Acute Upper Limb Ischemia, a Rare Presentation of Giant Cell Arteritis

Giant cell arteritis (GCA) is a systemic large vessel vasculitis, with extracranial arterial involvement described in 10-15% of cases, usually affecting the aorta and its branches. Patients with GCA are more likely to develop aortic aneurysms, but these are rarely present at the time of the diagnosis. We report the case of an 80-year-old Caucasian woman, who reported proximal muscle pain in the arms with morning stiffness of the shoulders for eight months. In the previous two months, she had developed worsening bilateral arm claudication, severe pain, cold extremities and digital necrosis. She had no palpable radial pulses and no measurable blood pressure. The patient had normochromic anemia, erythrocyte sedimentation rate of 120 mm/h, and a negative infectious and autoimmune workup. Computed tomography angiography revealed concentric wall thickening of the aorta extending to the aortic arch branches, particularly the subclavian and axillary arteries, which were severely stenotic, with areas of bilateral occlusion and an aneurysm of the ascending aorta (47 mm). Despite corticosteroid therapy there was progression to acute critical ischemia. She accordingly underwent surgical revascularization using a bilateral carotid-humeral bypass. After surgery, corticosteroid therapy was maintained and at six-month follow-up she was clinically stable with reduced inflammatory markers. GCA, usually a chronic benign vasculitis, presented exceptionally in this case as acute critical upper limb ischemia, resulting from a massive inflammatory process of the subclavian and axillary arteries, treated with salvage surgical revascularization.

Giant warts in a kidney transplant patient: regression with sirolimus.

Purpose: Recent reports have suggested that intraabdominal postoperative infection is associated with higher rates of overall and local recurrence and cancer-specific mortality. However, the mechanisms responsible for this association are unknown. We hypothesized that the greater inflammatory response in patients with postoperative intraabdominal infection is associated to an increase in local and systemic angiogenesis. Methods: We designed a prospective cohorts study with matched controls. Patients with postoperative intra-abdominal infection (abscess and/or anastomotic leakage) (group 1; n=17) after elective colorectal cancer resection operated on for cure were compared to patients with an uncomplicated postoperative course (group 2; n=17). IL-6 and VEGF levels were determined by ELISA in serum and peritoneal fluid at baseline, 48 hours and postoperative day 4 or at the time the peritoneal infection occurred. Results: No differences were observed in age, gender, preoperative CEA, tumor stage and location and type of procedure performed. Although there were no differences in serum IL-6 levels at 48 hours, this pro-inflammatory cytokine was higher in group 1 on postoperative day 4 (group 1: 21533 + 27900 vs. group 2: 1130 + 3563 pg/ml; p < 0.001). Serum VEGF levels were higher in group 1 on postoperative day 4 (group 1: 1212 + 1025 vs. group 2: 408 + 407 pg/ml; p < 0.01). Peritoneal fluid VEGF levels were also higher in group 1 at 48 hours (group 1: 4857 + 4384 vs. group 2: 630 + 461 pg/ml; p < 0.001) and postoperative day 4 (group 1: 32807 + 98486 vs. group 2: 1002 + 1229 pg/ml; p < 0.001). A positive correlation between serum IL-6 and VEGF serum levels was observed on postoperative day 4 (r=0.7; p<0.01). Conclusions: These results suggest that not only the inflammatory response but also the angiogenic pathways are stimulated in patients with intra-abdominal infection after surgery for colorectal cancer. The implications of this finding on long-term follow-up need to be evaluated.

DNA polymerase activity in trophoblast giant cells in the mouse /

In the developing mouse embryo, the diploid trophectoderm is known to undergo a diploid to giant cell transformation. These cells arise by a process of endoreduplication, characterized by replication of the entire genome without subsequent mitosis or cell division, leading to polyploidy and the formation of giant nuclei. Studies of 13.5 day rat trophoblast derived from the parietal yolk sac have indicated a relatively low rate of DNA polymerase a activity, the noinnal eukaryotic replicase, in comparison to that of DNA polymerase g. These results have suggested that endoreduplication in trophoblast giant cells may not employ the normal replicase enzyme, DNA polymerase a. In order to determine whether a 'switch' from DNA polymerase to DNA polymerase is a necessary concomitant of the diploid to giant cell transformation, two distinct populations of trophoblast giant cells, the primary giant cell derived from the mural trophectoderm and the secondary giant cell derived from the polar trophoectoderm were used. These two populations of trophoblast giant cells can be obtained from the tissue outgrowths of 3.5da blastocysts and the extraembryonic ectoderm (EX) and ectoplacental cone (EPC) of 7.5 day embryos respectively. Tissue outgrowths were treated with aphidicolin, a specific reversible inhibitor of eukaryotic DNA polymerase a, on various days after explantation. The effect of aphidicolin treatment was assessed both qualitatively, using autoradiography and quantitatively by scintillation counting and Feulgen staining. 3 DNA synthesis was measured in control and treated cultures after a Hthymidine pulse. Scintillation counts of the embryo proper revealed that DNA synthesis was consistently inhibited by greater than 907. in the presence of aphidicolin. Inhibition of DNA synthesis in the EX and EPC varied between 81-957. and 82-987. respectively, indicating that most DNA synthesis was mediated by DNA polymerase a, but that a small but significant amount of residual synthesis was indicated. A qualitative approach was then applied to determine whether the apparent residual DNA synthesis was restricted to a subpopulation of giant cells or whether all giant cells displayed a low level of DNA synthesis. Autoradiographs of the ICM of blastocysts and the embryo proper of 7.5da embryos, which acted as diploid control population, was completely inhibited regardless of duration in explant culture. In contrast, primary trophoblast giant cells derived from blastocysts and secondary giant cells derived from the EX and EPC were observed to possess some heavily labelled cells after aphidicolin treatment. These results suggest that although DNA polymerase a is the primary replicating enzyme responsible for endoreduplication in mouse trophoblast giant cells, some nonactivity is also observed. A DNA polymerase assay employing tissue lysates of outgrown 7.5da embryo, EX and EPC tissues was used to attempt to confirm the presence of higher nonactivity in tissues possessing trophoblast giant cells. Employing a series of inhibitors of DNA polymerases, it would appear that DNA polymerase a is the major polymerase active in all tissues of the 7.5da mouse embryo. The nature of the putative residual DNA synthetic activity could not be unequivically determined in this study. Therefore, these results suggest that both primary and secondary trophoblast giant cells possess and use DNA polymerase a in endoreduplicative DNA synthesis. It would appear that the high levels of DNA polymerase g activity reported in trophoblast tissue derived from the 13.5 da rat yolk sac was not a general feature of all endoreduplication.

Wrestling Card - Cardiff Giant

The wrestler's name is Cardiff Giant and the number stamped on the reverse is 649.

Preparing Students with ASD for Inclusive Classrooms: A Case Study of Giant Steps

Giant Steps is a therapeutic school for children with Autism Spectrum Disorder (ASD) founded in 1995 by a group of parents who felt that the public school system was not fully able to meet the needs of their children. While the education system has progressed through the years to offer all students with access to public education, many educators still are not adequately prepared to provide inclusive learning environments for students with ASD. Given the prevalence of ASD in southern Ontario (1 in every 42 boys and 1 in every 189 girls), research on ASD and inclusive practices is both vital and timely. The purpose of this qualitative case study is to understand how the Giant Steps program prepares and transitions students with ASD for inclusive classrooms. Data was collected through two rounds of in-depth interviews, and was subsequently analyzed and interpreted into research findings that are presented through three major themes (i.e., unique program aspects, holistic approach, inclusion not integration). Collectively, the themes provide insights about how students at Giant Steps are prepared for inclusion, as well as how different stakeholders within the Giant Steps program perceive inclusion and their role in preparing students for inclusive classrooms.

"It's all a Giant Web" : syncretism, agency and (re)connection in a contemporary Pagan community

Les anthropologues ont examiné le syncrétisme religieux, soit l’incorporation d’éléments de sources diverses, au sein des religions du monde depuis plusieurs décennies. Cependant, très peu d’intérêt a été accordé au paganisme contemporain, un Nouveau Mouvement Religieux hautement syncrétique. À travers les récits de plusieurs païens/nes contemporain/es à Montréal, j’examine comment et pourquoi les pratiquants sont inspiré/es à faire le choix d’incorporer divers éléments provenant de sources religieuses et non religieuses. Le recours à des sources différentes reflète l’effort de créer une expérience religieuse plus profonde et personnelle. La créativité impliquée dans la construction d’une pratique spirituelle et d’un système de croyance personnels est souvent conduite par un désir de (re)connexion, que ce soit à la terre, aux ancêtres, ou bien à une communauté. Les acteurs acquièrent un sentiment accru d’agentivité dans ce processus. Ma participation dans cette communauté a influencé mes expériences de recherche; j’examine également ma position en tant qu’anthropologue chez soi.

Characterization of the mammalian homologs of the Drosophila Melanogaster Endocytic protein lethal (2) giant discs 1

Endocytose joue un rôle dans l'activation du récepteur Notch. Des mutations dans le gène drosophilien lethal giant discs (lgd), provoque une prolifération cellulaire en perturbant l'endocytose de Notch. Les orthologues murins mlgd1 et 2 peuvent sauver ce phénotype, démontrant une fonction conservée. Cependant, des publications récentes suggèrent que les orthologs humains de lgd (hgd1/2) sont nucléaires. Dans cette étude, il est démontré que chez la Drosophile, le mutant dlgd(08) provoque l'accumulation de Notch dans des vésicules et une surprolifération de neuroblastes . Ceci suggère que Notch est activé a l'intérieur des endosomes dans les neuroblastes. L'immunohistochimie de cellules Hela indique que hlgd1 et 2 ne sont pas nucléaires, mais associés à des strctures endosomales. Enfin, la baisse d'expression par shRNA des gènes murins mlgd1 et mlgd2 provoque une différenciation accélérée des cellules souches hématopoïétiques dans la lignée lymphopoïèse T et bloque la transition DN3 / CD4+CD8+, suggérant une suractivation de Notch.

Development of Innovative Low Cost Larviculture Technologies of the Giant Fresh Water Prawn,Macrobrachium Rosenbergii(De Man)

School of Industrial Fisheries, Cochin University of Science and Technology

Apptication of Biofloc Technology (BFI) in Ihe nunery rearing and farming of giant freshwater prawn, Macrobrachillm rosenbergii (de Man)

This thesis Entitled Application of Biofloc technology (BFT) In the Nursery Rearing and Farming of Giant Freshwater Prawn,Macrobrachium Rosenbergii(De Man). Aquaculture, rearing plants and animals under controlled conditions is growing with an annual growth rate of 8.3% in the period 1970-2008 (FAO, 2010). This trend of growth is essential for the supply of protein-rich food for ever increasing world population. But growth and development of aquaculture should be in sustainable manner, preferably without jeopardizing the aquatic environment.In the present study, the application of BFT in the nursery rearing and farming ofgiant freshwater prawn, M. rosenbergii, is attempted. The result of the study is organised into eight chapters. In the first chapter, the subject is adequately introduced. Various types of aquaculture practices followed, development and status of Indian aquaculture, present status of freshwater pravm culture, BF T and its use for the sustainable aquaculture systems, theory of BFT based aquaculture practices, hypothesis, objective and outline of the thesis are described. An extensive review of literature on studies carried out so far on biofloc based aquaculture are given in chapter 2. The third chapter deals with the application of BFT in the primary nursery phase of freshwater prawn. Several workers suggested the need for an intermediate nursery phase in the culture system of freshwater prawn for the successful production. Thirty day experiment was conducted to study the effect of BFT on the water quality, and animal welfare under the various stocking densities. The study concluded that stocking finfishes in biofloc-based monoculture system of freshwater prawns has the potential of increasing total yield. Prawns having a higher commercial value than finfishes besides ensuring economic sustainability. Results showed that prawn yield and survival was better in catla dominated tanks. Based on the results of the study, it is recommended to incorporate 25% rohu and 75% catla in the biofloc-based culture system of giant freshwater prawns. The results of the present study also recommend to stock relatively larger catla for biofloc-based culture system. Fish production was also higher in the 100% catla tank. When catla was added in higher percentages it should ensured that the hiding objects in the culture ponds shall be used in order to reduce the chance of cannibalism among prawns. rohu and catla equally have the ability to harvest the biofloc, catla consumes the planktonic contributes in the floc whereas rohu grazed on the bacterial consortium suspended in the water column. In Chapter 8, recommendations and future research perspectives in the field of biofloc based aquaculture is presented.

Application of Biofloc Technology (BFT) in the nursery rearing and farming of giant freshwater prawn, Macrobrachium rosenbergii (deMan)

In India a study conducted by CIFE and CIBA (1997), concluded that shrimp farming does more good than harm and it is not eco-unfriendly (Krishnan and Birthal, 2002). Upsurge in coastal aquaculture activity induced by high profitability is reported to have caused adverse impacts on coastal ecosystems and social environments (Parthasarathy and Nirmala, 2000). The crustacean farming sector has received criticism for excessive use of formulated feed containing high protein, of which around 50% gets accumulated at the pond bottom as unconsumed (Avnimelech, 1999; Hari et al., 2004, 2006). The wasted feeds undergo the process of degradation and results in the release of toxic metabolites to the culture system. Reduction of protein in the feed, manipulation and utilisation of natural food in the culture system are the remedy for the above problems. But before reducing the feed protein, it should be confirmed that the feed with reduced protein is not affecting the growth and health of the cultured animal. In the present study, biofloc technology is identified as one of the innovative technologies for ensuring the ecological and environmental Sustainability and examines the compatibility of BFT for the sustainable aquaculture of giant prawn, M. rosenbergii. This thesis starts with a general introduction (Chapter-1), a brief review of the most relevant literature (Chapter-2), results of various experiments (Chapter-3-6), summary (Chapter-7) and recommendations and future research perspectives in the field of biofloc based aquaculture (Chapter – 8). The major objectives of this thesis are, to improve the ecological and economical sustainability of prawn farming by the applicationof BFT and to improve the nutrient utilisation in aquaculture systems.

Giant step bunching from self-organized coalescence of SrRuO3 islands

Step bunching develops in the epitaxy of SrRuO3 on vicinal SrTiO3(001) substrates. We have investigated the formation mechanisms and we show here that step bunching forms by lateral coalescence of wedgelike three-dimensional islands that are nucleated at substrate steps. After coalescence, wedgelike islands become wider and straighter with growth, forming a self-organized network of parallel step bunches with altitudes exceeding 30 unit cells, separated by atomically flat terraces. The formation mechanism of step bunching in SrRuO3, from nucleated islands, radically differs from one-dimensional models used to describe bunching in semiconducting materials. These results illustrate that growth phenomena of complex oxides can be dramatically different to those in semiconducting or metallic systems.

Asymmetric giant magnetoresistance in Co10Cu90 magnetic granular alloys

We have observed a type of giant magnetoresistance (GMR) in magnetic granular Co10Cu90 alloys. The asymmetric GMR depends strongly on the size of magnetic Co particles, which exhibit superparamagnetic behavior at given measured temperature. The asymmetric GMR points to a metastable state that develops when the sample is field-cooled, which is lost after recycling. We propose that high-field cooling produces more effective parallel alignment of small unblocked Co particle moments and interfacial magnetizations, which contributes to the further decrease of the resistance in comparison with the samples zero-field-cooled, and then applied to the same field.