993 resultados para successful cases
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WCDMA tukiasema (Node B) on osa UMTS-järjestelmän radioverkkoa. Node B on tärkeä verkkoelementti, jonka tarkoituksena on yhdistää mobiilikäyttäjät verkkoon. Telecom –ohjelmisto (TCOM SW) on vastuussa suuresta osasta Node B:n toiminnallisuutta. TCOM SW:n testaukseen käytetään paljon resursseja, jotta ohjelmiston oikeasta toiminnasta ja laadusta voidaan varmistua. System component testing on testausvaihe, jossa järjestelmän (Node B) osa (system component, tässä diplomityössä TCOM SW) testataan ennen sen integroimista muuhun järjestelmään. Tähän tarvitaan testityökalu ja testitapausten toteutus. Node B TTCN Tester (testeri) on työkalu, jota käytetään Node B:n ohjelmiston testauksessa. Testitapaukset toteutetaan TTCN-testinotaatiota käyttäen ja testataan testerin avulla. TCOM SW:n system component –testausvaihetta varten testeriin lisättiin uudet rajapinnat, joiden avulla voidaan simuloita Node B:n ATM-ohjelmistoa sekä WPA- ja WTR-yksiköitä. Tässä diplomityössä toteuttiin TTCN testitapaukset uusille rajapinnoille. Testitapaukset tekivät TCOM SW system component –testausvaiheen riippumattomaksi Node B:n ATM-ohjelmistosta sekä WPA- ja WTR-yksiköistä. Lisäksi TCOM SW:n toiminnan testaus näissä rajapinnoissa voidaan tästä lähtien tehdä automaattisesti. Testitapauksien toiminta varmistettiin testeriä käyttäen. Tulokset olivat hyviä, uudet testitapaukset ja TTCN rajapinnat toimivat oikein lisäten testauksen tehokkuutta.
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Työn tarkoituksena on tarkastella ERP-järjestelmän käyttöönottoa ja tarjota ohjekartta kuinka tehdä se menestyksekkäästi. Lisäksi työ kartoittaa Konecranesin saamia etuja ja hyötyjä yrityksen ottaessa ERP-järjestelmä käyttöön. Käyttöönottoprojekti, sen vaiheet ja muut merkittävät ERP-projekteihin liittyvät vaiheet on kuvattu työssä yksityiskohtaisesti. Ensiksi ERP-järjestelmän käyttöönottoa tarkastellaan kirjallisuuteen perustuen. Myöhemmin sitä tarkastellaan perustuen kirjoittajan kokemuksiin ja havaintoihin ERP-järjestelmän käyttöönotosta, ja vertaillaan käytännön suhdetta teoriaan.ERP-järjestemät ovat kalliita ja niiden käyttöön ottaminen on aikaa vievää. Viimeisen vuosikymmenen aikana yritykset ovat enenevissä määrin alkaneet ottamaan ERP-järjestelmiä käyttöön. ERP-järjestelmät ovat saavuttaneet kasvavaa suosiota mm. niiden operaatioita integroivan ja tehostavan luonteesta ansiosta sekä niiden kyvystä tarjota päivitettyä tietoa reaaliajassa.Myös menestyksekkäissä ERP-projekteissa on parantamisen varaa. Mitattaessa ERP- projektin menestyksellisyyttä pitäisi käyttää sekä määrällisiä että laadullisia mittareita. On helppoa käyttää ainoastaan määrällisiä mittareita. Usein kuitenkin laadulliset asiat ovat tärkeämpiä. Ihmiset on saatava sitoutumaan yhteiseen tavoitteeseen kommunikaation avulla. Huonoja ensivaikutelmia on vaikea muuttaa. Vaikka vaikuttaisikin siltä, että ERP-projekti on onnistunut, kun kaikki näyttää hyvältä ”paperilla”, loppujen lopuksi systeemiä käyttävät ihmiset päättävät projektin menestyksellisyydestä. Järjestelmän käyttöönottohetkeä on pidettävä ERP-projektin ensimmäisenä vaiheena.
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It is not known whether rainfall increases the risk of sporadic cases of Legionella pneumonia. We sought to test this hypothesis in a prospective observational cohort study of non-immunosuppressed adults hospitalized for community-acquired pneumonia (1995-2011). Cases with Legionella pneumonia were compared with those with non-Legionella pneumonia. Using daily rainfall data obtained from the regional meteorological service we examined patterns of rainfall over the days prior to admission in each study group. Of 4168 patients, 231 (5.5%) had Legionella pneumonia. The diagnosis was based on one or more of the following: sputum (41 cases), antigenuria (206) and serology (98). Daily rainfall average was 0.556 liters/m2 in the Legionella pneumonia group vs. 0.328 liters/m2 for non-Legionella pneumonia cases (p = 0.04). A ROC curve was plotted to compare the incidence of Legionella pneumonia and the weighted median rainfall. The cut-off point was 0.42 (AUC 0.54). Patients who were admitted to hospital with a prior weighted median rainfall higher than 0.42 were more likely to have Legionella pneumonia (OR 1.35; 95% CI 1.02-1.78; p = .03). Spearman Rho correlations revealed a relationship between Legionella pneumonia and rainfall average during each two-week reporting period (0.14; p = 0.003). No relationship was found between rainfall average and non-Legionella pneumonia cases (−0.06; p = 0.24). As a conclusion, rainfall is a significant risk factor for sporadic Legionella pneumonia. Physicians should carefully consider Legionella pneumonia when selecting diagnostic tests and antimicrobial therapy for patients presenting with CAP after periods of rainfall.
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In order to better understand the fate and activity of bacteria introduced into contaminated material for the purpose of enhancing biodegradation rates, we constructed Sphingomonas wittichii RW1 variants with gene reporters interrogating dibenzofuran metabolic activity. Three potential promoters from the dibenzofuran metabolic network were selected and fused to the gene for enhanced green fluorescent protein (EGFP). The stability of the resulting genetic constructions in RW1 was examined, with plasmids based on the broad-host range vector pME6012 being the most reliable. One of the selected promoters, upstream of the gene Swit_4925 for a putative 2-hydroxy-2,4-pentadienoate hydratase, was inducible by growth on dibenzofuran. Sphingomonas wittichii RW1 equipped with the Swit_4925 promoter egfp fusion grew in a variety of non-sterile sandy microcosms contaminated with dibenzofuran and material from a former gasification site. The strain also grew in microcosms without added dibenzofuran but to a very limited extent, and EGFP expression indicated the formation of consistent small subpopulations of cells with an active inferred dibenzofuran metabolic network. Evidence was obtained for competition for dibenzofuran metabolites scavenged by resident bacteria in the gasification site material, which resulted in a more rapid decline of the RW1 population. Our results show the importance of low inoculation densities in order to observe the population development of the introduced bacteria and further illustrate that the limited availability of unique carbon substrate may be the most important factor impinging growth.
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PURPOSE: The purpose of this study was to reach an international consensus to determine what key elements should be part of a transition program and what indicators could be used to assess its success. METHODS: For this purpose, a Delphi study including an international panel of 37 experts was carried out. The study consisted of three rounds, with response rates ranging from 86.5% to 95%. At each round, experts were asked to assess key elements (defined as the most important elements for the task) and indicators (defined as quantifiable characteristics). At each round, panelists were contacted via e-mail explaining them the tasks to be done and giving them the Web link where to complete the questionnaire. At Round 3, each key element and indicator was assessed as essential, very important, important, accessory, or unnecessary. A 70% agreement was used as cutoff. RESULTS: At Round 3, more than 70% of panelists agreed on six key elements being essential, with one of them (Assuring a good coordination between pediatric and adult professionals) reaching an almost complete consensus (97%). Additionally, 11 more obtained more than 70% agreement when combined with the Very important category. Among indicators, only one (Patient not lost to follow-up) was considered almost unanimously (91%) as essential by the panelists and seven others also reached consensus when the Very important category was included. CONCLUSIONS: Using these results as a framework to develop guidelines at local, national, and international levels would allow better assessing and comparing transition programs.
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OBJECTIVES: Partial cricotracheal resection (PCTR) is widely accepted for treating severe paediatric laryngotracheal stenosis (LTS). However, it remains limited to a few experienced centres. Here we report an update of the Lausanne experience in paediatric PCTR performed or supervised by a senior surgeon (Philippe Monnier). METHODS: An ongoing database of 129 paediatric patients who underwent PCTR for benign LTS between March 1978 and July 2012 at our hospital was retrospectively reviewed. Demographic characteristics and information on preoperative status, stenosis and surgery were collected. Primary outcomes were measured as overall and operation-specific decannulation rates (ODR and OSDR, respectively), and secondary outcomes as morbidity, mortality and postoperative functional results. RESULTS: A total of 129 paediatric patients [79 males and 50 females; mean age, 4.1 years (1 month-16 years, median age of 2 years old)] underwent PCTR during the study period. ODR and OSDR were 90 and 81%, respectively. The decannulation rates were significantly superior for single-stage PCTR compared with double-stage PCTR in both ODR and OSDR. Eight patients died postoperatively for reasons unrelated to surgery. Partial anastomotic dehiscence was seen in 13 patients, 9 of whom were successfully treated by revision surgery. Respiratory, voice and swallowing functions were near normal or only minimally impaired in 86, 65 and 81% of patients, respectively. CONCLUSIONS: PCTR is effective and feasible with good ODR and OSDR for highgrade / severe LTS. Glottic involvement and the presence of comorbidities were negative predictive factors of decannulation. Early detection and reintervention of postoperative incipient dehiscence contribute to avoiding the progress to late restenosis; however, voice improvement remains a challenge.
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Background: Malignant hypertension is defined by marked systemic arterial hypertension with retinal haemorrhages, exudation or papilloedema. Due to the rarity of this disease and due to its non-specific symptoms and lesions, the diagnosis can be challenging. Patients and Methods We investigated the types of symptoms and ocular lesions observed with ocular fundus examination, ocular fundus photography, fluorescein angiography and optical coherence tomography in a small case series of 7 patients with malignant hypertension. Results: Median systolic blood pressure (BP) was 205 mmHg ± 21. Median diastolic BP was 150 mmHg ± 16. Decrease in visual acuity (6/7 patients) and scotoma (5/7) were the main symptoms and Elschnig spot, flamed shaped haemorrhage, serous retinal detachment, cotton wool spots and optic nerve oedema were the five most frequently observed lesions. A regression of lesions was observed after therapy of systemic hypertension. Conclusion: The association of multiple lesions strongly suggests malignant hypertension. However even in cases with only one lesion malignant hypertension should be kept in mind.
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Aims: To determine the incidence and clinical features of patients diagnosed with pilomatrixoma. Patients and Method: A retrospective analysis was made of 205 cases of pilomatrixoma diagnosed according to clinical and histological criteria, with an evaluation of the incidence, patient age at presentation, gender, lesion location and size, single or multiple presentation, differential diagnosis, histopathological and clinical findings and relapses. Results: Pilomatrixoma was seen to account for 1.04% of all benign skin lesions. It tended to present in pediatric patients- almost 50% corresponding to individuals under 20 years of age- with a slight male predilection (107/98). Approximately 75% of all cases presented as single lesions measuring less than 15 mm in diameter. Multiple presentations were seen in 2.43% of cases. The most frequent locations were the head and orofacial zones (particularly the parotid region), with over 50% of all cases, followed by the upper (23.9%) and lower limbs (12.7%). Only one relapse was documented following simple lesion excision. Conclusions: The frequency of pilomatrixomas was 1.04% of all benign skin lesions- the lesions being predominantly located in the maxillofacial area. Due to the benign features of this disorder, simple removal of the lesion is considered to be the treatment of choice, and is associated with a very low relapse rate.
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Introduction: A study is made of the principal characteristics of the oral lesions biopsied in our Service of Oral Surgery and histologically diagnosed as corresponding to fibro-osseous lesions of the maxillas. Patients and methods: A retrospective review was made of all the biopsies made in a Service of Oral Surgery between 1996 and 2003. The reason for consultation was analyzed, along with patient age, sex, clinical and radiological characteristics, tentative diagnosis, histological diagnosis and treatment provided. Results: A total of 1238 biopsies were performed during the study period. Of these, only 11 corresponded to benign fibro-osseous lesions (7 women and 4 men). The mean patient age was 44 years (range 19-72 years). The most frequent location was the mandible (8 of the cases). In 7 patients the lesions constituted casual radiological findings; 4 presented bulging of the vestibular cortical bone, though only one of them reported pain. The histological diagnoses comprised 7 cemento-ossifying fibromas and 4 fibrous dysplasias. In 9 cases surgical resection was carried out, while in one case an incisional biopsy was performed, and in the remaining case curettage was decided. Discussion: These lesions are more frequent in women than in men, and the age at presentation is variable. In terms of lesion location, fibrous dysplasia is more common in the upper maxilla, while cemento-ossifying fibroma is more frequently found in the mandible. The diagnosis of such lesions is established upon contrasting the data obtained from the anamnesis, physical examination, the radiological characteristics, the intraoperative findings and the histological study, since both disorders have similar clinical and histological features- despite the fact that they constitute distinct disease conditions.