Spontaneous combined rupture of a pelvicalyceal cyst into the collector system and retroperitoneal space during the acquisition of computed tomography scan images: a case report

Abstract Introduction Pelvicalyceal cysts are common findings in autopsies and can manifest with a variety of patterns. These cystic lesions are usually a benign entity with no clinical significance unless they enlarge enough to cause compression of the adjacent collecting system and consequently obstructive uropathy. Few cases of the spontaneous rupture of pelvicalyceal renal cysts have been published and to the best of our knowledge there is no report of a combined rupture to collector system and retroperitoneal space documented during a multiphase computed tomography. Case presentation We report a case of a ‘real-time’ spontaneous rupture of a pelvicalyceal cyst into the collecting system with fistulization into the retroperitoneum. The patient was a 78-year-old Caucasian man with a previous history of renal stones and a large pelvicalyceal renal cyst who was admitted to our Emergency department with acute right flank pain. A multiphase computed tomography was performed and the pre-contrast images demonstrated a right pelvicalyceal renal cyst measuring 12.0 × 6.1cm in the lower pole causing moderate dilation of the upper right renal collection system. In addition, a partially obstructive stone on the left distal ureter with mild left hydronephrosis was noted. The nephrographic phase did not add any new information. The excretory phase (10-minute delay) demonstrated a spontaneous rupture of the cyst into the pelvicalyceal system with posterior fistulization into the retroperitoneal space. Conclusion In this case study we present time-related changes of a rare pelvicalyceal cyst complication, which to the best of our knowledge has fortunately not been previously documented. Analysis of the sequential images and comparison with an earlier scan allowed us to better understand the physiopathological process of the rupture, the clinical presentation and to elaborate hypotheses for its etiopathogenesis.

Non-neoplastic bulky mediastinal mass presentation in an adolescent patient: a case report

Abstract : Introduction Mediastinal masses in pediatric patients are very heterogeneous in origin and etiology. In the first decade of life, 70% of the mediastinal masses are benign whereas malignant tumors are more frequent in the second decade of life. Among the mediastinal masses, lymph nodes are the most common involved structures and could be enlarged due to a lymphoma, leukemia, metastatic disease, or due to infectious diseases as sarcoidosis, tuberculosis and others. Case presentation. We report a case of a 13-year-old Caucasian girl who came to the emergency room with a history of intermittent fever, weight loss and night sweating for at least 1 month. A radiologic image work-up presented an anterior and posterior mediastinal mass. The 18F-fluorodeoxyglucose positron emission tomography presented a high maximum standard uptake value, which directed our decision for mediastinal biopsy for diagnostic elucidation. Histologic examination described the mass as granulomatous tuberculosis. The patient was treated with anti-tuberculosis therapy and developed a full clinical recovery. Conclusions . The present case report demonstrates that a bulky mediastinal lymphadenopathy detected on 18F-fluorodeoxyglucose positron emission tomography is not always a malignant lesion, and in countries where tuberculosis is endemic, this etiology should not be forgotten during clinical investigations. There is a need for more accurate cut-off values for this technology; meanwhile, the further investigation of patients with bulky mediastinal masses with procedures such as the open biopsy is indispensable.

Postpartal recurrent non-ST elevation myocardial infarction in essential thrombocythaemia: case report and review of the literature

ABSTRACT: Normal pregnancy corresponds to a procoagulant state. Acute myocardial infarction during pregnancy is rare, yet considering the low non-pregnant risk score of childbearing women it is still surprisingly frequent. We report a case of postpartum recurrent non-ST elevation myocardial infarction in a 40-year-old caucasian woman with essential thrombocythaemia in the presence of a positive JAK-2 mutation and an elevated anti-cardiolipin IgM antibody titer. In the majority of cases of myocardial infarction in pregnancy or in the peripartal period, atherosclerosis, a thrombus or coronary artery dissection is observed. The combination of essential thrombocythaemia and elevated anti-cardiolipin IgM antibody titer in the presence of several cardiovascular risk factors seems to be causative in our case. In conclusion, with the continuing trend of childbearing at older ages, rare or unlikely conditions leading to severe events such as myocardial infarction must be considered in pregnant women.

Clinical presentation of a traumatic cervical spine disc rupture in alpine sports: a case report

ABSTRACT: Isolated non-skeletal injuries of the cervical spine are rare and frequently missed. Different evaluation algorithms for C-spine injuries, such as the Canadian C-spine Rule have been proposed, however with strong emphasis on excluding osseous lesions. Discoligamentary injuries may be masked by unique clinical situations presenting to the emergency physician. We report on the case of a 28-year-old patient being admitted to our emergency department after a snowboarding accident, with an assumed hyperflexion injury of the cervical spine. During the initial clinical encounter the only clinical finding the patient demonstrated, was a burning sensation in the palms bilaterally. No neck pain could be elicited and the patient was not intoxicated and did not have distracting injuries. Since the patient described a fall prevention attempt with both arms, a peripheral nerve contusion was considered as a differential diagnosis. However, a high level of suspicion and the use of sophisticated imaging (MRI and CT) of the cervical spine, ultimately led to the diagnosis of a traumatic disc rupture at the C5/6 level. The patient was subsequently treated with a ventral microdiscectomy with cage interposition and ventral plate stabilization at the C5/C6 level and could be discharged home with clearly improving symptoms and without further complications.This case underlines how clinical presentation and extent of injury can differ and it furthermore points out, that injuries contracted during alpine snow sports need to be considered high velocity injuries, thus putting the patient at risk for cervical spine trauma. In these patients, especially when presenting with an unclear neurologic pattern, the emergency doctor needs to be alert and may have to interpret rigid guidelines according to the situation. The importance of correctly using CT and MRI according to both - standardized protocols and the patient's clinical presentation - is crucial for exclusion of C-spine trauma.

Pica and refractory iron deficiency anaemia: a case report

ABSTRACT: INTRODUCTION: Iron deficiency is the most common cause of anaemia worldwide. Pica, the ingestion of substances that are inappropriate for consumption, is associated with iron deficiency and may be under-diagnosed. CASE PRESENTATION: A 34-year-old woman presented with iron deficiency anaemia refractory to treatment for more than a decade. The clinical presentation, endoscopic findings and laboratory investigations were consistent with pica. Subsequent geophysical analysis confirmed that the ingested material was kaolin, a negatively charged silicate. CONCLUSION: Prolonged unexplained iron deficiency anaemia should prompt clinicians to remember and inquire about pica. In our patient, this would have averted numerous unnecessary investigations and prevented a decade-long suffering.

Effectiveness of abstract interpretation in automatic parallelization: a case study in logic programming

We report on a detailed study of the application and effectiveness of program analysis based on abstract interpretation to automatic program parallelization. We study the case of parallelizing logic programs using the notion of strict independence. We first propose and prove correct a methodology for the application in the parallelization task of the information inferred by abstract interpretation, using a parametric domain. The methodology is generic in the sense of allowing the use of different analysis domains. A number of well-known approximation domains are then studied and the transformation into the parametric domain defined. The transformation directly illustrates the relevance and applicability of each abstract domain for the application. Both local and global analyzers are then built using these domains and embedded in a complete parallelizing compiler. Then, the performance of the domains in this context is assessed through a number of experiments. A comparatively wide range of aspects is studied, from the resources needed by the analyzers in terms of time and memory to the actual benefits obtained from the information inferred. Such benefits are evaluated both in terms of the characteristics of the parallelized code and of the actual speedups obtained from it. The results show that data flow analysis plays an important role in achieving efficient parallelizations, and that the cost of such analysis can be reasonable even for quite sophisticated abstract domains. Furthermore, the results also offer significant insight into the characteristics of the domains, the demands of the application, and the trade-offs involved.

Abstract multiple specialization and its application to program parallelization.

Program specialization optimizes programs for known valúes of the input. It is often the case that the set of possible input valúes is unknown, or this set is infinite. However, a form of specialization can still be performed in such cases by means of abstract interpretation, specialization then being with respect to abstract valúes (substitutions), rather than concrete ones. We study the múltiple specialization of logic programs based on abstract interpretation. This involves in principie, and based on information from global analysis, generating several versions of a program predicate for different uses of such predicate, optimizing these versions, and, finally, producing a new, "multiply specialized" program. While múltiple specialization has received theoretical attention, little previous evidence exists on its practicality. In this paper we report on the incorporation of múltiple specialization in a parallelizing compiler and quantify its effects. A novel approach to the design and implementation of the specialization system is proposed. The resulting implementation techniques result in identical specializations to those of the best previously proposed techniques but require little or no modification of some existing abstract interpreters. Our results show that, using the proposed techniques, the resulting "abstract múltiple specialization" is indeed a relevant technique in practice. In particular, in the parallelizing compiler application, a good number of run-time tests are eliminated and invariants extracted automatically from loops, resulting generally in lower overheads and in several cases in increased speedups.

Efficient negation using abstract interpretation

While negation has been a very active área of research in logic programming, comparatively few papers have been devoted to implementation issues. Furthermore, the negation-related capabilities of current Prolog systems are limited. We recently presented a novel method for incorporating negation in a Prolog compiler which takes a number of existing methods (some modified and improved by us) and uses them in a combined fashion. The method makes use of information provided by a global analysis of the source code. Our previous work focused on the systematic description of the techniques and the reasoning about correctness and completeness of the method, but provided no experimental evidence to evalúate the proposal. In this paper, we report on an implementation, using the Ciao Prolog system preprocessor, and provide experimental data which indicates that the method is not only feasible but also quite promising from the efficiency point of view. In addition, the tests have provided new insight as to how to improve the proposal further. Abstract interpretation techniques are shown to offer important improvements in this application.

The CIAO multiparadigm compiler and system: A progress report

Abstract is not available.

A proposal for an interchange abstract syntax for (parallel) Prolog

We propose an abstract syntax for Prolog that will help the manipulation of programs at compile-time, as well as the exchange of sources and information among the tools designed for this manipulation. This includes analysers, partial evaluators, and program transformation tools. We have chosen to concentrate on the information exchange format, rather than on the syntax of programs, for which we assume a simplified format. Our purpose is to provide a low-level meeting point for the tools which will allow them to read the same programs and understand the information about them. This report describes our first design in an informal way. We expect this design to evolve and concretize, along with the future development of the tools, during the project.

The CIAO multi-dialect compiler and system: A demo and status report

Abstract is not available

Freeform Optical Surfaces: Report from OSA's First Incubator Meeting

Just as business incubator programs are designed to support the development of fledgling companies, OSA?s new incubator meeting series is structured to encourage the growth of exciting new areas within optics. The first one was devoted to the topic of freeform optics-a field that is actively evolving due to recent technological advances.

Niemcy wobec wieloletnich ram finansowych unii Europejskiej na lata 2014-2020. Uwarunkowania i interesy. Raport OSW, pazdziernik 2011. = Germany and the multiannual financial framework of the European Union for the period 2014-2020. Considerations and interests. OSW Report, October 2011

No abstract.

Abstract of statements of insurance companies in Canada.

Some years issued in the series of Sessional papers of the Parliament of Canada.

Technical abstract bulletin.

Published with a companion volume, the Technical abstract bulletin index which includes seven indexes: 1.-Corporate author-Monitoring agency. 2.-Subject. 3.-Title. 4.-Personal author. 5.-Contract number. 6.-Report number. 7.-Release authority.