Weyl Gravity in Covariant Hamiltonian Formalism

We find covariant canonical formalism for Weyl invariant gravity. We discuss constraint structure of this theory and its gauge fixed form.Comment: 19 page

Report of results of pleural biopsy (Needle biopsy and open biopsy) in 108 cases and 245 biopsies

1. The results of 245 pleural biopsies perfomed in 108 patients including 219 pleural needle biopsies and 26 pleural open biopsies were reported. The method of pleural biopsy seems to be superior to any other currently available diagnostic procedures for the etiological diagnosis of pleurisy. 2. When the pleural needle biopsy is compared with the pleural open biopsy, the former method has definite advantages over the open biopsy. The pleural needle biopsy is simple, repeatable and has almost no complication. The method of pleural needle biopsy is the initial method of choice as Donohoe correctly stated and should be employed in every cases of the pleurisy to confirm the etiological diagnosis. The open biopsy should be reserved only for those cases in whom the needle biopsy had not proved satisfactory. 3. Utilizing the method of needle biopsy, the pathological diagnosis was made in 86 per cent of our cases at the initial biopsy. By repeated needle biopsies, the results have improved to 91-92 per cent. 4. Most of the failures of the pleural needle biopsy were noted at the early stage of the study due to the unfamiliarity of the biopsy technique and later due to the incooperation of the patients. 5. The presence of the free pleural fluid serves as a convenient guide for the performance of the needle biopsy but successful needle biopsy was easily done without presence of pleural fluid when there is adequate pleural thickening. 6. 63-75 per cent of our diagnosed cases were proved to have granulomatous pleuritis, 13-31 per cent non-specific pleuritis and 5.4-5.8 per cent eosinophilic pleuritis due to paragonomiasis. The distribution of this pathological diagnosis seems to reflect quite well the actual picture of incidences of pleurisy of various different etiology in young adults in Korea. 7. The relationship of the success in obtaining adequate tissue by needle biopsy and interval between onset of symptom and biopsy was discussed. It was found that the interval has no significant effect on the production of adequate tissue by needle biopsy if the time elapsed is 4 weeks or more from the onset of symptom. 8. The significance of the pathological findings of ranulomatous pleuritis at one biopsy and non-specific pleuritis at another biopsy in the same patient was discussed. It is concluded that the single finding of nonspecific pleuritis at one needle biopsy cannot rule out the presence of granulomatous pleuritis and it is recommended that pleural biopsy be repeated whenever necessary. 9. The diagnostic significance of the chemical analysis of the pleural fluid was discussed in correlation with the results of the pleural needle biopsies. It is concluded that the number of examinations are not quite sufficient to draw any definite conclusion at the present stage of our study. 10. The finding of sanguinous pleural fluid in the patient of granulomatous pleuritis is quite high (72.7 %) and it was found that the sanguinous pleural fluid was most frequently found in the patients with granulomatous pleuritis in non-cancerous age. 11. Two groups of pleurisy patients with or without parenchymal lung lesion on chest X-ray were discussed in correlation with the results of the needle biopsy. It was found that the incidence of the pathological evidence of granulomatous inflammation on the biopsy specimens in these two groups is almost the same regardless of the presence of the demonstrable parenchymal lung lesion. 12. Histopathological finding of granulomatous pleuritis was discussed in conjunction with the significance of two types of tubercles, the soft tubercles and hard tubercles. In all specimens diagnosed as granulomatous pleuritis granulomas were demonstrated ranging from large, conglomerate tubercles with central caseation or giant cells to small granulomas without central caseation or Langhans' giant cells. 13. Histopathological significance of the finding of non-specific pleuritis on the biopsy specimens was discussed and the existence of a specific entity of &#34;non-specific pleuritis&#34; which is equivalent to the non-specific inflammation of the pericardium. 14. Cases of pleurisy due to paragonomiasis were discussed and the need of specific attention for search of new cases was emphasized.</p