Poema de Fernan Gonçalez

lviii, 224 p

Minorities in American society

xiv, 493 p.; 23 cm

The phonology of the Spanish dialect of Mexico City /

"Reprinted from the Publications of the Modern Language Association of America [new ser.] vol. IV, no. 1 [i.e. 4]"--Title page verso.Vita.Ph. D. Johns Hopkins University 1894Includes bibliographical references (pages 5-11)

Improvement of severe myalgic encephalomyelitis/chronic fatigue syndrome symptoms following surgical treatment of cervical spinal stenosis

Abstract Background Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a potentially disabling disorder. Little is known about the contributors to severe forms of the illness. We describe three consecutive patients with severe ME/CFS whose symptoms improved after recognition and surgical management of their cervical spinal stenosis. Methods All patients satisfied clinical criteria for ME/CFS and orthostatic intolerance, and were later found to have cervical spinal stenosis. Overall function was assessed before and after surgery using the Karnofsky score and the SF-36 physical function subscale score. Results Neurological findings included > 3+ deep tendon reflexes in 2 of 3, a positive Hoffman sign in 2 of 3, tremor in 2 of 3, and absent gag reflex in 1 of 3. The cervical spine canal diameter in the three patients ranged from 6 to 8.5 mm. One had congenital cervical stenosis with superimposed spondylosis, and two had single- or two-level spondylosis. Anterior cervical disc replacement surgery in two patients and a hybrid anterior cervical disc fusion and disc replacement in the third was associated with a marked improvement in myelopathic symptoms, resolution of lightheadedness and hemodynamic dysfunction, improvement in activity levels, and improvement in global ME/CFS symptoms. Conclusions The prompt post-surgical restoration of more normal function suggests that cervical spine stenosis contributed to the pathogenesis of refractory ME/CFS and orthostatic symptoms. The improvements following surgery emphasize the importance of a careful search for myelopathic examination findings in those with ME/CFS, especially when individuals with severe impairment are not responding to treatment

Redeye Crossing Reach, Lower Mississippi River. Report 1: Sediment Investigation

Source: https://erdc-library.erdc.dren.mil/jspui/The sedimentation study conducted on the Redeye Crossing Reach of the Mississippi River about 3 miles downstream of Baton Rouge, LA, was a combination of numerical and physical movable-bed model studies to aid in the development of a satisfactory dike design for this reach. A two-dimensional numerical model, TABS-2, was used to predict the reduction in dredging that could be anticipated with the original dike design and subsequent modifications. Those modifications included changing the length, height, location, and number of spur dikes. The plans investigated addressed the required dike plan to maintain the existing 40-ft navigation channel through the reach and an enhancement of that plan to provide a 45-ft channel to be developed in the near future. Since no dikes presently exist in this portion of the Mississippi River, the physical movable-bed model study was also conducted to take advantage of the capabilities of both types of models. Thus the overall study allowed use of the numerical model to screen plans and the physical model to address detailed impacts of the plans. The physical model was constructed to a horizontal scale of 1:240 and a vertical scale of 1:200 including the river channel and overbank areas to the adjacent levees. During the overall testing program the numerical model was used to refine and test dikes plans. The dike plans deemed most successful from the numerical sedimentation model were also tested on the physical model

Covered Stent Treatment of Carotid Blowout Syndrome

Carotid artery blowout is a devastating complication of head and neck malignancy, irradiation, and trauma. New endovascular therapies of acute carotid artery rupture involve stent-directed, carotid-sparing treatment strategies. We report a case of successful covered stent treatment of carotid artery hemorrhage in the setting of head and neck cancer and review the literature describing the use of this therapeutic method. Evaluation of 19 recently reported cases of covered stent treatment of carotid artery blowout due to head and neck cancer and presenting with sentinel or acute hemorrhage demonstrates that this method is a fast and effective means of controlling bleeding, with a technical success rate of ~95%. A significant early recurrent hemorrhage rate raises concern regarding the short-term safety and efficacy of this therapy, however, and suggests that stent graft treatment of carotid artery rupture due to head and neck malignancy is best suited as a temporizing measure before more definitive therapy