Cerebral amyloid angiopathy-related inflammation – A case report presenting diagnostic difficulties

We describe an 86-year-old woman with a history of hypertension who presented sudden disturbances of consciousness and left hemiparesis. Brain magnetic resonance imaging (MRI) revealed diffused hyperintensive changes on T2-weighted images localized subcortically in the white matter of both cerebral hemispheres, corresponding to acute vasogenic edema, causing moderate mass effect. Posterior reversible encephalopathy syndrome was initially diagnosed. After implementation of anti-edema intravenous steroid treatment and hypotensive therapy the symptoms began to retire, till the total regression. The successive hospitalizations took place two and eight months later due to the occurrence of seizures, motor deficits and the development of mild cognitive impairment. Brain MRI revealed progression of the white matter changes and diffused subcortical microhemorrhages. Each time pulse steroid therapy was implemented and the symptoms improved significantly after several days. Chronic oral steroid treatment resulted in the stabilization of neurological status. The long-term observation of clinical symptoms, remission after immunosuppressive therapy and white matter changes with subcortical microhemorrhages in brain MRI leaded to the diagnosis of cerebral amyloid angiopathy-related inflammation

Kemampuan Siswa Dalam Menyelesaikan Soal-soal Uraian Terstruktur Pokok Bahasan Teori Kinetik Gas

"> Penelitian ini bertujuan untuk mengetahui (1) kemampuan kognitif yang dilihat dari hasil belajar peserta didik yang kelas XI MAN Model Palangka Raya dalam mengerjakan soal-soal uraian terstruktur pada pokok bahasan Teori Kinetik Gas; dan (2) kesulitan peserta didik dalam mengerjakan soal-soal uraian terstruktur. Penelitian ini menggunakan metode penelitian kuantitatif dalam mengumpulkan datanya. Penelitian ini menggunakan instrumen dalam bentuk soal uraian terstruktur. Hasil uji coba soal uraian terstruktur pada kelas XI IA-1 MAN Model Palangka Raya mendapatkan tingkat validitas rata-rata 0,536 dan tingkat reliabilitas soal 0,539 dengan kategori cukup. Hasil penelitian menunjukkan bahwa: (1) peserta didik yang mampu dan tidak mengalami masalah dalam mengerjakan soal-soal uraian terstruktur berjumlah 18 peserta didik dan 12 peserta didik tidak mampu dan mengalami masalah dalam mengerjakan soal-soal uraian terstruktur. Peserta didik yang mampu mengerjakan soal-soal uraian terstruktur memiliki ketuntasan belajar ≥ batas KKM, yaitu 60% (2) kesulitan peserta didik dalam mengerjakan soal-soal uraian terstruktur terdapat pada penyebutan dan penulisan satuan besaran pada jawaban dengan persentase kesulitan 36,7%, penguasaan operasi hitungan denganpersentase kesulitan 31,4% dan penulisan besaran yang ditanya dalam soal dengan persentase kesulitan 28,6%

Prawo zobowiązań : materiały dydaktyczne

Do Czytelników "Oddawane w ręce Czytelników materiały dydaktyczne przygotowane zostały z myślą o studentach prawa. Prawo cywilne jest bowiem przedmiotem, którego opanowanie sprawia im zazwyczaj sporo trudności. Często programy studiów przeznaczają na nie więcej godzin zajęć dydaktycznych aniżeli na inne ważne przedmioty. Wynika to po części z obszerności materiału normatywnego, orzecznictwa i literatury, a po części z miejsca, jakie prawo cywilne, a zwłaszcza jego część ogólna i prawo zobowiązań, zajmują w kształceniu prawników. Skłania to do podejmowania starań zmierzających do ułatwienia studentom przygotowania się do wykładów i ćwiczeń oraz zaliczeń i egzaminów. Na rynku znajduje się obecnie sporo publikacji, z których można korzystać, w tym kilka dobrych, mających szereg wydań podręczników oraz komentarze do kodeksów. Jednakże, jak pokazuje doświadczenie, nie wszyscy studenci sięgają po nie dostatecznie chętnie. Niektórych odstrasza sama ich objętość. Zespół pracowników Katedry Prawa Cywilnego Krakowskiej Akademii im. Andrzeja Frycza Modrzewskiego przystąpił więc do przygotowania programu z tego przedmiotu i wypróbował go w ciągu paru lat."(...

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Praca recenzowana / peer-reviewed pape

Efficacy and safety of minimally invasive surgery with thrombolysis in intracerebral haemorrhage evacuation (MISTIE III): a randomised, controlled, open-label, blinded endpoint phase 3 trial

Acute stroke due to supratentorial intracerebral haemorrhage is associated with high morbidity and mortality. Open craniotomy haematoma evacuation has not been found to have any benefit in large randomised trials. We assessed whether minimally invasive catheter evacuation followed by thrombolysis (MISTIE), with the aim of decreasing clot size to 15 mL or less, would improve functional outcome in patients with intracerebral haemorrhage. MISTIE III was an open-label, blinded endpoint, phase 3 trial done at 78 hospitals in the USA, Canada, Europe, Australia, and Asia. We enrolled patients aged 18 years or older with spontaneous, non-traumatic, supratentorial intracerebral haemorrhage of 30 mL or more. We used a computer-generated number sequence with a block size of four or six to centrally randomise patients to image-guided MISTIE treatment (1·0 mg alteplase every 8 h for up to nine doses) or standard medical care. Primary outcome was good functional outcome, defined as the proportion of patients who achieved a modified Rankin Scale (mRS) score of 0-3 at 365 days, adjusted for group differences in prespecified baseline covariates (stability intracerebral haemorrhage size, age, Glasgow Coma Scale, stability intraventricular haemorrhage size, and clot location). Analysis of the primary efficacy outcome was done in the modified intention-to-treat (mITT) population, which included all eligible, randomly assigned patients who were exposed to treatment. All randomly assigned patients were included in the safety analysis. This study is registered with ClinicalTrials.gov, number NCT01827046. Between Dec 30, 2013, and Aug 15, 2017, 506 patients were randomly allocated: 255 (50%) to the MISTIE group and 251 (50%) to standard medical care. 499 patients (n=250 in the MISTIE group; n=249 in the standard medical care group) received treatment and were included in the mITT analysis set. The mITT primary adjusted efficacy analysis estimated that 45% of patients in the MISTIE group and 41% patients in the standard medical care group had achieved an mRS score of 0-3 at 365 days (adjusted risk difference 4% [95% CI -4 to 12]; p=0·33). Sensitivity analyses of 365-day mRS using generalised ordered logistic regression models adjusted for baseline variables showed that the estimated odds ratios comparing MISTIE with standard medical care for mRS scores higher than 5 versus 5 or less, higher than 4 versus 4 or less, higher than 3 versus 3 or less, and higher than 2 versus 2 or less were 0·60 (p=0·03), 0·84 (p=0·42), 0·87 (p=0·49), and 0·82 (p=0·44), respectively. At 7 days, two (1%) of 255 patients in the MISTIE group and ten (4%) of 251 patients in the standard medical care group had died (p=0·02) and at 30 days, 24 (9%) patients in the MISTIE group and 37 (15%) patients in the standard medical care group had died (p=0·07). The number of patients with symptomatic bleeding and brain bacterial infections was similar between the MISTIE and standard medical care groups (six [2%] of 255 patients vs three [1%] of 251 patients; p=0·33 for symptomatic bleeding; two [1%] of 255 patients vs 0 [0%] of 251 patients; p=0·16 for brain bacterial infections). At 30 days, 76 (30%) of 255 patients in the MISTIE group and 84 (33%) of 251 patients in the standard medical care group had one or more serious adverse event, and the difference in number of serious adverse events between the groups was statistically significant (p=0·012). For moderate to large intracerebral haemorrhage, MISTIE did not improve the proportion of patients who achieved a good response 365 days after intracerebral haemorrhage. The procedure was safely adopted by our sample of surgeons. National Institute of Neurological Disorders and Stroke and Genentech. [Abstract copyright: Copyright © 2019 Elsevier Ltd. All rights reserved.

Candidate protein interactors of sexually dimorphic on the Y chromosome (SdY) in Atlantic salmon

Atlantic salmon depend on genetic cues to determine whether an individual is male or female. A novel sex-determining gene, sexually dimorphic on the Y chromosome (sdY), is found exclusively in all salmonids. Unlike other sex-determining genes, sdY lacks a DNA-binding domain. Instead, it is a divergent, truncated form of interferon regulatory factor 9. As a recently discovered gene, little is known about sdY; how it is involved in sex-determination and what proteins interact with it. Identification of protein interactors was done through a variety of techniques including yeast two-hybridization, co-immunoprecipitation and histidine-tagged pull down assays. These assays identified several proteins: SdY itself, 40S ribosomal protein S16 and SA, isocitrate dehydrogenase, heat shock protein HSP 90-beta, and ras GTPase-activating-like protein IQGAP1, as well as creatine kinase, GDP-mannose-4,6-dehydratase, sodium/potassium-transporting ATPase subunit alpha-1, AP-1 complex subunit beta-1, and hydroxysteroid dehydrogenase (17-beta) 4. The yeast two-hybrid assay also identified 3’ UTR of annexin A7-like and transmembrane protein 91-like, most likely false positives. This broad range of candidates has led me to believe that SdY is involved either in the biosynthesis of testosterone or in the testosterone signalling pathway

ZNACZENIE I POTRZEBA AUTORYTETU W EDUKACJI I W MIEJSCU PRACY

This article addresses the issue of authority and explains its significance for a contemporary school, university and workplace. It briefly presents the theoretical aspects of authority together with their determinants. The problem of authority crisis has been addressed, as well as the role played by authority in the past and nowadays has been presented, in the context of the education and workplace of the people surveyed. The survey was conducted on professionally active students and was aimed at presenting the modern perception and position of authority in young employees’ hierarchy of values, drawing attention to the connection between authority and power, and also showing the basis for building the authority of a teacher and an employer in the view of the people surveyed.W niniejszym artykule poruszono problematykę autorytetu oraz wyjaśniano jego znaczenie we współczesnej szkole, na uczelni i w miejscu pracy. Pokrótce zostały przedstawione teoretyczne aspekty autorytetu wraz z ich determinantami. Poruszony został problem kryzysu autorytetu, a także ukazana została rola, jaką odgrywał on kiedyś i jaką odgrywa obecnie w kontekście edukacji i miejsca pracy osób badanych. Badania ankietowe przeprowadzone wśród aktywnych zawodowo studentów miały na celu ukazanie współczesnego rozumienia i umiejscowienia autorytetu w systemie wartości młodych pracowników, wskazanie związku autorytetu z władzą, a także ukazanie podstaw budowania autorytetu nauczyciela i pracodawcy w opinii badanych osób

Pancreatic lipoma : an incydentaloma which can resemble cancer : analysis of 13 cases studied with CT and MRI

Background: The purpose of this article is to present computed tomography (CT) and magnetic resonance imaging (MRI) findings of rare pancreatic lipomas. Material/Methods: The analysis covered 13 patients (7 men and 6 women, aged 47-88, average: 65.6 years), with 13 pancreatic lipomas, whose cases constituted the basis for 10 contrast-enhanced CT and 5 MRI studies. Results: Lipomas measured from 6 mm to 32 mm (average 12.8 mm) and were located in the pancreatic head (n=7), body (n=2), tail (n=3) and uncinate process (n=1). Most lesions (n=11) were homogenous, well-circumscribed. On contrast-enhanced CT scans, macroscopic fat (<–30 HU) was present in 9 lipomas. In one case (10 mm lesion) the density was -20 HU and the lesion was poorly circumscribed with septations, which altogether made it difficult to precisely characterize its contents. On MR scans fat was demonstrated in all studied cases (n=5). Conclusions: Lipomas are rare, small, homogenous and well-circumscribed pancreatic tumours. The most important feature, decisive for the diagnosis and distinguishing them from pancreatic carcinoma, is detection of fatty tissue on CT and MR scans. In these cases differential diagnosis includes other rare fatty tumours of the pancreas (focal fatty infiltration, teratoma, liposarcoma)