Calcificações hepáticas: freqüência e significado

OBJETIVO: Avaliar a freqüência e a origem de calcificações hepáticas identificadas na tomografia computadorizada (TC). MATERIAIS E MÉTODOS: Estudo retrospectivo de 1.362 exames consecutivos de TC do abdome, para determinar a freqüência de calcificações hepáticas. Foram revistos os prontuários clínicos, no sentido de estabelecer a origem das calcificações. RESULTADOS: Observaram-se calcificações intra-hepáticas em 3,6% (49/1.362) dos exames. Houve predominância no sexo feminino (57,2%) sobre o masculino (42,8%), e a idade dos pacientes variou de 18 a 92 anos (média: 59,4; mediana: 63,5). A maioria das calcificações (39/49; 79,5%) foi de origem residual e sem repercussão clínica, 14,4% (7/49) estavam associadas a metástases hepáticas e 6,1% (3/49) estavam associadas a lesões císticas. Foram observadas sete lesões metastáticas calcificadas, sendo cinco por neoplasia de cólon, uma por sarcoma e uma por teratoma maligno de ovário. Dessas metástases, duas apresentaram calcificações após tratamento quimioterápico. CONCLUSÃO: As calcificações hepáticas são de baixa prevalência em exames tomográficos (< 5%) e são mais freqüentemente de origem residual por processos infecciosos e inflamatórios pregressos.

The empirical assessment of agency accountability: A regime approach and an application to the German Bundesnetzagentur

Regulation has in many cases been delegated to independent agencies, which has led to the question of how democratic accountability of these agencies is ensured. There are few empirical approaches to agency accountability. We offer such an approach, resting upon three propositions. First, we scrutinize agency accountability both de jure (accountability is ensured by formal rights of accountability 'fora' to receive information and impose consequences) and de facto (the capability of fora to use these rights depends on resources and decision costs that affect the credibility of their sanctioning capacity). Second, accountability must be evaluated separately at political, operational and managerial levels. And third, at each level accountability is enacted by a system of several (partially) interdependent fora, forming together an accountability regime. The proposed framework is applied to the case of the German Bundesnetzagentur's accountability regime, which shows its suitability for empirical purposes. Regulatory agencies are often considered as independent, yet accountable. This article provides a realistic framework for the study of accountability 'regimes' in which they are embedded. It emphasizes the need to identify the various actors (accountability fora) to which agencies are formally accountable (parliamentary committees, auditing bodies, courts, and so on) and to consider possible relationships between them. It argues that formal accountability 'on paper', as defined in official documents, does not fully account for de facto accountability, which depends on the resources possessed by the fora (mainly information-processing and decision-making capacities) and the credibility of their sanctioning capacities. The article applies this framework to the German Bundesnetzagentur.

Auditoria em centro de diagnóstico mamário para detecção precoce de câncer de mama

OBJETIVO: Este trabalho apresenta o modelo de auditoria nos resultados das mamografias do Centro de Diagnóstico Mamário da Santa Casa da Misericórdia do Rio de Janeiro. MATERIAIS E MÉTODOS: No período de maio de 1997 a setembro de 1998, foram realizadas 2.000 mamografias, sendo 1.570 em mulheres assintomáticas, cujos resultados foram objeto da auditoria. RESULTADOS: As mamografias das 1.570 mulheres assintomáticas foram classificadas em: categoria 1 - 1.362 casos; categoria 2 - 9 casos; categoria 3 - 95 casos; categoria 4 - 24 casos; categoria 5 - 6 casos; categoria 0 - 74 casos. Dos 199 exames anormais (categorias 0, 3, 4 e 5), foram acompanhadas 107 mulheres (54%) e perdidas 92 mulheres (46%). Os 107 casos incluídos no trabalho tiveram a seguinte classificação: categoria 3 - 48 casos; categoria 4 - 18 casos; categoria 5 - 4 casos; categoria 0 - 37 casos. Dos 48 casos categoria 3, nenhum caso de câncer foi encontrado; dos 18 casos categoria 4, dois casos de câncer foram encontrados; dos quatro casos categoria 5, todos foram diagnosticados câncer; dos 37 casos categoria 0, um caso de câncer foi encontrado. Os valores de auditoria obtidos foram os seguintes: valor preditivo positivo (baseado no exame com resultado anormal) - 11%; valor preditivo positivo (quando houve recomendação de biópsia) - 31%. A taxa de detecção de câncer, em 1.570 mulheres, foi de sete casos; a sensibilidade foi de 100%; a especificidade foi de 96%; a taxa de reconvocação foi de 4,7%. CONCLUSÃO: Todos os resultados obtidos reproduzem os resultados recomendados na literatura.

Radio continuum and near-infrared study of the MGRO J2019+37 region

MGRO J2019+37 is an unidentified extended source of very high energy gamma-rays originally reported by the Milagro Collaboration as the brightest TeV source in the Cygnus region. Its extended emission could be powered by either a single or several sources. The GeV pulsar AGL J2020.5+3653 , discovered by AGILE and associated with PSR J2021+3651 , could contribute to the emission from MGRO J2019+37 . Aims. Our aim is to identify radio and near-infrared sources in the field of the extended TeV source MGRO J2019+37 , and study potential counterparts to explain its emission. Methods. We surveyed a region of about 6 square degrees with the Giant Metrewave Radio Telescope (GMRT) at the frequency 610 MHz. We also observed the central square degree of this survey in the near-infrared -band using the 3.5 m telescope in Calar Alto. Archival X-ray observations of some specific fields are included. VLBI observations of an interesting radio source were performed. We explored possible scenarios to produce the multi-TeV emission from MGRO J2019+37 and studied which of the sources could be the main particle accelerator. Results. We present a catalogue of 362 radio sources detected with the GMRT in the field of MGRO J2019+37 , and the results of a cross-correlation of this catalog with one obtained at near-infrared wavelengths, which contains ~3105 sources, as well as with available X-ray observations of the region. Some peculiar sources inside the ~1° uncertainty region of the TeV emission from MGRO J2019+37 are discussed in detail, including the pulsar PSR J2021+3651 and its pulsar wind nebula PWN G75.2+0.1 , two new radio-jet sources, the H II region Sh 2-104 containing two star clusters, and the radio source NVSS J202032+363158 . We also find that the hadronic scenario is the most likely in case of a single accelerator, and discuss the possible contribution from the sources mentioned above. Conclusions. Although the radio and GeV pulsar PSR J2021+3651 / AGL J2020.5+3653 and its associated pulsar wind nebula PWN G75.2+0.1 can contribute to the emission from MGRO J2019+37 , extrapolation of the GeV spectrum does not explain the detected multi-TeV flux. Other sources discussed here could contribute to the emission of the Milagro source.

The Increasing Spectrum of Indications of Whole-Body MRI Beyond Oncology: Imaging Answers to Clinical Needs.

Whole-body coverage using MRI was developed almost 2 decades ago. The first applications focused on the investigation of the skeleton to detect neoplastic disease, mainly metastases from solid cancers, and involvement by multiple myeloma and lymphoma. But the extensive coverage of the whole musculoskeletal system, combined with the exquisite sensitivity of MRI to tissue alteration in relation to different pathologic conditions, mainly inflammation, has led to the identification of a growing number of indications outside oncology. Seronegative rheumatisms, systemic sclerosis, inflammatory diseases involving muscles or fascias, and multifocal osseous, vascular, or neurologic diseases represent currently validated or emerging indications of whole-body MRI (WB-MRI). We first illustrate the most valuable indications of WB-MRI in seronegative rheumatisms that include providing significant diagnostic information in patients with negative or ambiguous MRI of the sacroiliac joints and the lumbar spine, assessing disease activity in advanced (ankylosed) central disease, and evaluating the peripherally dominant forms of spondyloarthropathy. Then we review the increasing indications of WB-MRI in other rheumatologic and nonneoplastic disorders, underline the clinical needs, and illustrate the role of WB-MRI in the positive diagnosis and evaluation of disease burden, therapeutic decisions, and treatment monitoring.

Aortic Annulus Stabilization Technique for Rapid Deployment Aortic Valve Replacement.

NlmCategory="UNASSIGNED">Rapid deployment aortic valve replacement (RDAVR) with the use of rapid deployment valve systems represents a smart alternative to the use of standard aortic bioprosthesis for aortic valve replacement. Nevertheless, its use is still debatable in patients with pure aortic valve regurgitation or true bicuspid aortic valve because of the risk of postoperative paravalvular leak. To address this issue, an optimal annulus-valve size match seems to be the ideal surgical strategy. This article describes a new technique developed to stabilize the aortic annulus and prevent paravalvular leak after RDAVR. To confirm the feasibility, this technique was performed in six patients with severe symptomatic aortic stenosis who were scheduled to undergo aortic valve replacement at our center. All patients survived surgery and were discharged from the hospital. There were no new intracardiac conduction system disturbances observed, and a permanent pacemaker implantation was not required in any of the patients. The intraoperative and postoperative echocardiogram confirmed successful positioning of the valve, and no paravalvular leak was observed. In this preliminary experience, RDAVR through a full sternotomy or an upper hemisternotomy approach with the use of aortic annulus stabilization technique was safe, and no leak was observed. Future studies on large series of patients are necessary to confirm the safety and effectiveness of this technique in preventing paravalvular leak in patients with true bicuspid aortic valves or pure aortic regurgitation.

Pathologies vasculaires lymphatiques: apport de la lympho-fluoroscopie [Lymphatic vascular pathologies: contribution of lympho-fluoroscopy].

Si l'examen clinique revêt une importance essentielle en lymphologie et exige des praticiens expérimentés, la lymphoscintigraphie et plus récemment la lympho-fluoroscopie au vert d'indocyanine constituent des moyens d'investigation précieux dans la prévention, le diagnostic et le traitement des pathologies vasculaires lymphatiques. L'intérêt de la lymphoscintigraphie réside dans l'analyse qualitative et quantitative de la migration des macromolécules par les vaisseaux lymphatiques et l'évaluation du secteur lymphatique profond. La lympho-fluoroscopie se distingue de la lymphoscintigraphie par l'obtention d'une cartographie détaillée des vaisseaux lymphatiques superficiels et d'images dynamiques en temps réel. Elle apporte à l'angiologue et au physiothérapeute des informations irremplaçables sur leur contractilité et la présence de dérivations compensatoires à privilégier lors du drainage lymphatique manuel. If clinical examination has an essential importance in lymphology disorders and requires experimented practitioners, lymphoscintigraphy and more recently green indocyanine lympho-fluoroscopy constitute precious complementary investigations in prevention, diagnosis, and treatment of lymphatic vascular pathologies. The lymphoscintigraphy interest lies in qualitative and quantitative analysis of macromolecules migration within lymphatic vessels and the deep lymphatic network. The lympho-fluoroscopy distinguishes itself from lymphoscintigraphy allowing real time superficial lymphatic vessels detailed mapping, gathering important information on their contractility, and the presence of compensatory derivations to be favored during manual lymphatic drainage to angiologist and physiotherapist.

"Vedo il male e non lo posso schivare" : le rime di Antonio Brocardo tra classicismi e polemiche

Antonio Brocardo è ricordato per essere entrato in polemica con Pietro Bembo, suscitando clamore e indignazione. Le fonti antiche sulla vita del Bembo lo descrivono come un folle intento a distruggere qualcosa che non riusciva bene a comprendere Vitaliani lo definisce, nel titolo della sua monografia del 1902 (l'unica fino ad ora dedicata al poeta), «vittima del bembismo», probabilmente risentendo dei pesanti giudizi sul cardinale già presenti in Leopardi e poi nel De Sanctis. Eppure, già a partire da Croce, si cerca di ricostruire in maniera meno pregiudizievole la figura del poeta veneziano, considerando più da vicino i testi pervenuti. Ci si trova, però, di fronte ad uno scarto imponente: la tradizione lo vuole opposto al bembismo, mentre la lirica brocardiana non sembra per molti aspetti differenziarsi così platealmente dal canone bembesco, a giudizio di molte storie letterarie. Questa nuova edizione mira: a ricostruire scrupolosamente la biografia del poeta, l'ambiente frequentato ed i rapporti con altri poeti/intellettuali del suo tempo; a fare finalmente chiarezza sulle polemiche che videro il giovane veneziano come protagonista, a partire dalle fonti contemporanee (correggendo quanto riportato dalle biografìe del Bembo o dalle storie letterarie); a fornire un adeguato commento alle sue rime, dopo aver ristabilito un sicuro testo critico; a fare maggior chiarezza sul rapporto tra Brocardo ed il furbesco letterario; a collocare il poeta in una ben determinata fase del petrarchismo.

Radio continuum and near-ingrared study of the MGRO J2019+37 region

Context. MGRO J2019+37 is an unidentified extended source of very high energy gamma-rays originally reported by the Milagro Collaboration as the brightest TeV source in the Cygnus region. Its extended emission could be powered by either a single or several sources. The GeV pulsar AGL J2020.5+3653, discovered by AGILE and associated with PSR J2021+3651, could contribute to the emission from MGRO J2019+37. Our aim is to identify radio and near-infrared sources in the field of the extended TeV source MGRO J2019+37, and study potential counterparts to explain its emission. Methods: We surveyed a region of about 6 square degrees with the Giant Metrewave Radio Telescope (GMRT) at the frequency 610 MHz. We also observed the central square degree of this survey in the near-infrared Ks-band using the 3.5 m telescope in Calar Alto. Archival X-ray observations of some specific fields are included. VLBI observations of an interesting radio source were performed. We explored possible scenarios to produce the multi-TeV emission from MGRO J2019+37 and studied which of the sources could be the main particle accelerator. Results: We present a catalogue of 362 radio sources detected with the GMRT in the field of MGRO J2019+37, and the results of a cross-correlation of this catalog with one obtained at near-infrared wavelengths, which contains ∼3 × 105 sources, as well as with available X-ray observations of the region. Some peculiar sources inside the ∼1◦ uncertainty region of the TeV emission from MGRO J2019+37 are discussed in detail, including the pulsar PSR J2021+3651 and its pulsar wind nebula PWN G75.2+0.1, two new radio-jet sources, the Hii region Sh 2-104 containing two star clusters, and the radio source NVSS J202032+363158. We also find that the hadronic scenario is the most likely in case of a single accelerator, and discuss the possible contribution from the sources mentioned above. Conclusions: Although the radio and GeV pulsar PSR J2021+3651 / AGL J2020.5+3653 and its associated pulsar wind nebula PWN G75.2+0.1 can contribute to the emission from MGRO J2019+37, extrapolation of the GeV spectrum does not explain the detected multi-TeV flux. Other sources discussed here could contribute to the emission of the Milagro source

Kierrätyspolttoaineen käyttö leijupetikattilan konseptiin

Diplomityö tehtiin Rautjärven kunnassa sijaitsevalle M-real Simpeleen tehtaan voimalaitokselle. Voimalaitoksella on leijupetikattila ja se tuottaa prosessilämmön ja höyryn kartonki- ja paperikoneelle. Vuotuinen energiantuotanto on noin 115 GWh. Diplomityön tavoitteena oli tutkia kierrätyspolttoaineen käyttöä osana voimalaitoksen polttoainekonseptista. Voimalaitoksen biokattila on leijupetikattila, jossa poltetaan tehtaalta tulevaa kuorta ja lietettä sekä tehtaan ulkopuolisia puuperäisiä biopolttoaineita ja turvetta. Yksi työn päätavoitteista oli laatia voimassa olevan ympäristöluvan muutoshakemus, jotta kierrätyspolttoaineen käytölle saataisiin lupa. Suurten polttolaitosten päästöjen tarkkailu- ja raportointivaatimukset ovat uudistuneet viime vuosina paljon. Suurimpia muutosten aiheuttajia ovat Valtioneuvoston asetukset 1017/2002 ja 362/2003. Tässä työssä kuvataan uusien asetusten tuomia vaatimuksia itse kattilalle ja polttoaineen syötölle, jatkuvatoimisille mittalaitteille ja muille suoritettaville mittauksille. Uutena asiana on myös ilmapäästöjen seurantamittaukset ja -tapa, jolla tulokset ilmoitetaan. Mahdollisimman pieniin leijupetikattilamuutoksiin uskotaan pääsevän korvaamalla kierrätyspolttoaine REF1:llä 5 – 10 % turpeesta tai puupolttoaineista.

V. A. Koskenniemen kokoelma

Kirjallisuuden professori V. A. Koskenniemen (1885-1962) kirjakokoelma säilytetään erillisenä kokoelmana Turun yliopiston pääkirjaston Koskenniemi-huoneessa. Kokoelmaan kuuluu n. 2800 nidettä, suurin osa kaunokirjallisuutta, erityisesti suomalainen lyriikka, kirjallisuudentutkimusta ja estetiikka. Kokoelmassa on runsaasti omistuskirjoituksia V. A. Koskenniemelle. Kokoelmassa on myös 10 kpl. V. A. Koskenniemen omaa käsikirjoitusta sidottuina. (käsikirjoitusliuskat sidottu kirjoiksi): Elegioja ynnä muita runoja. Teoksen käsikirjoitus. 120 s., Ilm. Kootut teokset I. Porvoo 1955, s. 145-243; Hannu. Erään nuoruuden runoelma. Teoksen käsikirjoitus. 73 s., ilm. WSOY, Porvoo 1913; Hiilivalkea. Teoksen käsikirjoitus. 57 s., Ilm. Kootut teokset I. Porvoo 1955, s. 93-144; Kevätilta Quartier Latinissa. Parisin muistelmia. Teoksen käsikirjoitus. 210 s., Ilm. Kootut teokset V. Porvoo 1955, s. 5-51; Konsuli Brennerin jälkikesä. Romaani. Teoksen käsikirjoitus. 259 s., Ilm. Kootut teokset IV. Porvoo 1955, s. 5-161; Lyyra ja paimenhuilu. Runosuomennoksia. Teoksen käsikirjoitus. 109 s., Ilm. Kootut teokset II. Porvoo 1955, s. 303-362; Nuori Anssi. Teoksen käsikirjoitus. 28 s., Ilm. nimellä Nuori Anssi Porvoo 1918 ja Kootut teokset II. Porvoo 1955, s. 283-301; Runon kaupunkeja ynnä muita kirjoitelmia. Teoksen käsikirjoitus. 330 s., Ilm. Kootut teokset V Porvoo 1955, s. 53-155; Sydän ja kuolema. Elegioja, lauluja ja epitaafeja. Teoksen käsikirjoitus. 105 s., Ilm. Kootut teokset I. Porvoo 1955, s. 203-243; Uusia runoja. Teoksen käsikirjoitus. 146 s., Ilm. Kootut teokset I, Porvoo 1955, s. 245-309. Kokoelma on osittain luetteloimaton, melkein 1300 nidettä löytyy Volter-tietokannasta.

Um olhar holístico sobre a química de produtos naturais brasileira

This paper describes a comparative analysis on natural product chemistry between the Brazilian Chemical Society journals and twelve representative international publications in the area. The search using the ISI Web of Knowledge disclosed 41,362 publications in the years 2000-2002 containing at least one researcher from a Brazilian Institution, from which 12% belongs to natural products.

Le Constitutionnel : journal politique et littéraire

1816/12/26 (Numéro 361-362)-1816/12/27.