Pseudomembranous colitis due to clostridium difficile

Background: A 62-year-old Turkish man was referred for ultrasonography of a palpable mass in the left upper abdomen. Past medical history revealed emergency laparoscopic cholecystectomy for acute calculus cholecystitis about 6 months earlier in Turkey. On clinical examination therewas a small palpable mass with mild tenderness in the left subcostal region. Due to a language barrier it was uncertain if the swelling was present before or after the cholecystectomy. Ultrasonography revealed a calcified lesion. The differential diagnosis at that time was dystrophic calcifications or a soft tissue tumor with calcification. However, additional conventional imaging of the left subcostal region revealed no calcifications. In the work-up of a possible soft tissue tumor MRI was performed

Nodular regenerative hyperplasia of the liver and portal thrombosis

Background: A 35-year-old female presented with upper gastrointestinal tract bleeding. Fifteen years ago, the diagnosis of esophageal varices caused by idiopathic portal venous thrombus was made. Follow-up examinations revealed mild elevation of bilirubin levels and normal alphafetoprotein level on blood tests. Splenectomy had been performed 6 years previously due to portal hypertension caused by portal venous thrombus

Product assortment and customer mobility

Customers mobility is dependent on the sophistication of their needs: sophisticated customers need to travel more to fulfill their needs. In this paper, we provide more detailed evidence of this phenomenon, providing an empirical validation of the Central Place Theory. For each customer, we detect what is her favorite shop, where she purchases most products. We can study the relationship between the favorite shop and the closest one, by recording the influence of the shop’s size and the customer’s sophistication in the discordance cases, i.e. the cases in which the favorite shop is not the closest one. We show that larger shops are able to retain most of their closest customers and they are able to catch large portions of customers from smaller shops around them. We connect this observation with the shop’s larger sophistication, and not with its other characteristics, as the phenomenon is especially noticeable when customers want to satisfy their sophisticated needs. This is a confirmation of the recent extensions of the Central Place Theory, where the original assumptions of homogeneity in customer purchase power and needs are challenged. Different types of shops have also different survival logics. The largest shops get closed if they are unable to catch customers from the smaller shops, while medium size shops get closed if they cannot retain their closest customers. All analysis are performed on a large real-world dataset recording all purchases from millions of customers across the west coast of Italy.</p

Long-term effect of pentoxifylline and NG-nitro-L-arginine methyl ester on testicular function in spermatic artery ligation

Objective. To investigate long-term testicular function in pentoxifylline- and NG-nitro-L-arginine methyl ester (L- NAME)treated rats prior to spermatic artery ligation by assessing serum inhibin B concentration, a reliable endocrine marker of spermatogenesis. Material and methods. Forty prepubertal rats were randomly divided into four equal groups. Right orchiectomy was performed in all rats. Intraperitoneal pentoxifylline and L- NAME were administered to Groups 1 and 2, respectively. Rats in Group 3 did not receive any medication. The spermatic arteries of the left testes were ligated in all groups with the exception of the sham controls ( Group 4). One month postoperatively, a histopathologic evaluation was performed and serum inhibin B concentrations were assessed in all groups. Results. There were no statistically significant differences in testis size or serum inhibin B concentration between Groups 1, 2 and 3. However, the testes were significantly smaller (p(1) = 0.01, p(2) = 0.01, p(3) = 0.01) and serum inhibin B levels were significantly decreased (p(1) = 0.01, p(2) = 0.01, p(3) = 0.01) when Groups 1 - 3 were compared with Group 4. Histopathological evaluations revealed necrosis and calcification in all specimens with the exception of the sham-operated group. Conclusions. The long-term outcomes of spermatic artery ligation were poor and testicular atrophy developed in rat testes in all study groups. Testicular atrophy could not be reversed by preoperative administration of pentoxifylline and L- NAME

A Multivariate Change Point Detection Procedure for Monitoring Mean and Covariance Simultaneously

The signal issued by a control chart triggers the process professionals to investigate the special cause. Change point methods simplify the efforts to search for and identify the special cause. In this study, using maximum likelihood estimation, a multivariate joint change point estimation procedure for monitoring both location and dispersion simultaneously is proposed. After a signal is generated by the simultaneously used Hotelling's T-2 and/or generalized variance control charts, the procedure starts detecting the time of the change. The performance of the proposed method for several structural changes for the mean vector and covariance matrix is discussed