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Interesting Case (interesting + case)
Terms modified by Interesting Case Selected AbstractsFine-needle aspiration cytology of subcutaneous toxoplasmosis: A case reportDIAGNOSTIC CYTOPATHOLOGY, Issue 10 2010Xiaowei Chen M.D. Abstract Toxoplasmosis is a common opportunistic infection in patients with AIDS in whom it typically presents as encephalitis, pneumonia, lymphadenitis, and myocarditis. Skin involvement is very rare and, to our best knowledge, Toxoplasma gondii forming a subcutaneous mass has not been reported. Here, we report the findings of an interesting case of subcutaneous toxoplasmosis with the cytological appearance of an inflammatory fibrovascular lesion in a HIV-positive patient and discuss the differential diagnosis. Diagn. Cytopathol. 2010;38:716,720. © 2009 Wiley-Liss, Inc. [source] Spontaneous HBeAg seroconversion and loss of hepatitis B virus DNA after acute flare due to development of drug resistant mutants during entecavir monotherapyHEPATOLOGY RESEARCH, Issue 1 2009Ri-Cheng Mao Aims:, Patients with chronic hepatitis B virus (HBV) infection under entecavir (ETV) treatment develop resistant mutants with viral rebound. Here, we report an interesting case of spontaneous loss of HBV-DNA and seroconversion following an acute flare after the development of ETV-resistant mutants. This patient received ETV after lamivudine breakthrough. Methods:, Cloning and sequence analysis of the HBV reverse transcriptase (RT) region were performed with seven samples during ETV therapy. In addition, two full-length HBV genomes derived from samples before and after the emergence of ETV resistance were sequenced. Results:, ETV resistant mutants appeared at week 228, with virological and biochemical rebound at the same time. Unexpectedly, HBeAg seroconversion occurred 8 weeks later. The viral load decreased and became undetectable from week 252. Analysis of HBV isolates in the patient at week 124 revealed that wild-type HBV was predominant at that time and ETV resistant mutants were not found among 20 clones. Interestingly, a new mutant type with rtL180M+rtT184L was found alongside rtL180M+rtT184L+rtM204V/I at week 228 and appeared to develop independently, according to the sequence analysis. In contrast to the previously identified ETV resistant mutants, it did not carry the rtM204V/I mutations. Conclusion:, The data presented here indicates that the flare following the emergence of ETV resistant mutants may reflect immune-mediated control of HBV infection, leading to a spontaneous loss of HBV-DNA and seroconversion. [source] An interesting case of colocalization of segmental lichen planus and vitiligo in a 14-year-old boyINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 8 2002Kabir Sardana MD A 14-year-old boy had segmental vitiligo (L3,4) on the right thigh and leg for 4 years, and was advised to apply topical clobetasol propionate, 0.05%, in the night, with daily sun exposure for 10 min, as he refused to comply with topical psoralens. As there was no response to therapy even after 3 months, the patient stopped the steroid cream but continued with the sun exposure. Subsequently, the patient noticed gradual-onset, itchy, violaceous, pigmented, raised lesions superimposed on the vitiligo macules. Cutaneous examination revealed violaceous, polygonal papules, 0.5 × 0.5 cm in size, some of which coalesced to form discrete violaceous plaques, confined to areas of vitiligo, with a clear-cut demarcation from normal skin (Fig. 1). The scalp, palms, soles, nails, and mucosa were normal. Histopathology of the polygonal papules revealed hyperkeratosis, wedge-shaped hypergranulosis, irregular acanthosis with saw toothing of the rete ridges, basal cell liquefaction, and a band-like lymphocytic infiltrate (Fig. 2), consistent with lichen planus. The patient was subsequently prescribed fluticasone propionate (0.05%) ointment once daily for the lesions of lichen planus. There was a marked improvement in the lesions of lichen planus after 1 month. Figure 1. Violaceous papules of lichen planus colocalized on vitiligo macules with associated leukotrichia seen on the right leg Figure 2. Histopathology reveals hyperkeratosis, wedge-shaped hypergranulosis, irregular acanthosis with saw toothing of the rete ridges, basal cell liquefaction, and a band-like lymphocytic infiltrate (hematoxylin and eosin, × 40) [source] An interesting case of prehistoric trepanation from Poland: re-evaluation of the skull from the Franki Suchodolskie siteINTERNATIONAL JOURNAL OF OSTEOARCHAEOLOGY, Issue 2 2005W. Lorkiewicz Abstract The skull described here was excavated in Central Poland (archaeological site Franki Suchodolskie) in 1951, and was known as one of the oldest cases of healed trepanation. This skull, with later excavations from the Ukraine (cemeteries of Vasilyevka II and Vasilyevka III), was the basis for dating the beginning of the practice of trepanation in the Mesolithic period. The skull was never comprehensively described and dated, although it was scientifically extremely important. The skull has been reassessed by the authors of this paper has brought thorough verification of the knowledge concerning this excavation. According to radiocarbon analysis it is much younger than previously thought and has now been dated to the Late Neolithic or the Bronze Age. Earlier opinions about the healing and survival after the operation have not been confirmed: the hole in the squama of the frontal bone made by scraping and then by grooving has no evidence of healing. Radiological studies as well as computer tomography indicate lack of any healing processes in the bone tissue around the trepanation opening. The results of the analysis significantly modify ideas regarding the earliest skull operations in Central Europe, and change the time of the first trepanation to the Late Neolithic, as for most of the continent. Copyright © 2005 John Wiley & Sons, Ltd. [source] Delayed post-traumatic prostatic-urethrorectal fistula: Transperineal rectal sparing repair , Point of techniqueINTERNATIONAL JOURNAL OF UROLOGY, Issue 1 2006IQBAL SINGH Abstract, We describe the outcome and management of an unusual and interesting case of delayed post-traumatic prostatorectal fistula in a 40-year-old man. The fistula was repaired successfully via transperineal access without rectal or sphincteric transgression. We found the transperineal surgical approach simple, effective and useful in approaching the prostatorectal region for rectourinary fistulas. The transperineal approach is useful and should be considered in such select cases. We describe our technique that may be beneficial to many urologists. [source] Disciplined Litigation, Vigilant Litigation, and Deformation: Dramatic Organization Change in Jehovah's WitnessesJOURNAL FOR THE SCIENTIFIC STUDY OF RELIGION, Issue 1 2001Pauline Côté Jehovah's Witnesses' long-term development presents an interesting case of evolution in line with the "deformation thesis," an attempt at explaining dramatic shifts in organizational forms, activities, and even beliefs in controversial religious minorities. Derived from resource mobilization tradition, this thesis assumes that radical transformations result from major defensive resource allocation mandated by negative reactions of societal institutions. This is especially the case with reference to the adoption by Jehovah's Witnesses, a millenarian group, of a "disciplined litigation"strategy in the 1940s, a pattern later to be incorporated in religious activities and beliefs of the organization. Today, disciplined litigation and its successor, "vigilant litigation," seem legitimate ways to adapt to the prevailing religious climate and structure. As such, it can be conceived as a model for defensive moves taken by "younger" controversial religious minorities and reflects the enormous influence of the law and legal systems in shaping minority religions. [source] Diet composition and feeding of European anchovy Engraulis encrasicolus in Kiel Bight, western Baltic SeaJOURNAL OF FISH BIOLOGY, Issue 7 2010M. Schaber Diet composition of the expanding southern species European anchovy Engraulis encrasicolus in the western Baltic Sea was investigated. Results revealed an interesting case of bentho-pelagic coupling with potential implications for local fish species through competition for food resources. [source] Optical properties of correlated materials , Or why intelligent windows may look dirty,PHYSICA STATUS SOLIDI (B) BASIC SOLID STATE PHYSICS, Issue 9 2009Jan M. Tomczak Abstract Materials with strong electronic Coulomb correlations play an increasing role in modern materials applications. "Thermochromic" systems, which exhibit thermally induced changes in their optical response, provide a particularly interesting case. The optical switching associated with the metal,insulator transition of vanadium dioxide (VO2), for example, has been proposed for use in numerous applications, ranging from anti-laser shields to "intelligent" windows, which selectively filter radiative heat in hot weather conditions. Are present-day electronic structure techniques able to describe, or , eventually even predict , such a kind of behavior? How far are we from materials design using correlated oxides? These are the central questions we try to address in this article. We review recent attempts of calculating optical properties of correlated materials within dynamical mean field theory, and summarize results for VO2 obtained within a novel scheme aiming at particularly simple and efficient calculations of optical transition matrix elements within localized basis sets. Finally, by optimizing the geometry of "intelligent windows," we argue that this kind of technique can, in principle, be used to provide guidance for experiments, thus giving a rather optimistic answer to the above questions. [source] Gender and chain migration: the case of ArubaPOPULATION, SPACE AND PLACE (PREVIOUSLY:-INT JOURNAL OF POPULATION GEOGRAPHY), Issue 2 2010Haime Croes Abstract Family reunification and family formation form a substantial part of chain migration, as most countries accept this form of settlement on the basis of humanitarian commitment to protecting families. Yet this does not mean that all migrants are treated equally in allowing them to bring over family members. Whether people are allocated this statutory right depends on their social and economic position. Women might be ,triply disadvantaged' as migrant women are often in more marginal jobs, from a different ethnicity, and have a harder time in acquiring these statutory rights. In this contribution we test this gender hypothesis using data from Aruba. Aruba provides an interesting case because the rapid development of the tourist-driven economy has given rise to enormous labour shortages across the various sectors of the economy, and it is now among the ten countries in the world with the highest net immigration rate. Due to its geographical position the island has recruited labour migrants from both Latin and North America and also from Europe. Dutch nationals receive preferential treatment as Aruba is a country within the Kingdom of the Netherlands. This diversity in immigration allows for an analysis of the social, ethnic, economic and legal determinants of family reunification. The results show that women have a disadvantaged position with respect to each of these determinants. On top of that a separate gender effect remains, indicating that it is harder for women migrants to bring over their spouses and children from their home country. Copyright © 2009 John Wiley & Sons, Ltd. [source] Public Health Nursing Pioneer: Jane Elizabeth Hitchcock 1863,1939PUBLIC HEALTH NURSING, Issue 3 2003FAAN, Joellen W. Hawkins RNC, Ph.D. Abstract Jane Elizabeth Hitchcock was one of many distinguished nursing leaders of the 19th and early 20th centuries who attended a women's college before enrolling in a nurse training school. Like many of her contemporaries with equally impeccable family credentials, Hitchcock was something of an enigma to her family for choosing nursing over teaching, the most common acceptable career for women of her social class. Hitchcock's endowment of character, according to contemporary Lavinia Dock, exemplified the best of her Puritan roots. Her contributions to the evolution of public health nursing and the integration of public health nursing content into curriculums of training schools rivaled the achievements in higher education of her famous father, grandfather, and brother but garnered no comparable recognition. Her life presents an interesting case for analysis of an independent woman, a characteristic shared by many pioneers in the early years of public health nursing: 1893 to 1920. [source] Managing and reporting intangible assets in research technology organisationsR & D MANAGEMENT, Issue 2 2005Karl-Heinz Leitner In the last couple of years, new instruments and methods for measuring, valuing and managing different forms of intangible assets have been proposed. Firms started to implement comprehensive management techniques to identify and value different forms of intangible assets based on an integrative framework, incorporating different forms of intangible assets such as R&D and human capital. Research Technology Organisations (RTOs) present an interesting case for studying different forms of intangible assets, their interdependencies and their impact on outputs. The main business of these organisations is R&D; thus, nearly all forms of investments are related to the R&D process. Their outputs are knowledge-intensive products, services and public goods with the aim of improving the innovation output of their various customers. Some European RTOs have started to introduce new instruments for measuring and managing their intangible assets more explicitly. The paper investigates the general background, a specific model and empirical experiences of an Austrian RTO, which introduced an intellectual capital management system. [source] A case of carotenemia associated with ingestion of nutrient supplementsTHE JOURNAL OF DERMATOLOGY, Issue 2 2006Yuko TAKITA ABSTRACT Carotenemia is characterized by an abnormal yellowish orange pigmentation of the skin, most prominently seen on the palms and soles. Although it is associated with several disease such as diabetes, hypothyroidism and anorexia nervosa, it is caused by excessive intake of carotene-rich food such as oranges and carrots in most cases. Herein, we describe an interesting case of carotenemia in a 66-year-old female secondary to increased ingestion of oral supplements of carotene in order to improve hemorrhage in the eyeground. There could be an increasing trend of intake of commercial nutrient supplements in which case it is necessary to remind ourselves that commercial nutrient supplements could cause various skin disorders as side-effects. [source] An Unusual Staged Labial RejuvenationTHE JOURNAL OF SEXUAL MEDICINE, Issue 5 2008John P. Di Saia MD ABSTRACT Introduction., There have been concerns about the safety and effectiveness of publicized procedures in elective female genital rejuvenation. Aim., To present an interesting case in which a staged approach to rejuvenation of both the Labia majora and minora was performed safely and effectively. Methods., A patient with an unusual redundancy of both the Labia minora and majora presented interested in reduction. The procedure was performed in two parts. Results., Despite her complication following the first stage, 6 weeks after her second stage, the patient is satisfied. Conclusions., Cosmetic reduction of the Labia minora is well tolerated and can offer pleasing results with little morbidity. Surgery of the Labia majora may be more commonly complicated by bleeding. Di Saia JP. An unusual staged labial rejuvenation. J Sex Med 2008;5:1263,1267. [source] Comparison of halogen bonding and van der Waals and ,,, interactions in 4,5-dibromo-2-hexyloxyphenolACTA CRYSTALLOGRAPHICA SECTION C, Issue 5 2009Fabio D. Cukiernik The title compound, C12H16BrO2, is an interesting case of a simple organic molecule making use of five different types of intra- and intermolecular interactions (viz. conventional and nonconventional hydrogen bonds, and ,,,, Br...Br and Br...O contacts), all of them relevant in the molecular and crystal structure geometry. The molecules are strictly planar, with an intramolecular O,H...O hydrogen bond, and associate into two-dimensional structures parallel to (01) through two different types of halogen bonding. The planar structures, in turn, stack parallel to each other interlinked by C,H..., and ,,, contacts. Also discussed are the relevant structural features leading to the rather low melting point of the compound. [source] An interesting case of apparent over-pointingANZ JOURNAL OF SURGERY, Issue 6 2009Eugene T. H. Ek MBBS (Hons), PhD (Melb) No abstract is available for this article. [source] Molecular Materials with Contrasting Optical Responses from a Single-Pot Reaction and Fluorescence Switching in a Carbon AcidCHEMISTRY - A EUROPEAN JOURNAL, Issue 12 2009A. Patra Abstract Three for the price of one: The reaction of tetracyanoquinodimethane with an aromatic amine is shown to follow an unusual course leading to three products in a single pot. The product molecules form a family of materials with contrasting optical responses, in that they exhibit light emission of different colors and emission switching that is sensitively triggered by acidic/basic environments (see scheme). A wide variety of amines are known to react with 7,7,8,8-tetracyanoquinodimethane (TCNQ) to yield push,pull diaminodicyanoquinodimethanes with a strongly zwitterionic structure and significant optical and nonlinear optical properties. A novel course of reaction is observed now with the amine 2-methyl-4-chloroaniline, which leads to three well-defined products, A,C, in a single pot. A and B are formed through the replacement of one cyano group in TCNQ by the amine; A is a carbon acid and B is its corresponding salt. C is the conventional product in which two cyano groups in TCNQ are replaced by the amine. The products are characterized structurally and spectroscopic studies reveal contrasting optical responses. A is nonfluorescent, whereas B and C show red and green emission, respectively, in the solution and solid states. The acid/conjugate-base pair A and B can be interconverted through facile, reversible, and repeated deprotonation/protonation cycles, which are accompanied by instantaneous switching of the fluorescence. The current study illustrates an interesting case of a single-pot reaction yielding different optical materials with attributes that can be switched through simple approaches such as protonation or tuned through modification of the push,pull characteristics. [source] Generalized granuloma annulare associated with gastrointestinal stromal tumour: case report and review of clinical features and managementCLINICAL & EXPERIMENTAL DERMATOLOGY, Issue 4 2008M. L. S. Chiu Summary The paraneoplastic variant of granuloma annulare (GA) is a rare cutaneous manifestation of underlying malignancy that is most commonly associated with systemic lymphoma. We report an interesting case of a patient with gastrointestinal stornal tumour (GIST) of the stomach presenting with extensive generalized GA. GIST was diagnosed 2 months after the diagnosis of GA. Resolution of the GA was seen 1 month after surgical excision of GIST. The close correlation of the clinical courses of these two rare diseases suggests that their coexistence was more than a coincidental finding. This case highlights the importance of excluding paraneoplastic GA, especially in cases where the skin manifestations are extensive and resistant to treatment. [source] Spinoza on the Problem of AkrasiaEUROPEAN JOURNAL OF PHILOSOPHY, Issue 1 2010Eugene Marshall Though each is intuitive in a certain way, they both fail as explanations of the most interesting cases of akrasia. Spinoza's own thoughts on bondage and the affects follow, from which a Spinozist explanation of akrasia is constructed. This account is based in Spinoza's mechanistic psychology of cognitive affects. Because Spinoza's account explains action asissuing from modes of mind that are both cognitive and affective, it captures the intuitions that motivate the two traditional views while avoiding the pitfalls that result from their one-sided approaches. This project will allow us a fuller understanding of Spinozist moral psychology. In addition to this historical value, the Spinozist theory may offer a satisfactory explanation of certain hard cases of akrasia while avoiding the problems be set by other theories. For this reason, the Spinozist account could also be seen as a useful contribution to our philosophical understanding of the phenomenon of akrasia. [source] Use of methoxamine in the resuscitation of epinephrine resistant electromechanical dissociationANAESTHESIA, Issue 3 2002F. M. J. Harban Dr McBrien et al. describe three interesting cases of electromechanical dissociation (EMD) resistant to epinephrine treatment (McBrien et al. Anaesthesia 2001; 56: 1085,9). In these cases, an,, adrenergic agonist (methoxamine) proved to be lifesaving. However, to ,consider an , agonist for any case of cardiac arrest secondary to electromechanical dissociation which is unresponsive to epinephrine' may not be appropriate. These cases involved a specific situation where the likely cause of hypotension was a fall in the systemic vascular resistance (SVR). This occurred as a result of proven type 1 hypersensitivity in two cases and direct action of methylmethacrylate cement in the other. Clearly in this case, an , agonist is a logical choice. The Advanced Life Support guidelines are designed to cover a wide range of differing conditions for use by practitioners of differing experience who may or may not be aware of the originating event. Indeed, hypotension causing EMD may be as a result of cardiac tamponade, tension pneumothorax or hypovolaemia. It is unlikely that the use of , agonists would be helpful in these situations. It would seem prudent to continue to use epinephrine as the first line treatment for an EMD cardiac arrest and to advise using an , agonist in cases of hypotension where reduced SVR is suspected as the cause when epinephrine may not be effective in restoring the blood pressure. However, as methoxamine has now been withdrawn from clinical use, other , agonists such as metaraminol or phenylephrine may be more readily available. [source] 17 Our Patients, Our Residents, Their Case-Based Evidence: Development of an Intradepartmental Medical Education JournalACADEMIC EMERGENCY MEDICINE, Issue 2008Christopher Miller As clinical educators, we place a premium on teaching at the bedside. This academic medicine hallmark has many competitors in today's challenging emergency department environment. We therefore sought to complement bedside teaching with the creation of a monthly, case-based, best-evidence-practice, intra-departmental medical education journal. Residents were encouraged to annotate interesting cases during their shifts in a written log found in the emergency department. Monthly, a senior EM resident reviewed the cases and earmarked a select few for detailed review based on their potential educational merit. Comprehensive, evidence-based teaching summaries were presented in a case-report format (see attached examples). The completed manuscript was distributed electronically to staff and residents as a monthly medical education journal. Survey methodology performed at the conclusion of the publication's first year assessed its educational impact and estimated resources required for publication. 90% of residents reported reading the journal monthly, and 80% felt it was of high educational value. The mean preparation time was 16 hours per month. To assess reproducible and lasting didactic benefit, the journal was introduced at a second EM academic institution. To date, 19 issues at the primary site and 7 issues at the second have been published. Multi-institutional validation of its educational impact is ongoing, but interim analysis suggests continued success at both sites. [source] | ||||||||||||||||||||||