A Case of Atypical McCune-Albright Syndrome with Vaginal Bleeding

Abstract Background: McCune-Albright syndrome (MAS) is a rare non-inherited disorder characterized by the clinical triad of precocious puberty, cafe-au-lait skin lesions, and fibrous dysplasia of bone. Case Presentation: We report a girl with MAS, presenting initially with vaginal bleeding at the age of 17 months. Ultrasonography revealed unilateral ovarian cysts and ureteral and ovarian enlargement. Considering the clinical and paraclinical findings, the patient diagnosed as a case of gonadotropin-independent precocious puberty was treated with medroxy-progestrone acetate (MPA) for three months. During the follow up, recurrent episodes of bleeding, ovarian activation and cyst formation, as well as breast size development were reported. At the age of 5.5 years, fibrous dysplasia was detected, which in coexistence with precocious puberty confirmed the diagnosis of MAS. The patient had no cafe-au-lait skin macles during follow up. Conclusion: Considering that clinical manifestations of MAS appear later in the course of recurrent periods of ovarian activation and cyst formation, a careful clinical observation and follow up of patients is necessary and the diagnosis of MAS must be kept in mind in cases with gonadotropinindependent precocious puberty

The effect of (Ti + Al): V ratio on the structure and oxidation behaviour of TiAlN/VN nano-scale multilayer coatings

Nano-scaled multilayered TiAlN/VN coatings have been grown on stainless steel and M2 high speed steel substrates at U-B = - 85 V in an industrial, four target, Hauzer HTC 1000 coater using combined cathodic steered arc etching/unbalanced magnetron sputtering. X-ray diffraction (XRD) has been used to investigate the effects of process parameters (Target Power) on texture evolution (using texture parameter T*), development of residual stress (sin(2) psi method) and nano-scale multilayer period. The composition of the coating was determined using energy dispersive X-ray analysis. The thermal behaviour of the coatings in air was studied using thermo-gravimetric analysis, XRD and scanning electron microscopy. The bi-layer period varied between 2.8 and 3.1 nm and in all cases a {1 1 0} texture developed with a maximum value T* = 4.9. The residual stress varied between -5.2 and -7.4 GPa. The onset of rapid oxidation occurred between 628 and 645 degreesC depending on the (Ti+Al):V ratio. After oxidation in air at 550 degreesC AlVO4, TiO2 and V2O5 Phases were identified by XRD with the AlVO4, TiO2 being the major phases. The formation of AlVO4 appears to disrupt the formation of Al2O3 which imparts oxidation resistance to TiAlN based coatings. Increasing the temperature to 600 and 640 degreesC led to a dramatic increase in the formation of V2O5 which was highly oriented (0 0 1) with a plate-like morphology. At 640 degreesC there was no evidence of the coating on XRD. Increasing the temperature to 670 degreesC led to further formation of AlVO4 and a dramatic reduction in V2O5. (C) 2003 Elsevier B.V. All rights reserved

Substrate finishing and niobium content effects on the high temperature corrosion resistance in steam atmosphere of CrN/NbN superlattice coatings deposited by PVD-HIPIMS

The main objective of this work was to evaluate the oxidation resistance of three PVD-HIPIMS CrN/NbN coatings, studying the effect of the surface finishing of the substrate and the role of niobium content into the coating composition. CrN/NbN nano-multilayered films on P92 steel were tested at 650°C in pure steam atmosphere. The mass gain was measured at fixed intervals to study their oxidation kinetics. The morphology and thickness of nanoscales were measured by transmission electron microscopy (TEM). Characterization of coatings before and after the thermal treatment was performed by scanning electron microscopy-energy with facilities of dispersive X-ray spectroscopy (SEM–EDX) and X-ray diffraction (XRD). All coatings improved the oxidation resistance of the substrate material, but the best behaviour was exhibited by the CrN/NbN with the high niobium (Nb) content and deposited on the substrate with the finest surface finishing

The role of the automation development group in analytical research and development at Dupont Merck

Laboratory robotics has been firmly established in many non-QC laboratories as a valuable tool for automating pharmaceutical dosage form analysis. Often a single project or product line is used to justify an initial robot purchase thus introducing robotics to the laboratory for the first time. However, to gain widespread acceptance within the laboratory and to justify further investment in robotics, existing robots must be used to develop analyses for existing manual methods as well as new projects beyond the scope off the original purchase justification. The Automation Development Group in Analytical Research and Development is a team of analysts primarily devoted to developing new methods and adapting existing methods for the robot. This team approach developed the expertise and synergy necessary to significantly expand the contribution of robotics to automation in the authors' laboratory

TEM-EELS study of low-friction superlattice TiAlN/VN coating: the wear mechanisms

A 20-50 nm thick tribofilm was generated on the worn surface of a multilayer coating TiAlN/VN after dry sliding test against an alumina counterpart. The tribofilm was characterized by applying analytical transmission electron microscopy techniques with emphasis on detailed electron energy loss spectrometry and energy loss near edge structure analysis. Pronounced oxygen in the tribofilm indicated a predominant tribo-oxidation wear. Structural changes in the inner-shell ionization edges of N, Ti and V suggested decomposition of nitride fragments

A MODELING-BASED CLASSIFICATION ALGORITHM VALIDATED WITH SIMULATED DATA

We present a Generalized Lotka-Volterra (GLV) based approach for modeling and simulation of supervised inductive learning, and construction of an efficient classification algorithm. The GLV equations, typically used to explain the biological world, are employed to simulate the process of inductive learning. In addition, the modeling approach provides a key advantage over the more conventional constraint and optimization-based classification algorithms, as influences of outliers and local patterns, which can lead to problematic overfitting, are auto-moderated by the model itself. We present the bare-bones algorithm and motivate the model through axiomatic postulates. The algorithm is validated using benchmark simulated datasets, showing results competitive with other cutting-edge algorithms.

Uterine Fibroid Embolisation for Symptomatic Uterine Fibroids: A Survey of Clinical Practice in Europe

Item does not contain fulltextPURPOSE: To assess current uterine fibroid embolisation (UFE) practice in European countries and determine the clinical environment for UFE in different hospitals. MATERIAL AND METHODS: In May 2009, an invitation for an online survey was sent by e-mail to all members of the Cardiovascular and Interventional Radiologic Society of Europe, representing a total number of 1,250 different candidate European treatment centres. The survey covered 21 questions concerning local UFE practice. RESULTS: A total of 282 respondents completed the questionnaire. Fifteen questionnaires were excluded because they were doubles from centres that had already returned a questionnaire. The response rate was 267 of 1,250 centres (21.4%). Ninety-four respondents (33%) did not perform UFE and were excluded, and six centres were excluded because demographic data were missing. The remaining 167 respondents from different UFE centres were included in the study. Twenty-six percent of the respondents were from the United Kingdom (n = 43); 16% were from Germany (n = 27); 11% were from France (n = 18); and the remaining 47% (n = 79) were from other European countries. Most centres (48%, n = 80) had 5 to 10 years experience with UFE and performed 10 to 50 procedures annually (53% [n = 88]) of respondents). Additional demographic data, as well as specific data on referral of patients, UFE techniques used, and periprocedural and postprocedural, care will be provided. CONCLUSION: Although UFE as an alternative treatment for hysterectomy or myomectomy is widespread in Europe, its impact on the management of the patient with symptomatic fibroids seems, according to the overall numbers of UFE procedures, somewhat disappointing. Multiple factors might be responsible for this observation

Experience of sexual coercion and risky sexual behavior among Ugandan university students

<p>Abstract</p> <p>Background</p> <p>Growing worldwide evidence shows that the experience of sexual coercion is fairly prevalent among young people and is associated with risky sexual behavior thereafter. The causal mechanisms behind this are unclear but may be dependent on specific contextual determinants. Little is known about factors that could buffer the negative effects of coercion. The aim of this study was to assess the association between the experience of sexual coercion and risky sexual behavior among university students of both sexes in Uganda.</p> <p>Methods</p> <p>In 2005, 980 (80%) out of a total of 1,220 students enrolled in Mbarara University of Science and Technology in Uganda participated in a self-administered questionnaire covering socio-demographic and religious factors, social capital, mental health, alcohol use, and sexual behavior. A validated scale of six items was used to assess the experience of sexual coercion. Logistic regression analyses were applied to control for confounders. Potential buffering factors were analyzed by testing for effect modification.</p> <p>Results</p> <p>Fifty-nine percent of those who responded had previously had sexual intercourse. Among the male students 29.0%, and among the female students 33.1% reported having had some experience of sexual coercion. After controlling for age, gender, and educational level of household of origin, role of religion and trust in others sexual coercion was found to be statistically significantly associated with previously had sex (OR 1.6, 95% CI; 1.1-2.3), early sexual debut (OR 2.4, 95% CI; 1.5-3.7), as well as with having had a great number of sexual partners (OR 1.9, 95% CI; 1.2-3.0), but not with inconsistent condom use.</p> <p>Scoring low on an assessment of mental health problems, reporting high trust in others, or stating that religion played a major role in one's family of origin seemed to buffer the negative effect that the experience of sexual coercion had on the likelihood of having many sexual partners.</p> <p>Conclusion</p> <p>The findings of this study suggest that the experience of sexual coercion is common among youth/young adults in Uganda and is subsequently associated with risky sexual behavior in both sexes. The existence of individual and contextual factors that buffer the effects mentioned was also demonstrated. In the Ugandan context, this has implications for policy formulation and the implementation of preventive strategies for combating HIV/AIDS.</p

Hemodynamic predictors of aortic dilatation in bicuspid aortic valve by velocity-encoded cardiovascular magnetic resonance

<p>Abstract</p> <p>Background</p> <p>Congenital Bicuspid Aortic Valve (BAV) is a significant risk factor for serious complications including valve dysfunction, aortic dilatation, dissection, and sudden death. Clinical tools for identification and monitoring of BAV patients at high risk for development of aortic dilatation, an early complication, are not available.</p> <p>Methods</p> <p>This paper reports an investigation in 18 pediatric BAV patients and 10 normal controls of links between abnormal blood flow patterns in the ascending aorta and aortic dilatation using velocity-encoded cardiovascular magnetic resonance. Blood flow patterns were quantitatively expressed in the angle between systolic left ventricular outflow and the aortic root channel axis, and also correlated with known biochemical markers of vessel wall disease.</p> <p>Results</p> <p>The data confirm larger ascending aortas in BAV patients than in controls, and show more angled LV outflow in BAV (17.54 ± 0.87 degrees) than controls (10.01 ± 1.29) (p = 0.01). Significant correlation of systolic LV outflow jet angles with dilatation was found at different levels of the aorta in BAV patients STJ: r = 0.386 (N = 18, p = 0.048), AAO: r = 0.536 (N = 18, p = 0.022), and stronger correlation was found with patients and controls combined into one population: SOV: r = 0.405 (N = 28, p = 0.033), STJ: r = 0.562 (N = 28, p = 0.002), and AAO r = 0.645 (N = 28, p < 0.001). Dilatation and the flow jet angle were also found to correlate with plasma levels of matrix metallo-proteinase 2.</p> <p>Conclusions</p> <p>The results of this study provide new insights into the pathophysiological processes underlying aortic dilatation in BAV patients. These results show a possible path towards the development of clinical risk stratification protocols in order to reduce morbidity and mortality for this common congenital heart defect.</p