Giant cell arteritis: A rare cause of posterior vasculitis.

PURPOSE: To report three cases of posterior vasculitis associated with subacute giant cell arteritis (GCA). METHODS: Three patients with decreased vision underwent complete ophthalmologic examination and fluorescein angiography. RESULTS: All patients presented posterior vasculitis. Patient 1 had an erythrocyte sedimentation rate (ESR) of 38 mm/hr and a C-reactive protein (CRP) of 28mg/L. Patient 2 and 3 had an ESR of 104 and 95 mm/hr and a CRP of 42 and 195 mg/L accordingly. Diagnosis was established by temporal artery biopsy. Resolution was observed after systemic prednisolone therapy. CONCLUSION: GCA should be suspected when posterior vasculitis and relatively high ESR and CRP are present.

Wishes or Constraints? Mothers' Labour Force Participation and its Motivation in Switzerland

The aim of this article is to estimate the impact of various factors related to role conflict theory and preference theory on the reduction of women's labour force participation after their transition to parenthood. Objective and subjective dimensions of women's labour force participation are assessed. The empirical test is based on a survey of couples with children in Switzerland. Results show that compared to structural factors associated with role conflict reduction, preferences have little impact on mothers' labour force participation, but explain a good deal of their frustration if the factual situation does not correspond to their wishes. Structural factors, such as occupation, economic resources, childcare, and an urban environment, support mothers' labour force participation, whereas active networks and a home centred lifestyle preference help them to cope with frustrations.

EURECCA colorectal: multidisciplinary mission statement on better care for patients with colon and rectal cancer in Europe

Background: Care for patients with colon and rectal cancer has improved in the last twenty years however still considerable variation exists in cancer management and outcome between European countries. Therefore, EURECCA, which is the acronym of European Registration of cancer care, is aiming at defining core treatment strategies and developing a European audit structure in order to improve the quality of care for all patients with colon and rectal cancer. In December 2012 the first multidisciplinary consensus conference about colon and rectum was held looking for multidisciplinary consensus. The expert panel consisted of representatives of European scientific organisations involved in cancer care of patients with colon and rectal cancer and representatives of national colorectal registries. Methods: The expert panel had delegates of the European Society of Surgical Oncology (ESSO), European Society for Radiotherapy & Oncology (ESTRO), European Society of Pathology (ESP), European Society for Medical Oncology (ESMO), European Society of Radiology (ESR), European Society of Coloproctology (ESCP), European CanCer Organisation (ECCO), European Oncology Nursing Society (EONS) and the European Colorectal Cancer Patient Organisation (EuropaColon), as well as delegates from national registries or audits. Experts commented and voted on the two web-based online voting rounds before the meeting (between 4th and 25th October and between the 20th November and 3rd December 2012) as well as one online round after the meeting (4th20th March 2013) and were invited to lecture on the subjects during the meeting (13th15th December 2012). The sentences in the consensus document were available during the meeting and a televoting round during the conference by all participants was performed. All sentences that were voted on are available on the EURECCA website www.canceraudit.eu. The consensus document was divided in sections describing evidence based algorithms of diagnostics, pathology, surgery, medical oncology, radiotherapy, and follow-up where applicable for treatment of colon cancer, rectal cancer and stage IV separately. Consensus was achieved using the Delphi method. Results: The total number of the voted sentences was 465. All chapters were voted on by at least 75% of the experts. Of the 465 sentences, 84% achieved large consensus, 6% achieved moderate consensus, and 7% resulted in minimum consensus. Only 3% was disagreed by more than 50% of the members. Conclusions: It is feasible to achieve European Consensus on key diagnostic and treatment issues using the Delphi method. This consensus embodies the expertise of professionals from all disciplines involved in the care for patients with colon and rectal cancer. Diagnostic and treatment algorithms were developed to implement the current evidence and to define core treatment guidance for multidisciplinary team management of colon and rectal cancer throughout Europe.

Methylation signature of lymph node metastases in breast cancer patients.

BACKGROUND: Invasion and metastasis are two important hallmarks of malignant tumors caused by complex genetic and epigenetic alterations. The present study investigated the contribution of aberrant methylation profiles of cancer related genes, APC, BIN1, BMP6, BRCA1, CST6, ESR-b, GSTP1, P14 (ARF), P16 (CDKN2A), P21 (CDKN1A), PTEN, and TIMP3, in the matched axillary lymph node metastasis in comparison to the primary tumor tissue and the adjacent normal tissue from the same breast cancer patients to identify the potential of candidate genes methylation as metastatic markers. METHODS: The quantitative methylation analysis was performed using the SEQUENOM's EpiTYPER? assay which relies on matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS). RESULTS: The quantitative DNA methylation analysis of the candidate genes showed higher methylation proportion in the primary tumor tissue than that of the matched normal tissue and the differences were significant for the APC, BIN1, BMP6, BRCA1, CST6, ESR-b, P16, PTEN and TIMP3 promoter regions (P<0.05). Among those candidate methylated genes, APC, BMP6, BRCA1 and P16 displayed higher methylation proportion in the matched lymph node metastasis than that found in the normal tissue (P<0.05). The pathway analysis revealed that BMP6, BRCA1 and P16 have a role in prevention of neoplasm metastasis. CONCLUSIONS: The results of the present study showed methylation heterogeneity between primary tumors and metastatic lesion. The contribution of aberrant methylation alterations of BMP6, BRCA1 and P16 genes in lymph node metastasis might provide a further clue to establish useful biomarkers for screening metastasis.

Searching for sex-reversals to explain population demography and the evolution of sex chromosomes.

Sex determination can be purely genetic (as in mammals and birds), purely environmental (as in many reptiles), or genetic but reversible by environmental factors during a sensitive period in life, as in many fish and amphibians (Wallace et al. 1999; Baroiller et al. 2009a; Stelkens & Wedekind 2010). Such environmental sex reversal (ESR) can be induced, for example, by temperature changes or by exposure to hormone-active substances. ESR has long been recognized as a means to produce more profitable single-sex cultures in fish farms (Cnaani & Levavi-Sivan 2009), but we know very little about its prevalence in the wild. Obviously, induced feminization or masculinization may immediately distort population sex ratios, and distorted sex ratios are indeed reported from some amphibian and fish populations (Olsen et al. 2006; Alho et al. 2008; Brykov et al. 2008). However, sex ratios can also be skewed by, for example, segregation distorters or sex-specific mortality. Demonstrating ESR in the wild therefore requires the identification of sex-linked genetic markers (in the absence of heteromorphic sex chromosomes) followed by comparison of genotypes and phenotypes, or experimental crosses with individuals who seem sex reversed, followed by sexing of offspring after rearing under non-ESR conditions and at low mortality. In this issue, Alho et al. (2010) investigate the role of ESR in the common frog (Rana temporaria) and a population that has a distorted adult sex ratio. They developed new sex-linked microsatellite markers and tested wild-caught male and female adults for potential mismatches between phenotype and genotype. They found a significant proportion of phenotypic males with a female genotype. This suggests environmental masculinization, here with a prevalence of 9%. The authors then tested whether XX males naturally reproduce with XX females. They collected egg clutches and found that some had indeed a primary sex ratio of 100% daughters. Other clutches seemed to result from multi-male fertilizations of which at least one male had the female genotype. These results suggest that sex-reversed individuals affect the sex ratio in the following generation. But how relevant is ESR if its prevalence is rather low, and what are the implications of successful reproduction of sex-reversed individuals in the wild?

A pilot study of the efficacy of IL1 blockade by anakinra in acute calcific periarthritis of the rotator cuff

Background/Purpose: Calcific periarthritis of rotator cuff can induce acute and severe shoulder pain and is accompnied by signs of acute inflammation. The calcific deposits are composed of calcium phosphate crystals such as hydroxyapatite or basic calcium phosphate. These crystals stimulate the production and release of IL1b from macrophages, in an analogous manner to MSU and CPPD crystals. As IL1 blockade is effective in reducing signs and symptoms of inflammation in acute gout, we performed a pilot study to study if it is also effective in calcific periarthritis Methods: 5 consecutive patients were included (mean age: 62, 3 females, 2 males) between March 2011 and March 2012. Symptoms of acute shoulder pain at rest had to be present for _7 days before inclusion, associated with limitation of shoulder mobility and the presence on calcification in the rotator cuff by conventional radiography. None of the patients had responded to at least 48 hours of high doses of NSAIDs. Exclusion criteria included no corticosteroid therapy in the last 2 weeks and the exclusion of other rheumatologic or infectious diseases- .Clinical evaluation consisted of patient assessment of pain (total, rest and activity) by VAS (100mm scale) at days 0, 1, 3, 15, 42 and clinical examination of shoulder mobility at days 0, 3, 15. ESR and CRP were measured at days 0, 3. Plain radiographs were performed at days 0 and 15 and an ultrasound examination (including Doppler) was performed at days 0, 3, 15. Anakinra 100mg daily was administered for 3 consecutive days after the first evaluation (day 0). Rescue analgesics were allowed and recorded. Results: At inclusion, all patients had severe shoulder pain: mean (SD) VAS day pain of 72mm (_25mm), mean VAS night pain of 96 (_ 5) and impaired shoulder mobility. CRP was elevated in all of them (mean of 3X). Treatment with anakinra lead to rapid relief of pain in all patients, starting already on the first night following the first injection. The reduction of VAS pain was particularly striking for rest pain: mean (SD) VAS of 4mm (_ 5) at day 1 and this response was maintained for the 5 patients at the end of the three injections without any need of rescue medication. Mean rest VAS was 6 (_8) at day 3. The effect on day pain was less spectacular: mean (SD) VAS at D1 of 30 (_ 18), at D3 of 27 (_ 11). Shoulder mobility also improved and the CRP normalized in 4 of 5 patients at day 3. At day 42, 4 of 5 the patients were still totally asymptomatic. On X rays and US, the calcifications were reduced in size: mean maximal diameter of 21 mm at day 0 to 12 mm at day 15, but did not disappear in any patient. The main change on US was a significant and rapid (at day 3) reduction of Doppler activity around the calcification. Conclusion: This pilot open study suggests that IL-1_ inhibition may be an interesting therapeutic approach in acute calcific periarthritis, especially in patients who have not responded adequately to NSAIDs. The effect on pain seems to be more rapid (within a few hours) than steroid injection although a randomized controlled study needs to be performed to confirm this observation.

Metsäklusterin tutkimusverkosto: Metsäteollisuuden prosessien automaation, diagnostiikan ja kunnossapidon tutkimus

Tämä selvitys on osaEtelä-Suomen lääninhallituksen, ESR:n (Euroopan sosiaalirahasto) ja Lappeenrannan kaupungin rahoittamaa 'Metsäklusterin tutkimusverkostO'-hanketta, joka toteutettiin 1.10.2006-31.10.2007 välisenä aikana Lappeenrannan teknilliselläyliopistolla. Hankkeessa tehtiin selvitys metsäklusterin tutkimustoiminnasta jatutkimustarpeista rajattuna prosessianalytiikan, automaation ja käynnissäpidon alueille. LTY:n yhtenä vahvana strategisena painopistealueena on metsäklusteri ja -Metsäklusterin tutkimusverkostO'-hanke liittyy keskeisenä osana edellä mainittujen painopistealueiden selvitystyöhön LTY:ssä. Selvitykseen kuuluivat kirjallisuus- ja internethaut sekä haastattelututkimus. Internet- ja kirjallisuushauissa hyödynnettiin mm. yritysten ja toimijoiden kotisivuja, erilaisten tutkimushankkeiden raportteja, konferenssien ja seminaarien materiaaleja. Haastattelututkimuksessa haastateltiin metsäklusterissa toimivia automaatiosta, kunnossapidosta ja tuotannosta vastaavaa henkilöitä sekä alan tutkimuksesta vastaavia asiantuntijoita. Hankkeessa pidettiin loppuseminaari 27.9.2007 Lappeenrannan teknillisellä yliopistolla. Loppuseminaarissa esiteltiin hankkeen tulokset sekä kuultiin eri tahojen esityksiä prosessianalytiikkaan, -automaatioon ja käynnissäpitoon liittyen. Selvitys vahvisti olettamuksen, että metsäteollisuuden prosessiautomaation ja kunnossapidon toimialakenttä on erittäin monitahoinen ja parhaillaan muuttuva alue. Selvitystyön tuloksena tuli esille useita konkreettisia tutkimusaiheita, jotka vaihtelivat teknologisista teemoista: mittaustekniikka, prosessien tai laitteiden suorituskyky ja ylläpito talouteen liittyviin teemoihin: liiketoiminnan organisoituminen, verkottuneen liiketoiminnan strategiat sekä henkilöstön johtaminen muuttuvissa tilanteissa. Tutkimustoiminnan organisoitumista eri verkostoihin on tapahtunut ja tapahtumassa. Useita alueellisia ja kansallisia metsäteollisuuteen liittyviä verkostoja on jo olemassa, ja jatkossa automaatioon ja kunnossapitoon liittyvien aihepiirien vahvistaminen jo olemassa olevissa metsäklusteriin liittyvissä verkostoissa on tärkeää. Tämän lisäksi Kaakkois-Suomen alueellisten toimijoiden ja LTY:n liittyminen automaatioalan kansalliseen verkostoon on välttämätöntä.

Metsäklusterin tutkimusverkosto: Sähköteknisten laitteiden diagnostiikan tutkimustoiminta

Tämä raportti on laadittu Euroopan sosiaalirahaston (ESR) rahoittaman hankkeen Metsäklusterin tutkimusverkosto puitteissa vuoden 2007 aikana Lappeenrannan teknillisen yliopiston Sähkötekniikan osastolla. Varsinainen raporttiosuus koostuu neljästä pääkappaleesta. Ensimmäisessä pyritään hahmottamaan laitediagnostiikan kehitysnäkymiä. Toisessa tehdään lyhyt kartoitus sähkötekniikkaan liittyvästä kunnossapidon yliopistotutkimuksesta, jota tehdään suomalaisissa yliopistoissa. Neljännessä kappaleessa keskitytään sähkökäyttöjen diagnostiikan kansainvälisen tutkimuksen kartoitukseen. Viimeisessä kappaleessa käsitellään yleisesti ottaen laitediagnostiikassa hyödynnettävien menetelmien ja tekniikoiden tutkimusta. Pääasiallisina tutkimusmenetelminä tässä raportissa hyödynnetään tieteellisiä julkaisuja ja eri organisaatioiden www-sivuja.

EURECCA colorectal: multidisciplinary mission statement on better care for patients with colon and rectal cancer in Europe

Background: Care for patients with colon and rectal cancer has improved in the last twenty years however still considerable variation exists in cancer management and outcome between European countries. Therefore, EURECCA, which is the acronym of European Registration of cancer care, is aiming at defining core treatment strategies and developing a European audit structure in order to improve the quality of care for all patients with colon and rectal cancer. In December 2012 the first multidisciplinary consensus conference about colon and rectum was held looking for multidisciplinary consensus. The expert panel consisted of representatives of European scientific organisations involved in cancer care of patients with colon and rectal cancer and representatives of national colorectal registries. Methods: The expert panel had delegates of the European Society of Surgical Oncology (ESSO), European Society for Radiotherapy & Oncology (ESTRO), European Society of Pathology (ESP), European Society for Medical Oncology (ESMO), European Society of Radiology (ESR), European Society of Coloproctology (ESCP), European CanCer Organisation (ECCO), European Oncology Nursing Society (EONS) and the European Colorectal Cancer Patient Organisation (EuropaColon), as well as delegates from national registries or audits. Experts commented and voted on the two web-based online voting rounds before the meeting (between 4th and 25th October and between the 20th November and 3rd December 2012) as well as one online round after the meeting (4th-20th March 2013) and were invited to lecture on the subjects during the meeting (13th-15th December 2012). The sentences in the consensus document were available during the meeting and a televoting round during the conference by all participants was performed. All sentences that were voted on are available on the EURECCA website www.canceraudit.eu. The consensus document was divided in sections describing evidence based algorithms of diagnostics, pathology, surgery, medical oncology, radiotherapy, and follow-up where applicable for treatment of colon cancer, rectal cancer and stage IV separately. Consensus was achieved using the Delphi method. Results: The total number of the voted sentences was 465. All chapters were voted on by at least 75% of the experts. Of the 465 sentences, 84% achieved large consensus, 6% achieved moderate consensus, and 7% resulted in minimum consensus. Only 3% was disagreed by more than 50% of the members. Conclusions: It is feasible to achieve European Consensus on key diagnostic and treatment issues using the Delphi method. This consensus embodies the expertise of professionals from all disciplines involved in the care for patients with colon and rectal cancer. Diagnostic and treatment algorithms were developed to implement the current evidence and to define core treatment guidance for multidisciplinary team management of colon and rectal cancer throughout Europe.

Yrittäjien oppiminen ja verkostoituminen Voimaverkko- projektissa

Tämän tutkimuksen tarkoituksena oli kuvata pienyrittäjien verkostoitumista ja oppimista ohjatussa verkostoitumisprojektissa. Tutkimuskohteena on Voimaverkko-projekti. Case-projekti on Kiipulan ammattiopistossa toteutettu ESR-rahoitteinen kehittämisprojekti. Projektissa on ollut mukana 47 yrittäjää Kanta-Hämeen alueelta. Tutkimus on laadullinen tutkimus, jonka empiirinen osuus on kerätty kolmella menetelmällä. Projektiin osallistujat vastasivat kyselylomakkeisiin. Toisena menetelmänä käytettiin henkilökohtaisia teemahaastatteluja ja kolmantena palauteillan ryhmätyöskentelyä. Yrittäjien verkosto-osaaminen lisääntyi: yrittäjien välille syntyi sosiaalisia verkostoja ja liiketoiminnallista yhteistyötä. Projektin aikana yrittäjät oppivat uusia työskentelytapoja ja taitoja. Projekti auttoi yrittäjiä löytämään keinoja oman hyvinvoinnin parantamiseksi. Aineiston avulla on koottu yhteenveto ja tehty johtopäätöksiä, joita voidaan käyttää hyödyksi uusia projekteja kehitettäessä. Johtopäätöksissä esitetään kehittämisideoita mahdolliselle jatkohankkeelle.

Aramäisch

Table des matières: 1. Einführung 2. Sprachstufen des Aramäischen 2.1. Die frühesten Zeugnisse: Altaramäisch (9.-8. Jh. v.d.Z.) 2.2. Verwendung als lingua franca: Reichsaramäisch (ca. 700-200 v.d.Z.) 2.2.1. Inschriften und Dokumente aus neuassyrischer und neubabylonischer Zeit 2.2.2. Inschriften und Dokumente aus persischer und früh-nachpersischer Zeit 2.2.3. Kennzeichen des Reichsaramäischen 2.3. Lokale Fortentwicklungen: Mittelaramäisch (ca. 200 v.d.Z. - ca. 250 n.d.Z.) 2.4. Spätaramäisch (ca. 250-1200 n.d.Z.) 2.5. Neuaramäisch 3. Aramäisch im Tenach 3.1. Aramaismen 3.1.1. Gezielt verwendete Aramaismen 3.1.2. Aramaismen als Folge der fortwährenden Beeinflussung des Hebräischen durch das Aramäische 3.2. Die aramäischen Passagen in Esra, Daniel, Jeremia 3.2.1. Esr 4,8-6,18; 7,12-26 3.2.2. Daniel 2,4b-7,28 3.2.3. Jeremia 10,11 Literaturverzeichnis 1. Lexikonartikel 2. Textausgaben, Hilfsmittel und spezialisierte Literatur

The ESRg matrix for strong field d5 systems

This review has tried to collect and correlate all the various equations for the g matrix of strong field d5 systems obtained from different basis sets using full electron and hole formalism calculations. It has corrected mistakes found in the literature and shown how the failure to properly take in symmetry boundary conditions has produced a variety of apparently inconsistent equations in the literature. The review has reexamined the problem of spin-orbit interaction with excited t4e states and finds that the earlier reports that it is zero in octahedral symmetry is not correct. It has shown how redefining what x, y, and z are in the principal coordinate system simplifies, compared to previous methods, the analysis of experimental g values with the equations.

Draaman ja teatterin sovelluksia nuorten työpajaympäristössä : kuvaus Dynamo-hankkeen draamapajan toiminnan muotoutumisesta

Opinnäytetyö on kuvaus Lahden kaupungin nuorisopalveluiden Dynamo-hankkeen draamapajan toiminnasta. Kirjoittaja on työskennellyt draamapajan työvalmentajana Dynamon ensimmäisellä projektikaudella vuosina 2006-2008. Nuorten seudullinen työllisyyshanke Dynamo on Lahden nuorisopalveluiden hallinnoima ESR-rahoitteinen projekti. Dynamo tarjoaa tuettua työharjoittelua Lahden kaupunkiseudun 17-24-vuotiaille työttömille nuorille. Työharjoittelu kestää viisi kuukautta draama-, media-, sisustus- tai remonttipajassa. Opinnäytetyö on hankkeistettu Lahden kaupungin nuorisopalveluille. Draamapajassa nuoret tutustuvat taiteen ja kulttuurin tekemiseen. Opinnäytetyössä avataan ja tutkitaan draamapajan tavoitteita ja toiminnan muotoja. Draamapajan toimintaa lähestytään kolmesta teoreettisesta näkökulmasta, jotka ovat sosiokulttuurinen innostaminen, draamakasvatus ja soveltava teatteri. Draamapajan työskentely on luonteeltaan prosessinomaista. Opinnäytetyössä esitellään tapausesimerkkinä yksi draamapajan loppuprojekteista; devising-esitys Delirium tremensis eli kuinka jokerit sinä meiltä pimität. Esityksen syntyprosessin kuvauksessa havainnoillistetaan työtapoja käytännössä. Opinnäytetyön luvussa seitsemän tarkastellaan, millaisia välineitä teatteri-ilmaisun ohjaajan koulutus tarjoaa työvalmentajana toimimiseen. Kirjoituksessa pohditaan työvalmennuksen pedagogisia haasteita esittävän taiteen koulutuksen näkökulmasta. Loppupäätelmissä draamapaja nähdään soveltavan teatterin, draamakasvatuksen ja sosiokulttuurisen innostamisen sulatusuunina, jossa draaman eri lajityyppien väliset rajat ovat häilyviä. Toiminnassa sovelletaan erilaisia draamallisia ja toiminnallisia menetelmiä. Työskentelyn tavoitteena on mahdollistaa taiteeseen ja kulttuuriin tutustuminen sekä työharjoittelijan omien tavoitteiden saavuttaminen. Työvalmentajan tehtävä työskentelyssä on luoda tilaa osallistujien omalle merkityksenannolle. Parhaimmillaan merkityksenanto draamatyöskentelyssä voi saada aikaan uudelleenrakentumista nuoren ajattelussa ja toiminnassa.

Acute Infection in Total Knee Arthroplasty: Diagnosis and Treatment

Infection is one of the most serious complications after total knee arthroplasty (TKA). The current incidence of prosthetic knee infection is 1-3%, depending on the series(.) For treatment and control to be more cost effective, multidisciplinary groups made up of professionals from different specialities who can work together to eradicate these kinds of infections need to be assembled. About the microbiology, Staphylococcus aureus and coagulase-negative staphylococcus were among the most frequent microorganisms involved (74%). Anamnesis and clinical examination are of primary importance in order to determine whether the problem may point to a possible acute septic complication. The first diagnosis may then be supported by increased CRP and ESR levels. The surgical treatment for a chronic prosthetic knee infection has been perfectly defined and standardized, and consists in a two-stage implant revision process. In contrast, the treatment for acute prosthetic knee infection is currently under debate. Considering the different surgical techniques that already exist, surgical debridement with conservation of the prosthesis and polythene revision appears to be an attractive option for both surgeon and patient, as it is less aggressive than the two-stage revision process and has lower initial costs. The different results obtained from this technique, along with prognosis factors and conclusions to keep in mind when it is indicated for an acute prosthetic infection, whether post-operative or haematogenous, will be analysed by the authors.