Shoulder pain as one of the symptoms of syringomyelia

Syringomyelia is typically a progressive chronic condition caused by a disruption of normal cerebrospinal fluid flow. Earlier diagnosis is associated with better outcomes, because although the progression of neurological deficits usually stabilizes after intervention, many patients still remain at least partially symptomatic. In this paper, we describe the case of a 33-year-old female patient with syringomyelia. The patient reported to the Department of Neurology due to sensory disorders and shoulder pain for several months. On admission, neurological examination revealed right hand muscular deficit, abolition of sensation of temperature and asymmetry of tendon reflexes. A few weeks earlier, outpatient magnetic resonance imaging (MRI) of the cervical spine showed the features of Arnold-Chiari malformation, syringomyelia and C5/C6 and C6/C7 discopathy. During hospitalization, MRI of the thoracic spine was performed, and the syringomyelic cavity C2–Th6 was revealed. The patient in stable condition was discharged home and referred to the neurosurgery department. The patient underwent a medial sub-occipital craniectomy and, a month later, was admitted to the neurological rehabilitation department due to paresis and sensory disturbances of right upper limb. As a result of the physiotherapy, the right arm's motor function and general physical condition improved

Left-hemisphere ischemic stroke as a complication of cutaneous lupus erythematosus

We describe the case of a 33-year-old patient with cutaneous lupus erythematosus admitted to the Department of Neurology due to the weakness of right limbs and speech disorders after night sleep. On admission, neurological examination revealed: no verbal contact; mixed aphasia with motor predominance; wide, symmetrical and reactive pupils; conjugate gaze palsy in a horizontal direction; right-sided hemianopsia and right-sided pyramidal tract syndrome with right limbs paralysis and bilaterally positive Babinski's sign. Magnetic resonance imaging revealed changes in the type of fresh ischemia in the left hemisphere of the brain – in the temporal lobe / basal ganglia on the left side hyperintensive areas were visible. As a result of the therapy and rehabilitation, the patient's general and neurological condition was improved. The patient was discharged home with recommendations in good general condition

Ultrasonographic caval indices do not significantly contribute to predicting fluid responsiveness immediately after coronary artery bypass grafting when compared to passive leg raising

IVC_PLR_dataset (XLSX 15 kb

Selectivity of mixed iron-cobalt spinels deposited on a N,S-doped mesoporous carbon support in the oxygen reduction reaction in alkaline media

One of the practical efforts in the development of oxygen reduction reaction (ORR) catalysts applicable to fuel cells and metal-air batteries is focused on reducing the cost of the catalysts production. Herein, we have examined the ORR performance of cheap, non-noble metal based catalysts comprised of nanosized mixed Fe-Co spinels deposited on N,S-doped mesoporous carbon support (N,S-MPC). The effect of the chemical and phase composition of the active phase on the selectivity of catalysts in the ORR process in alkaline media was elucidated by changing the iron content. The synthesized materials were thoroughly characterized by transmission electron microscopy (TEM), X-ray diffraction (XRD), and Raman spectroscopy (RS). Detailed S/TEM/EDX and Raman analysis of the phase composition of the synthesized ORR catalysts revealed that the dominant mixed iron-cobalt spinel is accompanied by minor fractions of bare cobalt and highly dispersed spurious iron oxides (Fe2O3 and Fe3O4). The contribution of individual phases and their degree of agglomeration on the carbon support directly influence the selectivity of the obtained catalysts. It was found that the mixed iron-cobalt spinel single phase gives rise to significant improvement of the catalyst selectivity towards the desired 4e− reaction pathway, in comparison to the reference bare cobalt spinel, whereas spurious iron oxides play a negative role for the catalyst selectivity

Bridge Structures Cracks – What Made that Phenomena so Common?

AbstractThe common phenomena – cracks appearance on newly built reinforced concrete bridge structures - is being detected in Poland for several years now. That phenomena is regarded as threatening in case of bridge structures, despite the fact that reinforced concrete theory considers cracks as a standard concrete performance. Cracks are very likely to appear on concrete surface. Cracks are usually detected during concrete surface treatment before protective coating laying. Cracks appear on monolith structures, mainly at the slab spans and foreheads as well as, at support columns in a minor range. Concrete surface cracks openings reach up to 2mm size. The experience gained throughout consulting works on cracked structures are discussed in that paper. The influence of concrete surface mechanical cleaning prior the protective coatings laying on the crack “visual” intensification was also discussed herein. Crack openings measurement rules, as well as the most common mistakes made during the crack measurements and their real value assessment were described in the paper. The maximal crack opening allowances fluctuations in Polish and European concrete Codes were also discussed here. It was proved that the spotted crack opening increase is caused by the codes changes and by bold reinforcing cover. The bold cover is regarded as the corrosion protection of reinforcing bars. The cover bold and crack opening allowance dependency was discussed in the paper. The effect of Euro codes and the Minister of Transport and Maritime Economy Ordnance from May 30th 2000 titled “Technical requirements for highway engineering structures and their locations” simultaneous obligation on reinforced concrete structures cracks assessment was deliberated.At the conclusion the necessary modifications in crack assessment practice were claimed. The cracks should be assessed on the basis of homogenous code system. Their openings are dependent straight forward from the reinforcement cover thickness. One should avoid crack measurement at the sections, at which the crack edges are mechanically shattered. The crack opening assessment should be dependent on cover thickness. The rod anti shrinkage activity reaches the cover depth approximately to the depth equal to the rod diameter only. That fact should be taken under consideration during crack assessment

Giant left atrium associated with massive thrombus formation 14 years after orthotopic heart transplantation

Abstract We report the case of a 60-year-old patient who underwent orthotopic heart transplant 14 years earlier. Routine echocardiography showed giant masses in the left atrium. There were no symptoms or thromboembolic events in the past. Magnetic resonance imaging study revealed very enlarged left atrium (8.7 × 10.6 cm) occupied by irregular smooth mass (7 × 5 × 6.1 cm) with a stalk that was attached to the posterior left atrial wall in the area of graft suture lines. Intraoperative examination revealed a massive thrombus (12 × 10 cm) that filled almost the entire left atrial area