2,210 research outputs found

    Congenital hepatic fibrosis leading to cirrhosis and hepatocellular carcinoma: a case report

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    <p>Abstract</p> <p>Introduction</p> <p>Congenital hepatic fibrosis is an uncommon cause of portal hypertension. Despite the presence of portal hypertension, hepatocellular and renal function are usually well preserved. Congenital hepatic fibrosis is included in the group of congenital diseases of fibropolycystic disorders. These include a broad spectrum of clinical diseases which are usually accompanied by hepatic involvement.</p> <p>Case presentation</p> <p>We report the case of a 27-year-old Iranian woman with congenital hepatic fibrosis leading to cirrhosis and subsequently hepatocellular carcinoma.</p> <p>Conclusion</p> <p>Advanced cirrhosis was diagnosed and our patient was scheduled for liver transplantation. During preparation for transplant, a hepatic mass was discovered which was found to be hepatocellular carcinoma. Radiofrequency ablation was performed and our patient was referred for transplantation.</p

    A case of limbic encephalitis presenting as a paraneoplastic manifestation of limited stage small cell lung cancer: a case report

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    <p>Abstract</p> <p>Introduction</p> <p>The differential diagnosis of altered mental status and behavioral change is very extensive. Paraneoplastic limbic encephalitis is a rare cause of cognitive impairment, which should be considered in the differential diagnosis.</p> <p>Case presentation</p> <p>A 64-year-old British Caucasian woman presented to our hospital with a 12-week history of confusion and short-term memory loss. She was hyponatremic with a serum sodium level of 128mmol/L. Moreover, there was evidence of left hilar prominence on the chest radiograph. A thoracic computed tomography scan showed left hilar opacity with confluent lymphadenopathy. A percutaneous biopsy confirmed a diagnosis of small cell lung cancer. There was no radiological evidence of brain metastasis on the computed tomography scan. In view of continued cognitive impairment, which was felt to be disproportionate to hyponatremia, a magnetic resonance imaging scan of the brain was undertaken. It showed hyperintense signals from both hippocampi, highly suggestive of limbic encephalitis presenting as a paraneoplastic manifestation of small cell lung cancer. She had a significant radiological and clinical response following chemotherapy and radiotherapy.</p> <p>Conclusion</p> <p>This case highlights the importance of considering paraneoplastic syndromes in patients with neurological symptoms in the context of lung malignancy. If initial investigations fail to reveal the cause of cognitive impairment in a patient with malignancy, magnetic resonance imaging may be invaluable in the diagnosis of limbic encephalitis. The clinical presentation, diagnostic techniques and management of paraneoplastic limbic encephalitis are discussed in this case report.</p

    Design optimisation of reinforced concrete pile foundation using generalised reduced gradient algorithm

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    Purpose – The purpose of this study is to find the optimum design of Reinforced Concrete (RC) pile foundation to enable efficient use of structural concrete with greater consequences for global environment and economy. Design/methodology/approach – A non-linear optimisation technique based on the Generalised Reduced Gradient (GRG) algorithm was implemented to find the minimum cost of RC pile foundation in frictional soil. This was achieved by obtaining the optimum pile satisfying the serviceability and ultimate limit state requirements of BS 8004 and EC 7. The formulated structural optimisation procedure was applied to a case study project to assess the efficiency of the proposed design formulation. Findings – The results prove that the GRG method in Excel solver is an active, fast, accurate and efficient computer programme to obtain optimum pile design. The application of the optimisation for the case study project shows up to 26% cost reduction compared to the conventional design. Research limitations/implications – The design and formulation of design constraints will be limited to provisions of BS 8004 and EC 7. Practical implications – Since the minimum quantity of concrete was attained through optimisation, then minimum cement will be used and thus result in minimum CO2 emission. Therefore, the optimum design of concrete structures is a vital solution to limit the damage to the Earth’s climate and the physical environment resulting from high carbon emissions. Originality/value – The current study considers the incorporation of different soil ground parameters in the optimisation process rather than assuming any pile capacity value for the optimisation process

    Genetic diversity and population structure of Ascochyta rabiei from the western Iranian Ilam and Kermanshah provinces using MAT and SSR markers

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    Knowledge of genetic diversity in A. rabiei provides different levels of information that are important in the management of crop germplasm resources. Gene flow on a regional level indicates a significant potential risk for the regional spread of novel alleles that might contribute to fungicide resistance or the breakdown of resistance genes. Simple sequence repeat (SSR) and mating type (MAT) markers were used to determine the genetic structure, and estimate genetic diversity and the prevalence of mating types in 103 Ascochyta rabiei isolates from seven counties in the Ilam and Kermanshah provinces of western Iran (Ilam, Aseman abad, Holaylan, Chardavol, Dareh shahr, Gilangharb, and Sarpul). A set of 3 microsatellite primer pairs revealed a total of 75 alleles; the number of alleles varied from 15 to 34 for each marker. A high level of genetic variability was observed among A. rabiei isolates in the region. Genetic diversity was high (He = 0.788) within populations with corresponding high average gene flow and low genetic distances between populations. The smallest genetic distance was observed between isolates from Ilam and Chardavol. Both mating types were present in all populations, with the majority of the isolates belonging to Mat1-1 (64%), but within populations the proportions of each mating type were not significantly different from 50%. Results from this study will be useful in breeding for Ascochyta blight-resistant cultivars and developing necessary control measures

    Common carp (Cyprinus carpio L.) alters its feeding niche in response to changing food resources: direct observations in simulated ponds

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    We used customized fish tanks as model fish ponds to observe grazing, swimming, and conspecific social behavior of common carp (Cyprinus carpio) under variable food-resource conditions to assess alterations in feeding niche. Different food and feeding situations were created by using only pond water or pond water plus pond bottom sediment or pond water plus pond bottom sediment and artificial feeding. All tanks were fertilized twice, prior to stocking and 2 weeks later after starting the experiment to stimulate natural food production. Common carp preferred artificial feed over benthic macroinvertebrates, followed by zooplankton. Common carp did not prefer any group of phytoplankton in any treatment. Common carp was mainly benthic in habitat choice, feeding on benthic macroinvertebrates when only plankton and benthic macroinvertebrates were available in the system. In the absence of benthic macroinvertebrates, their feeding niche shifted from near the bottom of the tanks to the water column where they spent 85% of the total time and fed principally on zooplankton. Common carp readily switched to artificial feed when available, which led to better growth. Common carp preferred to graze individually. Behavioral observations of common carp in tanks yielded new information that assists our understanding of their ecological niche. This knowledge could be potentially used to further the development of common carp aquaculture

    Vestibular schwannoma with contralateral facial pain – case report

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    BACKGROUND: Vestibular schwannoma (acoustic neuroma) most commonly presents with ipsilateral disturbances of acoustic, vestibular, trigeminal and facial nerves. Presentation of vestibular schwannoma with contralateral facial pain is quite uncommon. CASE PRESENTATION: Among 156 cases of operated vestibular schwannoma, we found one case with unusual presentation of contralateral hemifacial pain. CONCLUSION: The presentation of contralateral facial pain in the vestibular schwannoma is rare. It seems that displacement and distortion of the brainstem and compression of the contralateral trigeminal nerve in Meckel's cave by the large mass lesion may lead to this atypical presentation. The best practice in these patients is removal of the tumour, although persistent contralateral pain after operation has been reported

    Lateral rectus metastasis from an occult systemic malignancy masquerading as abducens palsy: a case report

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    <p>Abstract</p> <p>Introduction</p> <p>Abduction deficit in the elderly is commonly caused by sixth cranial nerve palsy due to microvasculopathy. However, not all such cases are of neurogenic origin, as our case report shows.</p> <p>Case presentation</p> <p>We present the case of a 75-year-old woman who was generally unwell, developed acute diplopia and was found to have a right abduction deficit in a quiet eye with no gross orbital signs and symptoms. A computed tomography scan of the head and orbits revealed a metastatic mass in the right lateral rectus muscle. Systemic evaluation confirmed widespread thoracic and abdominal metastases from an occult systemic malignancy. Lateral rectus metastasis from an occult systemic malignancy was masquerading as abducens palsy.</p> <p>Conclusion</p> <p>Orbital metastasis involving extraocular muscles can present as isolated diplopia with minimal local signs and the absence of a history of systemic malignancy. A detailed history and systemic examination can identify suspicious cases, which should be investigated further. The clinician should avoid presuming that such an abduction deficit in the elderly is a benign neurogenic palsy.</p

    Social media usage among wine tourism DMOs

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    Social media is an important tool for tourism destination promotion. The usage and the contents published on these platforms have an important role in visitors’ decision-making process. Information and communication technologies are changing DMOs’ markets and communication paradigm, since they allow the interaction between these organizations, visitors, and stakeholders. Therefore, social media are increasing their relevance on DMOs’ marketing strategies. This purpose of this study is to analyze comparatively social media platforms’ usage by six wine tourism DMOs. The results were provided by the analysis of secondary data available on these platforms and DMOs posts on the four most popular social media platforms to tourism industry: Facebook, Instagram, Twitter, and YouTube. Results indicate that DMOs use their official accounts on these platforms on different ways. This study also reveals that Facebook is more interactive than other platforms, and YouTube achieves less engagement levels.info:eu-repo/semantics/publishedVersio
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