scholarly journals B.05 Hemi-laryngopharyngeal spasm (HELPS) syndrome: The discovery, cure, and characterization of a new neurological condition

2017 ◽  
Vol 44 (S2) ◽  
pp. S11-S11
Author(s):  
C Honey ◽  
M Morrison
Keyword(s):  
Surgical Care ◽  
Review Of The Literature ◽  
The Past ◽  
First Case ◽  
Patient Reported ◽  
Operative Outcome ◽  
Small Cohort ◽  
The Common ◽  
Similar Motor

Background: We published the world’s first case of hemi-laryngpharyngeal spasm (HELPS) syndrome cured by microvascular decompression (MVD) of the Xth cranial nerve in 2016. We now present a small cohort of patients (n=3) successfully treated with surgery in order to better delineate the common characteristics of this syndrome, diagnostic tests of choice, nuances of their surgical care and outcomes of their treatment. Methods: The history and physical examination of three patients with HELPS syndrome are presented. Pre-operative laryngoscopy, neuroimaging, response to botox and intra-operative videos are detailed. Post-operative outcome and complications are presented. Results: Each patient reported similar motor (choking) and sensory (coughing) features in their history. Episodic choking relentlessly progressed over the years until it occurred while sleeping and with frightening severity prompting tracheostomy in one patient and intubation in another. A “tickling” sensation deep in the throat triggered episodic coughing that worsened over the years until it occurred while sleeping and with frightening severity (syncope and incontinence). Conclusions: A review of the literature suggests that patients with similar symptoms, often called episodic laryngospasm in the past, have been treated with psychotherapy or antacids. With the recognition that a clearly defined subset of these patients have HELPS syndrome, we can offer them the potential of a neurosurgical cure.

scholarly journals Reversal of Ketamine Induced Acute Delirium with Continuous Midazolam Infusion in a Post Extubation Child with Refractory Bronchospasm: A Case Report

2020 ◽  
Vol 26 (2) ◽  
pp. 56-59
Author(s):  
Fahisham Taib ◽  
Laila Ab Mukmin
Keyword(s):  
Low Dose ◽  
Care Setting ◽  
Tertiary Hospital ◽  
Emergence Delirium ◽  
The Past ◽  
First Case ◽  
Midazolam Infusion ◽  
Standardized Treatment ◽  
Life Threatening ◽  
The Common

Continuous ketamine infusion has been used successfully to treat severe refractory bronchospasm in children requiring mechanical ventilation in the intensive care setting. One of the common side effects known is emergence delirium. There is no standardized treatment for the ketamine-induced emergence delirium although benzodiazepine, haloperidol and dexmedetomidine have been reported to be effective in the past. A 7-year-old girl admitted to a tertiary hospital for life-threatening asthma requiring immediate intubation and ventilation. Ketamine was used as sedative and bronchodilator in anticipation of her challenging ventilation strategy. She was successfully extubated on day 8 of admission, however, she developed symptoms associated with the delirium. Successful reversal of the symptoms was achieved after 48-hour use of low dose intravenous midazolam. This was the first case reported on the reversal of ketamine-induced emergence phenomenon using low dose intravenous midazolam infusion.

Primary Carcinoid of the Common Bile DućtImmunohistochemical Characterization of a Case and Review of the Literature

1991 ◽  
Vol 96 (3) ◽  
pp. 341-344 ◽  
Author(s):  
Arturo Angeles-Angeles ◽  
Leticia Quintanilla-Martínez ◽  
Jorge Larriva-Sahd
Keyword(s):  
Review Of The Literature ◽  
The Common

scholarly journals Phenotypic and Molecular Characterization of Mycobacterium tuberculosis Isolates Resistant to both Isoniazid and Ethambutol

2005 ◽  
Vol 49 (6) ◽  
pp. 2218-2225 ◽  
Author(s):  
Linda M. Parsons ◽  
Max Salfinger ◽  
Anne Clobridge ◽  
Jillian Dormandy ◽  
Lisa Mirabello ◽  
...  
Keyword(s):  
Mycobacterium Tuberculosis ◽  
Susceptibility Testing ◽  
Rapid Screening ◽  
The Past ◽  
Resistant Strains ◽  
The Common ◽  
Susceptibility Tests ◽  
High Level ◽  
Level Resistance

ABSTRACT In performing radiometric susceptibility testing on over 2,000 patient isolates of Mycobacterium tuberculosis during the past 6 years, we found that resistance to 7.5 μg/ml ethambutol (EMB) occurred only in isolates that are also resistant to 0.4 μg/ml isoniazid (INH). Using 157 selected isolates in the present study, we performed radiometric and agar proportion susceptibility tests and DNA sequencing of genetic regions associated with resistance to these two drugs. The goal was to study the occurrence of the common mutations associated with resistance to each drug and also to determine whether any particular INH-resistance-associated mutation occurred more often in combination with any particular EMB-resistance-associated mutation. In an analysis of 128 isolates resistant to 0.4 μg/ml INH, we found that a mutation at katG Ser315 was more common in isolates also resistant to 7.5 μg/ml EMB (61 of 67 = 91.0%) than in isolates either susceptible to EMB or resistant to 2.5 μg/ml EMB (39 of 60 = 65.0%). These observations suggest that INH-resistant strains with a mutation at katG Ser315 are more likely to acquire resistance to 7.5 μg/ml EMB than are isolates with INH-resistance-associated mutations at other sites. In addition, we found that 64 of 67 (95.5%) isolates resistant to 7.5 μg/ml EMB contained a mutation in either codon 306 or codon 406 of embB. Met306Val was the most common embB mutation, present in 52 (77.6%) of the 67 isolates. Most occurrences of this mutation (49 of 52 = 94.2%) were found in isolates that also contained the katG Ser315Thr mutation. Finally, sequencing this region of embB appears to be sufficiently sensitive for use as a rapid screening tool for detection of high-level resistance to EMB.

scholarly journals Recent Progress in Magnetron Sputtering Technology Used on Fabrics

Materials ◽  
2018 ◽  
Vol 11 (10) ◽  
pp. 1953 ◽  
Author(s):  
Xue-Qiang Tan ◽  
Jian-Yong Liu ◽  
Jia-Rong Niu ◽  
Jia-Yin Liu ◽  
Jun-Ying Tian
Keyword(s):  
Magnetron Sputtering ◽  
Recent Progress ◽  
Bacterial Resistance ◽  
Hydrophobic Properties ◽  
Existing Problems ◽  
The Past ◽  
The Common ◽  
Coated Fabrics ◽  
Common Target

The applications of magnetron sputtering technology on the surface coating of fabrics have attracted more and more attention from researchers. Over the past 15 years, researches on magnetron sputtering coated fabrics have been mainly focused on electromagnetic shielding, bacterial resistance, hydrophilic and hydrophobic properties and structural color etc. In this review, recent progress of the technology is discussed in detail, and the common target materials, technologies and functions and characterization of coated fabrics are summarized and analyzed. Finally, the existing problems and future prospects of this developing field are briefly proposed and discussed.

Neurosyphilis is more common in malignant syphilis: A case series and review of the literature

2019 ◽  
Vol 30 (8) ◽  
pp. 779-785
Author(s):  
Lin Zhu ◽  
Mei Shi ◽  
Rui-Rui Peng ◽  
Xin Gu ◽  
Zhifang Guan ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Chart Review ◽  
Case Series ◽  
Secondary Syphilis ◽  
Common Type ◽  
Review Of The Literature ◽  
First Case ◽  
Direct Association ◽  
The Common ◽  
The Relationship

Malignant syphilis is a rare skin manifestation of secondary syphilis, which has been reported primarily in the HIV-infected population. This study aimed to investigate the relationship between HIV infection, malignant syphilis, and neurosyphilis through a systematic chart review of 26 malignant syphilis patients seen at our hospital. We also performed a literature review of 83 reported malignant syphilis cases since 1987, when the first case of malignant syphilis co-infected with HIV was reported. We found there was no direct association between HIV infection and malignant syphilis or neurosyphilis. In contrast, we found that much higher proportion (30%) of malignant syphilis patients develop concurrent neurosyphilis compared to those with the common type of secondary syphilis (13.1%). Physicians should be aware of the fact that neurosyphilis is more common among patients with malignant syphilis and the importance of investigating for neurosyphilis in such patients.

scholarly journals An Introductory Word on Nietzsche

1913 ◽  
Vol 6 (4) ◽  
pp. 461-478
Author(s):  
William Mackintire Salter
Keyword(s):  
Require Time ◽  
General Characterization ◽  
The Past ◽  
State Of Mind ◽  
The Subject ◽  
The Common

According to Professor Riehl of Berlin, the most widely read of serious writers in Germany today is Nietzsche. German ideas require time to cross the Channel and still more time to reach America; but already translations of Nietzsche's numerous works are appearing in England, and within three or four years three books have been devoted to him in this country. Probably erelong the thoughtful among us will have to attend to him, as we have had to attend to other German writers in the past. As yet very confused ideas are current about him; his disciples are more or less confused themselves. Nietzsche once half-humorously remarked that the first disciples of a doctrine really prove nothing against it.Moreover, Nietzsche was a lonely, markedly individual thinker, caring more to express himself than to be comprehended by the ordinary reader, soliloquizing much; and he said many things that, unless we carefully, patiently attend, may mislead, have misled. I could easily quote passages from him that would offend you, as they did me when I first came upon them. No one needs to be studied more before he is judged. No one lends himself less to impressionist treatment, which is all he ordinarily gets from non-Continental writers. Indeed, I sometimes think that Nietzsche is a philosopher for philosophers and a moralist for moralists rather than for the common run of us, so subtle is his thinking, such an acquaintance with the history and refinements of philosophical and ethical speculation does he presuppose.Accordingly, it may be most useful, as well as most conformable to my abilities, to cover a quite limited field this morning; and I shall content myself, after giving a few facts about his life and a very general characterization of him, to portray somewhat in detail his state of mind during one—the first—period of his career. What I say may thus serve as a kind of introduction to the subject; and happy shall I be if I interest any one sufficiently to take it up on his own account.

scholarly journals Nocardia amikacinitolerans and cytomegalovirus: distinctive clinical and radiological characterization of the rare etiologies of brain abscesses: report of 2 cases

2019 ◽  
Vol 47 (2) ◽  
pp. E18 ◽  
Author(s):  
Travis Quinoa ◽  
Fareed Jumah ◽  
Vinayak Narayan ◽  
Zhenggang Xiong ◽  
Anil Nanda ◽  
...  
Keyword(s):  
Brain Biopsy ◽  
Review Of The Literature ◽  
Central Nervous System Infections ◽  
First Case ◽  
Lethal Complications ◽  
Immunosuppressed Patients ◽  
Brain Abscesses ◽  
Radiological Characterization ◽  
Neuroradiological Imaging

Central nervous system infections in immunosuppressed patients are rare but potentially lethal complications that require swift diagnoses and intervention. While the differential diagnosis for new lesions on neuroradiological imaging of immunosuppressed patients typically includes infections and neoplasms, image-based heuristics to differentiate the two has been shown to have variable reliability.The authors describe 2 rare CNS infections in immunocompromised patients with atypical physical and radiological presentations. In the first case, a 59-year-old man, who had recently undergone a renal transplantation, was found to have multifocal Nocardia amikacinitolerans abscesses masquerading as neoplasms on diffusion-weighted imaging (DWI); in the second case, a 33-year-old man with suspected recurrent Hodgkin’s lymphoma was found to have a nonpyogenic abscess with cytomegalovirus (CMV) encephalitis.As per review of the literature, this appears to be the first case of brain abscess caused by N. amikacinitolerans, a recently isolated superbug. Despite confirmation through brain biopsy later on in case 1, the initial radiological appearance was atypical, showing subtle diffusion restriction on DWI. Similarly, the authors present a case of CMV encephalitis that presented as a ring-enhancing lesion, which is extremely rare. Both cases draw attention to the reliability of neuroimaging in differentiating an abscess from a neoplasm.

The Use of Advanced Analytical Techniques for Characterization of the Chemical, Physical, and Crystallographic Nature of a Surface

1973 ◽  
Vol 31 ◽  
pp. 132-133 ◽  
Author(s):  
R. E. Herfert
Keyword(s):  
Surface Characterization ◽  
Analytical Techniques ◽  
X Ray Diffraction ◽  
Depth Of Penetration ◽  
X Ray ◽  
The Past ◽  
Transmission Electron ◽  
Scanning Electron

Studies of the nature of a surface, either metallic or nonmetallic, in the past, have been limited to the instrumentation available for these measurements. In the past, optical microscopy, replica transmission electron microscopy, electron or X-ray diffraction and optical or X-ray spectroscopy have provided the means of surface characterization. Actually, some of these techniques are not purely surface; the depth of penetration may be a few thousands of an inch. Within the last five years, instrumentation has been made available which now makes it practical for use to study the outer few 100A of layers and characterize it completely from a chemical, physical, and crystallographic standpoint. The scanning electron microscope (SEM) provides a means of viewing the surface of a material in situ to magnifications as high as 250,000X.

Isolation and characterization of oleochemical compounds from watermelon seed

2020 ◽  
Vol 10 (4) ◽  
pp. 79-82
Author(s):  
Madhubhushan M ◽  
Seshaiah S ◽  
Chandrudu J ◽  
Sagar R ◽  
Akila CR
Keyword(s):  
Cutting Tool ◽  
Citrullus Lanatus ◽  
Fatty Esters ◽  
Mineral Oils ◽  
Light Yellow ◽  
Isolation And Characterization ◽  
The Common ◽  
Set Up ◽  
Natural Gradation

The common watermelon item (Citrullus lanatus) seeds were gained from castoffs verdant nourishments for use by decorating, sun ventilation and pulverizing. Light yellow-toned oil was gotten by dissolvable withdrawal using oil atmosphere and the going with traits were gotten using oil ether: pH, refractive rundown, thickness, dissolvable miscibility, coagulating temperature, fire nature, express gravity, streak point and warmth of consuming. With a shallow level of unsaturation, stepped level of smoothness, and proximity of raised degree of the sensible proportion of free unsaturated fats. The low assessment of the solidifying temperature of the oil offered a hint that the oil can be managed in various areas paying little heed to the qualification in temperature. The following level of linoleic destructive of the oil offers a hint of natural gradation of solidarity. Fatty esters are increasing expanding significance as a biodegradable swap for mineral oils. In some request regions, for example, cutting tool oil, gearbox, pressure-driven oils, and greases for raw petroleum creation, the oleochemical items are set up. Nonetheless, certain particular wellsprings of fatty esters are hitherto to be abused for this comparative reason. This exploration subsequently tests into one of the less used wellsprings of fatty esters in watermelon. The oil from the kernels demonstrations a top-notch yield presents significant utilitarian gatherings for change and thus was utilized to set up an assortment of oleochemicals which demonstrated excellence materials in contrast with the routinely utilized oils feed frameworks for oleochemicals after portrayal. The photopolymers acquired indicated piercing vinyl protons for consistent polymerize.

Physical Failure Analysis Techniques for Front-End-of-Line Defect Analysis

2016 ◽  
Author(s):  
Dirk Doyle ◽  
Lawrence Benedict ◽  
Fritz Christian Awitan
Keyword(s):  
Cross Section ◽  
Focused Ion Beam ◽  
Ion Beam ◽  
Gate Oxide ◽  
Top Down ◽  
New Techniques ◽  
First Case ◽  
Transmission Electron ◽  
Scanning Transmission

Abstract Novel techniques to expose substrate-level defects are presented in this paper. New techniques such as inter-layer dielectric (ILD) thinning, high keV imaging, and XeF2 poly etch overflow are introduced. We describe these techniques as applied to two different defects types at FEOL. In the first case, by using ILD thinning and high keV imaging, coupled with focused ion beam (FIB) cross section and scanning transmission electron microscopy (STEM,) we were able to judge where to sample for TEM from a top down perspective while simultaneously providing the top down images giving both perspectives on the same sample. In the second case we show retention of the poly Si short after removal of CoSi2 formation on poly. Removal of the CoSi2 exposes the poly Si such that we can utilize XeF2 to remove poly without damaging gate oxide to reveal pinhole defects in the gate oxide. Overall, using these techniques have led to 1) increased chances of successfully finding the defects, 2) better characterization of the defects by having a planar view perspective and 3) reduced time in localizing defects compared to performing cross section alone.

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