Bilateral periorbital ecchymoses. An often missed sign of amyloid purpura.

Immunoglobulin light chain (AL) amyloidosis is a systemic disease caused by a plasma cell clone synthesizing an unstable light chain, which forms amyloid fibrils. Deposition of amyloid fibrils affects primarily kidney, heart, nervous system, spleen, liver, gastrointestinal tract and the skin. Skin bleeding in these patients is called amyloid purpura. Classically, it occurs spontaneously and bilaterally in the periorbital region. Vessel wall fragility and damage by amyloid are the principal causes of periorbital and gastrointestinal bleeding. Additionally, coagulation factor inhibitory circulating paraprotein, hyperfibrinolysis, platelet dysfunction or isolated acquired factor X deficiency may contribute to even more severe, diffuse bleedings. Early diagnosis remains essential for improving prognosis of patients with AL amyloidosis. Although pictures of amyloid purpura have been often reported in the literature, the clinical diagnosis may be delayed. We report a case of cutaneous manifestation of AL amyloidosis diagnosed not until one year after the appearance of the first symptoms. Diagnostic work-up revealed that the patient suffered from multiple myeloma with secondary AL amyloidosis. Atraumatic ecchymoses at the face, particularly the eyelids as well as in the neck should raise the suspicion of AL amyloidosis.

All-American tradition : Iowa track and cross-country 1984-85

Contains information about the staff and athletes of the Iowa Hawkeyes Track and Field team for the 1984/85 academic school year. Also includes past year's results, team records, quick facts and schedule.

Cyanogenesis and the onset of tapping panel dryness in rubber tree

The objective of this work was to study the influence of cyanogenesis on the onset of irreversible tapping panel dryness (TPD) and the physiological and histological aspects of secondary phloem in the trunk (tapping panel) of rubber trees (Hevea spp.). Two cyanogenic compounds, linamarin and KCN, were applied separately on the trunk bark of healthy mature trees belonging to two Brazilian clones (Fx 4098 and Fx 3899). Changes in histology, latex pressure potential (ΨP) and cyanogenic potential (HCNp) were followed in the trunk inner barks. In addition, the HCNp levels were determined in TPD-affected plants of both clones. The applications of linamarin or KCN in healthy plants decreased latex ΨP, and formed tylosoids associated with in situ coagulation of latex. The clone Fx 4098 had the higher HCNp and showed the quicker and stronger responses to the cyanogenic compounds. Plants with TPD syntoms had a higher HCNp than the untreated healthy ones. Since histological changes are also structural markers of early TPD, it can be inferred that excessive release of cyanide can induce it in sensitive rubber clones

Mesenteric venous thrombosis : MDCT features according to the underlying etiology : P1

Purpose: To work out certain, well-defined aetiologies frequently associated with mesenteric venous thrombosis (MVT) in order to predict a typical population at risk, since MVT is nowadays often incidentally detected on cross-sectional imaging. To demonstrate the MDCT features, frequency and extent of associated bowel ischemia according to the underlying pathology. Methods and materials: Our electronic database revealed 71 patients (25 women, mean age 55) with thrombosis of the superior and/or inferior mesenteric vein detected by MDCT between 2000 and 2008. Two radiologists jointly reviewed the corresponding MDCT features including intraluminal extension, underlying aetiology and associated bowel ischemia, if present. Results: MVT was associated with carcinoma in 31 (43.7%) patients (pancreas 21.1%, liver 9.9%, others 12.7%). Concomitant inflammation was seen in 15 (21.1%) patients (pancreatitis 11.3%, diverticulitis 4.2%, others 5.6%), whereas coagulation/hematologic disorders were found in 7 (9.9%) patients, liver cirrhosis in 6 (8.5%), mixed/miscellaneous causes in 5 (7%) and still unknown aetiologies in 5 patients (7%). MVT resulted from recent operations in 2 (2.8%) patients. MDCT features of venous bowel ischemia were present in 15 patients (21.1%). 46.5% of MVT were (sub) acute, while 53.5% chronic. The luminal extension was complete in 52.1%, subtotal (>50% of lumen) in 22.5% and partial (<50% of lumen) in 25.4% of patients, consisting either of blood clots (76.1%) or tumoral tissue (23.9%), the latter mainly due to pancreas adenocarcinoma (76.4%). Conclusion: MDCT features of MVT are seen with a wide range of underlying diseases. Signs of intestinal ischemia are infrequently associated, mostly occurring with coagulation/hematologic disorders (40%).

Laboratory Investigation of Bridge Strip Seal Joint Termination Details, SPR RB08-014, 2016

Bridge expansion joints, if not properly designed, constructed, and maintained, often lead to the deterioration of critical substructure elements. Strip seal expansion joints consisting of a steel extrusion and neoprene gland are one type of expansion joint and are commonly used by the Iowa Department of Transportation (DOT). Strip seal expansion joints are susceptible to tears and pull outs that allow water, chlorides, and debris to infiltrate the joint, and subsequently the bearings below. One area of the strip seal that is particularly problematic is where it terminates at the interface between the deck and the barrier rail. The Iowa DOT has noted that the initial construction quality of the current strip seal termination detail is not satisfactory, nor ideal, and a need exists for re-evaluation and possibly re-design of this detail. Desirable qualities of a strip seal termination detail provide a seal that is simple and fast to construct, facilitate quick gland removal and installation, and provide a reliable, durable barrier to prevent chloride-contaminated water from reaching the substructure. To meet the objectives of this research project, several strip seal termination details were evaluated in the laboratory. Alternate termination details may not only function better than the current Iowa DOT standard, but are also less complicated to construct, facilitating better quality control. However, uncertainties still exist regarding the long-term effects of using straight-through details, with or without the dogleg, that could not be answered in the laboratory in the short time frame of the research project.

Transjugular liver biopsy: prospective evaluation of the angle formed between the hepatic veins and the vena cava main axis and modification of a semi-automated biopsy device in cases of an unfavorable angle.

In cases of transjugular liver biopsies, the venous angle formed between the chosen hepatic vein and the vena cava main axis in a frontal plane can be large, leading to technical difficulties. In a prospective study including 139 consecutive patients who underwent transjugular liver biopsy using the Quick-Core biopsy set, the mean venous angle was equal to 49.6 degrees. For 21.1% of the patients, two attempts at hepatic venous catheterization failed because the venous angle was too large, with a mean of 69.7 degrees. In all of these patients, manual reshaping of the distal curvature of the stiffening metallic cannula, by forming a new mean angle equal to 48 degrees , allowed successful completion of the procedure in less than 10 min.

Red blood cell-derived microparticles isolated from blood units initiate and propagate thrombin generation.

BACKGROUND: Red blood cell-derived microparticles (RMPs) are small phospholipid vesicles shed from RBCs in blood units, where they accumulate during storage. Because microparticles are bioactive, it could be suggested that RMPs are mediators of posttransfusion complications or, on the contrary, constitute a potential hemostatic agent. STUDY DESIGN AND METHODS: This study was performed to establish the impact on coagulation of RMPs isolated from blood units. Using calibrated automated thrombography, we investigated whether RMPs affect thrombin generation (TG) in plasma. RESULTS: We found that RMPs were not only able to increase TG in plasma in the presence of a low exogenous tissue factor (TF) concentration, but also to initiate TG in plasma in absence of exogenous TF. TG induced by RMPs in the absence of exogenous TF was neither affected by the presence of blocking anti-TF nor by the absence of Factor (F)VII. It was significantly reduced in plasma deficient in FVIII or F IX and abolished in FII-, FV-, FX-, or FXI-deficient plasma. TG was also totally abolished when anti-XI 01A6 was added in the sample. Finally, neither Western blotting, flow cytometry, nor immunogold labeling allowed the detection of traces of TF antigen. In addition, RMPs did not comprise polyphosphate, an important modulator of coagulation. CONCLUSIONS: Taken together, our data show that RMPs have FXI-dependent procoagulant properties and are able to initiate and propagate TG. The anionic surface of RMPs might be the site of FXI-mediated TG amplification and intrinsic tenase and prothrombinase complex assembly.

Functional renal failure and haemorrhagic gastritis associated with endotoxaemia in cirrhosis

Forty-three patients with cirrhosis and ascites, 21 with normal renal function, 10 with a progressive functional renal failure (FRF), and 12 with a steady FRF, were investigated for the presence of endotoxaemia by the Limulus lysate test. Endotoxaemia was found in nine patients with FRF and in none of the 21 with normal renal function (P less than 0-01). A positive Limulus test was almost exclusively associated with a progressive FRF (eight of 10 patients) and all but one of them died. Renal function improved as endotoxaemia disappeared in the survivor. Endotoxaemia was also associated with haemorrhage due to acute erosions of the gastric mucosa, being present in six of the seven patients who had this complication. Intravascular coagulation was not found in any patient. The Limulus test was positive in the ascitic fluid in 18 of 21 patients tested, although only two of them had peritonitis. These results suggest that endotoxaemia may play a critical role in the development of progressive renal failure and haemorrhagic gastritis in cirrhosis, and emphasise the potential risk of procedures involving reinfusion of ascitic fluid.

Detection and chemical profiling of medicine counterfeits by Raman spectroscopy and chemometrics

Raman spectroscopy combined with chemometrics has recently become a widespread technique for the analysis of pharmaceutical solid forms. The application presented in this paper is the investigation of counterfeit medicines. This increasingly serious issue involves networks that are an integral part of industrialized organized crime. Efficient analytical tools are consequently required to fight against it. Quick and reliable authentication means are needed to allow the deployment of measures from the company and the authorities. For this purpose a method in two steps has been implemented here. The first step enables the identification of pharmaceutical tablets and capsules and the detection of their counterfeits. A nonlinear classification method, the Support Vector Machines (SVM), is computed together with a correlation with the database and the detection of Active Pharmaceutical Ingredient (API) peaks in the suspect product. If a counterfeit is detected, the second step allows its chemical profiling among former counterfeits in a forensic intelligence perspective. For this second step a classification based on Principal Component Analysis (PCA) and correlation distance measurements is applied to the Raman spectra of the counterfeits.

Superior flow for bridge to life with self-expanding venous cannulas.

BACKGROUND: Recently, a compact cardiopulmonary support (CPS) system designed for quick set-up for example, during emergency cannulation, has been introduced. Traditional rectilinear percutaneous cannulas are standard for remote vascular access with the original design. The present study was designed to assess the potential of performance increase by the introduction of next-generation, self-expanding venous cannulas, which can take advantage of the luminal width of the venous vasculature despite a relatively small access orifice. METHODS: Veno-arterial bypass was established in three bovine experiments (69+/-10 kg). The Lifebridge (Lifebridge GmbH, Munich, Germany) system was connected to the right atrium in a trans-jugular fashion with various venous cannulas; and the oxygenated blood was returned through the carotid artery with a 17 F percutaneous cannula. Two different venous cannulas were studied, and the correlation between the centrifugal pump speed (1500-3900 RPM), flow and the required negative pressure on the venous side was established: (A) Biomedicus 19 F (Medtronic, Tolochenaz, Switzerland); (B) Smart canula 18 F/36 F (Smartcanula LLC, Lausanne, Switzerland). RESULTS: At 1500 RPM, the blood flow was 0.44+/-0.26 l min(-1) for the 19 F rectilinear cannula versus 0.73+/-0.34 l min(-1) for the 18/36 F self-expanding cannula. At 2500 RPM the blood flow was 1.63+/-0.62 l min(-1) for the 19F rectilinear cannula versus 2.13+/-0.34 l min(-1) for the 18/36 F self-expanding cannula. At 3500 RPM, the blood flow was 2.78+/-0.47 l min(-1) for the 19 F rectilinear cannula versus 3.64+/-0.39 l min(-1) for the 18/36 F self-expanding cannula (p<0.01 for 18/36 F vs 19 F). At 1500 RPM, the venous line pressure was 18+/-8 mmHg for the 19F rectilinear cannula versus 19+/-5 mmHg for the 18/36 F self-expanding cannula. At 2500 RPM the venous line pressure accounted for -22+/-32 mmHg for the 19 F rectilinear cannula versus 2+/-5 mmHg for the 18/36 F self-expanding cannula. At 3500 RPM, the venous line pressure was -112+/-42 mmHg for the rectilinear cannula versus 28+/-7 mmHg for the 18/36 F self-expanding cannula (p<0.01 for 18 F/36 F vs 19 F). Conclusions: The negative pressure required to achieve adequate venous drainage with the self-expanding venous cannula accounts for approximately 31% of the pressure necessary with the 19 F rectilinear cannula. In addition, a pump flow of more than 4 l min(-1) can be achieved with the self-expanding design and a well-accepted negative inlet pressure for minimal blood trauma of less than 50 mmHg.

A Secure and Anonymous Cooperative Sensing Protocol for Cognitive Radio Networks

Spectrum is an essential resource for the provision of mobile services. In order to control and delimit its use, governmental agencies set up regulatory policies. Unfortunately, such policies have led to a deficiency of spectrum as only few frequency bands are left unlicensed, and these are used for the majority of new emerging wireless applications. One promising way to alleviate the spectrum shortage problem is adopting a spectrum sharing paradigm in which frequency bands are used opportunistically. Cognitive radio is the key technology to enable this shift of paradigm.Cognitive radio networks are self-organized systems in which devices cooperate to use those spectrum ranges that are not occupied by licensed users. They carry out spectrum sensing in order to detect vacant channels that can be used for communication. Even though spectrum sensing is an active area of research, an important issue remains unsolved: the secure authentication of sensing reports. Not providing security enables the input of false data in the system thus empowering false results. This paper presents a distributed protocol based on wireless physical layer security, symmetric cryptography and one-way functions that allows determining a final sensing decision from multiple sources in a quick and secure way, as well as it preserves users¿ privacy.

A Secure Cooperative Sensing Protocol for Cognitive Radio Networks

Cognitive radio networks sense spectrum occupancyand manage themselves to operate in unused bands without disturbing licensed users. Spectrum sensing is more accurate if jointly performed by several reliable nodes. Even though cooperative sensing is an active area of research, the secureauthentication of local sensing reports remains unsolved, thus empowering false results. This paper presents a distributed protocol based on digital signatures and hash functions, and ananalysis of its security features. The system allows determining a final sensing decision from multiple sources in a quick and secure way.

Flotaatio jätevedenpuhdistamon tertiäärivaiheena eräässä paperitehtaassa

Työn tavoitteena oli selvittää, kuinka tehokkaasti pystytään aktiivilieteprosessin läpikäynyttä, jälkiselkeytettyä vettä edelleen puhdistamaan flotaatiolla ennen sen johtamista vesistöön. Tarkoituksena oli löytää sellaiset kemikaalit ja näiden annokset, joilla tehtaalle asetetut jätevesien lupa-arvot voitaisiin huonossa tilanteessa, jätevesikuormitushuippujen aikana alittamaan. Työn kirjallisessaosassa tarkasteltiin lyhyesti, minkälaista jätevesikuormaa mekaanista massaa valmistavalta tehtaalta yleensä syntyy ja millaiset ovat tavanomaiset puhdistusmenetelmät. Myös flotaation teoriaa esiteltiin. Kokeellinen osa koostui kolmesta päävaiheesta: esi- eli niin sanotuista kuppikokeista, pilot-flotaatiokoeajoista jalaitosmittakaavan flotaatiokoeajoista. Esikokeet tehtiin niin kutsutulla Jar Test -laitteistolla ja pilot-flotaatiolaitteistona työssä käytettiin YIT:n valmistamaa pilot-flotaattoria. Laitosmittakaavan flotaatioaltaat olivat aikaisemmin biolietteen tiivistykseen käytettyjä, myöhemmin tertiääripuhdistukseen modifioituja flotaatioaltaita. Laitosmittakaavan flotaatiokoeajoissa testattiin neljän eri saostuskemikaalin ¿ polyalumiinikloridin (KEMPAC 18), rautapitoisen alumiinisulfaatin (AVR), ferrisulfaatin ja alumiinisulfaatin ¿ tehokkuutta tertiäärivaiheessa käsiteltävän veden puhdistajana. Esi- ja pilot-kokeiden perusteella laitosmittakaavan kokeisiin valittiin saostuskemikaalien rinnalle polymeeriksi Superfloc C 491. AVR- ja alumiinisulfaattiannokset laitosmittakaavan kokeissa olivat 200 ppm ja 400 ppm. KEMPAC 18- ja ferrisulfaattiannokset olivat 200ppm, 400 ppm ja 600 ppm. Polymeeriannos kokeissa oli pääasiassa 1,2 ppm. Tertiäärivaiheeseen tulevasta vedestä ja poistuvasta kirkasteesta määritettiin kiintoaine, pH, liukoinen ja kokonais-COD, liukoinen ja kokonaisfosfori sekä liukoinen ja kokonaistyppi. Laitosmittakaavan koeajojen tulosten mukaan eniten tertiäärivaiheessa saatiin käsiteltävästä vedestä erotettua fosforia ja toiseksi eniten COD:ta. Typpireduktiot olivat verrattain alhaiset ja myös kiintoainereduktiot jäivät usein pieniksi tai olivat jopa negatiiviset. Kaikki saostuskemikaalit saostivat COD- ja ravinnekuormaa. Eniten kuormaa saostuskemikaaleista saatiin erotettua AVR:llä ja toiseksi eniten KEMPAC 18:lla. Laitteistojen käyttökustannuksia huomioimatta AVR olisi edullisin vaihtoehto saostuskemikaaaliksietenkin pidempiaikaisessa käytössä. Lisäksi työssä tutkittiin polymeeriannoksen kasvattamisen 1,2 ppm:stä 2,5 ppm:ään vaikutusta puhdistustulokseen, kun saostuskemikaaliannos pidettiin vakiona. Tulosten mukaan polymeeriannoksen kasvattaminen kasvatti kokonais-COD- ja kokonaisfosforireduktiota. Myöslaitosmittakaavan flotaatioaltaiden pohjaputkistoja vertailtiin kiintoainereduktioiden perusteella. Kokeissa saatujen tulosten mukaan ei voitu sanoa, oliko toisen altaan pitkä kirkasteenpoistoputki vai toisen altaan lyhyt kirkasteenpoistoputki parempi vaihtoehto.

Integrating testcase generator into Eclipse environment

Tämädiplomityö tutkii kuinka Eclipse -ympäristöä voidaan käyttää testitapausten generoinnissa. Eräs diplomityön pääaiheista on tutkia voidaanko olemassa olevilla Eclipsen komponenteilla parantaa symboolitietoutta, jotta testitapausten generointiin saataisiin lisää tietoa. Aluksi diplomityö antaa lyhyen katsauksen ohjelmistojentestaukseen, jotta lukija ymmärtää mitä ohjelmistotekniikan osa-aluetta diplomityö käsittelee. Tämän jälkeen kerrotaan lisää tietoa itse testitapausten generointiprosessista. Kun perusteet on käsitelty, tutustetaan lukija Eclipse -ympäristöön, mikä se on, mistä se koostuu ja mitä sillä voidaan tehdä. Tarkempaa tietoa kerrotaan Eclipsen komponenteista joita voidaan käyttää apuna testitapausten generoinnissa. Integrointi esimerkkinä diplomityössä esitellään valmiin testitapausgeneraattorin integrointi Eclipse -ympäristöön. Lopuksi Eclipse -pohjaista ratkaisua verrataan symboolitietouden sekä ajoajan kannalta aikaisempaan ratkaisuun. Diplomityön tuloksena syntyi prototyyppi jonka avulla todistettiin, että Eclipse - ympäristöön on mahdollista integroida testitapausgeneraattori ja että se voi lisätä symboolitietoutta. Tämätietouden lisäys kuitenkin lisäsi myös tarvittavaa ajoaikaa, joissakintapauksissa jopa merkittävästi. Samalla todettiin, että tällä hetkellä on menossa projekteja joiden tarkoituksena on parantaa käytettyjen Eclipse komponenttien suorituskykyä ja että tämä voi parantaa tuloksia tulevaisuudessa.

Muuttuvien ammattitaitovaatimusten mukaisen koulutuksen käyttöönotto toisen asteen koulutuksessa

Yritykset tarvitsevat nopealla toimitusajalla uudenlaista osaamista omaavia työntekijöitä. Tämän vuoksi kouluttajien täytyy pystyä reagoimaan nopeasti työelämän esittämiin haasteisiin Kehittämällä uusi toimintamalli muuttuvien ammattitaitovaatimusten mukaisen koulutuksen käynnistämiseksi voidaan saavuttaa mittavia taloudellisia ja ajallisia säästöjä uusien osaajien koulutuksessa. Mallin avulla tapauskohtaisesti oikeat henkilöt tekevät oikea aikaisesti juuri oikeita toimenpiteitä ja näin toimien päästään mahdollisimman lyhyeen koulutusaikaan koulutustarvesignaalien vastaanottamisesta hetkeen, jolloin opiskelijat ovat valmiita siirtymään työelämään. Mikäli koulutuksen käynnistämiseen liittyvien tehtävien kanssa työskentelevät henkilöt, joilla ei ole kokonaisnäkemystä tai heiltä puuttuu päätösvalta päätösten tekemiseksi, niin tärkeää aikaa ja energiaa kuluu hukkaan. Samoin jos signaalien oikeita kulkuväyliä työelämästä oppilaitokselle ei tunnisteta tai ei osata hyödyntää, koulutusten aloittaminen viivästyy tai koulutusjää kokonaan toteutumatta.Tiiviissä yhteistyössä metallialan yritystoiminnan jakoulutuksen järjestäjän kanssa kehitetty robotisoitu laserhitsauskoulutus mahdollistaa juuri oikeanlaista osaamista omaavien työtekijöiden tuottamisen mahdollisimman tehokkaasti. Tehokkuus on todettavissa koulutuksen käynnistämiseen ja kouluttamiseen tarvittavan ajan lyhenemisenä sekä koulutuksesta syntyvien kustannusten vähenemisenä.