The long-term course of shoulder complaints:a prospective study in general practice

Objective. Assessment of the long-term course of shoulder complaints in patients in general practice with special focus on changes in diagnostic category and fluctuations in the severity of the complaints. Design. Prospective descriptive study. Setting. Four general practices in The Netherlands. Method. All patients (101) with shoulder complaints seen in a 5 month period were included. Assessment took place 26 weeks and 12-18 months after inclusion in the study with a pain questionnaire and a physical examination. Results. A total of 51% of the patients experienced (mostly recurrent) complaints after 26 weeks and 41% after 12-18 months. Diagnostic changes were found over the course of time, mostly from synovial disorders towards functional disorders of the structures of the shoulder girdle, but also the other way round. Although 52 of the 101 patients experienced complaints in week 26, 62% of those patients considered themselves 'cured'. After 12-18 months, 51% of the 39 patients experiencing complaints felt 'cured'. Conclusion. Many patients seen with shoulder complaints in general practice have recurrent complaints. The nature of these complaints varies considerably over the course of time, leading to changes in diagnostic category. Because of the fluctuating severity of the complaints over time, feeling 'cured' or not 'cured' is also subject to change over time

Granular cell tumors of the urinary bladder

BACKGROUND: Granular cell tumors (GCTs) are extremely rare lesions of the urinary bladder with only nine cases being reported in world literature of which one was malignant. Generally believed to be of neural origin based on histochemical, immunohistochemical, and ultrastructural studies; they mostly follow a clinically benign course but are commonly mistaken for malignant tumors since they are solid looking, ulcerated tumors with ill-defined margins. MATERIALS AND METHODS: We herein report two cases of GCTs, one benign and one malignant, presenting with gross hematuria in a 14- and a 47-year-old female, respectively. RESULTS: Histopathology revealed characteristic GCTs with positive immunostaining for neural marker (S-100) and negative immunostaining for epithelial (cytokeratin, Cam 5.2, AE/A13), neuroendocrine (neuron specific enolase, chromogranin A, and synaptophysin) and sarcoma (desmin, vimentin) markers. The benign tumor was successfully managed conservatively with transurethral resection alone while for the malignant tumor, radical cystectomy, hysterectomy with bilateral salpingo-oophorectomy, anterior vaginectomy, plus lymph node dissection was done. Both cases show long-term disease free survival. CONCLUSION: We recommend careful pathologic assessment for establishing the appropriate diagnosis and either a conservative or aggressive surgical treatment for benign or localized malignant GCT of the urinary bladder, respectively

Protégé: A Tool for Managing and Using Terminology in Radiology Applications

The development of standard terminologies such as RadLex is becoming important in radiology applications, such as structured reporting, teaching file authoring, report indexing, and text mining. The development and maintenance of these terminologies are challenging, however, because there are few specialized tools to help developers to browse, visualize, and edit large taxonomies. Protégé (http://protege.stanford.edu) is an open-source tool that allows developers to create and to manage terminologies and ontologies. It is more than a terminology-editing tool, as it also provides a platform for developers to use the terminologies in end-user applications. There are more than 70,000 registered users of Protégé who are using the system to manage terminologies and ontologies in many different domains. The RadLex project has recently adopted Protégé for managing its radiology terminology. Protégé provides several features particularly useful to managing radiology terminologies: an intuitive graphical user interface for navigating large taxonomies, visualization components for viewing complex term relationships, and a programming interface so developers can create terminology-driven radiology applications. In addition, Protégé has an extensible plug-in architecture, and its large user community has contributed a rich library of components and extensions that provide much additional useful functionalities. In this report, we describe Protégé’s features and its particular advantages in the radiology domain in the creation, maintenance, and use of radiology terminology

Ability of Archival Tags to Provide Estimates of Geographical Position Based on Light Intensity

Key words: archival tags, ambient light level, geoposition algorithm, light attenuation, positional errors, crepuscular, Equinox, pelagic fishes Abstract: We tested the ability of archival tags and their associated algorithms to esti-mate geographical position based on ambient light intensity by attaching six tags (three tags each from Northwest Marine Technologies [NMT] and Wild-life Computers [WC]) at different depths to a stationary mooring line in the Pacific Ocean (approx. 166º42'W, 24º00'N), for approximately one year (29-Aug-98 to 16-Aug-99). Upon retrieval, one tag each from the two vendors had malfunctioned: from these no data (NMT) or only partial data (WC) could be downloaded. An algorithm onboard the NMT tag automatically calculated geographical positions. For the WC tags, three different algorithms were used to estimate geographical positions from the recorded light intensity data. Es-timates of longitude from all tags were significantly less variable than those for latitude. The mean absolute error for longitude estimates from the NMT tags ranged from 0.29 to 0.35º, and for the WC tags from 0.13 to 0.25º. Th

Imaging aspects of cardiovascular disease at the cell and molecular level

Cell and molecular imaging has a long and distinguished history. Erythrocytes were visualized microscopically by van Leeuwenhoek in 1674, and microscope technology has evolved mightily since the first single-lens instruments, and now incorporates many types that do not use photons of light for image formation. The combination of these instruments with preparations stained with histochemical and immunohistochemical markers has revolutionized imaging by allowing the biochemical identification of components at subcellular resolution. The field of cardiovascular disease has benefited greatly from these advances for the characterization of disease etiologies. In this review, we will highlight and summarize the use of microscopy imaging systems, including light microscopy, electron microscopy, confocal scanning laser microscopy, laser scanning cytometry, laser microdissection, and atomic force microscopy in conjunction with a variety of histochemical techniques in studies aimed at understanding mechanisms underlying cardiovascular diseases at the cell and molecular level

Individual Differences and Metacognitive Knowledge of Visual Search Strategy

A crucial ability for an organism is to orient toward important objects and to ignore temporarily irrelevant objects. Attention provides the perceptual selectivity necessary to filter an overwhelming input of sensory information to allow for efficient object detection. Although much research has examined visual search and the ‘template’ of attentional set that allows for target detection, the behavior of individual subjects often reveals the limits of experimental control of attention. Few studies have examined important aspects such as individual differences and metacognitive strategies. The present study analyzes the data from two visual search experiments for a conjunctively defined target (Proulx, 2007). The data revealed attentional capture blindness, individual differences in search strategies, and a significant rate of metacognitive errors for the assessment of the strategies employed. These results highlight a challenge for visual attention studies to account for individual differences in search behavior and distractibility, and participants that do not (or are unable to) follow instructions