bluuebunny/crossref_metadata_2025 huggingface dataset:
Microstructure and Phase Evolution of Ni2FeGa Heusler Alloy Extended to Different Degrees of Undercooling
Authors: Nath Hrusikesh , Phanikumar Gandham
Published: May 2014

The Ni2FeGa Heusler alloy is synthesized by arc melting in argon atmosphere. It shows two phase microstructure, γ-phase ( disordered fcc ) and Austenite ( ordered bcc, L21 ). Phase identification and microstructural characterization were carried out using XRD, SEM and TEM. Solidification at various undercoolings upto 215 °C was performed using flux undercooling technique. B2O3 was used as the flux that provides an inert atmosphere and isolates the molten pool from the quartz tube. The solidified microstructure of the undercooled samples were analyzed and the result indicates γ-phase to be the primary phase to form. The samples are also textured. XRD patterns indicate different texture at different undercoolings. Possible mechanisms for such changes will be discussed. The competitive nucleation mechanism can not also be ruled out as the SEM micrographs show the globular morphology of γ-phase likely due to defragmentation of primary dendrites. Thermal analysis by DSC shows incongruent melting of Ni2FeGa Heusler alloy which strengthen the argument of poor nucleation ability of L21 ordered intermetallic austenite phase as compared to primary γ-phase. Up to achieved undercooling limits, γ-phase forms as the primary phase competitively with the L21 ordered phase. Studies indicate that competitive nucleation mechanism is a likely mechanism to explain the phase selection.
Effect of Mushy Zone Permeability on the Formation of Centerline Segregation in Slab Casting
Authors: Réger Mihály , Verő Balázs , Józsa Róbert , Csepeli Zsolt
Published: May 2014

A complex mathematical model characterizing the centerline segregation level in the mid region of continuously cast slabs was developed. The basic heat transfer and solidification model connected to the semi-empirical liquid feeding model (LMI - Liquid Motion Intensity model) gives the possibility to estimate the centerline segregation parameters of slab cast under industrial circumstances. Solid shell deformation changes the volume of the space available for the liquid inside the slab and hereby also changes the conditions of liquid supply.
Recurring Instability of Cellular Growth in a Near Peritectic Transparent NPG-TRIS Alloy System
Authors: Ludwig Andreas , Mogeritsch Johann
Published: May 2014

In this study, a near peritectic transparent metal-like solidifying NPG-TRIS alloy was directionally solidified in a thin sample under process conditions which favor cellular growth. Dif-ferent to an identical horizontally processed sample, the vertically processed sample revealed a cel-lular array which was curved. This curving was attributed to a convection-induced higher alloy con-centration at the sample edges compared to the sample center. Surprisingly, it was found that the curved cellular array is inherently unstable as three times dendrite-like structures shot forwards. As origin of these rapid advancements two possibilities were discussed. Either a convection-induced variation of the solute boundary layer might be responsible. Or it can be explained by a more gener-ic approach which due to the curved form of the cellular array considers extended freedom for cel-lular branching in combination with a relative large deviation of the preferential crystal growth di-rection from the heat flow direction. For the discussed phenomena the presence of the peritectic phase within the intercellular spacing was found to be not of importance.
On Factors Influencing Macro Shrinkage Porosity Formation in Compacted Graphite Iron
Authors: Vazehrad Sadaf , Elfsberg Jessica , Diószegi Attila
Published: May 2014

The purpose of this work is to investigate the relation between macro shrinkage porosity level and the level of graphite nodularity, gaseous elements and the size of eutectic colonies in compacted graphite iron. Also, the internal shrinkage-pore surfaces were analyzed by SEM and EDS techniques. It was found that samples with higher shrinkage porosity level, contained higher level of graphite nodularity and number of eutectic colonies. Also, samples with higher level of gaseous elements (Hydrogen and Nitrogen) showed higher tendency to shrinkage porosity formation. Austenite dendrites with different morphologies were observed inside the pores, indicating that were formed at different times during solidification, and the surface of the pores were covered with a layer of carbon film indicating that the pores were internal, with no contact to the atmosphere at elevated temperatures.
Viral Particles Drive Rapid Differentiation of Memory B Cells into Secondary Plasma Cells Producing Increased Levels of Antibodies
Authors: Zabel Franziska , Mohanan Deepa , Bessa Juliana , Link Alexander , Fettelschoss Antonia , Saudan Philippe , Kündig Thomas M. , Bachmann Martin F.
Published: May 2014

Extensive studies have been undertaken to describe naive B cells differentiating into memory B cells at a cellular and molecular level. However, relatively little is known about the fate of memory B cells upon Ag re-encounter. We have previously established a system based on virus-like particles (VLPs), which allows tracking of VLP-specific B cells by flow cytometry as well as histology. Using allotype markers, it is possible to adoptively transfer memory B cells into a naive mouse and track responses of naive and memory B cells in the same mouse under physiological conditions. We have observed that VLP-specific memory B cells quickly differentiated into plasma cells that drove the early onset of a strong humoral IgG response. However, neither IgM+ nor IgG+ memory B cells proliferated extensively or entered germinal centers. Remarkably, plasma cells derived from memory B cells preferentially homed to the bone marrow earlier and secreted increased levels of Abs when compared with primary plasma cells derived from naive B cells. Hence, memory B cells have the unique phenotype to differentiate into highly effective secondary plasma cells.
Cutting Edge: RIP1 Kinase Activity Is Dispensable for Normal Development but Is a Key Regulator of Inflammation in SHARPIN-Deficient Mice
Authors: Berger Scott B. , Kasparcova Viera , Hoffman Sandy , Swift Barb , Dare Lauren , Schaeffer Michelle , Capriotti Carol , Cook Michael , Finger Joshua , Hughes-Earle Angela , Harris Philip A. , Kaiser William J. , Mocarski Edward S. , Bertin John , Gough Peter J.
Published: May 2014

RIP1 (RIPK1) kinase is a key regulator of TNF-induced NF-κB activation, apoptosis, and necroptosis through its kinase and scaffolding activities. Dissecting the balance of RIP1 kinase activity and scaffolding function in vivo during development and TNF-dependent inflammation has been hampered by the perinatal lethality of RIP1-deficient mice. In this study, we generated RIP1 kinase–dead (Ripk1K45A) mice and showed they are viable and healthy, indicating that the kinase activity of RIP1, but not its scaffolding function, is dispensable for viability and homeostasis. After validating that the Ripk1K45A mice were specifically protected against necroptotic stimuli in vitro and in vivo, we crossed them with SHARPIN-deficient cpdm mice, which develop severe skin and multiorgan inflammation that has been hypothesized to be mediated by TNF-dependent apoptosis and/or necroptosis. Remarkably, crossing Ripk1K45A mice with the cpdm strain protected against all cpdm-related pathology. Together, these data suggest that RIP1 kinase represents an attractive therapeutic target for TNF-driven inflammatory diseases.
Physical features indicating the glacial transport distance of gahnite from the Izok Lake Cu-Zn-Pb-Ag VMS deposit, Nunavut
Authors: McClenaghan M B , Holmes D R S , Averill S A , Paulen R C , Layton-Matthews D
Published: May 2014

This small study of gahnite from the Izok Lake deposit and associated glacial dispersal train northwest of the deposit is the first to evaluate and report on the shape and surface characteristics of gahnite in glacial sediments. It demonstrates that increased
distance of glacial transport results in: 1) a significant decrease in the proportion of attached quartz and muscovite on individual gahnite grains; 2) no discernable wear on the actual gahnite grains; 3) a significant decrease in the number of gahnite grains in till; and, 4) reduced grain sizes.
Further work is recommended on other gahnite glacial dispersal trains to confirm and refine the proposed classification system and, in particular, to determine the distances at which a) none, and b) all, of the gahnite grain are completely free of quartz and muscovite. Future studies should ideally
include only till samples where gahnite populations have been picked to completion, and no grains have yet been removed for other uses such as EMP analysis, in order to avoid any bias. In samples with very large gahnite populations, a split should be picked to completion rather than trying to pick a
representative population of grains from the entire sample. Whereas quartz and muscovite are universal gahnite associates in all of the significant gahnite glacial dispersal trains that Overburden Drilling Management Limited has examined to date, other minerals such as spessartine may occur in
sufficient concentrations in some metamorphosed VMS alteration zones to be in direct contact with gahnite and thus potentially to adhere to some of the dispersed grains.
L-2 hydroxyglutaric aciduria in a South African Staffordshire Bull Terrier
Authors: Böhm Marlies , Henderson Howard , Van der Zwan Henriette , Basson Sandra
Published: May 2014

L-2 hydroxyglutaric aciduria is an autosomal recessive error of metabolism that manifests as an encephalopathy. The most common presenting signs are seizures, tremors, ataxia and/ or dementia. Some affected dogs show only subtle behavioural changes. Amongst canines, the condition has been best described in Staffordshire Bull Terriers. Although this is the first reported case in South Africa, at least three other affected dogs have been indentified by polmerase chain reaction (PCR) in this country. Affected dogs have normal haematology, serum biochemistry and routine urine analysis. This report discusses the advantages and limitations of the three main diagnostic modalities, namely: magnetic resonance imaging, urine gas chromatography-mass spectrometry and genetic testing. The aim of this report is to increase awareness of the condition, assist diagnosis in encephalopathic dogs and improve detection of carriers amongst breeding stock.
Anterior approach v. posterior approach - ultrasound-guided shoulder arthrogram injection
Authors: Neethling-du Toit Merle , De villiers Richard
Published: May 2014

Anterior approach ultrasound guided arthrogram injections are a quick reliable way of injecting contrast prior to MRI scan. We did a retrospective study on patients, previously injected and scanned at our clinic, to compare the more manifested posterior approach with the anterior approach. The success rate for successful intra-articular injections for the anterior approach far outweighs the posterior approach. Also the anterior approach is more tolerable for patients as the injections are much quicker and seemingly less painful. In our knowledge it is thus far better to perform anterior approach shoulder arthrogram injections than posterior approach injections
Digital SAJR: The web and more?
Authors: Van Niekerk JP
Published: May 2014

The switch of SAJR to a fully online journal has been most successfully managed by Jan Lotz, editor of the journal. In his editorial of April 2008 he explained the process of readers, authors and others accessing the SAJR in this format via www.sajr.org.za He promised that CPD would also be available for members. How has this shaped up some 18 months later?
Unusual presentation and inconlusive biopsy render fibroadenoma in two young females a diagnostic dilemma
Authors: Meerkotter D , Andronikou S
Published: May 2014

Two young non-lactating females presented with acutely painful breast masses. Sonographic features showed mixed echogenic masses. Core biopsy was non-diagnostic in both and surgical excision revealed infarcted fibroadenomas.

Although fibroadenomas are common, they do not commonly infarct and only rarely in non-lactating and non-pregnant females.

These two cases highlight the clinical and imaging characteristics of this important differential diagnosis.
The relationship between compression force, image quality and radiation dose in mammography
Authors: Korf A , Herbst C P , Rae W ID
Published: May 2014

Background. Mammography aims to obtain mammograms of best possible image quality with least possible radiation dose.1 Theoretically, an increase in breast compression gives a reduction in thickness, without changing the density, resulting in improved image quality and reduced radiation dose.

Aim. This study aims to investigate the relationship between compression force, phantom thickness, image quality and radiation dose. The existence of a compression point beyond which increased compression gives a change in density rather than thickness is also considered.

Method. Image quality is assessed with a contrast-detail phantom within Superflab phantom on a computed radiography (CR) mammography unit using automatic exposure control (AEC). Image quality is determined by visual inspection and image quality figure (IQF) scoring. The effect of compression and lesion depth on image quality is determined. Entrance and exit doses are calculated. The relationship between entrance dose, compression and thickness is investigated, as is the existence of a compression point beyond which a change in phantom density occurs. The average glandular dose (AGD) is calculated from the scanning average level (SAL) and logarithmic mean (LgM) according to Koen et al,2 and compared to the allowable limit.

Results. The geometry effect was not observed. An improvement in image quality with increased compression was found. Entrance dose did decrease with increased compression. This trend was not observed with exit dose as AEC was used and exit dose was calculated from SAL values. The “change-in-density” point of compression was determined. Both LgM and SAL could be used successfully for AGD calculation.
Radioiodine therapy in skeletal metastases from well-differentiated thyroid cancer: a Johannesburg experience
Authors: Perumal Nalini Sindy , Willy Vangu Mboyo-Di-Tamba Heben
Published: May 2014

Aim.The purpose of this study was to examine the outcome of patients with skeletal metastases from well-differentiated thyroid carcinoma and analyse the effect of variables that influence the prognosis of this disease.

Method. We retrospectively reviewed 352 patients treated and followed-up at the Charlotte Maxeke Johannesburg Academic Hospital’s thyroid cancer clinic from 1982 - 1999.

Findings. Skeletal metastases were diagnosed in 24 (6.8%), 17 at presentation to the thyroid clinic, and 7 at follow-up. Patients’ ages ranged from 30 - 77 years (mean 53.9 years) and the female:male ratio was 3.8:1. Based on the original pathology reports from resected tumours, 9 were papillary and 15 were follicular cancers. Twenty-three of the 24 patients underwent thyroid surgery as the initial management – total thyroidectomy in 18, subtotal thyroidectomy in 3, and lobectomy plus neck dissection in one. The diagnosis of thyroid cancer was based on lobectomy in a single subject. Radioactive iodine (RAI) was used as part of the original treatment; external radiation therapy (XRT) was mainly used to alleviate severe symptoms. Twenty-one patients (87.5%) were treated with RAI; 11 (45.8%) received radiotherapy. Seven patients died – 4 from neurological disease directly associated with bone metastases. Of the 17 surviving patients, 2 appeared to be disease-free, 8 were asymptomatic despite overt bony disease, and 7 had persistent symptoms which much improved in 5. Bone metastases were uncommon, and follicular cancer predominated in this survey.

Conclusion. RAI therapy improves quality of life in most patients. There is a place for XRT.
Radioactive news
Authors: Van Rensburg L Janse
Published: May 2014

N/A
Sonographic gallbladder wall thickness in normal adult population in Nigeria
Authors: Mohammed S , Tahir A , Ahidjo A , Mustapha Z , O Franza
Published: May 2014

Aim. The aim of the study was to determine the ultrasonic gallbladder wall thickness in normal adult Nigerians so as to create standards for defining gallbladder abnormalities in Nigerians.

Method. Four hundred adults comprising 228 (57%) women and 172 (43%) men aged 16 - 78 years, who had normal clinical history and physical findings, were recruited. The gallbladder wall thickness was obtained in the supine, prone and right anterior oblique positions. Differences in gallbladder wall thickness were determined using the chi-square test, while the relationship between the ultrasound-measured gallbladder wall thickness and the subjects’ age, sex, height and weight were analysed using the Pearson product moment correlation. Normal ranges and related statistics were estimated and tabulated according to age group and sex.

Results. The mean age of the subjects was 32±13.2 years. The mean gallbladder wall thickness range was 1.8 - 2.8 mm±0.5mm. The thickness range for females was 1.7 - 2.7 mm±0.5 mm, and that for males was 1.9 - 2.9 mm±0.5 mm. There was a statistically significant difference (p
Pycnodysostosis with the focus on clinical and radiographic findings
Authors: Barnard Benjamin Wybrand , Hiddema Wim
Published: May 2014

Pycnodyostosis is a rare autosomal recessive disorder that manifests as generalised osteosclerosis of the skeleton as a result of decreased bone turnover. Patients tend to suffer from numerous fractures owing to dense, abnormally brittle bones. The syndrome has a number of characteristic clinical and radiographic signs that differentiate it from other osteosclerotic conditions. This report is of a young man with a history of long bone fractures.
Unilateral axillary adenopathy with unremarkable breast imaging – differential diagnoses
Authors: Peters Gudrun , Jones Catherine Mary
Published: May 2014

Unilateral axillary adenopathy may be caused by a wide range of both benign and malignant aetiologies. While the most common cause is inflammation, infection or trauma of the breast, thoracic wall or arm, a significant proportion of cases are due to occult malignancy. In female patients particularly, breast malignancy must be excluded with mammography and ultrasound. Local inflammation, infection or trauma of the thoracic wall or arm should also be sought when deciding the most appropriate recommendation for management. This case report outlines the most significant pathologies and discusses the need to rule out sinister pathology, even when a benign local cause is evident.
Multimodal magnetic resonance imaging increases the overall diagnostic accuracy in brain tumours: Correlation with histopathology
Authors: Abul-Kasim Kasim , Thurnher Majda , Puchner Stefan , Sundgren Pia
Published: May 2014

Background: The aim of this retrospective study was to assess the contribution of multimodal MRI techniques, specifically perfusion-weighted imaging (PWI), and/or MR spectroscopy (MRS), in increasing the diagnostic accuracy of MRI in brain tumours.Methods: Forty-four patients with suspected brain tumours (27 (61%) patients male, mean age 58±17 (mean±SD) years) were included in this retrospective analysis. Patients were examined with conventional MR sequences, DWI, and with PWI and/or MRS. The concordance between the diagnoses obtained with multimodal MRI and with the conventional MR sequences, and the final diagnosis obtained by biopsy, was estimated. Fisher’s exact test and/or chi-square test was performed to estimate the added utility of multimodal MRI. Statistical significance was set at p<0.05.Results: With multimodal MRI, the diagnosis in 41 (93%) patients was the same as that obtained by biopsy, compared with 39% (17/44) patients when the readers were allowed to give one diagnostic possibility during the evaluation of the conventional MR sequences alone (p<0.001). The concordance between the diagnoses provided by evaluating the multimodal MRIs and the final diagnoses was almost perfect (κ value 0.92, 95% CI 0.82 - 1). PWI primarily helped to differentiate lymphomas from other solid tumours, whereas MRS helped to differentiate malignant glioma from metastasis. Both PWI and MRS helped in grading astrocytomas.Conclusion: Multimodal MRI increases diagnostic accuracy and should, wherever available, be performed in the work-up of brain tumours, although this entails increased examination cost and time.
Gastric trichobezoar: Food for thought
Authors: Maharaj Narisha , Naidoo Pumersha , Naidu Vanesha , Maharajh Jaynund
Published: May 2014

A bezoar is an agglomeration of food or indigestible foreign material in the gastro-intestinal tract. It is an uncommon cause of abdominal symptomatology and can result in intestinal obstruction. This report is of an adolescent girl with a history of abdominal distension and trichophagia.
Tracheal bronchus and pulmonary, hepatic and renal vascular congenital abnormalities – a case report
Authors: Vedajallam Schadie , Ismail Farzanah , Joshi Jayneel , Chacko Anith , Lockhat Zarina , Andronikou Savvas
Published: May 2014

Tracheal bronchus, also referred to as bronchus suis or pig’s bronchus, is a rare tracheobronchial anomaly where an ectopic bronchus arises from the lateral wall of the trachea above the carina and supplies the entire upper lobe or a segment of the upper lobe. It affects 0.5 – 2% of the population and may be detected incidentally or in patients who present with bronchospasm, persistent cough, recurrent upper lobe infections and haemoptysis. Surgical resection is reserved for patients with severe or persistent symptoms which are resistant to treatment. We present a case of a symptomatic five month old patient who had a type II right sided tracheal bronchus on bronchography and CT.
Endovascular therapy of acute tumour-related obstruction of the superior vena cava using a self-expanding Nitinol stent
Authors: Kamusella Peter , Wissgott Christian , Andresen Reimer
Published: May 2014

Objective: To evaluate, in a retrospective study, the clinical efficacy and safety of the self-expanding Nitinol stent in the superior vena cava to alleviate upper venous congestion.Method: In 22 patients (15 men, 7 women), a tumour-related compression of the superior vena cava was diagnosed by spiral CT after intravenous application of contrast medium. Clinically, acute superior vena cava syndrome was found in all patients. Histologically, a bronchial carcinoma was present in 14/22, a lymphoma in 6/22, and mediastinal lymphnode metastases (1 breast carcinoma, 1 malignant melanoma) in 2/22. After a transfemoral approach, cavography was initially performed. The degree of stenosis was classified according to the Stanford classification. In accordance with the degree of stenosis, a self-expanding Nitinol stent was placed.Results: Endovascular stent implantation was conducted without complications in all patients. A marked improvement in acute symptoms was observed clinically within 24 hours in all patients. In the follow-up period of up to 2 years, there were no cases of stent migration. In 7/22 patients, the CT follow-ups revealed tumour progression (3/7 after 3 months, 2/7 after 6 months, and 2/7 after 12 months) with evidence of residual stenosis caused by tumour growth through the stent mesh. During the follow-up period, 15/22 patients died (mean survival 6.4 months).Conclusion: Self-expanding Nitinol stents provide endovascular therapy for superior vena cava syndrome, having a high radial expansive force and the facility to be placed precisely, and alleviating acute, life-threatening symptoms in the palliative situation.
Torus palatinus
Authors: Naidoo Pumersha , Maharaj Narisha , Maharajh Jaynund , Moosa Ashraf
Published: May 2014

Kupffer and Bessel-Hagen coined the term torus palatinus in 1879 for a benign osseous protuberance arising from the midline of the hard palate. Tori are present in approximately 20% of the population and are occult until adulthood. Recent advances in modern radiology have led to improved evaluation and diagnosis of tori.
Vascular malformations Part 2 - current classification of vascular malformations
Authors: Duncan Ian C. , Fourie Pieter A.
Published: May 2014

No abstract available.
Rare variation in the origin of the right vertebral artery
Authors: Ligege P. , Scholtz L.
Published: May 2014

No abstract available.
Variants of the left aortic arch branches
Authors: Makhanya N.Z. , Mamogale R.T. , Khan N.
Published: May 2014

The normal aorta has three branches from its arch, but variations in this pattern are not uncommon. Our interest was to correlate the documented statistics to the variants observed in our patients. This was done by randomly selecting 60 patients on whom arch aortograms were performed. Our patients did not demonstrate all of the variants described. There was close correlation between the documented values and our patients except for the aberrant right subclavian artery which was more than three times more common in our patients.
Surveying Indian gay men for coping skills and HIV testing patterns using the internet
Authors: Jethwani KS , Mishra SV , Jethwani PS , Sawant NS
Published: May 2014

Background:

Surveying vulnerable and incarcerated populations is often challenging. Newer methods to reach and collect sensitive information in a safe, secure, and valid manner can go a long way in addressing this unmet need. Homosexual men in India live with inadequate social support, marginalization, and lack legal recognition. These make them less reachable by public health agencies, and make them more likely to continue with high-risk behaviors, and contract human immunodeficiency virus (HIV).

Aims:

To understand coping skills and HIV testing patterns of homosexual men versus heterosexual men.

Materials and Methods:

An internet based study using a secure web platform and an anonymised questionnaire. The brief COPE Inventory was used to assess coping styles.

Results:

A total of 124 respondents were studied. Homosexual men used negative coping skills such as behavioral disengagement and tested for HIV significantly more often than heterosexual men. Heterosexual respondents used positive coping skills more often. The most commonly used coping skill by heterosexual men was instrumental coping and by homosexual men was acceptance.

Discussion:

Overall, homosexual men used negative coping mechanisms, like behavioral disengagement more often. The Indian family structure and social support is probably responsible for heterosexual men's over-reliance on instrumental coping, while resulting in disengagement in homosexuals.

Conclusion:

The lack of legal and social recognition of homosexuality has negatively impacted lives of gay men in India. This is strongly linked to harmful psychological and public health implications for HIV prevention and mental health for homosexual men.
Is Cystatin-C superior to creatinine in the early diagnosis of contrast-induced nephropathy?
Authors: Ebru AE , Kilic A , Korkmaz FS , Seker R , Sasmaz H , Demirtas S , Biyikli Z
Published: May 2014

Background/Aims:

The aim of this study was to assess whether changes in Cystatin C (CyC) after 48 h post contrast media exposure was a reliable indicator of acute kidney injury and the validity of a risk scoring tool for contrast-induced acute kidney injury (CI-AKI).

Materials and Methods:

We enrolled 121 patients for whom diagnostic coronary angiography were planned. The risk score for CI-AKI was calculated and serum creatinine (sCr) and CyC were measured before and 48 h post coronary angiography. CyC and sCr based AKI was calculated as a 25% increase from baseline within 48 h from contrast media exposure.

Results:

Mean serum CyC and creatinine concentrations were 0.88 ± 0.27 mg/dL and 0.79 ± 0.22 mg/dL, respectively before the procedure and 1.07 ± 0.47 mg/dL and 0.89 ± 0.36 mg/dL, respectively 48 h after contrast media exposure (P < 0.001). CyC based AKI occured in 45 patients (37.19 %) and sCr based AKI occured in 20 patients (16.52%) after the procedure. Mean risk score was found to be 4.00 ± 3.478 and 3.60 ± 4.122 for CyC based AKI and sCr based AKI, respectively and was significantly increased in CyC based AKI group (P < 0.001).

Conclusions:

CyC measured 48 h after contrast media exposure may be a more sensitive indicator of CI-AKI relative to creatinine and Mehran risk scoring is in good correlation with CyC increase.
IL-21 and other serum proinflammatory cytokine levels in patients with multiple myeloma at diagnosis
Authors: Mehtap O , Atesoglu EB , Tarkun P , Hacihanefioglu A , Dolasik I , Musul MM
Published: May 2014

Background:

IL-6, IL1-β, TNF-α and IL-21 have been identified in the growth, progression and dissemination of multiple myeloma. To dte, there is no published data about serum levels of IL-21 in patients with multiple myeloma. In the present study we have investigated circulating levels of cytokines, such as IL-6, IL-1β, TNF-α, IL-21 and the association of these levels with the disease stage in newly diagnosed multiple myeloma patients.

Materials and Methods:

Twenty healthy controls and 44 newly diagnosed multiple myeloma patients were evaluated. Patients were classified according to Durie-Salmon criteria, international staging system (ISS) and bone disease. Quantification of cytokine levels in serum were performed by using ELISA.

Results:

The levels of cytokines in patients’ serum are found elevated than healthy controls. However, only the serum levels of IL-1β and TNF-α were found statistically significant. TNF-α levels of patients with ISS stage 3 were significantly higher than patients with ISS stage 1 and 2 (P 0.000). IL-1β was significantly elevated in advanced stage patients (stage II-III) (P 0.040). There was no correlation between IL-1β, TNF-α, IL-21 levels and bone lesions. IL-6 levels were significantly elevated who have at least three visible lytic bone lesions and/or bone fracture in comparison to patients who have one or two visible or no visible lytic bone lesions (P 0.048).

Conclusion:

It appears that there is no association of serum IL-21 level with multiple myeloma in contrast to the other cytokines such as IL-6, IL-1β, TNF-α.
A rare case of nephrotic syndrome
Authors: Agarwal S , Divecha C , Tullu MS , Deshmukh CT
Published: May 2014

An 18-month-old female child presented to us with clinical features suggestive of nephrotic syndrome. Her physical examination and detailed family history highlighted the familial occurrence of abnormal nails, suggesting a diagnosis of the Nail-Patella syndrome. Nail-Patella syndrome is a rare cause of nephrotic syndrome in children. This case highlights the importance of a detailed history, including pedigree and a thorough examination of the patient.
Cardiovascular abnormalities with single dose of tapentadol
Authors: Vachhani A , Barvaliya M , Naik V , Tripathi CB
Published: May 2014

This case represents the development of dizziness, palpitation, tightness in chest, flushing, and tremor on consumption of a single dose of tapentadol (100 mg) for acute lower back pain. The patient was admitted in the intensive cardiac care unit for continuous monitoring. At admission, electrocardiogram showed tachycardia (140/min) along with ST segment elevation in second chest lead (V2). The patient was monitored and advised not to take further doses of tapentadol. He was discharged after 36 hours of admission. Tapentadol should be used cautiously in patients with cardiovascular diseases and receiving sympathomimetic drugs.
The dangerous gamble of heparinization within two weeks of nonoperative traumatic acute subdural hematoma in patients with increased stroke risk
Authors: McClelland S , Mackey SJ , Kim SS
Published: May 2014

Background:

In traumatic acute subdural hematoma (aSDH) management, systemic anticoagulation is contraindicated, particularly during the first 2 weeks. We present two cases of patients with nonoperative aSDH whose stroke risk led to heparinization within 2 weeks of the initial hemorrhage and examine their outcomes to illustrate the risks and benefits associated with systemic anticoagulation.

Materials and Methods:

Two elderly males, on warfarin at baseline who developed traumatic nonoperative aSDH were heparinized within 2 weeks of aSDH onset.

Results:

One patient showed a decreased SDH volume on Day 19. The second patient developed sudden onset headache with fixed/dilated pupils on Day 5. In this patient, a CT scan of the brain revealed marked enlargement of the aSDH from 0.9 to 2.4 cm with midline shift of 1.5 cm, and uncal herniation that was incompatible with life.

Conclusion:

Heparinization within two weeks of aSDH may cause SDH enlargement resulting in rapidly fatal neurologic deterioration. Further study is needed to more definitively address this issue.
Splenogonadal fusion mimicking a testis tumor
Authors: Sountoulides P , Neri F , Bellocci R , Schips L , Cindolo L
Published: May 2014

The presence of ectopic splenic tissue in the scrotum is attributed to splenogonadal fusion, a rare congenital anomaly. This ectopic splenic tissue can be an incidental finding or less often present as a scrotal mass later in adult life. Given the rarity of splenogonadal fusion, especially in the adult population, this case highlights the clinical characteristics of the condition, with a special focus on the signs and findings that might help prevent unnecessary orchiectomy.
Clinical profile and management of tuberculous bronchoesophageal fistula
Authors: Baijal Rajiv , Ramegowda Praveen Kumar Hadlahally , Jain Mayank , Gupta Deepak , Shah Nimish , Kulkarni Sandeep
Published: May 2014

Background and Objectives: Tracheoesophageal/bronchoesophageal fistula is a rare clinical condition, and occurs due to a variety of disease processes. This report describes the clinical profile, management, and outcome of bronchoesophageal fistulas due to tuberculosis in five patients. Patients and Methods: Patients diagnosed with esophageal tuberculosis over the last eight years were included. Details regarding the demographics, symptomatology, barium swallow, upper GI endoscopy, with biopsy and high resolution computed tomography of the chest were recorded for patients with tracheoesophageal fistula. The diagnosis was confirmed by acid fast bacilli (AFB) positive fluid aspirate/brush cytology from the fistula, lymph node biopsy showing caseous necrosis or AFB bacillus and tissue tuberculosis culture and polymerase chain reaction (PCR). Results: There were five patients (four males and one female) with a mean age of 43.8 ± 17 years (range, 17 to 59 years). The mean duration of symptoms was 38 ± 7 days. The most common symptom was coughing on swallowing followed by dysphagia. Two patients had concomitant pulmonary tuberculosis; two had human immunodeficiency virus (HIV) infection, and one was a post-renal transplant. The diagnosis of tuberculosis was established in all five patients with esophageal cytology, lymph node biopsy, and tissue tuberculosis PCR. All the patients were successfully treated with a combination of antituberculous drugs (five patients), glue application on fistula (one patient), Percutaneous endoscopic gastrostomy (PEG) tube insertion (three patients), and surgery (one patient). Conclusions: Tuberculous bronchoesophageal fistula is a rare complication and can be successfully managed predominatly with a combination of antituberculous treatment, PEG tube placement, and rarely surgery.
An unusual experience with endoscopic retrograde cholangiopancreatography
Authors: Patil Mallikarjun , Sheth Keyur A. , Adarsh C. K. , Girisha B.
Published: May 2014

The endoscopic retrograde cholangiopancreatography (ERCP) is known for its varied diagnostic and therapeutic utility for a variety of disorders. However it has greater likelihood of procedure related complications among the endoscopic procedures of gastrointestinal tract. The extraluminal hemorrhagic complications following ERCP are potentially life threatening though relatively rare. We present a 50 year patient with choledocholithiasis and cholelithiasis developing rare complication of subcapsular hepatic hematoma, following ERCP due to guide wire injury.
Treatment and follow-up of a case of bleeding duodenal varix
Authors: Chandrasekar Viveksandeep Thoguluva , Janakan Gokul Bollu , Venkatachalam Rajesh , Seshadri Chandrasekar Thoguluva
Published: May 2014

Duodenal varices (DV) are rare in patients with portal hypertension secondary to liver disease. Their tendency to bleed is less common than in gastroesophageal varices, but can sometimes produce a life-threatening bleed. They are often difficult to diagnose and treat. We present a case of a 35-year-old man with parenchymal liver disease admitted with complaints of hematemesis and melena. Upper gastrointestinal endoscopy was performed and a duodenal varix, with stigmata of a recent bleed, was noted in the second part of the duodenum. Five milliliters of N-butyl-2-cyanoacrylate glue was injected into the varix leading to obliteration. A follow-up study with an endoscopic ultrasound and repeat endoscopy showed near total obturation of the varix and success of the therapy. This report concludes that glue injection can effectively be used as a first-line treatment for bleeding duodenal varices.
Rips induction: index of the dual lamination of an $\mathbb{R}$-tree
Authors: Coulbois Thierry , Hilion Arnaud
Published: May 2014

Let

T

be a

\mathbb{R}

-tree in the boundary of the Outer Space CV

_N

, with dense orbits. The

\mathcal{Q}

-index of

T

is defined by means of the dual lamination of

T

. It is a generalisation of the Poincaré Lefschetz index of a foliation on a surface. We prove that the

\mathcal{Q}

-index of

T

is bounded above by

2N-2

, and we study the case of equality. The main tool is to develop the Rips machine in order to deal with systems of isometries on compact

\mathbb{R}

-trees.

Combining our results on the

\mathcal{Q}

-index with results on the classical geometric index of a tree, developed by Gaboriau and Levitt, we obtain a beginning classification of trees.
Rank gradient in co-final towers of certain Kleinian groups
Authors: Girão Darlan
Published: May 2014

We prove that if the fundamental group of an orientable finite volume hyperbolic 3-manifold has finite index in the reflection group of a right-angled ideal polyhedron in

\mathbb{H}^3

then it has a co-final tower of finite sheeted covers with positive rank gradient. The manifolds we consider are also known to have co-final towers of covers with zero rank gradient.
Semigroups arising from asynchronous automata
Authors: McCune David
Published: May 2014

In this paper we study semigroups of transformations of free monoids (and transformations of the corresponding tree boundaries) that arise from asynchronous automata. We introduce a subclass of asynchronous automata that we call “expanding automata”. We show that every free partially commutative monoid is a synchronous automaton semigroup, and every free partially commutative semigroup is an expanding automaton semigroup. We show that undecidability arises in the actions of these semigroups on trees. In particular, in the class of asynchronous automata there is no algorithm which detects the presence of coincidence points and there is no algorithm which detects the presence of fixed points. We show that the classes of semigroups that arise from synchronous, expanding, and asynchronous automata are distinct classes of semigroups. We end the paper by covering some basic algebraic theory of these semigroups, with an emphasis on subgroups.
Nuevas resistencias comunicativas: la rebelión de los ACARP
Authors: Del Amo Castro Ion Andoni , Letamendia Onzain Arkaitz , Diaux González Jasón
Published: May 2014

Introducción. El trabajo pretende ser una aportación en el debate en torno al papel que los medios de comunicación tienen en el cultivo de asunciones sobre la realidad, especialmente a raíz de la emergencia de las nuevas tecnologías de la información y la comunicación (TICs). Objetivos. Se analizarán dos formas específicas y novedosas de disputa comunicativa por parte de los movimientos sociales: los lip dub reivindicativos y las grabaciones ciudadanas de actuaciones policiales. Englobamos a ambas bajo la categoría de Artefacto Cultural Audiovisual de Reivindicación y Protesta (ACARP). Metodología. Se realiza un análisis teórico acerca de las relaciones entre poder, comunicación y resistencias, proponiendo una lectura acerca de los distintos planos en los que resistencias y disputas se articulan. Para el análisis empírico, atendemos a las reflexiones metodológicas en torno a la sociología visual, aplicándolas a seis de estos artefactos audiovisuales en el contexto vasco. Resultados y conclusiones. Los resultados proporcionan una caracterización general de estos artefactos audiovisuales. El análisis del caso vasco permite situar estas innovaciones tácticas y comunicativas, y discutir acerca de la importancia del contexto, la construcción del discurso, las posibles tendencias a la espectacularización y las posibilidades de contrarrestrar estereotipaciones.
Occupational Therapy can Flourish in the 21st Century — A Case for Professional Engagement with Health Economics
Authors: Lambert Rod , Radford Kate , Smyth Genevieve , Morley Mary , Ahmed-Landeryou Musharrat
Published: May 2014

The view that the profession of occupational therapy will flourish in the 21st century was expressed before the banking system and financial market collapse in 2008. The profession now competes for scarce resources as austerity measures take effect. A summit meeting at the College of Occupational Therapists, in May 2013, discussed how to improve the profession's understanding and use of health economics. At this meeting, short-, medium-, and longer-term approaches were discussed, with the aim of improving the quality and quantity of publications on economic evaluations in occupational therapy. Despite an increasing number of publications on health economics across professions, occupational therapy lags behind. This focus is now vital for the profession.
Occupational Therapy for Care Home Residents with Stroke: What is Routine National Practice?
Authors: Fletcher-Smith Joanna , Drummond Avril , Sackley Catherine , Moody Amy , Walker Marion
Published: May 2014

Introduction:

Information is currently lacking on the provision of occupational therapy for care home residents with stroke. The aim of this study was to identify current routine occupational therapy practice for this stroke population.

Method:

A questionnaire targeting qualified occupational therapists with work experience in a care home setting was designed, piloted, and transferred to an online survey. An invitation to participate was distributed via three of the College of Occupational Therapists Specialist Sections, social networking sites, and flyers at conferences.

Findings:

Responses were analysed from 114 respondents representing the United Kingdom, the majority (72%) of whom were employed by the National Health Service. Ninety-two respondents (81%) had delivered occupational therapy to a care home resident with stroke in the last year but only 16% were ‘stroke specialists’. The most common aims of intervention were to: maintain participation in activities of daily living, improve posture and positioning, and provide training. Non-standardized assessment was the most common form of assessment used. The functional approach was most frequently adopted. The most frequently provided intervention was ‘seating and positioning’.

Conclusion:

Occupational therapy is available to some stroke survivors in care homes; however, interventions are not commonly evidence based and are not routinely delivered by stroke specialists.
Dental Prosthetic Status and Prosthetic Needs of the Institutionalized Elderly Living in Geriatric Homes in Hyderabad: A Pilot Study
Authors: Ratnakar P , Maheswar G , Kumar G Ajay , Malathi S , Sridevi K , Someshwar B
Published: May 2014

Introduction

To promote oral health among the elderly, we need to know their prosthetic status and prosthetic need. Hence, a survey of prosthetic status and need of elderly inmates of geriatric homes in Hyderabad was done.

Materials and methods

A cross-sectional study was undertaken, and 174 subjects aged 60 years and above were examined of which 103 were male and 71 were female (59.2% males and 40.8% females). The oral examination of the study subjects was carried out using basic oral health surveys, WHO 1997 criteria.

Results

Majority of the subjects, 73 (70.8%) males and 53 (74.6%) females had no prosthesis. Only 4.6% had complete dentures and 21.1% had removable partial dentures and 10.9% had single/multiple bridges. Need for any prosthesis was (83.5%) male and 63 (88.7%) female subjects and nearly 82. 8% subjects required one-unit prosthesis.

Conclusion

Dental prosthetic status of people living in geriatric homes is very poor and there is high unmet need for prosthetic care existed among the institutionalized elderly surveyed.

Key messages

A prevention based intervention programs to reduce early tooth loss is recommended and Oral health programs should be specially designed for these special group.

How to cite this article

Kumar GA, Maheswar G, Malathi S, Sridevi K, Ratnakar P, Someshwar B. Dental Prosthetic Status and Prosthetic Needs of the Institutionalized Elderly Living in Geriatric Homes in Hyderabad: A Pilot Study. J Contemp Dent Pract 2013;14(6):1169-1172.
Primary Mucosal Melanoma: Report of Two Cases
Authors: Karunakaran Anila , Ravindran Rathy , Shenoy Mahesh , Arshad Mohammed , Laxmi MK Shruthi
Published: May 2014

Primary mucosal malignant melanoma is of unusual occurrence and poor prognosis. We report two cases of primary mucosal melanoma, one in a 70-year-old male in the palate and the other in a 73-year-old female in the maxillary sinus. Early diagnosis and proper clinical and cytologic evaluation is necessary to institute therapeutic intervention. These cases are reported on account of their rarity of occurrence and difficulty of treatment.

How to cite this article

Karunakaran A, Ravindran R, Shenoy M, Arshad M, Laxmi MKS. Primary Mucosal Melanoma: Report of Two Cases. J Contemp Dent Pract 2013;14(6):1189-1192.
Microbial Flora in Oral Diseases
Authors: Sanketh DS , Amrutha N
Published: May 2014

The oral cavity being the hub of gamut of microbes, promotes the establishment of distinct microbial communities, such as on the mucosa and teeth. Metabolism of these organisms facilitates the attachment and growth of the subsequent colonisers. A delicate balance is maintained in the microbial ecosystem, with these organisms contributing to normal development and defences. However, any change or disruption in the microbial profile due to either intrinsic or extrinsic factors can result in an unfavorable shift toward pathogenic organisms triggering various diseases like dental caries or periodontitis. Furthermore, recent findings also state that these microorganisms may lead to systemic diseases like diabetes or atherosclerosis. This article is an attempt to give an overview of the altered flora in diseased states.

How to cite this article

Patil S, Rao RS, Sanketh DS, Amrutha N. Microbial Flora in Oral Diseases. J Contemp Dent Pract 2013;14(6):1202-1208.