (CJ-arm) and the test-based approach using RDTs (RDT-arm in a high-transmission setting in Ghana. A total of 3046 eligible children (1527 in the RDT arm and 1519 in the CJ- arm) living around 32 health centres were enrolled. Nearly half were female (48.7%) and 47.8% were below the age of 12 months as at enrolment. Over 24-months, the incidence of all episodes of malaria following the first febrile illness was 0.64 (95% CI 0.49-0.82) and 0.76 (0.63-0.93) per child per year in the RDT and CJ arms respectively (adjusted rate ratio 1.13 (0.82-1.55). After the first episode of febrile illness, the incidence of severe anaemia was the same in both arms (0.11 per child per year) and that of moderate anaemia was 0.16 (0.13-0.21) vs. 0.17 (0.14-0.21) per child year respectively. The incidence of severe febrile illness was 0.15 (0.09, 0.24) in the RDT arm compared to 0.17 (0.11, 0.28) per child per year respectively. The proportion of fever cases receiving ACT was lower in the RDT arm (72% vs 81%; p = 0.02). The test-based approach to the management of malaria did not increase the incidence of malaria or anaemia among under-five children in this setting. ClinicalTrials.gov NCT00832754.
Zhao, Liang; de Hoog, G Sybren; Cornelissen, Akke; Lyu, Qian; Mou, Lili; Liu, Taohua; Cao, Yu; Vatanshenassan, Mansoureh; Kang, Yingqian
Rapid identification of pathogenic yeasts is a crucial step in timely and appropriate antifungal therapy. For diagnostics in the clinical laboratory, simplified alternatives to barcoding are needed. CandiSelect 4 (CS4) medium, a chromogenic medium for isolation of clinical yeasts, allows routine recognition of Candida albicans and presumptive identification of Candida tropicalis, Candida glabrata, and Candida krusei. We evaluated an extension of this method with 46 non-Candida albicans Candida (NCAC) and 7 Malassezia species. The medium supported growth of all species tested and a wide diversity of cultural types were observed. Colony colours were in violet, turquoise (including green and blue), or white tinges. Eight NCAC species produced violet pigmentation similar to that of C. albicans. Most NCAC species, including C. glabrata and C. tropicalis were distributed in the turquoise group. Malassezia species were invariably blue. Copyright © 2015 The British Mycological Society. Published by Elsevier Ltd. All rights reserved.
BEN-ZVI, I.; RAO, T.; BURRILL, A.; CHANG, X.; GRIMES, J.; RANK, J.; SEGALOV, Z.; SMEDLEY, J.
We present the design and experimental progress on the diamond secondary emitter as an electron source for high average power injectors. The design criteria for average currents up to 1 A and charge up to 20 nC are established. Secondary Electron Yield (SEY) exceeding 200 in transmission mode and 50 in emission mode have been measured. Preliminary results on the design and fabrication of the self contained capsule with primary electron source and secondary electron emitter will also be presented.
Full Text Available Diagnosis of pulmonary tuberculosis (PTB in children is challenging due to difficulties in obtaining good quality sputum specimens as well as the paucibacillary nature of disease. Globally a large proportion of pediatric tuberculosis (TB cases are diagnosed based only on clinical findings. Xpert MTB/RIF, a highly sensitive and specific rapid tool, offers a promising solution in addressing these challenges. This study presents the results from pediatric groups taking part in a large demonstration study wherein Xpert MTB/RIF testing replaced smear microscopy for all presumptive PTB cases in public health facilities across India.The study covered a population of 8.8 million across 18 programmatic sub-district level tuberculosis units (TU, with one Xpert MTB/RIF platform established at each study TU. Pediatric presumptive PTB cases (both TB and Drug Resistant TB (DR-TB accessing any public health facilities in study area were prospectively enrolled and tested on Xpert MTB/RIF following a standardized diagnostic algorithm.4,600 pediatric presumptive pulmonary TB cases were enrolled. 590 (12.8%, CI 11.8-13.8 pediatric PTB were diagnosed. Overall 10.4% (CI 9.5-11.2 of presumptive PTB cases had positive results by Xpert MTB/RIF, compared with 4.8% (CI 4.2-5.4 who had smear-positive results. Upfront Xpert MTB/RIF testing of presumptive PTB and presumptive DR-TB cases resulted in diagnosis of 79 and 12 rifampicin resistance cases, respectively. Positive predictive value (PPV for rifampicin resistance detection was high (98%, CI 90.1-99.9, with no statistically significant variation with respect to past history of treatment.Upfront access to Xpert MTB/RIF testing in pediatric presumptive PTB cases was associated with a two-fold increase in bacteriologically-confirmed PTB, and increased detection of rifampicin-resistant TB cases under routine operational conditions across India. These results suggest that routine Xpert MTB/RIF testing is a promising
English, Shane W; Fergusson, D; Chassé, M; Lauzier, F; Griesdale, D; Algird, A; Kramer, A; Tinmouth, A; Lum, C; Sinclair, J; Marshall, S; Dowlatshahi, D; Boutin, A; Pagliarello, G; McIntyre, L A
Introduction Anaemia is common in aneurysmal subarachnoid haemorrhage (aSAH) and is a potential critical modifiable factor affecting secondary injury. Despite physiological evidence and management guidelines that support maintaining a higher haemoglobin level in patients with aSAH, current practice is one of a more restrictive approach to transfusion. The goal of this multicentre pilot trial is to determine the feasibility of successfully conducting a red blood cell (RBC) transfusion trial in adult patients with acute aSAH and anaemia (Hb ≤100 g/L), comparing a liberal transfusion strategy (Hb ≤100 g/L) with a restrictive strategy (Hb ≤80 g/L) on the combined rate of death and severe disability at 12 months. Methods Design This is a multicentre open-label randomised controlled pilot trial at 5 academic tertiary care centres. Population We are targeting adult aSAH patients within 14 days of their initial bleed and with anaemia (Hb ≤110 g/L). Randomisation Central computer-generated randomisation, stratified by centre, will be undertaken from the host centre. Randomisation into 1 of the 2 treatment arms will occur when the haemoglobin levels of eligible patients fall to ≤100 g/L. Intervention Patients will be randomly assigned to either a liberal (threshold: Hb ≤100 g/L) or a restrictive transfusion strategy (threshold: Hb ≤80 g/L). Outcome Primary: Centre randomisation rate over the study period. Secondary: (1) transfusion threshold adherence; (2) study RBC transfusion protocol adherence; and (3) outcome assessment including vital status at hospital discharge, modified Rankin Score at 6 and 12 months and Functional Independence Measure and EuroQOL Quality of Life Scale scores at 12 months. Outcome measures will be reported in aggregate. Ethics and dissemination The study protocol has been approved by the host centre (OHSN-REB 20150433-01H). This study will determine the feasibility of conducting the large pragmatic RCT comparing 2
Rozenshtraukh, L.C.; Rybakova, N.I.; Vinner, M.G.
Pathological changes, promoting the development of secondary pneumonias, are investigated. To this group belong: blood circulation disturbance in small circle, bronchial passability disturbance, aspiration of liquids, gases and vapors, infections and purulent processes, intoxications, injuries, operative interference. Roetgenologic symptomatics of each secondary acute pneumonia form is presented in detail
Jamal, Sophie A; Miller, Paul D
We reviewed the etiology and management of secondary and tertiary hyperparathyroidism. Secondary hyperparathyroidism is characterized by an increase in parathyroid hormone (PTH) that is appropriate and in response to a stimulus, most commonly low serum calcium. In secondary hyperparathyroidism, the serum calcium is normal and the PTH level is elevated. Tertiary hyperparathyroidism is characterized by excessive secretion of PTH after longstanding secondary hyperparathyroidism, in which hypercalcemia has ensued. Tertiary hyperparathyroidism typically occurs in men and women with chronic kidney disease usually after kidney transplant. The etiology and treatment of secondary hyperparathyroidism is relatively straightforward whereas data on the management of tertiary hyperparathyroidism is limited to a few small trials with short follow-up. Copyright © 2013 The International Society for Clinical Densitometry. Published by Elsevier Inc. All rights reserved.
Parker, David M.; Cai, Weidong; Garan, Daniel W.; Harris, Arthur J.
A secondary fuel delivery system for delivering a secondary stream of fuel and/or diluent to a secondary combustion zone located in the transition piece of a combustion engine, downstream of the engine primary combustion region is disclosed. The system includes a manifold formed integral to, and surrounding a portion of, the transition piece, a manifold inlet port, and a collection of injection nozzles. A flowsleeve augments fuel/diluent flow velocity and improves the system cooling effectiveness. Passive cooling elements, including effusion cooling holes located within the transition boundary and thermal-stress-dissipating gaps that resist thermal stress accumulation, provide supplemental heat dissipation in key areas. The system delivers a secondary fuel/diluent mixture to a secondary combustion zone located along the length of the transition piece, while reducing the impact of elevated vibration levels found within the transition piece and avoiding the heat dissipation difficulties often associated with traditional vibration reduction methods.
Full Text Available Traumatic events do not only affect the person who was directly exposed to the incident, but they might also lead to some reactions on people with whom they interact. It is argued that, reactions given to a traumatic event by being exposed to the incident either primarily or secondarily, resemble each other. While in primary exposure the perceived threat is subjective, in secondary exposure the threat belongs to the person one interacts with. Secondary exposition to trauma may lead to re-experiencing, avoidance, and increased arousal symptoms as well as impairment in daily functioning. Briefly, secondary exposition to a traumatic incident induces parallel reactions as in those who are primarily exposed. In addition to these, taking specific precautions help decreasing the negative effects of secondary traumatic stress. This review focuses on the secondary traumatic stress and secondary traumatic stress disorder of workers who offer service in relief operations. For this aim, related theoretical concepts along with the literature studies are presented and information regarding ways of coping with the negative effects of secondary traumatization is discussed.
Solidly grounded in up-to-date research, theory and technology,?Teaching Secondary Mathematics?is a practical, student-friendly, and popular text for secondary mathematics methods courses. It provides clear and useful approaches for mathematics teachers, and shows how concepts typically found in a secondary mathematics curriculum can be taught in a positive and encouraging way. The thoroughly revised fourth edition combines this pragmatic approach with truly innovative and integrated technology content throughout. Synthesized content between the book and comprehensive companion websi
Secondary amenorrhea is the cessation of menstrual flow for a period of 6 months or more in the absence ... as anxiety can be the root cause of amenorrhea. Treatment can range from behavior modification for excessive ...
Ida Ayu Basmatika
Full Text Available Secondary brain injury is a condision that occurs at some times after the primary impact and can be largely prevented and treated. Most brain injury ends with deadly consequences which is caused by secondary damage to the brain. Traumatic brain injured still represents the leading cause of morbidity and mortality in individuals under the age of 45 years in the world. The classification of secondary brain injured is divided into extracranial and intracranial causes. The cause of extracranial such as hipoxia, hypotensi, hyponatremia, hypertermia, hypoglycemia or hyperglycemia. The cause of intracranial such as extradural, subdural, intraserebral, intraventrikular, dan subarachnoid hemorrhage. Beside that secondary injury can also be caused by edema and infection. Post-traumatic cerebral injured is characterized by direct tissue damage, impaired regulation of cerebral blood flow (cerebral blood flow / CBF, and disruption of metabolism. Manifestations of secondary brain injured include increased intracranial pressure, ischemic brain damage, cerebral hypoxia and hypercarbi, as well as disruption of cerebral autoregulation. The first priority is to stabilize the patient's cervical spine injury, relieve and maintain airway, ensure adequate ventilation (breathing, and making venous access for fluid resuscitation pathways (circulation and assessing the level of awareness and disability. This steps is crucial in patients with head injured to prevent hypoxia and hypotension, which is the main cause of secondary brain injury.
Tart, Kelly M; Babski, Danielle M; Lee, Justine A
To evaluate a clinical population of dogs diagnosed with presumptive aspiration pneumonia (AP) and determine diagnostic and treatment modalities contributing to survival. Retrospective study. A university veterinary teaching hospital in an urban setting. One hundred and twenty-five dogs with presumed AP treated from 2005 to 2008. None. Dogs with presumptive AP identified by a review of medical records had an overall survival of 81.6% (102/125). Male large-breed dogs (mean 24.9 kg; 82/125) were overrepresented and were more likely to develop AP in this study population. Recent anesthesia had been performed in 16% (20/125), and vomiting was reported in 64% (80/125). The most common radiographic findings were a predominantly alveolar pattern (187/272, [68.8%] total lung lobes) in the right middle lung lobe (80/115, [69.6%]). A mean of 2 lung lobes were involved radiographically, and the relationship between survival and the number of lung lobes affected was statistically significant (P=0.04). Neutrophilia with a left shift was common with no significant change on consecutive daily evaluations. The mean PaO(2) was 77.7 mm Hg (SD, 17.5 mm Hg) (range, 40.7-100 mm Hg) with a median alveolar-arterial gradient of 41.1 mm Hg (range, 8.1-81.8 mm Hg). In this study population, 37.6% (47/125) of dogs had microbial cultures performed and of these, 76.6% (36/47) were positive for growth; Escherichia coli (38.8%), Mycoplasma spp. (21.3%), Pasturella spp. (19.1%), and Staphylococcus spp. (17%) were the most common isolates in either single or multiagent infections. No treatment modality was statistically associated with increased survival. Colloid therapy was a negative prognostic indicator. In this study the overall prognosis for AP was good. Patients with only 1 affected lung lobe appeared more likely to survive. Supportive treatment modalities are warranted for the hospitalized patient, although no individual treatment method was found to be clearly superior to others.
Full Text Available Laboratory confirmation among presumptive tuberculosis (PTB patients is pivotal in ensuring prompt management. Limited information exists in Tanzania regarding the performance of GeneXpert MTB/RIF® in comparison with conventional methods. An operational study was conducted involving 806 PTB patients at Sekou Toure Hospital in Mwanza, Tanzania from June to November 2013. Patients’ information was obtained and their respective sputum samples analyzed by lightemitting diode fluorescent microscopy (LED FM and GeneXpert MTB/RIF®. The mean age of study participants was 39.6±16.0 years, with males accounting for 50.5%. The majority of patients (97.5% were new cases. The proportions of PTB patients confirmed by LED FM and GeneXpert MTB/RIF® were 14.1% (114/806 and 23.7% (191/806 respectively, resulting into a 9.6% incremental detection rate by GeneXpert MTB/RIF® over LED FM. The detection rate among HIV positive individuals was also higher [23.6% (63/267 vs 14.2% (38/267, respectively], with an incremental detection of 9.4%. The incremental detection of PTB by GeneXpert MTB/RIF® over LED FM calls for expansion of its use to increase detection of smear negative PTB among people living with HIV.
Ramage, Jason G; Prentice, Kristin W; DePalma, Lindsay; Venkateswaran, Kodumudi S; Chivukula, Sruti; Chapman, Carol; Bell, Melissa; Datta, Shomik; Singh, Ajay; Hoffmaster, Alex; Sarwar, Jawad; Parameswaran, Nishanth; Joshi, Mrinmayi; Thirunavkkarasu, Nagarajan; Krishnan, Viswanathan; Morse, Stephen; Avila, Julie R; Sharma, Shashi; Estacio, Peter L; Stanker, Larry; Hodge, David R; Pillai, Segaran P
We conducted a comprehensive, multiphase laboratory evaluation of the Anthrax BioThreat Alert(®) test strip, a lateral flow immunoassay (LFA) for the rapid detection of Bacillus anthracis spores. The study, conducted at 2 sites, evaluated this assay for the detection of spores from the Ames and Sterne strains of B. anthracis, as well as those from an additional 22 strains. Phylogenetic near neighbors, environmental background organisms, white powders, and environmental samples were also tested. The Anthrax LFA demonstrated a limit of detection of about 10(6) spores/mL (ca. 1.5 × 10(5) spores/assay). In this study, overall sensitivity of the LFA was 99.3%, and the specificity was 98.6%. The results indicated that the specificity, sensitivity, limit of detection, dynamic range, and repeatability of the assay support its use in the field for the purpose of qualitatively evaluating suspicious white powders and environmental samples for the presumptive presence of B. anthracis spores.
Ramage, Jason G; Prentice, Kristin Willner; Morse, Stephen A; Carter, Andrew J; Datta, Shomik; Drumgoole, Rahsaan; Gargis, Shaw R; Griffin-Thomas, Latoya; Hastings, Rebecca; Masri, Heather P; Reed, Matthew S; Sharma, Shashi K; Singh, Ajay K; Swaney, Erin; Swanson, Tanya; Gauthier, Cheryl; Toney, Denise; Pohl, Jan; Shakamuri, Priyanka; Stuchlik, Olga; Elder, Ian A; Estacio, Peter L; Garber, Eric A E; Hojvat, Sally; Kellogg, Richard B; Kovacs, Gerald; Stanker, Larry; Weigel, Linda; Hodge, David R; Pillai, Segaran P
Abrin is a heterodimeric toxin present in the seeds of the Abrus precatorius plant. The easily obtainable seeds can yield a highly toxic product that can be used in various types of biocrimes and terrorism-related activities, including "white-powder" letters. Although the vast majority of these threats are hoaxes, the lack of rapid and reliable detection assays for abrin, such as lateral flow assays (LFAs), can be an impediment to accurate and rapid hazard assessment. One of the complicating factors associated with LFAs is the use of antibodies of poor affinity and specificity that cross-react with near neighbors or that bind to plant lectins, which are capable of nonspecifically cross-linking the capture and detector antibodies. Because of the critical need to promote public safety and public health, we conducted a comprehensive laboratory evaluation of a commercial LFA for the rapid detection of abrin. This study was conducted using comprehensive inclusivity and exclusivity panels of abrin and near-neighbor plant materials, along with panels of lectins, related proteins, white powders, and environmental background material, to determine the sensitivity, specificity, limit of detection, dynamic range, and repeatability of the assay for the specific intended use of evaluating suspicious white powders and environmental samples for the presumptive presence of abrin.
Darling, C L
Primary cultures of clinical material were screened for the presence of colonies suspected of being Streptococcus agalactiae (Lancefield group B). Sixty-three such cultures and 108 other isolates of beta-hemolytic streptococci (groups A, C, and G), encountered during the first 3 months of the investigation, were studied by Lancefield grouping, sodium hippurate hydrolysis, and a standardized CAMP test. All streptococci were inoculated perpendicularly to streaks of a beta-toxin-producing staphylococcus on sheep blood agar plates and incubated aerobically in a candle jar and anaerobically at 37 C. Plates were examined after 5 to 6 and 18 h of incubation. The production of a distinct "arrowhead" of hemolysis was indicative of a positive CAMP reaction. All group B streptococci produced a positive CAMP reaction in the candle jar or anaerobically, usually within 5 to 6 h, and aerobically after 18 h of incubation. All group A streptococci produced a positive reaction only under anaerobic conditions. Groups C and G streptococci were negative under all atmospheres. The CAMP reaction is a prompt and reliable procedure for the presumptive identification of group B streptococci when a candle jar atmosphere is used during incubation.
Baby, Sabulal; Johnson, Anil John; Govindan, Balaji
Ganoderma is a genus of medicinal mushrooms. This review deals with secondary metabolites isolated from Ganoderma and their biological significance. Phytochemical studies over the last 40years led to the isolation of 431 secondary metabolites from various Ganoderma species. The major secondary compounds isolated are (a) C30 lanostanes (ganoderic acids), (b) C30 lanostanes (aldehydes, alcohols, esters, glycosides, lactones, ketones), (c) C27 lanostanes (lucidenic acids), (d) C27 lanostanes (alcohols, lactones, esters), (e) C24, C25 lanostanes (f) C30 pentacyclic triterpenes, (g) meroterpenoids, (h) farnesyl hydroquinones (meroterpenoids), (i) C15 sesquiterpenoids, (j) steroids, (k) alkaloids, (l) prenyl hydroquinone (m) benzofurans, (n) benzopyran-4-one derivatives and (o) benzenoid derivatives. Ganoderma lucidum is the species extensively studied for its secondary metabolites and biological activities. Ganoderma applanatum, Ganoderma colossum, Ganoderma sinense, Ganoderma cochlear, Ganoderma tsugae, Ganoderma amboinense, Ganoderma orbiforme, Ganoderma resinaceum, Ganoderma hainanense, Ganoderma concinna, Ganoderma pfeifferi, Ganoderma neo-japonicum, Ganoderma tropicum, Ganoderma australe, Ganoderma carnosum, Ganoderma fornicatum, Ganoderma lipsiense (synonym G. applanatum), Ganoderma mastoporum, Ganoderma theaecolum, Ganoderma boninense, Ganoderma capense and Ganoderma annulare are the other Ganoderma species subjected to phytochemical studies. Further phytochemical studies on Ganoderma could lead to the discovery of hitherto unknown biologically active secondary metabolites. Copyright © 2015 Elsevier Ltd. All rights reserved.
Wang, Justin; Alotaibi, Naif M; Samuel, Nardin; Ibrahim, George M; Fallah, Aria; Cusimano, Michael D
Acquired Chiari malformations (ACM) and associated syringomyelia secondary to space-occupying lesions can cause neurologic deficits independent of or in combination with the offending mass. Although type I Chiari malformations are traditionally treated with posterior fossa decompression, optimal surgical management of ACM and associated syringomyelia remains unclear. The purpose of this study is to review the current literature surrounding the management of ACM. A systematic review was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Using the relevant keywords, articles were identified through multiple databases from inception to April 2016. Our primary outcome was postoperative resolution of tonsillar herniation, syringomyelia, and clinical symptoms and signs. Thirty studies (27 case reports and 3 case series), encompassing 44 patients, were included in the review. Meningiomas (36%) and arachnoid cysts (32%) were the lesions most commonly associated with ACM. Offending lesions were usually large (85%) and almost all were found in the posterior fossa (89%). Syringomyelia was present in 82% of cases. Overall, all but 1 patient had improvement or resolution of their syringomyelia after surgery and none required a syrinx shunt. Rates of tonsillar ascent, syrinx resolution, and neurologic recovery were similar in patients who underwent lesion removal alone versus those who underwent posterior fossa decompression and lesion removal. Space-occupying lesions in the posterior fossa are a rare cause of ACM and syringomyelia. Surgical management of the underlying lesion improves ACM and associated syringomyelia without the need for syrinx shunting. Copyright © 2016 Elsevier Inc. All rights reserved.
Melander, L.; Sonders, U.
Secondary isotope effects can be produced by isotopes of elements heavier than hydrogen, but secondary isotope effects of hydrogen are of greater interest, because they are larger and can be measured easier. Such aspects of the problem as solvolytic reactions (in the case of α-position and β-position in organic compounds), reactions of compounds with deuterium remoted from reaction centre, with deuterium in nonsaturated compounds, participation of neighbouring groups in the reaction, are considered. Besides, steric isotope effects and inductive isotope effects are considered
Herrick, Ariane; Muir, Lindsay
Raynaud's phenomenon is episodic vasospasm of the peripheral vessels. It presents as episodic colour changes of the digits (sometimes accompanied by pain and paraesthesia), usually in response to cold exposure or stress. The classic triphasic colour change is white (ischaemia), then blue (de-oxygenation), then red (reperfusion). Raynaud's phenomenon can be primary (idiopathic) or secondary to several different conditions and causes. When secondary (e.g., to systemic sclerosis), it can progress to ulceration of the fingers and toes. This review deals with secondary Raynaud's phenomenon. We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of surgical interventions in complicated secondary Raynaud's phenomenon? We searched: Medline, Embase, The Cochrane Library, and other important databases up to March 2014 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). We found two studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. In this systematic review, we present information relating to the effectiveness and safety of the following interventions: botulinum toxin, simple debridement/surgical toilet of ulcers, peripheral sympathectomy (digital, digital plus sympathectomy of the ulnar and/or radial artery, ligation of the ulnar artery), cervical/thoracic sympathectomy, arterial reconstruction (venous graft, arterial graft, balloon angioplasty), and amputation.
Figure shows formation of two secondary drops of unequal size and their merger. The process is same as the earlier process until t= 0.039 Tc with necking occurring at two places, one at the bottom of the column and the other at the middle. The necking at the middle of the liquid column is due to Raleigh instability.
Moye, Michael D.; And Others
This curriculum guide is designed to offer guidelines along with supporting resources and teaching ideas from which the local secondary instructor can extract a cosmetology curriculum that meets local needs. Following an outline of the philosophy and goals underlying state and local vocational education programs in Georgia, the purpose and…
First page Back Continue Last page Overview Graphics. Notes: Figure shows formation of two secondary drops of unequal size and their merger. The process is same as the earlier process until t= 0.039 Tc with necking occurring at two places, one at the bottom of the column and the other at the middle. The necking at the ...
Tantelinirina Rakotondriamanga, Jean Kala and Jutta M. Hammer
CH-8057 Zurich, Switzerland. Missouri Botanical Garden (MBG). Madagascar Research and Conservation Program. BP 3391. Antananarivo, 101 ..... south are clearly influenced by tourism, where forests are heav- ily exploited for construction material and charcoal production. (Du Puy and Moat 1998, Seddon et al. 2000).
Full Text Available No abstract available. Article truncated at 150 words. A 40 year-old woman with adult attention deficit hyperactive and bipolar 1 disorder presents with an altered mental status. Per her family, she had been non-verbal, with reduced oral intake, confusion and sedated for the past three days. Per her husband, she had episodes of diarrhea and abdominal discomfort. She was on multiple medications including ramelteon 8mg nightly, atomoxetine 40mg daily, hydroxyzine 25mg twice daily, bupropion 75mg twice daily and risperidone 2mg daily with recent addition of lithium ER 1200mg/daily started one month prior to presentation with unknown adherence. Upon arrival, vital signs were within normal limits. Physical exam revealed an overweight Caucasian woman with a significant coarse tremor visible at rest, restlessness and diaphoresis. Neurological examination was limited by patient hesitancy, however, it did not demonstrate focal deficits except for altered consciousness with Glasgow Coma Scale of 10. Notable laboratory findings were Na+ 134 mEq/L, K+ 3.2 mEq/L, and ...
Christiansen, Dorte Mølgaard; Bak, Rikke; Elklit, Ask
secondary victims, including family members, partners, and friends of male and female rape victims. We found that many respondents found it difficult to support the PV and that their relationship with the PV was often affected by the assault. Furthermore, the sample showed significant levels...... of social support for the respondent, and feeling let down by others. The respondents were generally interested in friend-, family-, and partner-focused interventions, particularly in receiving education about how best to support a rape victim...
Sroubek, Z.; Zavadil, J.; Kubec, F.
Secondary ion mass spectroscopy is one of the modern methods suitable for the analysis of thin films and solid state surfaces. The method is capable of providing the compositional information with a depth resolution below 0.1 μm and a sensitivity of the order of 10 -3 ppm for some impurities. The review article contains a description of the method, a list of typical applications and a short account of relevant theories. (author)
Temporomandibular joint, or TMJ, dysfunction, can be a cause of secondary headache. Secondary headaches result from underlying disorders which produce pain as a symptom. The TMJ may become painful and dysfunctional as a result ...
To critically appraise experimental ex vivo research that has focused on secondary caries, and to offer possible explanations for the seemingly poor correlation to clinical observations. The literature relating to the etiopathogenesis or prevention of secondary caries gained from experimental ex vivo research was reviewed, with particular emphasis on microleakage and artificial caries-like lesions. It is doubtful whether a caries wall lesion can exist independently of an outer enamel caries lesion. Microleakage experiments apparently continue to emerge regardless of multiple reviews questioning the reliability and validity of the method. Several of the approaches used to generate artificial caries-like lesions are very aggressive. Remarkably little discussion has evolved about how these aggressive approaches create microenvironments that do not occur in reality. Corrosion- and biodegradation products may influence the biofilm qualitatively and quantitatively and it is difficult to replicate these variables in any ex vivo environment. Clinical data sampling method, patient demography as well as study methodology influences the incidence and prevalence estimates of secondary caries. Clinical results based on clinical work in settings where cost per unit time is of nominal concern do not provide any indications on how the restorative material will perform when placed by the average dentists in the mouths of their spectrum of patients during a busy workday. The term "wall lesion" including its variants is ill defined, has been, and is still being used indiscriminately. Stakeholders should avoid using this ambiguous label due to its connotation to an entity that does not exist per se. Copyright © 2015 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.
M. Yu. Yukina
Full Text Available Hypertension is a very common disease with high morbidity and reduction in quality of life. Endocrine disorders are the most common cause of secondary hypertension affecting ~3% of the population. Primary aldosteronism can be the cause of endocrine hypertension more often than other endocrine disorders. Other less common causes of endocrine hypertension include Cushing syndrome, pheochromocytoma, thyroid disorders, and hyperparathyroidism. Endocrine hypertension is potentially curable if the underlying cause is identified and treated accordingly. Younger age at manifestation of resistance to multiple antihypertensive drugs, together with other clinical signs of an endocrine disorder, should raise the suspicion and prompt the appropriate evaluation.
GANIL, a user's facility since 1983, can deliver a broad spectrum of heavy-ion beams, from He to U, to well-equipped experimental areas. Their very large intensities are to be exploited to produce secondary beams, either using the fragmentation method (beams at energy per nucleon larger than 30 MeV/u), or the ISOL method. With the latter one, these ions have to be re-accelerated. The project of a cyclotron as a post-accelerator is described. (author) 11 refs.; 7 figs.; 3 tabs
Murray, Eileen; Baldinger, Erin; Wasserman, Nicholas; Broderick, Shawn; White, Diana
There is an ongoing debate among scholars in understanding what mathematical knowledge secondary teachers should have in order to provide effective instruction. We explore connections between advanced and secondary mathematics as an entry point into this debate. In many cases, advanced mathematics is considered relevant for secondary teachers…
Full Text Available Background & Objectives: Considering new pandemic attack with new emerging (H1N1 influenza virus, the study was designed for evaluating clinical and epidemiologic characteristics of patients in Imam Khomeini hospital, admitted with presumptive diagnosis of H1N1 influenza . In all of the patients clinical and paraclinical findings and outcome (including mortality rate and definitive diagnosis were evaluated. Bed occupancy rate in infectious disease ward and ICU and also mean days of admission were calculated. Methods: This is a cross sectional study . All 118 patients with acute respiratory symptoms and possible diagnosis of emerging H1N1 influenza that had been admitted at least 24 hours in hospital from 20 October to 1 February 2009 were enrolled in the study. Data collection was done based on questionnaires, with a team other than researchers. The questionnaire included demographic data , clinical symptoms , laboratory findings , radiographic manifestations and outcome of patients. Data analysis was performed with SPSS software version16. Results: A total of 118 patients were studied: 71 patients ( 60.2% were female and 47 patients ( 39.8% were male. Mean ( ± SD age of admitted patients was 33.81 ± 15.64 years old. The most of admitted patients were in age range of 15 to 30 years old. The most common findings in CXR were bilateral respiratory consolidations and the most common symptoms were fever, weakness and fatigue. About 12.7% of patients had diarrhea. Leukopenia (WBC 10000 occurred respectively in 4.58% and 33.2% of cases . Nine patients (7% were admitted in ICU. I n 21 patients (18% RT-PCR test results were positive and three of these patients had been admitted in ICU. In patients admitted in ICU while their diagnosis was confirmed, mortality was 33%. 48.3% of patients had at least one predisposing medical condition . Total admission days were 577 days, consisting 519 days in infectious disease ward and 58 days in ICU. Average of
Goldberg, Matthew S; Doucette, John T; Lim, Henry W; Spencer, James; Carucci, John A; Rigel, Darrell S
Since its inception in 1985, the American Academy of Dermatology (AAD) National Melanoma/Skin Cancer Screening Program has strived to enhance early detection of cutaneous malignant melanoma (MM) by providing nationwide skin cancer education campaigns in combination with free skin cancer screenings. To analyze the AAD screening data from 2001 to 2005 in order to identify factors associated with MM detection, and thereby derive a model of increased likelihood for MM detection through visual skin examinations at screenings. Patients completed a standardized AAD pre-screening form with historical and phenotypic information. Clinicians then recorded suspected clinical findings noted at visual skin examination. Statistical analyses were conducted using SPSS 14 (SPSS Inc., Chicago, Ill). Five factors, which can be remembered with the acronym HARMM, independently increased the likelihood of suspected MM being found in the 362,804 persons screened: History of previous melanoma (odds ratio [OR] = 3.3; 95% confidence interval [CI], 2.9-3.8); Age over 50 (OR = 1.2; 95% CI, 1.1-1.3); Regular dermatologist absent (OR = 1.4; 95% CI, 1.3-1.5); Mole changing (OR = 2.0; 95% CI, 1.9-2.2); and Male gender (OR = 1.4; 95% CI, 1.3-1.5). Individuals at highest risk (4 or 5 factors) comprised only 5.8% of the total population, yet accounted for 13.6% of presumptive MM findings, and were 4.4 times (95% CI, 3.8-5.1) more likely to be diagnosed with suspected MM than individuals at lowest risk (0 or 1 factor). Receipt of a total skin examination at screening independently increased the likelihood for identifying suspected MM (OR = 1.4; 95% CI, 1.3-1.6). However, significantly fewer screenees in the highest risk group versus those in the lowest risk group underwent total skin examinations (53.7% vs 62.5%). Risk factors studied limited to variables collected in screenee enrollment form. A higher-risk subgroup of the skin cancer screening population can be identified through assessment of MM
Christiansen, Dorte; Bak, Rikke; Elklit, Ask
Rape is often a very traumatic experience, which affects not only the primary victim (PV) but also his/her significant others. Studies on secondary victims of rape are few and have almost exclusively studied male partners of female rape victims. This study examined the impact of rape on 107 secondary victims, including family members, partners, and friends of male and female rape victims. We found that many respondents found it difficult to support the PV and that their relationship with the PV was often affected by the assault. Furthermore, the sample showed significant levels of traumatization, and it was estimated that approximately one quarter of the respondents suffered from posttraumatic stress syndrome (PTSD). Degree of traumatization was associated with a more recent assault, higher efforts to support the PV, recurrent thoughts about having been able to prevent the assault, a lack of social support for the respondent, and feeling let down by others. The respondents were generally interested in friend-, family-, and partner-focused interventions, particularly in receiving education about how best to support a rape victim.
Presumption of lawful acquirement of property and confiscation of unlawfully acquired property in the case-law of the Romanian Constitutional Court. The reference constitutional framework for regulating of the extended confiscation
Full Text Available This study examines - from a dual perspective - historical and teleological, the constitutional provisions that enshrine the presumption of lawful acquirement of assets, including the development and interpretation thereof in the case-law of the Constitutional Court, in order to create a framework for analysis of Law no. 63/2012 amending and supplementing the Criminal Code and Law no. 286/2009 on the Criminal Code, a law that establishes the measure of extended confiscation, expression of international regulatory concerns in this area.
Larsen, Britt Østergaard; Jensen, Leif; Pilegaard Jensen, Torben
The purpose of this article is to investigate educational choices and attainment of children who experience social problems during their upbringing. The study explores the extent to which social problems can help explain the gaps in entry and dropout rates in upper secondary education in Denmark...... statistical model of educational progression. By using this method, we parcel educational attainment into a series of transitions and the model is able to control for educational selection and unobserved heterogeneity. We apply counterfactual analyses to allow a formal decomposition of the effects of social...... problems. The results show that social problems during upbringing have a large and significant effect on children's educational outcome and that the indicators of social problems explain about 20–30 per cent of the class differences in the students’ educational outcomes....
Basanta, I; Sevillano, C; Álvarez, M D
A case is presented of an 85 year-old Caucasian female with lymphoma that recurred in the orbit (secondary ocular adnexal lymphoma). The orbital tumour was a diffuse large B-cell lymphoma according to the REAL classification (Revised European-American Lymphoma Classification). Orbital lymphomas are predominantly B-cell proliferations of a variety of histological types, and most are low-grade tumours. Patients are usually middle-aged or elderly, and it is slightly more common in women. A palpable mass, proptosis and blepharoptosis are the most common signs of presentation. Copyright © 2011 Sociedad Española de Oftalmología. Published by Elsevier España, S.L.U. All rights reserved.
This study was undertaken in Dodoma Municipal, Tanzania in order to assess the development and status of school library services under the Secondary Education Development Plan (SEDP). The study involved 44 secondary schools, 186 teachers, 44 heads of schools, 16 school librarians, one Regional Education Officer, ...
This talk deals with the investigation of secondary interactions in proton-nucleus and nucleus-nucleus collisions using the Monte Carlo event generator HIJET. The HIJET generator considers p-A and A-A collisions to be a sum of independent N-N collisions, with the N-N cross section and scattering dynamics not dependent on whether the nucleon has previously participated in an interaction. It is very reasonable to assume that each collision should be well represented by an independent N-N collision, however the cross section for the forward going struck nucleon may be different. For each primary N-N interaction, a call is made to the MINBIAS routine of the program ISAJET - an event generator for high energy N-N interactions. MINBIAS computes the energy loss of the colliding nucleons and production of particles. MINBIAS is based on inclusive high energy N-N interactions forming multi-pomeron chains, with each chain fragmenting according to the Field-Feynman algorithm
Marcum-Dietrich, Nanette I.; Mahoney, Tim
Millersville University of Pennsylvania (MU) has over 150 years of proud heritage in the preparation of teachers. This article describes how the Secondary Education Professional Development School (PDS) Program model has transformed Millersville University's secondary teacher education from a traditional teacher preparation program into a dynamic…
This article considers the far-reaching potential and the particular characteristics of performance art within the secondary art curriculum. It discusses the means by which an art department has incorporated it into their teaching curriculum at a state secondary school with reference to installations and the work of different performance artists…
Hollanders, A.C.C.; Kuper, N.K.; Opdam, N.J.M.; Huysmans, M.C.D.N.J.M.
Secondary caries is reported as one of the most important reasons for replacing restorations. The patient's general caries risk plays an important role in the development of secondary caries. The connection, at the patient level, between various factors, the risk of caries and restoration factors,
Md Saion bin Salikin.
A secondary Standard Dosimetry Laboratory has been established in the Tun Ismail Research Centre, Malaysia as a national laboratory for reference and standardization purposes in the field of radiation dosimetry. This article gives brief accounts on the general information, development of the facility, programmes to be carried out as well as other information on the relevant aspects of the secondary standard dosimetry laboratory. (author)
H. Corby eKistler
Full Text Available Fungal secondary metabolism is often considered apart from the essential housekeeping functions of the cell. However, there are clear links between fundamental cellular metabolism and the biochemical pathways leading to secondary metabolite synthesis. Besides utilizing key biochemical precursors shared with the most essential processes of the cell (e.g. amino acids, acetyl CoA, NADPH, enzymes for secondary metabolite synthesis are compartmentalized at conserved subcellular sites that position pathway enzymes to use these common biochemical precursors. Co-compartmentalization of secondary metabolism pathway enzymes also may function to channel precursors, promote pathway efficiency and sequester pathway intermediates and products from the rest of the cell. In this review we discuss the compartmentalization of three well-studied fungal secondary metabolite biosynthetic pathways for penicillin G, aflatoxin and deoxynivalenol, and summarize evidence used to infer subcellular localization. We also discuss how these metabolites potentially are trafficked within the cell and may be exported.
Westsik, Joseph H.
Summary The U.S. Department of Energy (DOE) is making plans to dispose of 54 million gallons of radioactive tank wastes at the Hanford Site near Richland, Washington. The high-level wastes and low-activity wastes will be vitrified and placed in permanent disposal sites. Processing of the tank wastes will generate secondary wastes, including routine solid wastes and liquid process effluents, and these need to be processed and disposed of also. The Department of Energy Office of Waste Processing sponsored a meeting to develop a roadmap to outline the steps necessary to design the secondary waste forms. Representatives from DOE, the U.S. Environmental Protection Agency, the Washington State Department of Ecology, the Oregon Department of Energy, Nuclear Regulatory Commission, technical experts from the DOE national laboratories, academia, and private consultants convened in Richland, Washington, during the week of July 21-23, 2008, to participate in a workshop to identify the risks and uncertainties associated with the treatment and disposal of the secondary wastes and to develop a roadmap for addressing those risks and uncertainties. This report describes the results of the roadmap meeting in Richland. Processing of the tank wastes will generate secondary wastes, including routine solid wastes and liquid process effluents. The secondary waste roadmap workshop focused on the waste streams that contained the largest fractions of the 129I and 99Tc that the Integrated Disposal Facility risk assessment analyses were showing to have the largest contribution to the estimated IDF disposal impacts to groundwater. Thus, the roadmapping effort was to focus on the scrubber/off-gas treatment liquids with 99Tc to be sent to the Effluent Treatment Facility for treatment and solidification and the silver mordenite and carbon beds with the captured 129I to be packaged and sent to the IDF. At the highest level, the secondary waste roadmap includes elements addressing regulatory and
Hemorragia de tronco cerebral após remoção cirúrgica de cisto aracnóide da fissura silviana: Relato de caso Brainstem hemorrhage after surgical removal of arachnoid cyst of the sylvian fissure: case report
Full Text Available Os autores relatam um caso de hemorragia de tronco cerebral após craniotomia para ressecção de grande cisto aracnóide de fissura silviana esquerda. A sintomatologia inicial pré-operatória incluía sinais de hipertensão intracraniana e a tomografia computadorizada mostrava desvio de linha média. Diversos fatores são discutidos para explicar o sangramento parenquimatoso pós-operatório: edema cerebral, diminuição do retorno venoso e de fluxo sanguíneo no lado comprimido. Entretanto a fisiopatologia da hemorragia parenquimatosa em casos como o relatado permanece obscura. Uma abordagem cirúrgica mais cautelosa é proposta nesses pacientes com de hipertensão intracraniana.The authors report a case of a hemorrhage of the brainstem after craniotomy for resection of a huge arachnoid cyst of the sylvian fissure on the left hemisphere. The previous simptomatology included clinical signs of increased intracranial pressure, and the computerized tomography showed midline shift. Some factors may contribute to brain hemorrhage post-operatively: cerebral edema, ipsilateral changes in the venous reflux and blood perfusion, although the physiopathology remains obscure. A more careful approach is suggested in such cases with intracranial hypertension.
Full Text Available OBJECTIVE: To determine the sensitivity and specificity of a Computer Aided Diagnosis (CAD program for scoring chest x-rays (CXRs of presumptive tuberculosis (TB patients compared to Xpert MTB/RIF (Xpert. METHOD: Consecutive presumptive TB patients with a cough of any duration were offered digital CXR, and opt out HIV testing. CXRs were electronically scored as normal (CAD score ≤ 60 or abnormal (CAD score > 60 using a CAD program. All patients regardless of CAD score were requested to submit a spot sputum sample for testing with Xpert and a spot and morning sample for testing with LED Fluorescence Microscopy-(FM. RESULTS: Of 350 patients with evaluable data, 291 (83.1% had an abnormal CXR score by CAD. The sensitivity, specificity, positive predictive value (PPV and negative predictive value (NPV of CXR compared to Xpert were 100% (95%CI 96.2-100, 23.2% (95%CI 18.2-28.9, 33.0% (95%CI 27.6-38.7 and 100% (95% 93.9-100, respectively. The area under the receiver operator curve (AUC for CAD was 0.71 (95%CI 0.66-0.77. CXR abnormality correlated with smear grade (r = 0.30, p<0.0001 and with Xpert CT(r = 0.37, p<0.0001. CONCLUSIONS: To our knowledge this is the first time that a CAD program for TB has been successfully tested in a real world setting. The study shows that the CAD program had high sensitivity but low specificity and PPV. The use of CAD with digital CXR has the potential to increase the use and availability of chest radiography in screening for TB where trained human resources are scarce.
The invention relates to a method of producing ethanol by fermentation, said method comprising a secondary liquefaction step in the presence of a themostable acid alpha-amylase or, a themostable maltogenic acid alpha-amylase.......The invention relates to a method of producing ethanol by fermentation, said method comprising a secondary liquefaction step in the presence of a themostable acid alpha-amylase or, a themostable maltogenic acid alpha-amylase....
Salama, F.M.; El-Shabrawy, N.O.; Nosseir, S.A.; Abo El-Azayem, Naglaa.
Impotence is one of the problems which is still obscure both in its aetiology and treatment. The present study deals with the possible hormonal changes in cases of secondary infertility. The study involved 25 patients diagnosed as secondary impotence. Hormonal assay was performed for the following hormones: 1. Prolaction hormone. 2. Luteinising hormone (L.H.). 3. Testosterone. 4. Follicle stimulating hormone (F.S.H.). The assay was carried out by radioimmunoassay using double antibody technique. Results are discussed
Kanaya, K.; Ono, S.; Ishigaki, F.
The high yield of secondary electron emission from insulators due to electron bombardment may be the result of an increase of the depth of escape. The free-electron scattering theory is applied to the high energy of primary beams, but cannot be applied to the low energy of secondary escaping beams because of the large energy gap of the insulators. The plasmon loss with the valence electron is considered when the secondary electrons escape. Based on the energy retardation power formula of the penetration and energy loss of an electron probe into solid targets, secondary electron emissions from insulators are calculated from the assumptions that the distribution of the secondary electrons due to both incident and back-scattered electrons within the target is isotropic and that it follows the absorption law of the Lenard type. The universal yield-energy curve of the secondary electron emission, which is deduced as a function of three parameters such as ionisation potential, valence electron and the back-scattered coefficient in addition to the free-electron density effect, is found to be in good agreement with the experimental results. (author)
Full Text Available A 70-year-old female, with a history of progressive dyspnoea, was admitted to the critical care unit after successful resuscitation following a witnessed, out of hospital cardiorespiratory arrest. A presumptive diagnosis of cardiorespiratory arrest secondary to an exacerbation of chronic obstructive pulmonary disease was made. However, on more detailed examination a large anterior, midline neck mass was noted. Following tracheal intubation, a computerised tomography scan of the patient’s neck and thorax revealed a seven-centimetre, well-defined, nonenhancing, rounded homogeneous opacity at the thoracic inlet, consistent with a large midline thyroid cyst. Needle aspiration of the cyst was performed and yielded approximately 50 mL of frank blood. After an uncomplicated tracheal extubation and recovery, an elective subtotal thyroidectomy was performed prior to hospital discharge. Histology of the specimen revealed a benign thyroid cyst within a multinodular goitre. Euthyroid multinodular goitres are more likely to be managed conservatively due to an asymptomatic clinical course in most patients. However, the risk of respiratory distress and acute airway obstruction from tracheal compression or acute haemorrhage should be kept in mind. Patients at risk of this life threatening complication should be managed with elective thyroidectomy to reduce morbidity and mortality.
Iglesias Otero, M; Portela Romero, M; Bugarín González, R; Ventura Victoria, M A
Raynaud's phenomenon is a clinical disease characterized by episodic attacks of vasoconstriction of the arteries and arterioles of the extremities such as fingers and toes, sometimes the ears and nose, in response to cold or emotional stimuli. A classic attack is the pallor of the distal extremity, followed by cyanosis and redness, accompanied by paresthesia, usually as heat. When it occurs without apparent cause is called primary Raynaud's phenomenon. When associated with other disease, is called secondary Raynaud's phenomenon. The secondary table is associated with increased frequency of rheumatic diseases of collagen. They can also present certain drugs that cause vasoconstriction, such as ergotamine, beta-adrenergic antagonists, contraception and sympathomimetic drugs. Regarding the latter, we present a case of Raynaud's phenomenon secondary to methylphenidate in a 14 years. Copyright © 2012 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.
Doubt, Lorna; McColl, Mary Ann
A phenomenological study of seven teenagers with physical disabilities attending a regular secondary school focused on social integration and the factors influencing it. Results showed extrinsic and intrinsic factors that facilitate or limit integration. Occupational therapists can ensure that schools are inclusive and that clients are capable of…
Cultural and national history have profoundly modeled Greek society and continue to play a vital role in Greek policy and in cultural and social life. This handbook provides a brief overview of secondary education in Greece. The first part describes the country's societal, historical, and political background; educational history and current…
... 34 Education 2 2010-07-01 2010-07-01 false Secondary school. 300.36 Section 300.36 Education... DISABILITIES General Definitions Used in This Part § 300.36 Secondary school. Secondary school means a nonprofit institutional day or residential school, including a public secondary charter school that provides...
Heitor, Teresa V.; Freire da Silva, Jose M. R.
The aim of the Secondary School Modernisation Programme, being implemented in Portugal by "Parque Escolar, EPE", is based on the pursuit of quality and makes Portuguese education a potential international benchmark. This paper discusses the strategies adopted to reorganise school spaces. It describes the conceptual model and highlights…
Manetti, Liliana Maria; Delaporte, Rosemeres Horwat; Laverde Jr., Antonio
This review describes aspects of the Bromeliaceae family dealing the traditional applications, biological activities and distribution of secondary metabolites in distinct subfamilies. Some species are used with medicinal purposed in the treatment of respiratory, diabetes or inflammation diseases, and gastrointestinal disorders. Special emphasis on cycloartane triterpenoids and flavonoids, typical metabolites of this family, are presented. Bromeliaceae is unique amongst the monocotyledons in t...
My program examines the plant secondary metabolites (i.e. phenolics) important for human health, and which impart the organoleptic properties that are quality indicators for fresh and processed foods. Consumer expectations such as appearance, taste, or texture influence their purchasing decisions; a...
Bari, A.U.; Mehmood, T.; Khan, B.; Malik, N.; Malik, K.Z.; Sukhera, A.M.
Syphilis is a chronic, systemic and sexually transmitted infectious disease affecting most of the organs in the body. A young African man presented with vertigo, unsteadiness of gait and a skin rash suggestive of secondary syphilis. Diagnosis was confirmed on serology and was treated with two shots of long-acting penicillin, following which his symptoms settled. (author)
Post, Gerhard F.; Ruizenaar, H.W.A.
The first step in constructing timetables in secondary schools in Netherlands consists of constructing the clusterschemes for the higher classes. A clusterscheme contains clusterlines with optional subjects that will be taught in parallel; the problem is to divide these optional subjects in
Karlson, Kristian Bernt
Current methods for decomposing class differentials in educational decisions into primary and secondary effects produce many parameters, rendering them ill-equipped for parsimonious comparisons across countries or birth cohorts. This paper develops a parametric method that provides an optimal sum...
Dennison, W. F.
Considers the problems inherent in British secondary school organization, the resistance to change built into the organizational systems, and possible organizational concepts that could serve the same general purposes (curricular oversight and student services) while adapting more successfully to changing needs and conditions. (PGD)
Full Text Available Infertility is an experience that strikes at the very core of a woman’s life and as a whole her family and society. Studies in Bangladesh to evaluate the factors are difficult to come by. This case control study was carried out from Jan 2010 to June 2010 to find out the factors associated with secondary infertility. A total of 70 cases were selected from the infertility unit of Bangabandhu Sheikh Mujib Medical University and 70 unmatched controls from the same hospital attending the pediatrics unit with their children were also recruited. Data were collected by interview and review of documents. No age difference was noticed between the cases (29.26 ± 4.13 and controls (29.21 ± 3.95. Association of secondary infertility was found with body mass index (p=0.036, previous bad obstetric history (p = 0.011 and previous caesarian delivery (p=0.044. Women with secondary infertility were more than four times more likely to have gynecological problem(s than their fertile counterparts [OR 4.76 with 95% CI (2.018-11.270]. The factors identified in this study might help the policy makers in designing prevention and health care programmes and thus reducing the hidden burden of secondary infertility. Ibrahim Med. Coll. J. 2011; 5(1: 17-21
Cines, Douglas B.; Liebman, Howard; Stasi, Roberto
Primary immune thrombocytopenic purpura (ITP) remains a diagnosis of exclusion both from nonimmune causes of thrombocytopenia and immune thrombocytopenia that develops in the context of other disorders (secondary immune thrombocytopenia). The pathobiology, natural history, and response to therapy of the diverse causes of secondary ITP differ from each other and from primary ITP, so accurate diagnosis is essential. Immune thrombocytopenia can be secondary to medications or to a concurrent disease, such as an autoimmune condition (eg, systemic lupus erythematosus [SLE], antiphospholipid antibody syndrome [APS], immune thyroid disease, or Evans syndrome), a lymphoproliferative disease (eg, chronic lymphocytic leukemia or large granular T-lymphocyte lymphocytic leukemia), or chronic infection, eg, with Helicobacter pylori, human immunodeficiency virus (HIV), or hepatitis C virus (HCV). Response to infection may generate antibodies that cross-react with platelet antigens (HIV, H pylori) or immune complexes that bind to platelet Fcγ receptors (HCV) and platelet production may be impaired by infection of megakaryocyte bone marrow-dependent progenitor cells (HCV and HIV), decreased production of thrombopoietin (TPO), and splenic sequestration of platelets secondary to portal hypertension (HCV). Sudden and severe onset of thrombocytopenia has been observed in children after vaccination for measles, mumps, and rubella or natural viral infections, including Epstein-Barr virus, cytomegalovirus, and varicella zoster virus. This thrombocytopenia may be caused by cross-reacting antibodies and closely mimics acute ITP of childhood. Proper diagnosis and treatment of the underlying disorder, where necessary, play an important role in patient management. PMID:19245930
I. A. Starodubtseva
Full Text Available The paper considers the problems of comorbidities in patients with rheumatoid arthritis (RA. Two or more RA-related conditions were diagnosed according to the results of the QUEST-RA program implemented in 34 countries. Osteoarthritis along with hypertension, hyperlipidemia, and osteoporosis was detected among the most commonly diseases. Owing to expanded diagnostic capabilities, the recognition and treatment of the comorbidities have recently received much attention, as embodied in the draft Association of Rheumatologists of Russia Guidelines for RA management (2014; Part 1. The concept and major characteristics of secondary osteoarthritis in RA are analyzed. It is precisely the inflammatory process and underlying disease-related risk factors, including treatment, that have impact on the development of secondary osteoarthritis and patients’ quality of life as a whole. All this allows an inference about the mechanisms closely intertwined with the underlying disease for the development of secondary osteoarthritis, which initiates cartilage damage and further remodeling. Primary and secondary osteoarthritis was comparatively analyzed. Particular emphasis is placed on current cartilage biomarkers, their diagnostic value and role in monitoring the efficiency of treatment in clinical trials. The paper provides a comparative analysis of detectable serum and urine biomarkers according to the results of the complex analysis made by the National Institutes of Health. Particular attention is given to cartilage oligomeric matrix protein (COMP. Foreign authors’ investigations suggest that there is a relationship between serum COMP levels and disease severity and joint X-ray changes. There is evidence for the efficacy of hyaluronic acid used in the treatment of secondary osteoarthritis in patients with RA.
Full Text Available Abstract Background The aim of this work was to detect antigens, non-self to the dam, potentially present in chick embryo prior to organogenesis with a view to establishing the consequences of their neutralization on chick development. To this end, hens were immunized with the extract from embryos incubated for 53 h. Their eggs were either used to isolate immunoglobulins for dot and blot tests or incubated for variable lengths of time. Results Immunoblot tests, using adsorbed primary and secondary antibodies against paternal serum, revealed the presence of at least four antigens of 32, 34, 70 and 200 kDa that can be classified as soluble alloantigens. The same antibodies against chick embryo extracts (between 53 h and 9 showed at least five aged antigens of 34, 52, 90, 200 and 250 kDa, not detected in cock serum, that can thus be considered as soluble, foreign to the immunized hens and transitory antigens. The abnormalities observed included arrested development and fetal death, as well as minor functional damage in the few chicks that were born alive. The ratio of abnormal to normal embryos was 2.85 in the experimental group and 0.43 in the control group. With regard to congenital anomalies it must be said that of the 81 eggs incubated only four chicks were born alive, and of these, only one had a healthy birth and subsequent growth. The other three showed a transitory ataxia and one of them presented adult lumbar scoliosis and asymmetric pelvis. Conclusions The problem of recurrent spontaneous abortions is revisited in the light of these results. Some recent data suggest that soluble alloantigens may be candidates for a new etiological entity in recurrent spontaneous abortions. They can also be the cause of some congenital anomalies. The soluble, foreign, transitory antigens may have a similar effect although there is no supportive data in the literature.
HIMALAIA (Hypertension Induction in the Management of AneurysmaL subArachnoid haemorrhage with secondary IschaemiA) : a randomized single- blind controlled trial of induced hypertension vs. no induced hypertension in the treatment of delayed cerebral ischemia after subarachnoid hemorrhage
Gathier, C. S.; van den Bergh, W. M.; Slooter, A. J. C.
RationaleDelayed cerebral ischemia (DCI) is a major complication after aneurysmal subarachnoid hemorrhage (SAH). One option to treat delayed cerebral ischemia is to use induced hypertension, but its efficacy on the eventual outcome has not been proven in a randomized clinical trial. This article
Retail fertilizer and pesticide dealers across the United States are installing secondary containment at their facilities or are seriously considering it. Much of this work is in response to new state regulations; however, many dealers not facing new regulations are upgrading their facilities to reduce their liability, lower their insurance costs, or comply with anticipated regulations. The Tennessee Valley Authority`s (TVA) National Fertilizer and Environmental Research Center (NFERC) has assisted dealers in 22 states in retrofitting containment to their facilities. Simultaneous improvements in the operational efficiency of the facilities have been achieved at many of the sites. This paper is based on experience gained in that work and details the rationale used in planning secondary containment and facility modifications.
Ringsted, Thomas K; Enghuus, Casper; Petersen, Morten A
of analgesic drug effects in humans. However, since the methods applied in demarcating the secondary hyperalgesia zone seem inconsistent across studies, we examined the effect of a standardized approach upon the measurement of SHA following a first degree burn injury (BI). NEW METHOD: The study was a two.......0001). No day-to-day or observer-to-observer differences in SHAs were observed. Intraclass correlation coefficients, in the range of 0.51 to 0.84, indicated a moderate to almost perfect reliability between observers. COMPARISON WITH EXISTING METHODS: No standardized approach in SHA-assessment has hitherto been...... presented. CONCLUSIONS: This is the first study to demonstrate that demarcation of secondary hyperalgesia zones depends on the developed pressure of the punctate stimulator used....
Phillips, M. J.; Lim, S. S.
The increase in the number of vehicles and, subsequently, the volume of batteries made by manufacturers in Malaysia have seen a dramatic rise in lead demand over the last five years. Without any lead mines, the only source of lead in Malaysia has been from the recycling of lead/acid batteries. Metal Reclamation (Industries) has commenced the design of a new and advanced secondary lead plant at West Port, Malaysia to meet the increasing demand for lead and the increasingly stringent environmental regulations. The plant is designed to produce up to 75 000 t of lead and lead alloys per year. The plant will also produce, as by-products: polypropylene chips, wallboard-grade gypsum, non-leachable slag for use in construction. A discussion of the process and the products from the new secondary smelter is outlined.
We describe a 90-year-old woman with right upper limb monoparesis secondary to varicella zoster virus infection as a result of extensive inflammatory involvement of the entire brachial plexus at root level. To our knowledge, this is the first report of entire brachial plexus involvement in a living patient of such advanced age. Despite a delay in presentation and thus initiation of treatment, a favourable clinical response was observed.
Aburjeli, Bruna de Oliveira Melim; Avila, Ana Flavia Assis de; Diniz, Renata Lopes Furletti Caldeira; Motta, Emilia Guerra Pinto Coelho; Ribeiro, Marcelo Almeida; Moreira, Wanderval, E-mail: email@example.com [Radiology and Imaging Diagnosis, Hospital Mater Dei, Belo Horizonte, MG (Brazil)
Secondary middle turbinate is an anatomical variant rarely observed in the nasal cavity, firstly described by Khanobthamchai et al. as a bone structure originating from the lateral nasal wall and covered by soft tissue. In most cases reported in the literature, this variant is bilateral, occurring without associated complications. In the present report, the authors describe the case of patient of their institution with such anatomical variation. (author)
Full Text Available Secondary mucin deposition in the skin is a common feature of lupus erythematosus and dermatomyositis. In scleroderma, it occurs uncommonly or in small amount. We describe a 7-year-old boy with progressive, linear, bound-down plaques involving the thighs, lower abdomen and back with no systemic involvement. Histopathology showed features of scleroderma with abundant mucin deposition in the reticular dermis. This report highlights excessive mucin deposition in lesions of morphea.
Validez del diagnóstico presuntivo de leishmaniasis cutánea realizado por mediadores comunitarios en Colombia The validity of a presumptive diagnosis of cutaneous leishmaniasis performed by community health workers in Colombia
captación activa de casos en la comunidad.OBJECTIVE: To validate a method for the presumptive diagnosis of cutaneous leishmaniasis based on the observation of clinical-epidemiological criteria, carried out by community health workers in three endemic municipalities in Santander, a department in northeastern Colombia. METHODS: This evaluation study of diagnostic technologies was based on a cross-sectional sampling of suspected cases of cutaneous leishmaniasis in the municipalities of Rionegro, El Playón, and Landázuri. After being trained, the community health workers carried out the presumptive diagnoses of cutaneous leishmaniasis between October 2004 and November 2005. At the time of diagnosis, the health workers also collected samples for confirmatory diagnosis through Field's stain method, culturing, and polymerase chain reaction. Four criteria were used to assess the validity of the presumptive diagnoses carried out by the health workers: sensitivity, specificity, positive predictive value, and negative predictive value. Replicability among the health workers was estimated through their observed level of agreement. RESULTS: According to the laboratory tests, of the 196 patients studied, 33 (16.8% were negative and 163 (83.2% were positive. For all the levels of certainty of the clinical diagnosis, the sensitivity was between 52% and 98% (k(1, 0 = 39.0% and the specificity between 9% and 55% (k(0, 0 = 14.0%. The area under the receiver operating characteristic curve was 56.5% (95% confidence interval: 45.6% to 67.4%. The proportion of positive agreement and of negative agreement was 86.3% and 43.5%, respectively. CONCLUSIONS: The sensitivity of the presumptive diagnosis carried out by the health workers surpasses that of the parasitological diagnostic methods generally used in the three endemic areas, but its specificity is much lower. Even though this approach is not useful as a diagnostic test for cutaneous leishmaniasis or as a criterion for deciding to proceed
Matrix effect and cross-reactivity of select amphetamine-type substances, designer analogues, and putrefactive amines using the Bio-Quant direct ELISA presumptive assays for amphetamine and methamphetamine.
Apollonio, Luigino G; Whittall, Ian R; Pianca, Dennis J; Kyd, Jennelle M; Maher, William A
The aim of this study was to evaluate the Bio-Quant Direct ELISA assays for amphetamine and methamphetamine in the routine presumptive screening of biological fluids. Standard concentration curves of the target analytes were assayed to assess sensitivity, and known concentrations of common amphetamine-type substances (ephedrine, pseudoephedrine, phentermine), designer analogues (MDA, MDMA, MDEA, MBDB, PMA, 4-MTA, 2CB), and putrefactive amines (phenylethylamine, putrescine, tryptamine, tyramine) were analyzed to determine cross-reactivity. Results of the standard curve studies show the capacity of both Direct ELISA kits to confidently detect down to 3 ng/mL interday (PBS matrix; CVs 6.3-15.5%). Cross-reactivity relative to that of 50 ng/mL preparations of the target compounds demonstrated that the Direct ELISA kit for amphetamine also detected MDA (282%), PMA (265%), 4-MTA (280%), and phentermine (61%), and the Direct ELISA for methamphetamine also assayed positive for MDMA (73%), MDEA (18%), pseudoephedrine (19%), MBDB (8%), and ephedrine (9%). Matrix studies demonstrated that both ELISA kits could be applied to screening of blood, urine, and saliva to a concentration of 6 ng/mL or lower. In conclusion, the Bio-Quant Direct ELISA kits for amphetamine and methamphetamine are fast and accurate and have demonstrated themselves to be useful tools in routine toxicological testing.
Maung, Kyaw Nyunt; Yoshida, Tomoharu; Liu, Gang
A classification framework of the secondary resources was applied to evaluate the framework's applicability and to assess secondary aluminum reserves for 19 countries. Estimated amounts of secondary aluminum reserves in 2010 were 85 million tonnes in the United States, 65 million tonnes in China......, 29 million tonnes in Japan, and 413 million tonnes globally. For the United States, its secondary reserves are larger than its primary reserves, although the global primary reserves (28,000 million tonnes) are much larger than the estimated secondary reserves. Considerable amounts of secondary...
Secondary containers and service containers are used by pesticide applicators in the process of applying a pesticide. EPA does not require secondary containers or service containers to be labeled or to meet particular construction standards. Learn more.
US Agency for International Development — The Secondary Analysis and Results Tracking (SART) activity provides support for the development of two databases to manage secondary and third-party data, data...
Secondary chondrosarcoma: Malignant transformation of pre-existing hereditary and non-hereditary cartilaginous lesions. SCS Vlok, GWW Wagener, D Zaharie. Abstract. Secondary chondrosarcoma is a malignant hyaline cartilage tumour originating from a cartilaginous precursor, either osteochondroma or enchondroma.
Glyphosate is a unique herbicide with interesting secondary effects. Unfortunately, some have assumed that the secondary effects that occur in glyphosate-susceptible plants treated with glyphosate, such as altered mineral nutrition, reduced phenolic compound production and pathogen resistance, also ...
U.S. Environmental Protection Agency — NAVTEQ Secondary Highways for the United States. The Secondary Highways layer contains Road Network features based on the Functional Class value on each link present...
Rado Gazo; James D. McGlothlin; Yuehwern, Wiedenbeck, Jan Yih; Yuehwern Yih
The main goal of the project was to initiate a pilot program in ergonomics for the secondary wood products industry. Case studies were conducted at three Midwest secondary wood product companies in 2000 and 2001.
Fatih Camadan; Galip Yüksel
The aim of this study was to analyze perfectionism among Turkish secondary school students. Perfectionism was compared according to the some variables like academic achievement, type of school, field (Quantitative, Verbal and Equally Weighted) and gender. The study was performed with271 female and 320 male students. In this study Frost Multidimentional Perfectionism Scale (FMPS) adapted into Turkish by Özbay and Mısırlı-Taşdemir (2003), was used. At the end of the study, in all subscales of p...
Winn, David R; Onel, Yasar
In a Secondary Emission electron(SEe) detector module, Secondary Emission electrons (SEe) are generated from an SE surface/cathode, when charged hadronic or electromagnetic particles, particularly shower particles, penetrate an SE sampling module placed between absorber materials (Fe, Cu, Pb, W etc) in calorimeters. The SE cathode is a thin (10–50 nm thick) film (simple metal-oxides, or other higher yield materials) on the surface of a metal plate, which serves as the entrance “window” to a compact vacuum vessel (metal or metal-ceramic); this SE film cathode is analogous to a photocathode, and the SEe are similar to p.e., which are then amplified by dynodes, also is in a PMT. SE sensor modules can make use of electrochemically etched/machined or laser-cut metal mesh dynode sheets, as large as ∼30 cm square, to amplify the Secondary Emission Electrons (SEe), much like those that compact metal mesh or mesh dynode PMT's use to amplify p.e.'s. The construction requirements easier than a PMT, since the entire final assembly can be done in air; there are no critical controlled thin film depositions, cesiation or other oxygen-excluded processes or other required vacuum activation, and consequently bake-out can be a refractory temperatures; the module is sealed by normal vacuum techniques (welding or brazing or other high temperature joinings), with a simple final heated vacuum pump-out and tip-off. The modules envisioned are compact, high gain, high speed, exceptionally radiation damage resistant, rugged, and cost effective, and can be fabricated in arbitrary tileable shapes. The SE sensor module anodes can be segmented transversely to sizes appropriate to reconstruct electromagnetic cores with high precision. The GEANT4 and existing calorimeter data estimated calorimeter response performance is between 35–50 Secondary Emission electrons per GeV, in a 1 cm thick Cu absorber calorimeter, with a gain per SEe > 10 5 per SEe, and an e/pi<1.2. The calorimeter pulse
Full Text Available An eight month-old infant presented with a 10-day history of vomiting and diarrhea, and a one-week history of swelling of the lower extremities. Laboratory evaluations revealed hypoproteinemia and lymphocytopenia due to protein-losing enteropathy. Peroral small bowel biopsy showed intestinal lymphangiectasia. Subsequent onset of unexplained ecchymosis and obstructive jaundice resulted in additional studies which revealed an omental neuroblastoma as the underlying etiology of the infant’s symptoms. This report emphasizes the importance of considering secondary, obstructive causes for lymphangiectasia and protein-losing enteropathy.
A great variety of Secondary Emission Monitors (SEM) are used all over the PS Complex. At other accelerators they are also called wire-grids, harps, etc. They are used to measure beam density profiles (from which beam size and emittance can be derived) in single-pass locations (not on circulating beams). Top left: two individual wire-planes. Top right: a combination of a horizontal and a vertical wire plane. Bottom left: a ribbon grid in its frame, with connecting wires. Bottom right: a SEM-grid with its insertion/retraction mechanism.
Weber, Tilmann; Kim, Hyun Uk
. In this context, this review gives a summary of tools and databases that currently are available to mine, identify and characterize natural product biosynthesis pathways and their producers based on ‘omics data. A web portal called Secondary Metabolite Bioinformatics Portal (SMBP at http......://www.secondarymetabolites.org) is introduced to provide a one-stop catalog and links to these bioinformatics resources. In addition, an outlook is presented how the existing tools and those to be developed will influence synthetic biology approaches in the natural products field....
A basic nuclear physics teaching programme, at present being used in a number of Hungarian secondary schools, is described in this and a previous article (Marx. Phys. Educ.; 11: 409 (1976)). Simple notions of quantum theory and general principles of superposition and de Broglie wavelength, the uncertainty relation and the exclusion principle are used. Using these principles, teaching of concepts concerning the excited states of the hydrogen atom, Pauli's exclusion principle, ion formation, covariant bonding and the shape of molecules, are discussed. (U.K.)
Morsy, Mohamed S; Dishmon, Dwight A; Garg, Nadish; Weber, Karl T
Secondary hyperparathyroidism (SHPT) is a well-known pathophysiologic feature of chronic renal failure. In recent years, SHPT has become recognized as a complication of the aldosteronism associated with congestive heart failure and where excretory Ca 2+ and Mg 2+ wasting results in plasma-ionized hypocalcemia and hypomagnesemia. Elevations in plasma parathyroid hormone have adverse systemic consequences, including intracellular Ca 2+ overloading of myocytes and vascular smooth muscle with the induction of oxidative stress. Herein, we briefly review the presence and adverse outcomes of SHPT in persons with heart failure. Copyright © 2017 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.
Motta, Robert W.
A review of childhood secondary trauma is presented. Secondary trauma involves the transfer and acquisition of negative affective and dysfunctional cognitive states due to prolonged and extended contact with others, such as family members, who have been traumatized. As such, secondary trauma refers to a spread of trauma reactions from the victim…
... non-specific chronic inflammatory changes. The patient's secondary amyloidosis was presumed to be related to the long standing RHD after exclusion of other causes of secondary amyloidosis. The patient finally died due to heart failure and acute pulmonary edema. Conclusion: Long standing RHD can lead to secondary ...
Roberts, Christine K.
Educational researchers have examined both observed and perceived influences of the job satisfaction levels of secondary teachers and post-secondary department chairs. However, researchers have largely ignored a third group of educators: secondary Content Area Leaders (CALs). The overall satisfaction levels and the potentially influencing factors…
Recommendations are discussed with regard to population ecology, microbial food webs, marine ecosystems, improved instrumentation, and effects of land and sea on shallow marine systems. The control of secondary production is discussed with regard to present status of knowledge; research needs for studies on dominant secondary producers, food webs that lead to commercial species, and significant features of the trophic structure of shallow water marine communities. Secondary production at the land-water interface is discussed with regard to present status of knowledge; importance of macrophytes to secondary production; export to secondary consumers; utilization of macrophyte primary production; and correlations between secondary production and river discharge. The role of microorganisms in secondary production is also discussed
Pomeroy, L.R. (ed.)
Recommendations are discussed with regard to population ecology, microbial food webs, marine ecosystems, improved instrumentation, and effects of land and sea on shallow marine systems. The control of secondary production is discussed with regard to present status of knowledge; research needs for studies on dominant secondary producers, food webs that lead to commercial species, and significant features of the trophic structure of shallow water marine communities. Secondary production at the land-water interface is discussed with regard to present status of knowledge; importance of macrophytes to secondary production; export to secondary consumers; utilization of macrophyte primary production; and correlations between secondary production and river discharge. The role of microorganisms in secondary production is also discussed. (HLW)
Srinivasan-Rao, Triveni [Shoreham, NY; Ben-Zvi, Ilan [Setauket, NY
An electron gun for generating an electron beam is provided, which includes a secondary emitter. The secondary emitter includes a non-contaminating negative-electron-affinity (NEA) material and emitting surface. The gun includes an accelerating region which accelerates the secondaries from the emitting surface. The secondaries are emitted in response to a primary beam generated external to the accelerating region. The accelerating region may include a superconducting radio frequency (RF) cavity, and the gun may be operated in a continuous wave (CW) mode. The secondary emitter includes hydrogenated diamond. A uniform electrically conductive layer is superposed on the emitter to replenish the extracted current, preventing charging of the emitter. An encapsulated secondary emission enhanced cathode device, useful in a superconducting RF cavity, includes a housing for maintaining vacuum, a cathode, e.g., a photocathode, and the non-contaminating NEA secondary emitter with the uniform electrically conductive layer superposed thereon.
Jeenanyaphat kotluckkham; Sirisak Chanluechai; Rangsan Chomya
The present research aimed at 1) studyingthe state of academic administration of the secondary schools under the Secondary Educational Service Area Office19; 2) studying the academic administration of the 3 master schools; and 3) studying the guidelines forthe academic administration of the secondary schools under the Secondary Educational Service Area Office 19.The research was carried out in 3 phases. Phase 1 was the study of theacademic administration of the secondary school...
Ogawa, Yoshihiko; Imai, Yuichiro; Yoshihara, Shingo; Fujikura, Hiroyuki; Hirai, Nobuyasu; Sato, Masatoshi; Ogawa, Taku; Uno, Kenji; Kasahara, Kei; Yano, Hisakazu; Mikasa, Keiichi
Pulmonary involvement in secondary syphilis is considered a rare occurrence; however, the number of cases has increased in the 2000s. This is likely due to the increased use of computed tomography scans and molecular diagnostic testing. We report a case of an HIV-positive man with pleural chest pain and bilateral subpleural nodules on chest computed tomography. His rapid plasma reagin and Treponema pallidum hemagglutination tests were positive, and the specimen of one of the pulmonary nodules obtained by transthoracic biopsy was positive for the polA gene of Treponema pallidum. Since clinical manifestations of syphilis are highly variable, clinicians should bear in mind that pleural chest pain with bilateral subpleural nodules can be caused by pulmonary syphilis.
Full Text Available We have selected several Kepler objects with potentially the deepest secondary eclipses. By combination of many single phased light-curves (LCs we have produced a smooth LC with a larger SNR and made the secondary eclipses more distinct. This allowed us to measure the depth of primary and secondary minimum with greater accuracy and then to determine stellar and planetary radii by simplex modelling.
... Banks and Banking FEDERAL HOUSING FINANCE BOARD FEDERAL HOME LOAN BANK MEMBERS AND HOUSING ASSOCIATES... are in substantial compliance with all aspects of the enforcement action; or (ii) Written analysis. A written analysis acceptable to the Bank indicating that the applicant or its directors or senior officers...
placed in the OPD and thick blood films were prepared ... film results. Prescribers in the OPD were aware of the screening process. Daily tallies in the Pharmacy were made as described above. Phase III: Two weeks prior to Phase III, the results of. Phase II were .... nual yearly drug budget for the Dept of Orthopaedics.
A report of Avian encephalomyelitis outbreak in two flocks of adult Japanese quail is presented. High mortalities, tremor, ataxia and lateral recumbency were the prominent clinical signs observed. Absence of gross pathology and microscopic lesions of gliosis, neuronal degeneration, meningitis, congested blood vessel with ...
... of the transactions described in § 1.341-1 the fair market value of the section 341 assets held by it constitutes 50 percent or more of the fair market value of its total assets and the fair market value of the... accrual basis, on July 31, 1955, owned assets with the following fair market values: Cash, $175,000; note...
Tate, Judith Ann; Happ, Mary Beth
Qualitative secondary analysis (QSA) is the use of qualitative data that was collected by someone else or was collected to answer a different research question. Secondary analysis of qualitative data provides an opportunity to maximize data utility, particularly with difficult-to-reach patient populations. However, qualitative secondary analysis methods require careful consideration and explicit description to best understand, contextualize, and evaluate the research results. In this article, we describe methodologic considerations using a case exemplar to illustrate challenges specific to qualitative secondary analysis and strategies to overcome them. Copyright © 2017 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.
Full Text Available The aim of this study was to analyze perfectionism among Turkish secondary school students. Perfectionism was compared according to the some variables like academic achievement, type of school, field (Quantitative, Verbal and Equally Weighted and gender. The study was performed with271 female and 320 male students. In this study Frost Multidimentional Perfectionism Scale (FMPS adapted into Turkish by Özbay and Mısırlı-Taşdemir (2003, was used. At the end of the study, in all subscales of perfectionism scale, there was significant variation according to student’s academic success levels. There was significant variation according to the school types in all subscales except Personal Standards subscale. While there was significant variation according to the field, in Parental Criticism and Concern over Mistakes subscales; according to gender, there was significant variation only in Doubt about Actions subscale. To not acceptnonperfect situations while trying to reach a goal may cause that students have procrastination behaviors and more anxiety. Therefore, their academic achievement may be affected negatively. With individual and group psychological counseling to perfectionist students can help them to notice their characteristics well and determine realistic goal. In this way, their academic achievement can be contributed positively
Pearl, W.L.; Sawochka, S.G.
Several types of corrosion damage are currently chronic problems in PWR recirculating steam generators. One probable cause of damage is a local high concentration of an aggressive chemical even though only trace levels are present in feedwater. A wide variety of trace chemicals can find their way into feedwater, depending on the sources of condenser cooling water and the specific feedwater treatment. In February 1975, Nuclear Water and Waste Technology Corporation (NWT), was contracted to characterize secondary system water chemistry at five operating PWRs. Plants were selected to allow effects of cooling water chemistry and operating history on steam generator corrosion to be evaluated. Calvert Cliffs 1, Prairie Island 1 and 2, Surry 2, and Turkey Point 4 were monitored during the program. Results to date in the following areas are summarized: (1) plant chemistry variations during normal operation, transients, and shutdowns; (2) effects of condenser leakage on steam generator chemistry; (3) corrosion product transport during all phases of operation; (4) analytical prediction of chemistry in local areas from bulk water chemistry measurements; and (5) correlation of corrosion damage to chemistry variation
Cozzolino, Mario; Tomlinson, James; Walsh, Liron; Bellasi, Antonio
Secondary hyperparathyroidism (SHPT), a common, serious, and progressive complication of chronic kidney disease (CKD), is characterized by elevated serum parathyroid hormone (PTH), parathyroid gland hyperplasia, and mineral metabolism abnormalities. These disturbances may result in CKD-mineral and bone disorder (CKD-MBD), which is associated with poor quality of life and short life expectancy. The goal of SHPT treatment is to maintain PTH, calcium, and phosphorus within accepted targeted ranges. This review highlights the pathogenesis of SHPT and current SHPT therapeutic approaches, including the use of low-phosphate diets, phosphate binders, 1,25-dihydroxyvitamin D3 (calcitriol) and its analogs, calcimimetics, and parathyroidectomy in addition to discussing emerging drugs in development for SHPT. Numerous studies indicate that mineral abnormalities occur early in the course of CKD, are prevalent by the time patients enter dialysis, and foreshadow a risk of cardiovascular and all-cause mortality. Several newly developed compounds may potentially overcome the limitations of current SHPT therapies. If emerging therapies can reduce PTH, normalize mineral metabolism, promote treatment adherence, and reduce the risk of side effects, they may provide the requisite features for improving long-term outcomes in patients with SHPT receiving dialysis and reduce the risks of CKD-MBD.
Gupta, Nancy; Haq, Khwaja F.; Mahajan, Sugandhi; Nagpal, Prashant; Doshi, Bijal
Patient: Female, 66 Final Diagnosis: Calciphylaxis Symptoms: Gastrointesinal haemorrhage Medication: None Clinical Procedure: Hemodialysis • blood transfusions Specialty: Gastroenterology and Hepatology Objective: Rare disease Background: Calciphylaxis is associated with a high mortality that approaches 80%. The diagnosis is usually made when obvious skin lesions (painful violaceous mottling of the skin) are present. However, visceral involvement is rare. We present a case of calciphylaxis leading to lower gastrointestinal (GI) bleeding and rectal ulceration of the GI mucosa. Case Report: A 66-year-old woman with past medical history of diabetes mellitus, hypertension, end-stage renal disease (ESRD), recently diagnosed ovarian cancer, and on hemodialysis (HD) presented with painful black necrotic eschar on both legs. The radiograph of the legs demonstrated extensive calcification of the lower extremity arteries. The hospital course was complicated with lower GI bleeding. A CT scan of the abdomen revealed severe circumferential calcification of the abdominal aorta, celiac artery, and superior and inferior mesenteric arteries and their branches. Colonoscopy revealed severe rectal necrosis. She was deemed to be a poor surgical candidate due to comorbidities and presence of extensive vascular calcifications. Recurrent episodes of profuse GI bleeding were managed conservatively with blood transfusion as needed. Following her diagnosis of calciphylaxis, supplementation with vitamin D and calcium containing phosphate binders was stopped. She was started on daily hemodialysis with low calcium dialysate bath as well as intravenous sodium thiosulphate. The clinical condition of the patient deteriorated. The patient died secondary to multiorgan failure. Conclusions: Calciphylaxis leading to intestinal ischemia/perforation should be considered in the differential diagnosis in ESRD on HD presenting with abdominal pain or GI bleeding. PMID:26572938
Sidirourgos, L.; Kersten, M.
Large scale data warehouses rely heavily on secondary indexes, such as bitmaps and b-trees, to limit access to slow IO devices. However, with the advent of large main memory systems, cache conscious secondary indexes are needed to improve also the transfer bandwidth between memory and cpu. In this
Assessing Participation in Secondary Education Quality Enhancement: Teachers, Parents and Communities in Cross River State. ... ailing economy, low moral values and philosophy of the end justifies the means were reasons for low parents and communities involvement in secondary education-quality improvement.
Secondary wall is an abundant component of plant biomass and has a potential to be a renewable resource of bioenergy and biomaterials. It is important to unravel the molecular mechanism underlying secondary wall formation and how it contributes to plant biomass production. In this review, we summarized the potential ...
Philip A. Araman
Competitiveness, imports, exports, and technological improvements--these are issues facing secondary wood-product manufacturers. The major problems focus on increasing foreign imports and the inability of U.S. industries to repell the imports. How and where should we, as researchers, allocate our efforts to enhance the competitiveness of secondary forest industries in...
Stone, James R., III
Describes a study which sought to establish outcome standards very important for secondary marketing education. Business people, former students, and marketing educators were asked to judge the standards identified from the literature in terms of importance to secondary marketing education. (CT)
Pandis, Spyros N.; Harley, Robert A.; Cass, Glen R.; Seinfeld, John H.
A Lagrangian trajectory model simulating the formation, transport and deposition of secondary organic aerosol is developed and applied to the Los Angeles area, for the air pollution episode of 27-28 August 1987. The predicted secondary organic aerosol on 28 August 1987 represents 15-22% of the measured particulate organic carbon at inland locations in the base case simulations, and 5-8% of that at coastal locations. A maximum secondary organic aerosol concentration of 6.8 μg m -3 is predicted for Claremont, CA, during this episode. On a daily average basis at Claremont about 46% of this secondary organic aerosol is predicted to be a result of the oxidation of non-toluene aromatics (xylenes, alkylbenzenes, etc.), 19% from toluene, 16% from biogenic hydrocarbons (α-pinene, ß-pinene, etc.), 15% from alkanes and 4% from alkenes. The major uncertainties in predicting secondary organic aerosol concentrations are the reactive organic gas emissions, the aerosol yields and the partitioning of the condensable gases between the two phases. Doubling the reactive organic gas (ROG) emissions results in an increase of the secondary organic aerosol predicted at Claremont by a factor of 2.3. Predicted secondary organic aerosol levels are less sensitive to changes in secondary organic aerosol deposition and NO x emissions than to ROG emissions.
Chmielewska, E.; Kuruc, J.
This text-book consist of five parts: (I) Waste management; (II) Solid waste management; (III) Recovery and recycling of secondary raw materials; (IV) Radioactive waste management; Examples of verification knowledge and testing of the secondary students through the worksheet. (V) Suggestions for leisure time activities. This text-book is assigned for high school students.
The study investigated the impact of Story Telling and Story Retelling on Secondary School Students' Reading Comprehension and Written Composition performance. Two hundred and forty (240) Junior Secondary School Students from three selected schools in Pankshin Local Government Area of Plateau State were ...
... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Secondary acquisitions. 801.4 Section 801.4... HART-SCOTT-RODINO ANTITRUST IMPROVEMENTS ACT OF 1976 COVERAGE RULES § 801.4 Secondary acquisitions. (a) Whenever as the result of an acquisition (the “primary acquisition”) an acquiring person controls an entity...
This is an expost facto research designed to determine the influence of emotional intelligence on leadership success of secondary school principals in Rivers State of Nigeria. The population consisted 441 principals (243 in public and 198 in private) secondary schools in Rivers State. A sample of 208 principals drawn ...
Aim: To assess patient satisfaction on dental services among secondary school students. Design: Cross-sectional study. Study participants: 200 Secondary school students in Makambako township randomly selected from school class registers. Methods: Self-administered structured questionnaire in a class room. Reliability ...
SMOKING HABITS AMONG SECONDARY SCHOOL STUDENTS IN SELECTED DISTRICTS IN ZIMBABWE. ... Journal of Child and Adolescent Mental Health ... Objective To examine the relationship between smoking habits and indicators of socioeconomic status, the urban/rural dimension and gender among secondary ...
This study, a descriptive survey research design investigated startegies for maintaining discipline and orderliness in secondary schools in awkaEducation zone, Anambra State. Population was all the 68 principals and2085 teachers in secondary schools in Awka Education zone. Two research questions and two null ...
Mitchell, Donna Mathewson
Teaching in secondary visual arts classrooms is complex and challenging work. While it is implicated in much research, the complexity of the lived experience of secondary visual arts teaching has rarely been the subject of sustained and synthesized research. In this paper, the potential of practice as a concept to examine and represent secondary…
African Journal of Educational Studies in Mathematics and Sciences Vol. 4, 2006. 41. Predicting Students' Performance in the Senior Secondary. Certificate Examinations from Performance in the Junior Secondary. Certificate Examinations in Ondo State, igeria. Adeyemi, T. O.. Department of Educational Foundations and ...
A set of programs has been developed for the prediction and display of nucleic acid secondary structures. Information from experimental data can be used to restrict or enforce secondary structural elements. The predictions can be displayed either on normal line printers or on graphic devices like plotters or graphic terminals.
Tosun, Cemal; Genç, Murat
The purpose of this study is to identify the factors that affect the secondary school students' attitudes in science. This study was conducted using survey method. The sample of the study was 503 students from four different secondary schools in Bartin and Düzce. Data were obtained using the Survey of Factors Affecting Students' Science Attitudes…
Oct 18, 2012 ... addition to that in stipules and flowers. Or, COCH negative- ly regulates UNI in all the lateral organs: stipules, leaves and bracteole and flower bearing secondary inflorescences. We report here the results of quantitative comparisons of the biomass of various organs, morphology of secondary inflo- rescence ...
This paper explores religious adolescents' reported experiences of secondary schools. Fifty-four qualitative interviews were conducted in places of worship in three cities in England with Christians (n = 46), Jews (n = 38) and Muslims (n = 15). Secondary schools of a religious and non-religious character were reported as not providing a suitable…
The study focused on Counselling for Entrepreneurship Development at the Secondary School Level in Akwa Ibom State. The population comprised 705 principals of public and approved private secondary school in the State. A sample of 255 (116 male and 139 female) principals was drawn, using the stratified sampling ...
Nakpodia, E. D.
This paper examined the usefulness of record management in Nigerian Secondary Schools. Record keeping is one of the administrative principles in secondary school administration and it cannot be overemphasized in any organisation. The continuity of any school organisation depends on availability of useful records of past activities. In a complex…
Brown, Chris L.
The purpose of this qualitative study was to describe secondary teachers' perceptions of online learning in Washington. This was done by distributing a survey to three districts in the State of Washington to identify the advantages and challenges of online learning according to participating secondary teachers. In addition, the teachers provided…
The study, a descriptive survey research design was used to identify the challenges that impede secondary school administration today in Anambra State. The population of the study was all the 259 public secondary school principals in the state. Two research questions and two null hypotheses guided the study. A 20-item ...
Nigerian Journal of Guidance and Counselling ... Abstract. This paper discussed the need for creating career awareness among Secondary School Students through career fair Career selection is a critical issue for secondary school students who may not be aware of the existing occupations in the labour market.
To assess the factors associated with adolescent pregnancies among secondary students at Tanga municipality. A cross sectional descriptive analytical study which targeted all girls in secondary schools at Tanga municipality, Low socioeconomic status was found to be an important cause for adolescent pregnancies as ...
Yu-Wai-Man, Patrick; Neoh, Christopher
Visual morbidity following a subarachnoid haemorrhage is common among survivors and it is usually the result of vascular ischaemia at the time of the initial insult. In this report, we present an unusual case of delayed, progressive visual loss following intervention for a ruptured anterior communicating artery aneurysm. We discuss the possible etiological factors and highlight potential diagnostic pitfalls.
Jha, Deepak K
Similar to most of the other medical and surgical fields, neurosurgery has changed drastically in recent decades, especially in instrumentation and equipment. Safety, scope of treating initially considered nontreatable neurosurgical conditions, and prognosis of most neurosurgical procedures have improved significantly. Newer instruments and equipments are being introduced exponentially, leading to tremendous cost escalation of neurosurgical treatment. However, equitable distribution of neurosurgical services in society is far from reality. We need to look back and learn from our teachers and forefathers of neurosurgery their innovative ways to accomplish difficult procedures without advanced tools and techniques. Microneurosurgery is considered a highly skilled technique, and instruments used for it are delicate, precise, and costlier than similar instruments for macroneurosurgery. Frugal innovative techniques and tools are presented for making stainless steel wire and plate microdissectors that are effective for microneurosurgical procedures and can be helpful for neurosurgeons working in resource-poor settings. Copyright © 2018 Elsevier Inc. All rights reserved.
Wang, Kai; Eisele, Magnus; Hwang, Yunho; Radermacher, Reinhard [Center for Environmental Energy Engineering, Department of Mechanical Engineering, University of Maryland, College Park, MD 20742 (United States)
Due to the environmental damage caused by HFC refrigerants, there is an increasing universal interest to research environmentally friendly fluids in refrigerants and alternative approaches to the traditional DX refrigeration system. These refrigerants include ammonia, carbon dioxide, hydrocarbon, R152a and HFO1234yf. Major drawbacks of these refrigerants are their potential flammability and safety hazards. One way to overcome this issue is to use the new refrigerants in conjunction with a secondary loop refrigeration system. Additional benefits of the secondary loop refrigeration system are refrigerant charges, leakage reduction, potential maintenance simplification, and low operating cost. This article presents a comprehensive review of the secondary loop refrigeration systems. Furthermore, this review covers the performance and risk assessment of flammable refrigerants, secondary refrigerants and components of the secondary loop refrigeration system within the following applications: commercial refrigeration, residential air conditioning/heat pumping, and mobile air conditioning. (author)
Full Text Available Diffuse amyloid goiter (AG is an entity characterized by the deposition of amyloid in the thyroid gland. AG may be associated with either primary or secondary amyloidosis. Secondary amyloidosis is rarely caused by inflammatory bowel diseases. Secondary amyloidosis is relatively more common in the patients with Crohn’s disease, whereas it is highly rare in patients with ulcerative colitis. Diffuse amyloid goiter caused by ulcerative colitis is also a rare condition. In the presence of amyloid in the thyroid gland, medullary thyroid cancer should be kept in mind in the differential diagnosis. Imaging techniques and biochemical tests are not very helpful in the diagnosis of secondary amyloid goiter and the definitive diagnosis is established based on the histopathologic analysis and histochemical staining techniques. In this report, we present a 35-year-old male patient with diffuse amyloid goiter caused by secondary amyloidosis associated with ulcerative colitis.
Campioli, Matteo; Leblans, Niki; Michelsen, Anders
Our knowledge of stem secondary growth of arctic shrubs (a key component of tundra net primary production, NPP) is very limited. Here, we investigated the impact of the physical elements of the environment on shrub secondary growth by comparing annual growth rates of model species from similar...... habitats at contrasting altitude, microtopography, latitude, geographical location, and soil type, in both the sub- and High Arctic. We found that secondary growth has a modest sensitivity to the environment but with large differences among species. For example, the evergreen Cassiope tetragona is affected...... by altitude, microtopography, and latitude, whereas the evergreen Empetrum hermaphroditum has rather constant secondary growth in all environments. Deciduous species seem to be most affected by microtopography. Furthermore, the impact of the environment on secondary growth differed from the impact on primary...
Semblat, J.-F.; Kham, M.; Guéguen, P.; Bard, P.-Y.
At the scale of a city, surface structures like buildings can modify the seismic free- field and behave as secondary seismic sources. At a local scale, some experimental evidences of the site-structure interaction were previously given (Guéguen, 2000). Thanks to the boundary element method, the global problem of site-city interaction is herein investigated in two dimensions at the scale of an alluvial deposit and an entire city considering a whole building network. An alluvial deposit located in the center of Nice (France) was firstly considered for the analysis of free-field amplification (Semblat, 2000). The amplification factor was estimated by the boundary element method and compared with experimental results (SSR, HVSR). Starting from these free-field simulations, several site-city models were considered which describe both superficial soil layers and surface structures. We in- vestigate herein the influence of both building type and building density on the modi- fication of free-field amplification. To compare free-field amplification and amplification in urban configurations, sur- face amplification is compared in both cases for a specific uniform building type and various building densities at differents frequencies. Depending on these various pa- rameters, the free-field amplification level could be increased by 20 to 50%. Other urban configurations are considered with various building types in uniform and inho- mogeneous arrangements. For the specific site considered, the various site-city BEM models show that site-city interaction can lead to a strong increase of the free-field am- plification factor. Around the fundamental frequency of a specific building type, for a homogeneous urban configuration, particular resonance effects are observed. These results are in good agreement with previous experimental and local scale numerical results (Guéguen, 2000) and show that the coincidence of the respective eigenfre- quencies of both alluvial deposit and
Fleischhacker, Sheila E.; Evenson, Kelly R.; Sharkey, Joseph; Pitts, Stephanie B.J.; Rodriguez, Daniel A.
Context Improving access to healthy foods is a promising strategy to prevent nutrition-related chronic diseases. To characterize retail food environments and identify areas with limited retail access, researchers, government programs, and community advocates have primarily used secondary retail food outlet data sources (e.g., InfoUSA or government food registries). To advance the state of the science on measuring retail food environments, this systematic review examined the evidence for validity reported for secondary retail food outlet data sources for characterizing retail food environments. Evidence acquisition A literature search was conducted through December 31, 2012 to identify peer-reviewed published literature that compared secondary retail food outlet data sources to primary data sources (i.e., field observations) for accuracy of identifying the type and location of retail food outlets. Data were analyzed in 2013. Evidence synthesis Nineteen studies met the inclusion criteria. The evidence for validity reported varied by secondary data sources examined, primary data–gathering approaches, retail food outlets examined, and geographic and sociodemographic characteristics. More than half of the studies (53%) did not report evidence for validity by type of food outlet examined and by a particular secondary data source. Conclusions Researchers should strive to gather primary data but if relying on secondary data sources, InfoUSA and government food registries had higher levels of agreement than reported by other secondary data sources and may provide sufficient accuracy for exploring these associations in large study areas. PMID:24050423
Safai, Akbar; Vasei, Mohammad; Attaranzadeh, Armin; Azad, Fariborz; Tabibi, Narjes
Secondary amenorrhea is a condition in which there is cessation of menses after at least one menstruation. It is a symptom of different diseases, such as hormonal disturbances which range from pituitary to ovarian origin, as well as chromosomal abnormalities. Knowledge of the distinct cause of secondary amenorrhea is of tremendous benefit for the management and monitoring of patients. In this study, we determine the chromosomal abnormalities in patients with secondary amenorrhea in Southwest Iran. We selected 94 patients with secondary amenorrhea who referred to our Cytogenetic Ward from 2004 until 2009. For karyotyping, peripheral blood lymphocyte cultures were set up by conventional technique. In this study, 5.3% (n=5) of patients with secondary amenorrhea presented with chromosomal abnormalities, of which all contained an X element. The chromosomal abnormalities were: i) 45, X (n=1); ii) 47, XXX (n=1); iii) 45, X / 45, Xi(X)q (n=1); iv) 45, X/46,X,+mar (n=1); and v) 46,X,del(Xq)(q23q28) (n=1). Our study revealed that some causes of secondary amenorrhea could be due to chromosomal abnormalities. Therefore, cytogenetic studies should be important tests in the evaluation of patients with secondary amenorrhea.
Strohl, A; Pozzi, S; Wattiez, R; Roesen, B; Miño de Kaspar, H; Klauss, V
Glaucoma is the third-most-frequent cause of blindness in the world, with a total of 5.2 million blind people as a result of this disease; 80% live in developing countries. In Paraguay, after cataract it is the second-most-frequent-cause. Early detection of the risk factors and groups can help to avoid progress of this disease. Trauma, cataract and infectious uveitis represent special risks for developing secondary glaucoma, which is a more frequent cause of blindness in third-world countries than in industrialized nations. Until now there has been little data regarding the causes, disease course, and options for therapy. Therefore, secondary glaucoma was examined in Paraguay to obtain information on the situation in Latin America. The aim of the study was to explore the causes of secondary glaucoma for programs concerning prevention and therapy. From November 1996 to February 1997 patients with secondary glaucoma were examined at the University Hospital of Asunción, Paraguay. After the clinical examination the secondary glaucomas were classified. Patients with primary glaucoma were included in the same period of time as well in order to get the rate of secondary glaucoma. Altogether 293 patients were examined: 61 with secondary and 232 with primary glaucoma. The causes of secondary glaucoma in 73 eyes were: 20 (27%) with pseudoexfoliation glaucoma, 19 (26%) with post-traumatic glaucoma, 16 (22%) with neovascular glaucoma, 4 (5%) with lens-related glaucoma, 3 (4%) with glaucoma associated with ocular surgery, 2 (3%) with pigmentary and 2 (3%) with corticoid-induced glaucoma. A ratio of 4:1 primary glaucomas to secondary glaucomas was found. The development of special measures for prevention and early therapy is only possible if the causes of this severe disease are explored. The results of this study represent basic information and could help to introduce of prevention programs.
Pries-Heje, Jan; Hansen, Magnus Rotvit Perlt
design by analyzing two cases where secondary designers fundamentally change functionality, content and technology complexity level. The first case redesigns a decision model for agile development in an insurance company; the second creates a contingency model for choosing project management tools...... and techniques in a hospital. Our analysis of the two cases leads to the identification of four principles of design implementation that primary designers can apply to enable secondary design and four corresponding design implementation principles that secondary designers themselves need to apply....
I. V. Kotova
Full Text Available We present a clinical case of parathyroid cancer in a patient with relapsing secondary hyperparathyroidism at 4 years after subtotal parathyroidectomy. Its unique character is related to the combination of relapsing secondary hyperparathyroidism, parathyromatosis, ectopic of an adenomatous hyperplastic parathyroid gland into the thyroid gland, and parathyroid cancer. Several most complicated aspects of parathyroid surgery are disclosed, such as the choice of strategy for surgical intervention in secondary hyperparathyroidism, complexity of morphological and cytological diagnostics of this disorder.
Risks of hemolysis in glucose-6-phosphate dehydrogenase deficient infants exposed to chlorproguanil-dapsone, mefloquine and sulfadoxine-pyrimethamine as part of intermittent presumptive treatment of malaria in infants
Poirot, Eugenie; Vittinghoff, Eric; Ishengoma, Deus
) antimalarial regimens. We sought to examine the joint effects of G6PD status and IPTi antimalarial treatment on incidence of hemolysis in asymptomatic children treated with CD, sulfadoxine-pyrimethamine (SP), and mefloquine (MQ). METHODS: A secondary analysis of data from a double-blind, placebo...
Immunodiagnostic confirmation of hydatid disease in patients with a presumptive diagnosis of infection Confirmación inmunodiagnóstica de la hidatidosis en pacientes con diagnóstico presuntivo de la infeccion
V. M. Varela-diaz
Full Text Available Information obtained from the routine application of hydatid immunodiagnostic techniques in different clinical situations over a seven-year period is presented. The Immunoelectrophoresis test was used until it was replaced by the simpler, more sensitive and equally specific arc 5 double diffusion (DD5 test. Examination of sera from 1,888 patients with signs and/or symptoms compatible with hydatid disease revealed that the presurgical confirmation of Echinococcus granulosus infection is only obtained by detection of anti-antigen 5 antibodies. The latter were not found in 1,539 presumptive hydatidosis patients whose definitive diagnoses corresponded to other disease conditions. However, false positive latex agglutination test results were obtained in two cases. In all patients whose preoperative serum showed three or more uncharacteristic bands in the absence of anti-antigen 5 antibodies, hydatid cysts were found sur gically. DD5 testing of a fluid sample collected by puncture established its hydatid etiology. Post-operative monitoring of hydatidosis patients demonstrated that persistence of DD5-positivity two years after surgery established the presence of other cysts. Further evidence was obtained in patients with hydatid cysts in intrathoracic, abdominal or other locations associating cyst membrane integrity, antigen release and immunodiagnostic test positivity.Se presenta la información obtenida de la aplicación de las técnicas inmunodiagnósticas para hidatidosis en diferentes situaciones clínicas durante un período de 7 años. Se empleó la prueba de inmunoelectroforesis hasta que se la sustituyó por la prueba de doble difusión arco 5 (DD5, igualmente específica pero de mayor sensibilidad y sencillez. El examen de sueros de 1 888 pacientes con signos y/o sintomas compatibles con la hidatidosis reveló que la confirmación prequirúrgica de la infeccion por Echinococcus granulosus sólo se obtiene mediante la detección de anticuerpos
Müller, Hans-Reinhard; Möbius, Eberhard; Wood, Brian E.
An accurate, analytic heliospheric neutral test-particle code for helium atoms from the interstellar medium (ISM) is coupled to global heliospheric models dominated by hydrogen and protons from the solar wind and the ISM. This coupling enables the forward-calculation of secondary helium neutrals from first principles. Secondaries are produced predominantly in the outer heliosheath, upwind of the heliopause, by charge exchange of helium ions with neutral atoms. The forward model integrates the secondary production terms along neutral trajectories and calculates the combined neutral helium phase space density in the innermost heliosphere where it can be related to in-situ observations. The phase space density of the secondary component is lower than that of primary neutral helium, but its presence can change the analysis of primaries and the ISM, and can yield valuable insight into the characteristics of the plasma in the outer heliosheath. (paper)
Petrtýl, M.; Balík, Karel; Povýšil, C.; Žaloudková, Margit
Roč. 1, č. 3 (2016), s. 38-52 ISSN 2459-4148 Institutional support: RVO:67985891 Keywords : cortical bone * histology * secondary osteons * nanoshall * microfibers Subject RIV: FP - Other Medical Disciplines
Campbell, C.; Laanemets, U.; Lillepea, M.; Loog, T.; Kammiste, T.; Kartner, P.; Magi, O.; Truus, K.
Presents a review of English textbooks developed for secondary learners of English as a Second Language. The survey was prepared by a group of seven Estonian teachers and a British English language teaching consultant. (Author/JL)
Huerta, C. E.; Patino, M. I.; Wirz, R. E.
In this work, a Monte Carlo model is used to investigate electron induced secondary electron emission for varying effects of complex surfaces by using simple geometric constructs. Geometries used in the model include: vertical fibers for velvet-like surfaces, tapered pillars for carpet-like surfaces, and a cage-like configuration of interlaced horizontal and vertical fibers for nano-structured fuzz. The model accurately captures the secondary electron emission yield dependence on incidence angle. The model shows that unlike other structured surfaces previously studied, tungsten fuzz exhibits secondary electron emission yield that is independent of primary electron incidence angle, due to the prevalence of horizontally-oriented fibers in the fuzz geometry. This is confirmed with new data presented herein of the secondary electron emission yield of tungsten fuzz at incidence angles from 0-60°.
Webster, Neil; Vagnby, Bo Hellisen; Thomsen, Thomas J.
Debriefing note regarding joint programming for the Secondary Education Support Programme (2003- 2007). The note specifies preparation of SIP Physical Guidelines; Training needs assessment for Physical School Status and Rapid Technical Assessments; SIP/DEP preparation; Selection criteria...
Rangelands throughout the world contain varying but often substantial proportions of shrubs. Shrubs are generally heavily chemically defended, and herbivores must either contend with their plant secondary metabolites (PSM) or avoid a significant component of the available forage. Browsing ruminants ...
May 16, 2007 ... immobilise microbial cells or enzymes, depending on the bioreactor's application. Operational ... perspective. Key words: Membrane bioreactor, gradostat reactor, secondary metabolite production, biofilm, wastewater treatment. INTRODUCTION ... suitable to immobilize P. chrysosporium biofilms in MGR.
Spontaneous cecal perforation secondary to acute fulminant gastroenteritis: report of a rare case. Duvuru Ram, Vilvapathy S. Karthikeyan, Sarath C. Sistla, Sheik M. Ali, Parnandi Sridhar, Nagarajan Rajkumar ...
Volume concentrations of steady-state secondary organic aerosol (SOA) were measured in several hydrocarbon/NOx irradiation experiments. These measurements were used to estimate the thermal behavior of the particles that may be formed in the atmosphere. These laborator...
Mosby, Robert J.
The author describes the Developmental By-Pass (DBP) Instructional technology for teaching secondary and college learning disabled (LD) students by allowing students to bypass ordering and organizational deficits. (SB)
Sasiene, Gwen Hagenbuch
Research pertaining to female athletes' problems with secondary amenorrhea is reviewed. Studies point to stress, weight loss, anorexia nervosa, obesity, arduous athletic training, and age of onset of training as factors which may contribute to this disorder. (PP)
U.S. Environmental Protection Agency — Volume concentrations of secondary organic aerosol (SOA) are measured in 139 steady-state, single precursor hydrocarbon oxidation experiments after passing through a...
Full Text Available The article presents tendencies of Holocaust denial among secondary school pupils in Slovenia. It focuses on research implemented in January 2012, in which 400 Slovenian secondary school pupils were included. In spite of the assumption that Holocaust denial amongst the youth in Slovenia already exists, we also assumed that a degree of Holocaust denial amongs Slovenian pupils is lower that amongst their peers in other EU countries. Research also inquired about the level of anti-Semitism in conjunction with Holocaust denial. The research project confirmed that students on lower levels of high school education and with less history and sociology lessons in curriculum are more receptive for the Holocaust denial and anti-Semitism is more present in this demographic. The level of Holocaust denial amongst secondary school pupils is not negligible; it suggests that this topic should be more thoroughly discussed in secondary schools.
Shestopalov, B V
The calculation of protein three-dimensional structure from the amino acid sequence is a fundamental problem to be solved. This paper presents principles of the code theory of protein secondary structure, and their consequence--the amino acid code of protein secondary structure. The doublet code model of protein secondary structure, developed earlier by the author (Shestopalov, 1990), is part of this theory. The theory basis are: 1) the name secondary structure is assigned to the conformation, stabilized only by the nearest (intraresidual) and middle-range (at a distance no more than that between residues i and i + 5) interactions; 2) the secondary structure consists of regular (alpha-helical and beta-structural) and irregular (coil) segments; 3) the alpha-helices, beta-strands and coil segments are encoded, respectively, by residue pairs (i, i + 4), (i, i + 2), (i, i = 1), according to the numbers of residues per period, 3.6, 2, 1; 4) all such pairs in the amino acid sequence are codons for elementary structural elements, or structurons; 5) the codons are divided into 21 types depending on their strength, i.e. their encoding capability; 6) overlappings of structurons of one and the same structure generate the longer segments of this structure; 7) overlapping of structurons of different structures is forbidden, and therefore selection of codons is required, the codon selection is hierarchic; 8) the code theory of protein secondary structure generates six variants of the amino acid code of protein secondary structure. There are two possible kinds of model construction based on the theory: the physical one using physical properties of amino acid residues, and the statistical one using results of statistical analysis of a great body of structural data. Some evident consequences of the theory are: a) the theory can be used for calculating the secondary structure from the amino acid sequence as a partial solution of the problem of calculation of protein three
von Conta, P. E. W.
A secondary combustion system for a woodburning stove employs a concave shaped screen for dispersing exhaust gases. A mixing chamber is formed in an insulated conduit between the concave screen and a second planar screen. The planar screen is perforated to form a random array of flaps which increase the turbulence of the exhaust stream so that a secondary combustion of the exhaust gases is produced.
Bills, Gerald F; Gloer, James B
Many Fungi have a well-developed secondary metabolism. The diversity of fungal species and the diversification of biosynthetic gene clusters underscores a nearly limitless potential for metabolic variation and an untapped resource for drug discovery and synthetic biology. Much of the ecological success of the filamentous fungi in colonizing the planet is owed to their ability to deploy their secondary metabolites in concert with their penetrative and absorptive mode of life. Fungal secondary metabolites exhibit biological activities that have been developed into life-saving medicines and agrochemicals. Toxic metabolites, known as mycotoxins, contaminate human and livestock food and indoor environments. Secondary metabolites are determinants of fungal diseases of humans, animals, and plants. Secondary metabolites exhibit a staggering variation in chemical structures and biological activities, yet their biosynthetic pathways share a number of key characteristics. The genes encoding cooperative steps of a biosynthetic pathway tend to be located contiguously on the chromosome in coregulated gene clusters. Advances in genome sequencing, computational tools, and analytical chemistry are enabling the rapid connection of gene clusters with their metabolic products. At least three fungal drug precursors, penicillin K and V, mycophenolic acid, and pleuromutilin, have been produced by synthetic reconstruction and expression of respective gene clusters in heterologous hosts. This review summarizes general aspects of fungal secondary metabolism and recent developments in our understanding of how and why fungi make secondary metabolites, how these molecules are produced, and how their biosynthetic genes are distributed across the Fungi. The breadth of fungal secondary metabolite diversity is highlighted by recent information on the biosynthesis of important fungus-derived metabolites that have contributed to human health and agriculture and that have negatively impacted crops
The article presents tendencies of Holocaust denial among secondary school pupils in Slovenia. It focuses on research implemented in January 2012, in which 400 Slovenian secondary school pupils were included. In spite of the assumption that Holocaust denial amongst the youth in Slovenia already exists, we also assumed that a degree of Holocaust denial amongs Slovenian pupils is lower that amongst their peers in other EU countries. Research also inquired about the level of anti-Semitism in con...
In the area of the total energy flow, possibilities and limits of shifts in time (storage) and in space (transfer) of secondary energy, i.e. electrical, chemical and thermal energy are examined and formulated. These shifts are linked to the qualitative conversions of secondary energy. The multiple technological possibilities, the spectrum of governing factors and the numerous technical and economical parameters show that only a complex optimization is possible. (Auth.)
Graphical methods proposed by Platzman and by Fano are applied to the analysis of the basic features observed in secondary electron spectra. These methods are useful not only in checking the consistency of experimental data, but also in extrapolating the spectra to the range of primary- and secondary-electron energies not covered by experiments. Illustrative examples are presented for He, Ne, and NO. (U.S.)
Andersen, Claus A.; Bohr, Henrik; Brunak, Søren
In the last decade, the prediction of protein secondary structure has been optimized using essentially one and the same assignment scheme known as DSSP. We present here a different scheme, which is more predictable. This scheme predicts directly the hydrogen bonds, which stabilize the secondary......-forward neural network with one hidden layer on a data set identical to the one used in earlier work....
This bachelor thesis is a review of available literature about lichen secondary metabolites and their functions. Lichens produce a great variety of these compounds; most of them are unique to the lichen symbiosis and are not found in higher plants. Besides the role of these compounds in chemotaxonomy and systematics, lichen secondary metabolites exhibit various biological functions and can affect biotic and abiotic interactions of lichens with their environment. Well-known and often described...
Tan, Yuen Teng
Student engagement is important to prevent school dropout and enhance school experiences. Engagement of secondary 2 and 3 students in Singapore was studied with Student Engagement Instrument (SEI) and its relation to burnout. The SEI measured students’ cognitive and affective engagement while burnout was examined using School Burnout Inventory (SBI). An electronic survey was administered to 335 students from two secondary schools. The engagement and burnout across grades, streams, gender, aca...
Xie, Chun-Feng; Lou, Hong-Xiang
Bryophytes frequently grow in an unfavorable environment as the earliest land plants, and inevitably biosynthesize secondary metabolites against biotic or abiotic stress. They not only defend against the plant competition, microbial attack, and insect or animal predation, but also function in UV protection, drought tolerance, and freezing survival. This review covers the ecological aspect of secondary metabolites in bryophytes and is taxonomically presented according to the ecological significances.
Lithium secondary batteries have been key to mobile electronics since 1990. Large-format batteries typically for electric vehicles and energystorage systems are attracting much attention due to current energy and environmental issues. Lithium batteries are expected to play a centralrole in boosting green technologies. Therefore, a large number of scientists and engineers are carrying out research and development onlithium secondary batteries.The book is written in a straightforward fashion suitable for undergraduate and graduate students, as well as scientists, and engineer
and has been reported with PUVA use. To date, there are three reported cases of secondary localized cutaneous amyloidosis associated with mycosis...Secondary localized cutaneous amyloidosis is often not clinically apparent , but may be seen histologically. It is associated with several skin tumors...fungoides prior to any treatment. We present a case of a 39-year-old female who presented to the dermatology clinic for evaluation of facial acne
The theme of this bachelor´s thesis is Problems of discipline at secondary education. The aim of this work is to map the problems of school discipline at the students of higher secondary education. The basic terms concerned the problems of discipline, the definitions and analysis of the lack of discipline are being described in the theoretical part. This thesis also tries to find out possible reasons, preventative arrangements and remedy possibilities of the lack of discipline at the students...
Mashkoor, Aasim; Ahmed, Ovais
This is a secondary stage of theory of economic development. This research study is covering the secondary phase of development which rules the tactical plans of the main strategy. In this stage, the social and economical demands varies from country to country and we have developed the theory according to the Pakistani economic conditions. It requires great a lot of technical and strategic analysis to chose the accurate plans accordingly.
Chiovitti, Anthony; Duncan, Jacinta C; Jabbar, Abdul
Engaging secondary school students with science education is crucial for a society that demands a high level of scientific literacy in order to deal with the economic and social challenges of the 21st century. Here we present how parasitology could be used to engage and promote science in secondary school students under the auspice of a 'Specialist Centre' model for science education. Copyright © 2017 Elsevier Ltd. All rights reserved.
The work presented in this dissertation is a contribution to the study of the transition to turbulence in open shear flows. Results from direct numerical simulations are interpreted within the framework of hydrodynamic stability theory. The first chapter is an introduction to the primary and secondary instabilities observed in jets and mixing layers. The numerical method used in the present study is detailed in the second chapter. The dynamics of homogeneous circular jets subjected to stream wise and azimuthal perturbations are investigated in the third chapter. A complete scenario describing the evolution of the jet is proposed with emphasis on the dynamics of vorticity within the flow. In the fourth chapter a parametric study reveals a three-dimensional secondary instability mainly controlled in the linear regime by the Strouhal number of the primary instability. In the nonlinear regime the dynamics of the azimuthal harmonies are described by means of model equations and are linked to the formation of stream wise vortices in the braid. The fifth chapter is dedicated to the convective or absolute nature of the secondary instabilities in plane shear layers. It is shown that there are flow configurations for which the two-dimensional secondary instability (pairing) is absolute even though the primary instability (Kelvin-Helmholtz) is convective. Some preliminary results concerning the three-dimensional secondary instabilities arc presented at the end of this chapter. The last chapter summarizes the main results and examines possible extensions of this work. (author) [fr
Sullivan, Sylvia C.; Hoose, Corinna; Kiselev, Alexei; Leisner, Thomas; Nenes, Athanasios
Disparities between the measured concentrations of ice-nucleating particles (INPs) and in-cloud ice crystal number concentrations (ICNCs) have led to the hypothesis that mechanisms other than primary nucleation form ice in the atmosphere. Here, we model three of these secondary production mechanisms - rime splintering, frozen droplet shattering, and ice-ice collisional breakup - with a six-hydrometeor-class parcel model. We perform three sets of simulations to understand temporal evolution of ice hydrometeor number (Nice), thermodynamic limitations, and the impact of parametric uncertainty when secondary production is active. Output is assessed in terms of the number of primarily nucleated ice crystals that must exist before secondary production initiates (NINP(lim)) as well as the ICNC enhancement from secondary production and the timing of a 100-fold enhancement. Nice evolution can be understood in terms of collision-based nonlinearity and the phasedness of the process, i.e., whether it involves ice hydrometeors, liquid ones, or both. Ice-ice collisional breakup is the only process for which a meaningful NINP(lim) exists (0.002 up to 0.15 L-1). For droplet shattering and rime splintering, a warm enough cloud base temperature and modest updraft are the more important criteria for initiation. The low values of NINP(lim) here suggest that, under appropriate thermodynamic conditions for secondary ice production, perturbations in cloud concentration nuclei concentrations are more influential in mixed-phase partitioning than those in INP concentrations.
Pusztahelyi, Tünde; Holb, Imre J.; Pócsi, István
Fungi and plants are rich sources of thousands of secondary metabolites. The genetically coded possibilities for secondary metabolite production, the stimuli of the production, and the special phytotoxins basically determine the microscopic fungi-host plant interactions and the pathogenic lifestyle of fungi. The review introduces plant secondary metabolites usually with antifungal effect as well as the importance of signaling molecules in induced systemic resistance and systemic acquired resistance processes. The review also concerns the mimicking of plant effector molecules like auxins, gibberellins and abscisic acid by fungal secondary metabolites that modulate plant growth or even can subvert the plant defense responses such as programmed cell death to gain nutrients for fungal growth and colonization. It also looks through the special secondary metabolite production and host selective toxins of some significant fungal pathogens and the plant response in form of phytoalexin production. New results coming from genome and transcriptional analyses in context of selected fungal pathogens and their hosts are also discussed. PMID:26300892
Full Text Available Introduction Use of hadron therapy as an advanced radiotherapy technique is increasing. In this method, secondary particles are produced through primary beam interactions with the beam-transport system and the patient’s body. In this study, Monte Carlo simulations were employed to determine the dose of produced secondary particles, particularly neutrons during treatment. Materials and Methods In this study, secondary particles, produced by proton and ion beams, were simulated for a cancer treatment plan. In particular, we evaluated the distribution of secondary neutrons, produced by a 400 MeV/u carbon beam on an electronic crate, which was exposed to radiation field under radioactive conditions. The level of major secondary particles, particularly neutrons, irradiating the target, was evaluated, using FLUKA Monte Carlo code. Results The fluences and radiation doses were applied to determine the shielding efficiency of devices and the probability of radiation damage to nearby electronic systems. According to the results, by using maximum-energy carbon ions (400 MeV/u, electronic devices are exposed to a dose rate of 0.05 µSv/s and an integrated dose of about 34 mSv, each year. Conclusion The simulation results could provide significant information about radiation assessment; they could also be a major help for clinical facilities to meet shielding requirements. Moreover, such simulations are essential for determining the radiation level, which is responsible for radiation-induced damages.
Full Text Available This paper explores the policy issues circling around the structural "transition" in upper secondary education implicit in the twenty-year increase in secondary and third-level school enrollment rates in Taiwan. This expansion has taken place within a secondary school system which is rigidly divided into both general, i.e., academic, and vocational tracks and into public and private sectors: the majority of students are enrolled in the private vocational sector which is only loosely articulated with the university sector. These features of the school system are analysed against the background of social and economic developments in Taiwan as well as public opinion. The analysis suggests that the present structures of school must be "reformed" in ways that will result in a more unified secondary system with both greater public funding and better articulation of all school types with the third level. The policy options that circle around the possibility of such reforms in the areas of curriculum, examination structures and second level-third level articulation are discussed and a policy framework for the reform of the Taiwan secondary education sector is outlined.
Morrison, Lindy E; Joy, Jane P
To investigate the prevalence of secondary traumatic stress among Emergency nurses in the West of Scotland and explore their experiences of this. Unexpected death, trauma and violence are regular occurrences that contribute to the stressful environment nurses working in the Emergency department experience. A potential consequence of repeated exposure to such stressors can be referred to as secondary traumatic stress. Triangulation of methods of data collection, using two distinct phases: Phase 1 - quantitative Phase 2 - qualitative METHODS: Quantitative data were collated via postal questionnaire, from a convenience sample of Emergency nurses. Qualitative data were subsequently collated from a focus group constituting of a random sample of these Emergency nurses. Descriptive statistics were computed and thematic analysis conducted. All data were collated during February 2013. 75% of the sampled Emergency nurses reported at least one secondary traumatic stress symptom in the last week. Participants said that acute occupational stressors such as resuscitation and death were the influencing factors towards this. Strategies such as formal debriefing and social support were cited as beneficial tools for the management of secondary traumatic stress; however, barriers such as time and experience were found to inhibit their common use. Secondary traumatic stress is a prevalent phenomenon among Emergency nurses in the West of Scotland and if not managed appropriately, could represent a significant barrier to the mental health of this group and their capacity to provide quality care. © 2016 John Wiley & Sons Ltd.
Franco, W; Pérez-Díaz, I M
To evaluate the interaction between selected yeasts and bacteria and associate their metabolic activity with secondary cucumber fermentation. Selected yeast and bacteria, isolated from cucumber secondary fermentations, were inoculated as single and mixed cultures in a cucumber juice model system. Our results confirmed that during storage of fermented cucumbers and in the presence of oxygen, spoilage yeasts are able to grow and utilize the lactic and acetic acids present in the medium, which results in increased brine pH and the chemical reduction in the environment. These conditions favour opportunistic bacteria that continue the degradation of lactic acid. Lactobacillus buchneri, Clostridium bifermentans and Enterobacter cloacae were able to produce acetic, butyric and propionic acids, respectively, when inoculated in the experimental medium at pH 4.6. Yeast and bacteria interactions favoured the survival of Cl. bifermentans and E. cloacae at the acidic pH typical of fermented cucumbers (3.2), but only E. cloacae was able to produce a secondary product. The methodology used in this study confirmed that a complex microbiota is responsible for the changes observed during fermented cucumber secondary fermentation and that certain microbial interactions may be essential for the production of propionic and butyric acids. Understanding the dynamics of the development of secondary cucumber fermentation aids in the identification of strategies to prevent its occurrence and economic losses for the pickling industry. © 2012 No claim to US Government works.
Xie, Ai-Gen; Uhm, Han-Sup; Chen, Yun-Yun; Choi, Eun-Ha
On the basis of the free-electron model, the energy range of internal secondary electrons, the energy band of a metal, the formula for inelastic mean escape depth, the processes and characteristics of secondary electron emission, the probability of internal secondary electrons reaching surface and passing over the surface barrier into vacuum B as a function of original work function Φ and the distance from Fermi energy to the bottom of the conduction band EF was deduced. According to the characteristics of creation of an excited electron, the definition of average energy required to produce an internal secondary electron ɛ, the energy range of excited electrons and internal secondary electrons and the energy band of a metal, the formula for expressing ɛ using the number of valence electron of the atom V, Φ,EF and atomic number Z was obtained. Based on the processes and characteristics of secondary electron emission, several relationships among the parameters of the secondary electron emission and the deduced formulae for B and ɛ, the formula for expressing maximum secondary electron yield of metals δm using Z, V, back-scattering coefficient r, incident energy of primary electron at which secondary electron yield reaches δm, Φ and EF was deduced and demonstrated to be true. According to the deduced formula for δm and the relationships among δm and several parameters of secondary electron emitter, it can be concluded that high δm values are linked to high V, Z and Φ values, and vice versa. Based on the processes and characteristics of secondary electron emission and the deduced formulae for the B, ɛ and δm, the influences of surface properties on δm were discussed.
Campana, F; Carvelli, J; Fricain, J C; Vergier, B; Boralevi, F; Kaplanski, G
Syphilis is a sexually transmitted infection (STI) related to Treponema pallidum. Secondary syphilis is the blood-borne systemic spread of Treponema. We report the case of secondary syphilis in a patient without risk of STIs factor. The clinical picture began with a genital affection followed by oral erosions and ulcers and an anterior and then posterior uveitis. Serology established the diagnosis and intravenous penicillin G treatment allowed for healing. Called the "great pretender" because of its clinical polymorphism, secondary syphilis can lead to formidable neurological and ophthalmological complications. Serological diagnosis is based on the use of treponemal and a nontreponemal tests. Penicillin G remains the treatment of choice and must be adapted according to the clinical damage. Copyright © 2016 Elsevier Masson SAS. All rights reserved.
von Conta, P.E.W.
This patent describes an improved secondary combustion system for combusting the exhaust gases exiting from a fire box in a wood burning stove comprising: an insulated conduit defining an exhaust passageway leading from an intake opening to an exit opening; screen means interposed across the exhaust passageway in the vicinity of the intake opening to impart a rapid acceleration to a gas stream entering the exhaust passageway; rotation means to impart a rotation to the gas stream in a first portion of the exhaust passageway; counter-rotation means to impart a counter-rotation to the gas stream in a second portion of the exhaust passageway; deceleration means to decelerate the gas stream in the second portion of the exhaust passageway; and secondary air means to inject a source of secondary air into the exhaust passageway.
Ng, Alex L K; Kwok, Peter S K; Chan, Tommy C Y
The authors report four cases of residual intrastromal lenticule after seemingly uneventful small incision lenticule extraction (SMILE) surgery and the outcome after a secondary procedure to remove the lenticule remnant. Case reports. All four cases presented with suboptimal corrected distance visual acuity (CDVA) and refractive surprise. Irregularities in the corneal curvature and elevation were detected on corneal topography and tomography. Careful review of the intraoperative video showed an incomplete removal of the SMILE lenticule. All four cases underwent a secondary surgical procedure to remove the residual lenticule remnant. All cases had improvements in the CDVA, refraction, and topography, with the CDVA returning to the preoperative value (20/20) in all cases. Performing an early, secondary lenticular remnant removal operation is feasible, safe, and can result in improvement in both refraction and visual acuity. During the original SMILE surgery, surgeons should routinely examine the removed lenticule for completeness. [J Refract Surg. 2017;33(11):779-782.]. Copyright 2017, SLACK Incorporated.
Branka Ribič Hederih
Full Text Available Procrastination is a trait and/or a form of behavior that denotes an individual’s delay in an activity which should be done, and which causes discomfort. In the study we wished to determine the differences between high school students regarding gender, educational programme and learning success of the previous school year in three factors. On a sample of 284 high school students of different Slovenian secondary schools, we found that on average boys show statistically significantly more shortage of learning self-discipline than girls, while girls, on average, significantly more discomfort than boys. Comparison of secondary school students between programmes showed that, on average, gimnazija students show significantly more learning self-discipline than students in secondary technical education. The comparison in relation to different levels of learning success at the end of the previous school year and the factors of procrastination showed, however, no statistically significant differences.
Fontan, Guillaume; Morel, Pascal
In a context of investment and renewal of equipment, Electricite De France (EDF) put enhanced efforts on operating practices during start-up of the secondary circuit, in order to improve operational performance and materials lifetime. This article focuses on the objective of optimizing the filling, the chemical conditioning and the thermal conditioning of the secondary fluid, while taking into account the following issues: - Limiting the time required to obtain a proper chemistry, - Limiting the amount of water and steam used, - Limiting the amount of effluent generated. The scope is all start-up conditions of secondary circuit, both after refuelling outage or fortuitous shutdowns of the plant. The recommendations produced are based on existing local procedures and good practices, which were collected and developed in order to propose a generic methodology understandable and useful both for operators, chemists and managers. (authors)
Full Text Available The article discusses the introduction of secondary school students (young researchers to research projects, which include writing an independent research paper. Young researchers compete with their fellows at competitions for best research projects in secondary schools. Each young researcher has to choose a supervisor and together they select research topic. Young researchers then create their own work plan which will help them to develop their aims and hypotheses. With the aid of the literature and the analysis of their experimental results, they are able to complete their paper. The role of the supervisor and the librarian, who can also act as their supervisor or cosupervisor, is crucial. The choice of research methods is central in the work of young researchers since this helps them to acquire important research skills already in primary and secondary schools. Good teamwork between the researcher, the supervisor and the librarian is a precondition for a good and useful research paper.
Neill, Alex; Berg, Melanie; Stevens, Liesje
This report investigates the behaviour, attitudes and experiences of New Zealand secondary students with money and financial products. It also looks at financial literacy programmes in New Zealand secondary schools and explores barriers to the implementation of financial literacy teaching. The research was commissioned by the Commission for…
Vaz, Sharmila; Falkmer, Marita; Ciccarelli, Marina; Passmore, Anne; Parsons, Richard; Black, Melissa; Cuomo, Belinda; Tan, Tele; Falkmer, Torbjörn
It is unknown if, and how, students redefine their sense of school belongingness after negotiating the transition to secondary school. The current study used longitudinal data from 266 students with, and without, disabilities who negotiated the transition from 52 primary schools to 152 secondary schools. The study presents the 13 most significant personal student and contextual factors associated with belongingness in the first year of secondary school. Student perception of school belongingness was found to be stable across the transition. No variability in school belongingness due to gender, disability or household-socio-economic status (SES) was noted. Primary school belongingness accounted for 22% of the variability in secondary school belongingness. Several personal student factors (competence, coping skills) and school factors (low-level classroom task-goal orientation), which influenced belongingness in primary school, continued to influence belongingness in secondary school. In secondary school, effort-goal orientation of the student and perception of their school’s tolerance to disability were each associated with perception of school belongingness. Family factors did not influence belongingness in secondary school. Findings of the current study highlight the need for primary schools to foster belongingness among their students at an early age, and transfer students’ belongingness profiles as part of the hand-over documentation. Most of the factors that influenced school belongingness before and after the transition to secondary are amenable to change. PMID:26372554
Full Text Available It is unknown if, and how, students redefine their sense of school belongingness after negotiating the transition to secondary school. The current study used longitudinal data from 266 students with, and without, disabilities who negotiated the transition from 52 primary schools to 152 secondary schools. The study presents the 13 most significant personal student and contextual factors associated with belongingness in the first year of secondary school. Student perception of school belongingness was found to be stable across the transition. No variability in school belongingness due to gender, disability or household-socio-economic status (SES was noted. Primary school belongingness accounted for 22% of the variability in secondary school belongingness. Several personal student factors (competence, coping skills and school factors (low-level classroom task-goal orientation, which influenced belongingness in primary school, continued to influence belongingness in secondary school. In secondary school, effort-goal orientation of the student and perception of their school's tolerance to disability were each associated with perception of school belongingness. Family factors did not influence belongingness in secondary school. Findings of the current study highlight the need for primary schools to foster belongingness among their students at an early age, and transfer students' belongingness profiles as part of the hand-over documentation. Most of the factors that influenced school belongingness before and after the transition to secondary are amenable to change.
James, Asena Muganda; Simiyu, Aggrey Mukasa; Riechi, Andrew
Learners are the key stakeholders of a school for it to be registered by the Department of Education. However the retention of these learners in Kenya's Secondary Level Education is a great challenge in Kenya. Every secondary school dropout signifies unfulfilled objective, goal and aim for the individual as well as the community at large. The…
According to the latest statistics, suicide is the 3rd leading cause of death in those aged 15-24 (CDC, 2010), when many are enrolled in secondary and post-secondary institutions. Because of such alarming statistics, the need for prevention education is great. However, many counselors and educators feel ill- equipped in prevention and intervention…
The aim of this article is to contribute to the development of the modern theory of lexicographical functions by offering a critical examination of the following concepts associated with it: primary needs, primary data, secondary needs, secondary data, function-related needs, and function-related data. By way of introduction, ...
Fabian, Ido Didi; Puccinelli, Francesco; Gaillard, Marie-Claire; Beck-Popovic, Maja; Munier, Francis L
Reports on retinoblastoma relapse at the optic nerve head (ONH) are anecdotal and include only treatments by external beam radiotherapy (EBRT) or enucleation. We aimed to describe such cases, termed secondary epipapillary retinoblastoma, diagnosed and monitored with the assistance of hand-held spectral domain optical coherence tomography (HHSD-OCT) and treated with intraophthalmic artery chemotherapy (IAC) and/or intravitreous chemotherapy (IViC). A retrospective analysis of secondary epipapillary retinoblastoma cases treated conservatively. Four males and two females were included, diagnosed with secondary epipapillary retinoblastoma at a median time of 8.6 months (mean 24.0) from initial retinoblastoma diagnosis. HHSD-OCT was used in all cases for accurate diagnosis; in 2/6, the epipapillary relapse was detected only by means of HHSD-OCT. Treatments for secondary epipapillary retinoblastoma included IAC and IViC (n=4), IAC alone (n=1) and IViC alone (n=1). HHSD-OCT demonstrated complete epipapillary tumour regression in all cases, achieved in a median time of 1.6 months (mean 1.8). The median time from secondary epipapillary retinoblastoma resolution to last visit was 29.2 months (mean 27.5). At last visit, all eyes were tumour-free and no cases of metastasis recorded. Cases of retinoblastoma relapse at the ONH show common clinical features and represent specific diagnostic and therapeutic challenge; hence, we propose to consider this condition as a subset of retinoblastoma, termed secondary epipapillary retinoblastoma. HHSD-OCT is an invaluable diagnostic tool in the initial diagnosis as well as in monitoring these lesions, and IAC and IViC are efficient modalities for this clinical scenario, obviating the need for EBRT or enucleation. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
Ubaldo O. Martín
the larvae migrate through the capillaries, taking up residence in different tissues. Clinical manifestations are associated with mechanical and/or reaction damage caused by these parasites larvae. Clinical diagnosis is difficult. The method applied in this work is the demonstration of antibodies against the helminth in the blood of children, target host population of this parasitic disease. An ELISA test was performed using T. canis larval excretory-secretory products as antigen. A total of 100 children presumptively diagnosed of toxocariasis that had been derived from different services of the Regional Children’s Hospital for complementary studies, were included in the analysis. The test detected two different populations: infected (59 and non-infected (41. The statistical analysis showed a non significant association between infection and sex (p = 0.279. Infected subjects tended to be older than the non infected (p = 0.009. Eosinophilia was detected in 100% of seropositive children and in 85.2% of the seronegative. There was no significant association between infection and leucocytosis ( = 0.950. The association of these two parameters was significantly higher among infected patients (R = 0.918. Respiratory symptoms and signs were more frequently detected in the positive population (p = 0.05. Dogs tenancy was as frequent among infected as in the non infected homes (p = 0.53. According to these results, prevention, early diagnosis and opportune treatment for toxocariasis should be considered as prioritary health activities in this region.
If teachers are to successfully develop their students' English language skills it is vital that they overcome any existing lack of confidence and training in grammar and language concepts. Language Knowledge for Secondary Teachers is an accessible book aiming to equip secondary teachers with the knowledge they need to teach language effectively. It clearly explains the essential concepts for language study, introduces the terminology needed for 'talking about language' and shows how this knowledge can be applied to the skills of reading, writing, speaking and listening. This
Sato, Shinji; Kanazawa, Mitsutaka; Noda, Koji; Takada, Eiichi; Komiyama, Akihito; Ichinohe, Ken-ichi; Sano, Yoshinobu
To replace the scintillation-ripple monitor, we have developed a new monitor with a smaller destructive effect on the beam. In this monitor, we use secondary electrons emitted from an aluminum foil with a thickness of 2 μm. The signals of secondary electrons are amplified by an electron multiplier having a maximum gain of 10 6 . By using the new monitor, we could clearly observe the beam ripple with a beam intensity of 3.6x10 8 pps (particle per second). This monitor can also be used as an intensity monitor in the range of 10 4 - 10 9 pps. (author)
Holm, Claus; Schreiber, Trine; Tønnesen, Pia Hvid
The discussion paper is a publication from the project Information Literacy in the Upper Secondary School. The project is a collaboration between the National Library of Education at the Danish School of Education, Aarhus University, and the Royal School of Library and Information Science....... The project is funded by Denmark's Electronic Research Library (DEFF). The discussion paper is published in connection with the conference Information Literacy in the Upper Secondary School on 22 April 2010. See video streaming from the conference etc. at www.dpu.dk/info....
The major factor influencing secondary trading for the last few years has been the large contractural commitments built up by consumers for reactor programs which have proven to be unrealistic. The situation has intensified as a result of utilities needing to generate capital through inventory liquidation or reductions. The flexibilities in most contracts are inadequate to match the types of external and/or internal factors faced by the industry. This situation also suggests the need for secondary markets to help the industry adjust to unforeseen difficulties. They are very active markets at this time, but their influence in relation to the long-term method of doing business should not be exaggerated
Weeks, J.R.; van Rooyen, D.
The bases for establishing Technical Specifications for PWR secondary water chemistry are reviewed. Whereas extremely stringent control of secondary water needs to be maintained to prevent denting in some units, sound bases for establishing limits that will prevent stress corrosion, wastage, and denting do not exist at the present time. This area is being examined very thoroughly by industry-sponsored research programs. Based on the evidence available to date, short term control limits are suggested; establishment of these or other limits as Technical Specifications is not recommended until the results of the research programs have been obtained and evaluated
A. D. Jeyanthy Victoria; Dr. G. Subramonian
Self-esteem is an important aspect in the happy and peaceful living of individuals. It is a feeling of ‘being good’ of one’s own self. The current study explored the level of self-esteem and significant difference in self-esteem among the prospective secondary teachers with regard to gender, locality and nature of the teacher training institute. The prospective secondary teachers (N=665) studying in the teacher training institutes were surveyed using Self Esteem Scale constructed and standard...
Fahimian, Benjamin P.; DeMarco, John J.; Keyes, Roy
is the normal tissue dose resulting from secondary neutrons produced in the annihilation of antiprotons on the nucleons of the target atoms. Here we present the first organ specific Monte Carlo calculations of normal tissue equivalent neutron dose in antiproton therapy through the use of a segmented CT......-based human phantom. The MCNPX Monte Carlo code was employed to quantify the peripheral dose for a cylindrical spread out Bragg peak representing a treatment volume of 1 cm diameter and 1 cm length in the frontal lobe of a segmented whole-body phantom of a 38 year old male. The secondary neutron organ dose...
Hydon, Stephen; Wong, Marleen; Langley, Audra K; Stein, Bradley D; Kataoka, Sheryl H
Teachers can be vulnerable to secondary traumatic stress (STS) because of their supportive role with students and potential exposure to students' experiences with traumas, violence, disasters, or crises. STS symptoms, similar to those found in posttraumatic stress disorder, include nightmares, avoidance, agitation, and withdrawal, and can result from secondary exposure to hearing about students' traumas. This article describes how STS presents, how teachers can be at risk, and how STS can manifest in schools. A US Department of Education training program is presented, and thoughts on future directions are discussed. Copyright © 2015 Elsevier Inc. All rights reserved.
Abdelmohsen, Usama Ramadan; Grkovic, Tanja; Balasubramanian, Srikkanth; Kamel, Mohamed Salah; Quinn, Ronald J; Hentschel, Ute
Genomic sequence data have revealed the presence of a large fraction of putatively silent biosynthetic gene clusters in the genomes of actinomycetes that encode for secondary metabolites, which are not detected under standard fermentation conditions. This review focuses on the effects of biological (co-cultivation), chemical, as well as molecular elicitation on secondary metabolism in actinomycetes. Our review covers the literature until June 2014 and exemplifies the diversity of natural products that have been recovered by such approaches from the phylum Actinobacteria. Copyright © 2015. Published by Elsevier Inc.
... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false SBA Secondary Market. 120.601... Market Fiscal and Transfer Agent (fta) § 120.601 SBA Secondary Market. The SBA secondary market (“Secondary Market”) consists of the sale of Certificates, representing either the entire guaranteed portion...
This study examined the strategies commonly adopted by Osun state secondary school students in processing career information. It specifically examined the sources of career information available to the students, the uses to which the students put the information collected and how their career decision making skills can be ...
Secondary hypertension is rare and the diagnosis may be challenging although, on occasion, there are clinical features indicative of a specific underlying cause. The more commonly encountered causes include renal parenchymal and vascular disease, phaeochromocytoma, endocrine causes, sleep apnoea and drugs.
Leslie, Paul; Murphy, Elizabeth
The goal of the study was to explore post-secondary students' purposes for blogging with particular attention to the social and instructional purposes. The sample of blogs came from an all-women's college in the United Arab Emirates. Content analysis was conducted on eight blogs using previously tested instruments to identify social presence and…
Hedayati, Nasibeh; Kuusisto, Elina; Gholami, Khalil; Tirri, Kirsi
This article examines Iranian secondary students' (N = 336) life purposes. Economic and hedonistic life goals were the most valued. Relationships in terms of having a family and children were also appreciated. In the students' views, religiousness was associated with social goals such as helping others in need and volunteering in the community.…
Oct 28, 2015 ... The aims of this study were the analysis of the secondary metabolites and evaluation of the antibacterial and antifungal activity of Alternaria alternata. Twenty six bioactive compounds were identified in methanolic extract of Alternaria alternata. The identification of bioactive chemical compounds is based on ...
Background: The emergence of multiple-drug resistance bacteria has become a major threat and thus calls for an urgent need to search for new effective and safe anti-bacterial agents. Objectives: This study aims to evaluate the anticancer and antibacterial activities of secondary metabolites from Penicillium sp., ...
Trust Territory of the Pacific Islands Dept. of Education, Saipan.
This curriculum guide on residential wiring for secondary students is one of six developed for inservice teachers at Marianas High School in Saipan. The guide provides the rationale, description, goals, and objectives of the program; the program of studies and performance objectives by levels; samples of lesson plans for effective delivery of…
Langbein, Wolfgang; Jensen, Jacob Riis; Hvam, Jørn Märcher
We investigate the time-resolved secondary emission of a homogeneously broadened microcavity after resonant excitation. The sample consists of a 25nm GaAs single quantum well (QW) in the center of a wedged ¥ë cavity with AlAs/AlGaAs Bragg reflectors, grown by molecular beam epitaxy. At zero...
Klein, R.I.; Whitaker, R.W.; Sandford, M.T. II.
Recent developments relating the conditions in molecular clouds to star formation triggered by a prior stellar generation are reviewed. Primary processes are those that lead to the formation of a first stellar generation. The secondary processes that produce stars in response to effects caused by existing stars are compared and evaluated in terms of the observational data presently available. We discuss the role of turbulence to produce clumpy cloud structures and introduce new work on colliding inter-cloud gas flows leading to non-linear inhomogeneous cloud structures in an intially smooth cloud. This clumpy morphology has important consequences for secondary formation. The triggering processes of supernovae, stellar winds, and H II regions are discussed with emphasis on the consequences for radiation driven implosion as a promising secondary star formation mechanism. Detailed two-dimensional, radiation-hydrodynamic calculations of radiation driven implosion are discussed. This mechanism is shown to be highly efficient in synchronizing the formation of new stars in congruent to 1-3 x 10 4 years and could account for the recent evidence for new massive star formation in several UCHII regions. It is concluded that, while no single theory adequately explains the variety of star formation observed, a uniform description of star formation is likely to involve several secondary processes. Advances in the theory of star formation will require multiple dimensional calculations of coupled processes. The important non-linear interactions include hydrodynamics, radiation transport, and magnetic fields
The study examined the impact of effective communication in secondary school administration in Enugu State. It was a descriptive study. The study comprised 659 respondents made up of 28 principals and 631 teachers. The population of the study was obtained through random sampling technique. The instrument used for ...
Chemical composition, secondary metabolites, in vitro gas production characteristics and acceptability study of some forage for ruminant feeding in South-Western Nigeria. ... Chemical composition and qualitative analysis of saponins, phenol and steroids of the plants were determined. In vitro gas production (IVGP) was ...
Christiansen, O B; Larsen, E C; Egerup, P
OBJECTIVE: To determine whether infusions with intravenous immunoglobulin (IVIg) during early pregnancy increase live birth rate in women with secondary recurrent miscarriage compared with placebo. DESIGN: A single-centre, randomised, double-blind, placebo-controlled trial. SETTING: A tertiary...
In this chapter the recovery and recycling of secondary raw materials is explained. This chapter consists of the following parts: Paper and tetrapaks; Car wrecks; Scrap metal; Plastics; Used tires; Electrical and electronic equipment; Glass; Accumulators and batteries; Spent oil; Low-and non-waste technology.
Belov, A.V.; Dorman, L.I.; Sirotina, I.V.
Altitude dependences of coupling coefficients and secondary cosmic ray variations are investigated. The partial and variational barometric coefficients are calculated according to data on coupling coefficients of a neutron component. Application of data on altitude dependence of variations for calculation of barometric coefficient changes and for determination of a rigidity primary variation spectrum is discussed
Histological examination confirmed dysgerminoma of the right ovary and corpus luteal cyst on the left ovary. Post-operatively, her menstration has resumed, facial hair growth disappeared and clitoridal enlargement is diminishing. Key Words: Ovarian, Dysgerminoma, Secondary Amenorrhoea. [Trop J Obstet Gynaecol, 2004 ...
Garcia Zubia, J.; Angulo Martinez, I.; Martinez Pieper, G.; Lopez de Ipina Gonzalez de Artaza, D.; Hernandez Jayo, U.; Orduna Fernandez, P.; Dziabenko, O.; Rodriguez Gil, L.; van Riesen, Siswa; Anjewierden, Anjo Allert; Kamp, Ellen; de Jong, Anthonius J.M.
This paper presents a remote lab designed for teaching the Archimedes’ principle to secondary school students, as well as an online virtual lab on the general domain of buoyancy. The Archimedes remote lab is integrated into WebLab-Deusto. Both labs are promoted for usage in frame of the Go-Lab
de Bruin, Leon R.; Harris, Anne
This study investigates and compares elements of creativity in secondary schools and classrooms in Australia and Singapore. Statistical analysis and qualitative investigation of teacher, student and leadership perceptions of the emergence, fostering and absence of creativity in school learning environments is explored. This large-scale…
... factors are discussed based on the evidence obtained by observations and research findings. The importance of teaching reading 'as a subject in the secondary school is hinted. Recommendations are made to ensure that reading as a tool to learning is given a prominent place in schools and libraries throughout Nigeria ...
A new secondary beam design is outlined for the Meson M6 Beamline that combines versatility with economy. The beamline described will transport charged particles of either sign to 800 GeV/c and bring the beam to a focus in one of three potential experimental areas. The plan makes maximal use of existing civil construction
Microalgae play a fundamental role in primary and secondary wastewater treatment. In this work the growth, photosynthetic activity and removal of phosphorus from wastewater effluents by indigenous blue-green algal species, Spirulina and Oscillatoria, isolated from Gaborone oxidation ponds was studied. Oscillatoria and ...
This study investigated the relationship between continuous assessment scores and junior secondary school certificate examination(JSCE) final scores in Imo State. A sample of four hundred students were purposively selected from thirty eight thousand students who took the 1997 JSCE in Imo State. The data used were ...
Somatic embryogenesis was achieved from immature cotyledon explants of Persian walnut (Juglans regia L.) cave. "Chandler" on DKW medium. Secondary somatic embryogenesis, the process by which adventitious embryos are formed from primary somatic embryos, is frequent during somatic embryogenesis in Persian ...
The main purpose of this study was to investigate factors influencing examination malpractice in some selected secondary schools in Cross River State, Nigeria. A sample of one thousand two hundred (1200) students were selected across the three educational zones of Ogoja, Ikom and Calabar using stratified, random ...
National Technical Assistance Center on Transition, 2016
Recently researchers have begun focusing on young adults with mental health disorders transitioning into adulthood. Research exploring the importance of mental health support in secondary transition have yielded positive outcomes. For example, strong collaboration between educational and mental health agencies ensuring academic, employment, and…
CROCKETT, DINA B.
SECONDARY ONOMATOPOEIA, ALSO REFERRED TO AS "SOUND-SYMBOLISM," DESIGNATES THE REPRESENTATION IN SPEECH SOUNDS OF NON-ACOUSTIC EXPERIENCES. THE NON-ACOUSTIC EXPERIENCES DEALT WITH ARE VISUAL (IMPRESSIONS OF MAGNITUDE AND LUMINOSITY) AND EMOTIONAL (MOODS OF GLOOM AND HAPPINESS). THIS PAPER DESCRIBES AN EMPIRICAL STUDY DESIGNED TO EXPLORE…
We report a case of a 42 year old patient who collapsed at an airport departure lounge. The patient was investigated and found to have advanced renal failure with serum potassium (K+) of 10.3 mmol/L, creatinine of 3581 µmol/L and urea of 59.9 mmol/L secondary to obstructive uropathy due to advanced bladder cancer.
Journal of Technology and Education in Nigeria ... The purpose of this study was to investigate the relationship between mathematical language and learners\\' achievement in secondary school mathematics in Kenya and the extent to which mathematical language is perceived by learners and teachers to influence ...
Rivers State University of Science & Technology, Port Harcourt, Nigeria. Email: firstname.lastname@example.org. ABSTRACT. The purpose of the study was to investigate students' performance in chemical calculations involving gas equation, mole concept and chemical equations. 100 Senior Secondary. (SS) students from 10 schools ...
Peninsula Humane Society, San Mateo, CA.
Activities in this teacher's packet are designed to familiarize secondary school students with the responsibilities involved in pet ownership. Teaching plans are provided for a total of 12 lessons grouped under social studies, language arts, math, and health sciences. Activities focus on pet overpopulation, expressions of social responses in…
Wong, Wayne A.; Macosko, Robert P.
The NASA Glenn Research Center is developing technologies that utilize solar energy for various space applications including electrical power conversion, thermal propulsion, and furnaces. Common to all of these applications is the need for highly efficient, solar concentration systems. An effort is underway to develop the innovative single crystal refractive secondary concentrator, which uses refraction and total internal reflection to efficiently concentrate and direct solar energy. The refractive secondary offers very high throughput efficiencies (greater than 90%), and when used in combination with advanced primary concentrators, enables very high concentration ratios (10,0(X) to 1) and very high temperatures (greater than 2000 K). Presented is an overview of the refractive secondary concentrator development effort at the NASA Glenn Research Center, including optical design and analysis techniques, thermal modeling capabilities, crystal materials characterization testing, optical coatings evaluation, and component testing. Also presented is a discussion of potential future activity and technical issues yet to be resolved. Much of the work performed to date has been in support of the NASA Marshall Space Flight Center's Solar Thermal Propulsion Program. The many benefits of a refractive secondary concentrator that enable efficient, high temperature thermal propulsion system designs, apply equally well to other solar applications including furnaces and power generation systems such as solar dynamics, concentrated thermal photovoltaics, and thermionics.
Objective To examine the relationship between smoking habits and indicators of socioeconomic status, the urban/rural dimension and gender among secondary school students from selected districts in Zimbabwe. Design A two-stage stratified random sample of students was drawn. Schools were stratified by school type ...
Nov 1, 2006 ... dysrrhythmia, ventricular fibrillation or asystole, the previously thought cause of death in patients with hyperkalaemia (11,12), but secondary to other associated biochemical changes (Tables 1 and 2). These changes often result in severe loss of consciousness as our patient when first seen with a. Glasgow ...
This article is the result of years of study, both formal and informal; hundreds of hours of traditional and Montessori classroom observations; reading and digesting articles and books on secondary education, Montessori education, adolescent brain research, leadership, and best practices in education; and most enlightening of all, 20 years of…
Knuth, Eric J.
Examines in-service secondary school mathematics teachers' conceptions of proof. Suggests that teachers recognize the variety of roles that proof plays in mathematics. Noticeably absent, however, was a view of proof as a tool for learning mathematics. Many of the teachers held limited views of the nature of proof in mathematics and demonstrated…
The aims of this study were the analysis of the secondary metabolites and evaluation of the antibacterial and antifungal activity of Alternaria alternata. Twenty six bioactive compounds were identified in methanolic extract of Alternaria alternata. The identification of bioactive chemical compounds is based on the peak area, ...
Burke, N G
Tumours of the chest wall are uncommon and are usually malignant. A bone haemangioma is a rare benign vascular neoplasm, which more commonly occurs in middle-aged patients. We present the case of a scoliosis caused by a rib haemangioma in an adolescent male. Other causes of scoliosis secondary to rib lesions are discussed.
Full Text Available A 35 year old male had arthropathy of large joints, psoriasiform skin lesions and circinate balanitis preceded by recurrent episodes of dysentery. He also developed feature of nephritic syndrome due to secondary amyloidosis as confirmed by renal and rectal biopsy.
Hesketh, Anthony J.; Knight, Peter T.
Examines the 1996 prospectuses of secondary schools, whose 1991 prospectuses were reviewed in earlier research, in order to consider the ways in which schools present themselves in the educational market place. Shows that the business of marketing through prospectuses is taken seriously and can be modeled using game theories. (DSK)
Conclusion: Secondary school students are aware of the subject of sexuality education, but lack adequate information on sexuality issues. Parents and teachers are a poor source of information for students. Parents, Teachers and students need to be enlightened on sexuality education. There is also a need to incorporate it ...
meeting the criteria for DSM IV- TR is increasing. What is not clear with this increase is whether it is primary mania or secondary mania linked with HIV. METHODS. This study design was a case series in which patients with acute manic episodes were admitted to. Chainama Hills College Hospital and University. Teaching ...
The study showed the importance of carbohydrate and nitrogen cycle related metabolites in mediating tolerance in cassava by affecting their phenotypic expression in the plant. Keywords: Hydrothermal stress, bio-chemicals, pigments, secondary metabolites, cassava. African Journal of Biotechnology, Vol 13(31) 3173-3186 ...
Jan 18, 2011 ... Abstract. The purpose of this study was to identify effective classroom management techniques for secondary schools teachers. Two research questions were answered using mean while two hypotheses were formulated and tested using t-test and one way analysis of variance. at 0.05 level of significance.
Dec 5, 2017 ... investigated the knowledge of emergency contraceptives among secondary school learners in the rural area of Moletji-Mashashane, ... often owing to a lack of knowledge regarding the use contraceptives. Several studies ..... What do we really know about the impact of price changes on contraceptive use?
Whitfield, Natasha; Kanter, Deborah
Those in close contact with trauma survivors are themselves at risk for trauma (e.g., Bride, 2007; Figley, 1995). Family, friends, and professionals who bear witness to the emotional retelling and re-enacting of traumatic events can experience what is called "secondary trauma" (Elwood, Mott, Lohr, & Galovski, 2011). The literature…
The study used descriptive design of survey type to assess emotional intelligence among secondary school students in Ibadan metropolis, Oyo State, Nigeria. The influences of demographic variables such as gender, family type and age on emotional intelligence were examined. The participants in the study were 393 ...
Brent, Brian O.; Deangelis, Karen J.; Surash, Barbara M.
The literature on the principalship is extensive, revealing ways in which principals can foster or impede school success. At the same time, another formal secondary school-level position, the department chair, has garnered little scholarly attention. Thus far, the literature offers a limited account of the roles that chairs should or do perform in…
The purpose of this study was to evaluate the practices and challenges of Human Resource Management (HRM) in some selected government secondary schools in East Shoa Zone (sample size: 285 teachers and staff). To this end, descriptive survey method was employed. Accordingly, the study results reveal ...
Krassel, Karl Fritjof; Heinesen, Eskil
We analyze class-size effects on academic achievement in secondary school in Denmark exploiting an institutional setting where pupils cannot predict class size prior to enrollment, and where post-enrollment responses aimed at affecting realized class size are unlikely. We identify class-size effects combining a regression discontinuity design with…
Hofferth, Sandra L.
This article first provides an overview of the part that secondary data analysis plays in the field of family studies in the early 21st century. It addresses changes over time in the use of existing omnibus data sets and discusses their advantages and disadvantages. The second part of the article focuses on the elements that make a study a…
Young, Rebekah; Johnson, David
Secondary respondent data are underutilized because researchers avoid using these data in the presence of substantial missing data. The authors reviewed, evaluated, and tested solutions to this problem. Five strategies of dealing with missing partner data were reviewed: (a) complete case analysis, (b) inverse probability weighting, (c) correction…
Kim, S.; Procházka, Jan; Bush, J.O.
jaro, č. 125 (2017), č. článku e56041. ISSN 1940-087X Institutional support: RVO:68378050 Keywords : Developmental Biology * Issue 125 * live imaging * secondary palate * tissue fusion * cleft * craniofacial Subject RIV: EB - Genetics ; Molecular Biology OBOR OECD: Developmental biology Impact factor: 1.232, year: 2016
Van Decar, Patricia
Presents 12 study guides for teaching secondary school students about Korean history and culture. The study guides deal with ancient legends, history, family, women's roles, traditions, folk customs, economic development, the division of Korea, the Korean War, links with the United States, and comparisons between North and South Korea. (GEA)
Dec 2, 2014 ... lead points are uncommon. Lymphoma, polyps, Meckel's diverticulum and hematoma are most common identified lead points in children. Aim of the work: To assess the role of multidetector computed tomographic imaging in the diagnosis of secondary intussusception with pathological leading points in ...
Disciplinary Journal , Ethiopia. Vol. 4 (2) April, 2010. ISSN 1994-9057 (Print). ISSN 2070-0083 (Online). Secondary School Student's Attitude towards Consumer ... home and shopping situation. For instance in Nigeria, with the present – meltdown of the ...
The study identified the sources of occupational stress in secondary school managers in Kano state, Nigeria. Survey design was used and a random sampling was used to select the study sample, which consisted of 421 school managers. An inventory, the School Managers Sources of Stress Inventory was used to collect ...
Thomas E Jackson
Full Text Available The first case of central serous chorioretinopathy secondary to blunt trauma is presented. Optical coherence tomography performed on presentation, 3 days after trauma, demonstrated a neurosensory detachment of the macular, thus confirming clinical findings. At 3 months after injury, the retina had spontaneously flattened at the macular and vision had returned to normal.
Full Text Available A 45-year female presented with a sudden eruption of multiple brownish black nodular lesions since 5 months over the face, trunk and extremities which were clinically diagnosed as a case of nodular malignant melanoma. Histopathologically, they revealed the secondaries from carcinoma rectum.
emotional intelligence on leadership success of secondary school principals in Rivers State of ... social settings. When emotions are aroused, the individual is either in a disturbed or excited mental state with accompanying distinctive thoughts and feelings. To achieve a ... These include: ability to perceive, appraise and ...
Pries-Heje, Jan; Hansen, Magnus Rotvit Perlt
User-based redesign after implementation has been studied in many contexts gone by many different names, such as appropriation of technology, malleable design and secondary design. The phenomenon of redesigning content has mainly revolved around technologies such as Facebook, Twitter, or Wikipedia...
Trust Territory of the Pacific Islands Dept. of Education, Saipan.
This agricultural curriculum guide on horticulture for secondary students is one of six developed for inservice teachers at Marianas High School in Saipan. The guide provides the rationale, description, goals, and objectives of the program; the program of studies and performance objectives by levels; samples of lesson plans for effective delivery…
Burnett, Michael F.; Smith, Charles W.
The objectives of the study were to determine characteristics of secondary horticulture teachers, the structure of horticulture departments, funding sources, nature and scope of facilities, types of supervised occupational experience programs in which horticulture students participated, and curriculum characteristics of vocational horticulture…
... seniority status. LICUs eligible to accept CDCI SC without any match must follow the pro- rata loss... how losses are distributed among accounts under the pro-rata loss distribution procedure of Sec. 701...-rata among all secondary capital accounts held by the LICU at the time the losses are realized. In...
The secondary accounting curriculum must be modified to include computers and software. Educators must be aware of the computer skills needed on the job and of the accounting software that is available. Software selection must be tailored to fit the curriculum and the time available. (JOW)
Bonuso, Carl; Shakeshaft, Charol
A study was conducted to understand why so few of the secondary school principals in New York State are women. Results suggest two possible causes: either sufficient women candidates do not apply for the positions, or sex discrimination still exists. (KH)
Nogay, Kathleen; Beebe, Robert J.
The purpose of this study was to investigate the perceptions of teachers and supervisors toward the principal leadership behaviors of female secondary principals in Ohio. Principal self-perceptions were also included to complete the study. The literature shows that women continue to be underrepresented in a field in which the majority of…
The secondary systems of a nuclear power plant comprises the steam, condensate and feedwater cycle, the steam plant auxiliary or ancillary systems and the cooling water systems. The presentation gives a general review about the main systems which show a high similarity of PWR and BWR plants. (orig./RW)