Secondary membranous nephropathy associated with guillain-barré syndrome.

Membranous nephropathy (MN) is one of the most common causes of nephrotic syndrome (NS) in adults. It may be primary, usually mediated by IgG4 anti-phospholipase A2 autoantibodies or secondary to various other conditions. Guillain- Barré syndrome (GBS) has been associated with MN, but a cause and effect relation has not been proven. We present a case of concurrent development of GBS and severe NS, with renal biopsy demonstrating MN. IgG4 stain was negative, indicating that most likely, the MN was secondary and probably caused by the underlying GBS

Sacred communities: contestations and connections

This article discusses a project whose purpose was to review existing qualitative and quantitative data from two separate studies to provide new insights about everyday religion and belonging. Researchers engaged in knowledge exchange and dialogue with new and former research participants, with other researchers involved in similar research, and with wider academic networks beyond the core disciplines represented here, principally anthropology and geography. Key concluding themes related to the ambivalent nature of ‘faith’, connections over place and time, and the contested nature of community. Implicit in terms like ‘faith’, ‘community’, and ‘life course’ are larger interwoven narratives of space, time, place, corporeality, and emotion. The authors found that understanding how places, communities, and faiths differ and intersect requires an understanding of social relatedness and boundaries

Cerebral Arteriovenous Malformations: Evaluation and Management.

There has been increased detection of incidental AVMs as result of the frequent use of advanced imaging techniques. The natural history of AVM is poorly understood and its management is controversial. This review provides an overview of the epidemiology, pathophysiology, natural history, clinical presentation, diagnosis, and management of AVMs. The authors discussed the imaging techniques available for detecting AVMs with regard to the advantages and disadvantages of each imaging modality. Furthermore, this review paper discusses the factors that must be considered for the most appropriate management strategy (based on the current evidence in the literature) and the risks and benefits of each management option

Novel partial anomalous pulmonary venous connection associated with brain abscess.

BACKGROUND: Right-to-left vascular shunts are associated with brain abscess. CASE REPORT: We present a 47-year-old female with a cryptogenic left thalamic abscess on which Streptococcus mitis grew upon aspiration. Computed tomography of the chest with contrast agent revealed an anomalous connection between the left superior pulmonary and brachiocephalic veins. A right-to-left shunt was confirmed in a transthoracic echocardiogram study in which bubbles were injected into the left arm; this shunt had not previously been noted upon right-arm injection. CONCLUSIONS: We recommend aggressive evaluation for right-to-left shunts in patients who present with cryptogenic brain abscesses. In addition to imaging, this should include a bubble-based study with left-arm saline injection

Declaring a Patient Brain Dead on Extracorporeal Membrane Oxygenation (ECMO): Are There Guidelines or Misconceptions

Objectives: To review the clinical practice variations and trends with declaring patients brain dead on ECMO To highlight the need for the development of consensus guidelines to assist clinicians in the accurate diagnosis of brain death in this specific patient populatio

Deep CCD Surface Photometry of Galaxy Clusters I: Methods and Initial Studies of Intracluster Starlight

We report the initial results of a deep imaging survey of galaxy clusters. The primary goals of this survey are to quantify the amount of intracluster light as a function of cluster properties, and to quantify the frequency of tidal debris. We outline the techniques needed to perform such a survey, and we report findings for the first two galaxy clusters in the survey: Abell 1413, and MKW 7 . These clusters vary greatly in richness and structure. We show that our surface photometry reliably reaches to a surface brightness of \mu_v = 26.5 mags per arcsec. We find that both clusters show clear excesses over a best-fitting r^{1/4} profile: this was expected for Abell 1413, but not for MKW 7. Both clusters also show evidence of tidal debris in the form of plumes and arc-like structures, but no long tidal arcs were detected. We also find that the central cD galaxy in Abell 1413 is flattened at large radii, with an ellipticity of $\approx 0.8$, the largest measured ellipticity of any cD galaxy to date.Comment: 58 pages, 24 figures, accepted for publication in the Astrophysical Journal. Version has extremely low resolution figures to comply with 650k limit. High resolution version is available at http://burro.astr.cwru.edu/johnf/icl1.ps.gz Obtaining high resolution version is strongly reccomende

A Chandra Observation of the Obscured Star-Forming Complex W40

The young stellar cluster illuminating the W40 H II region, one of the nearest massive star forming regions, has been observed with the ACIS detector on board the Chandra X-ray Observatory. Due to its high obscuration, this is a poorly-studied stellar cluster with only a handful of bright stars visible in the optical band, including three OB stars identified as primary excitation sources. We detect 225 X-ray sources, of which 85% are confidently identified as young stellar members of the region. Two potential distances of the cluster, 260 pc and 600 pc, are used in the paper. Supposing the X-ray luminosity function to be universal, it supports a 600 pc distance as a lower limit for W40 and a total population of at least 600 stars down to 0.1 Mo under the assumption of a coeval population with a uniform obscuration. In fact, there is strong spatial variation in Ks-band-excess disk fraction and non-uniform obscuration due to a dust lane that is identified in absorption in optical, infrared and X-ray. The dust lane is likely part of a ring of material which includes the molecular core within W40. In contrast to the likely ongoing star formation in the dust lane, the molecular core is inactive. The star cluster has a spherical morphology, an isothermal sphere density profile, and mass segregation down to 1.5 Mo. However, other cluster properties, including a \leq{1} Myr age estimate and ongoing star formation, indicate that the cluster is not dynamically relaxed. X-ray diffuse emission and a powerful flare from a young stellar object are also reported.Comment: Accepted for publication in The Astrophysical Journal. 60 pages, 16 figure

Drum-Boiler Dynamics

This paper describes a nonlinear dynamic model for natural circulation drum-boilers. The nonlinear model which is intended for model based control focuses on the complicated dynamics ofthe drum, downcomer, and riser components. A strong effort has been made to strike a balance between fidelity and simplicity. The model is derived from first principles, and is characterized by a few physical parameters. Results from validation of the model against unique plant data are presented. The model captures the shrink and swell effect very well. It also describes the behavior of the system over a wide operating range