Successful Treatment of Pneumothorax in a Dog With Sterile Pleural Fibrosis Caused by Chylothorax

A 2-year-old, 12 kg, intact male crossbreed dog was presented with respiratory distress, exercise intolerance, and gagging. Plain thoracic radiographs revealed severe pleural effusion. Although bilateral needle thoracocentesis and chest tube placement were performed, no re-expansion of the lung lobes occurred. Pleural effusion was of chylous quality and led to lung entrapment. Computer tomography revealed a highly atrophic and atelectatic right middle lung lobe. The remaining lung lobes were only expanded to ~40%. Visceral pleura and pericardium showed a heterogeneous thickening consistent with pleural fibrosis. Partial pericardiectomy with resection of the middle lung lobe through a right lateral thoracotomy was performed. Ligation of the thoracic duct and ablation of the cisterna chyli was achieved through a single paracostal approach. Histopathology revealed chronic-active proliferative beginning granulomatous pleuritis, fibrotic pericarditis, and partial coagulative necrosis with incomplete granulomatous sequestration in the resected middle lung lobe. Chylothorax resolved after surgical intervention. Active pleural effusion resolved, and lung entrapment changed to trapped lung disease. The remaining lung lobes re-expanded to ~80% over the following 6 days. The dog was discharged 10 days later. Mild to moderate pleural effusion of non-chylic quality was present during the following 4 months. Meloxicam was administered for 4 months because of its anti-fibrotic and anti-inflammatory properties. Fifteen months later, thoracic radiographs revealed full radiologic expansion of the lungs with persistent mild pleural fibrosis. To the authors' knowledge, this is the first case report of pneumothorax due pleural fibrosis caused by chylothorax in a dog with an excellent clinical outcome

Bilateral Congenital Dislocation of the Knee with Ipsilateral Developmental Dysplasia of the Hip – Report of Three Patients

Congenital dislocation of the knee (CDK) is a very rare condition. Here we report our strategy and results in treatment of three children with CDK. All three patients were treated with conservative method, and only one had underwent a surgical procedure on one knee. Of the remaining, we recorded a good outcome with conservative treatment in three knees, while two had poorer outcome as a result of musculoskeletal anomalies. We also present here a unique case of a child born without cruciate ligaments and patellas on both sides. We performed the operative procedure by Z-plasty of the extensor apparatus on one left knee according to Niebauer and King on one child. The clinical result of this procedure was very good. Five years after the operation we decided to perform an MRI examination to assess the postoperative status of the operated knee, especially the position and the shape of left patella. We found the asymmetry and high position of the operated patella resulting in patella alta. Compared to the initial clinical presentation, we consider all patients to have good clinical presentation nowdays

Going Side by Side: Defence and Resilience in Swedish Security Policy

Resilienz-basierte Ansätze sind in Schwedens Sicherheitsstrategien mittlerweile fest verankert. Vor allem die staatliche Agentur für Zivilschutz (MSB; angesiedelt im Verteidigungsministerium) hat in den letzten Jahren systematisch einen Resilienz-Ansatz forciert. Als Paradebeispiel dafür gilt eine ihrer jüngsten Strategien, die Gefahren wie verbreitete Antibiotika Resistenz, den Klimawandel und eine großflächige Energiewende, so genannte Risiken mit geringer Wahrscheinlichkeit, aber hoher Wirkung, miteinander verknüpft. Diese Resilienz-basierten Ansätze in Schwedens Sicherheitspolitik sind Teil der konzeptionellen Ausrichtung an 'gesellschaftlicher Sicherheit', die ihre Wurzeln in den 2000er Jahren hat. 'Gesellschaftliche Sicherheit' gehört zu den weiten Sicherheitsansätzen, deren Aufkommen eine Wahrnehmungsverschiebung von Bedrohungen aufzeigt. Statt Kriegs-Szenarien rückten zunehmend 'hybride' Bedrohungen in den Vordergrund, was eine sicherheitspolitische Ausrichtung an Resilienz zur Folge hatte. In der jüngsten schwedischen Sicherheitsstrategie zeichnet sich jedoch ein gegenläufiger Trend ab. Zum ersten Mal seit zwei Dekaden wurde Schwedens Verteidigungsbudget erhöht. Russland, als klares Feindbild, dominiert diese Strategie und rückt traditionelle Verteidigungsmaßnahmen wieder in den Fokus. Obwohl Resilienz- und Verteidigungsmaßnahmen nach wie vor nebeneinander bestehen, scheint Verteidigung gerade die Oberhand zurückzugewinnen.Sweden has taken considerable steps towards applying resilience-based approaches in its security policy. The Swedish Civil Contingencies Agency, MSB, has implemented a resilience approach par excellence in their most recent all-hazard strategy. 'Low probability-high impact' risks are systematized and interrelated by exploring the impact of potentialities such as antibiotic resistance, climate change or energy transition. These efforts are part of 'Societal Security', which became the main direction of Swedish Security Strategies during the 2000s. Such a 'wide' security approach can be backtracked to a change in threat perception from war-based scenarios to hybrid threats. Consequently, Sweden has focused its security efforts on ‘hybrid threats’ and 'societal security' over the past decade. This went hand in hand with taking up resilience-based procedures. In Sweden’s most recent 'Defence and Security Policy', however, a shift back to traditional defence strategies indicates a significant change. Sweden’s military budget increased for the first time in two decades, and the scenario is dominated by Russia as clearly identifiable threat. While resilience and defence measures appear to go hand in hand in Sweden’s security approach, state spending once again favours defence

The Difference Resilience Makes: U.S. National Preparedness - from Civil Defence to Resilience

Resilienz ist mittlerweile eine etablierte Komponente der Sicherheitsarchitektur. Allerdings ist das konzeptionelle Verhältnis von Resilienz zu Verteidigung und Sicherheit immer noch unklar. In diesem Arbeitspapier wird diese Problemstellung aufgegriffen und argumentiert, dass Resilienz die Ablöse von früheren zivilen Verteidigungskonzepten ist. Aus diesem Grund stellt es an Hand eines historischen Abrisses die Ursprünge von Resilienz dar und verfolgt Veränderungen und Kontinuitäten. Der Fokus liegt dabei auf der Gestaltung von National Preparedness (Nationale Einsatzbereitschaft) in den USA. Die These ist geleitet von der Forschungsfrage was ist der Unterschied den Resilienz macht? Im ersten Teil werden die Gründe für die Entstehung von zivilen bzw. passiven Verteidigungskonzepten gegeben. Passive Verteidigung ist in den Jahren 1950 bis ca. 1980 als komplementär zur aktiven Verteidigung konzipiert. Während den 1970er Jahren findet eine massive Veränderung statt, da Katastrophenschutz nunmehr als Sicherheitsaufgabe des Staates wahrgenommen und in die Agenda der zivilen Verteidigung eingespeist wurde. Die Zusammengehörigkeit dieser Sektoren wurde damit argumentiert, dass jede Krise ein lokales Phänomen sei und beides Vorbereitung (dual-use approach) benötige. Diese Argumentation wurde im Zuge der Einführung von Resilienz-Politiken wieder aufgegriffen. Das Ende des Kalten Krieges hat zu einer fundamentalen konzeptionellen Veränderung von Sicherheit geführt und hat zivile Verteidigung obsolet gemacht. Katastrophenschutz wurde unabhängig, während frühere zivile Verteidigungsaufgaben im neuen Konzept der 'Homeland Security' eingefasst werden sollten. Dieses wurde benötigt, da Terrorismus als immer größere Bedrohung wahrgenommen wurde. Nach 9/11 wurde aus der Heimat Verteidigung das Ministerium für Heimatschutz, welches dem Verteidigungsministerium nachempfunden war und insofern mehr auf Sicherheitsaufgaben denn auf Katastrophenschutz konzentriert war. Das Scheitern dieses Ansatzes wurde durch den durchgängig fehlerhaften Umgang mit dem Orkan Katrina deutlich. Aus diesem Grund wurden alte Elemente des Katastrophenschutzes - Risikominderung (risk mitigation) und Resilienz - eingeführt.Resilience is a new component of the security empire. But its conceptual relations to security and defence are still unclear. This paper argues that resilience is the replacement of former civil defence measures in the US. Hence, it traces the origins of resilience during the past 60 years of US policy history. National preparedness thereby serves as the key issue along which the conceptual changes are traced. The paper is guided by the research question what is the difference resilience makes and, therefore, establishes changes and continuities along the way. In the first part, the reasons for the introduction of civil, or passive, defence as complementary to active defence are given. During this period, approximately 1950-1980, civil defence was based on retaliation and deterrence logics. During the 1970s, a major change took place when emergency management became part of security considerations and mitigation was introduced. Emergency management was nevertheless subsumed under a civil defence agenda. It was subsumed due to a 'dual-use' logic, stating that emergency preparation is fundamentally a local issue and independent of its source. Two characteristics of today's resilience policies are found in this regard: first, the 'dual-use' approach as precedent for todays' 'all-hazard' policies and second the perception that all emergencies are local phenomena. The end of the Cold War led to a decisive change in the concept of security itself and rendered former civil defence conceptions obsolete. Thus, emergency management became independent, while civil defence considerations were poured into a new conception of 'homeland defence' directed at the new emerging threat of terrorism. After 9/11, homeland defence became 'Homeland Security', and incorporated the emergency management sector. The Department of Homeland Security was modelled after the Department of Defence and acted under the tight security conceptions 'prevent, protect, and respond'. These conceptions proved too tight for an agency responsible for 'all-hazards' as shown by Hurricane Katrina. After Hurricane Katrina, a new disaster circle was inaugurated which brought mitigation back and moreover introduced resilience as guiding organisational principle

The Concept of Resilience between State Security and Sovereign Security: a Look at Policy Challenges and Interests of the UK

Resilienz hat sich in den letzten Jahren zu einem Schlüsselbegriff in nationalen und internationalen Sicherheitskonzepten entwickelt. Der derzeitige Stand der Forschung verbindet das Konzept vielfach mit einer neoliberalen Politik des staatlichen Rückzugs aus seiner sicherheitspolitischen Verantwortung, oder mit einem nahezu totalitären Zugriff auf "resiliente Subjekte". Anhand einer empirischen Untersuchung der britischen Resilienz-Politik zeigt dieser Artikel, dass keiner dieser Ansätze zutrifft. Vielmehr entpuppt sich Resilienz als ein profaner Ansatz des Katastrophenschutzes auf lokaler Ebene. Allerdings ermöglicht Resilienz damit erst wieder die Sicherheitsverantwortlichkeit des Staates, der an seinem Versprechen der "umfassenden Sicherheit" gescheitert ist. Damit ist Resilienz nicht als Rückzug souveräner Sicherheitspolitik zu verstehen, sondern als staatliches Micro-Management der potenziellen Katastrophen. Resilienz löst daher die Idee einer souveränen Sicherheit auch nicht ab, sondern verbindet das sicherheitspolitisch Mögliche und Unmögliche in einem Resilienz-Sicherheits-Nexus.Resilience is on the rise in security policies, at the international as well as at the national level. Current academic research often links resilience with either the neoliberal retreat of the state and the respective attempt of 'governing from a distance', or with an almost totalitarian grasp of 'resilient subjects', or both. Against the background of the application of resilience in UK security policy, this article argues that resilience does neither of these. Instead, it unfolds as a rather mundane endeavour focused on micro-practices of civil emergency response at the local level. In doing so, resilience enables the repackaging of 'unbound security', which was doomed to fail in delivering its promise. It is, however, neither offering another promise nor symbolising a retreat from state responsibility, but engages in a defensive micro-management of potential catastrophe. Resilience hence does not replace security as a practice of the state deriving from its sovereignty, but links up with it to create a nexus between the doable and the undoable, the resilience-security-nexus

Identity Construction in Insurgent Movements: a Case Study of the Colombian Ejército de Liberación Nacional

In Studien im Bereich der Friedens- und Konfliktforschung und der kritischen Terrorismusforschung wurde Identität als Faktor herangezogen um die Beständigkeit von Guerilla/Terrorismus-Gruppierungen zu erklären. Dieser Artikel fokussiert sich auf die Identitätskonstruktion der linken, kolumbianischen Guerilla-Gruppierung "Ejército de Liberación Nacitonal" (ELN; Deutsch: Nationale Befreiungsarmee). Als marxistisch-leninistische Organisation ist es das erklärte Ziel der ELN den Kapitalismus zu überwinden. In der Perzeption der ELN erfordert die Überwindung des Kapitalismus die Überwindung des Individualismus und darum kreiert die ELN "kollektive Persönlichkeiten". In diesem Artikel werden die Mechanismen an Hand derer eine "kollektive Persönlichkeit" indoktriniert wird aufgezeigt. Diese spezifische Identitätskonstruktion ist der Hauptfaktor, warum Menschen in dieser Gruppierung bleiben und kämpfen, wodurch folglich die Beständigkeit der Gruppierung abgesichert wird.In conflict studies, identity has been posited as an explanatory factor of the resilience of insurgencies. This article focuses on the identity formation of the National Liberation Army (ELN), a leftist insurgency group in Colombia. As Marxist-Leninist organisation, the ELN aims to overcome capitalism. In their perception, this is possible via the transformation of the individual into a 'collective personality'. Along the dimensions of 'content' and ‘contestation’ we will demonstrate the mechanisms they impose for such identity formation. Identity, as we will argue, is a main factor in explaining why people participate in this insurgency and thereby enhance its resilience

Students with Disabilities: The Disconnect between Self Advocacy and Social Justice Practices of Teachers

This paper explored the perceptions of special education staff and college students with disabilities about self-advocacy instruction through the lens of social justice. Investigated were three public schools and one community college. Data revealed differing perceptions between educators and students regarding the level of self-advocacy instruction that students with disabilities received. The implications for this research and practice include that high school personnel understands and implements principles of social justice to teach students with disabilities to have self-advocacy skills

Resilience and the transformation of sovereign security:A look at policy challenges and interests

Resilience is on the rise in security policies, at the international as well as at the national level. Current academic research often links resilience with either the neoliberal retreat of the state and the respective attempt of ‘governing from a distance’, or with an almost totalitarian grasp of ‘resilient subjects’, or both. Against the background of the application of resilience in UK security policy, this article argues that resilience does neither of these. Instead, it unfolds as a rather mundane endeavour focused on micro-practices of civil emergency response at the local level. In doing so, resilience enables the repackaging of ‘unbound security’, which was doomed to fail in delivering its promise. It is, however, neither offering another promise nor symbolising a retreat from state responsibility, but engages in a defensive micro-management of potential catastrophe. Resilience hence does not replace security as a practice of the state deriving from its sovereignty, but links up with it to create a nexus between the doable and the undoable, the resilience-security-nexus

TGFβ-signaling in Squamous Cell Carcinoma Occurring in Recessive Dystrophic Epidermolysis Bullosa

Background: Recessive dystrophic epidermolysis bullosa (RDEB) is a hereditary skin disorder characterized by mechanical fragility of the skin, resulting in blistering and chronic wounds. The causative mutations lie in the COL7A1 gene. Patients suffering from RDEB have a high risk to develop aggressive, rapidly metastasizing squamous cell carcinomas (SCCs). Cutaneous RDEB SCCs develop preferentially in long-term skin wounds or cutaneous scars. Albeit being well differentiated, they show a more aggressive behavior than UV-induced SCCs. These findings suggest other contributing factors in SCC tumorigenesis in RDEB. Objective: To analyze factors contributing to RDEB tumorigenesis, we conducted a comprehensive gene expression study comparing a non-malignant RDEB (RDEB-CL) to a RDEB SCC cell line (SCCRDEB4) to achieve an overview on the changes of the gene expression levels in RDEB related skin cancer. Methods: We applied cDNA arrays comprising 9738 human expressed sequence tags (EST) with various functions. Selected results were verified by Real-time RT PCR. Results: Large-scale gene expression analysis revealed changes in the expression level of transforming growth factor β1 (TGFβ1) and several genes under the control of TGFβ for RDEB and SCCRDEB4 cell lines. Even untransformed RDEB keratinocytes show elevated levels of TGFβ1. Conclusion: Our findings demonstrate a prominent role of TGFβ-signaling in RDEB-related skin cancer. Once activated, TGFβ signaling either in response to wounding or in order to influence type VII collagen expression levels could facilitate cancer development and progression. Moreover, TGFβ signaling might also represent a potentially useful therapeutic target in this disease