Cerebrospinal Fluid and Hydrocephalus: Physiology, Diagnosis, and Treatment Andreas K
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The Diagnosis of Subarachnoid Haemorrhage
Journal ofNeurology, Neurosurgery, and Psychiatry 1990;53:365-372 365 J Neurol Neurosurg Psychiatry: first published as 10.1136/jnnp.53.5.365 on 1 May 1990. Downloaded from OCCASIONAL REVIEW The diagnosis of subarachnoid haemorrhage M Vermeulen, J van Gijn Lumbar puncture (LP) has for a long time been of 55 patients with SAH who had LP, before the mainstay of diagnosis in patients who CT scanning and within 12 hours of the bleed. presented with symptoms or signs of subarach- Intracranial haematomas with brain shift was noid haemorrhage (SAH). At present, com- proven by operation or subsequent CT scan- puted tomography (CT) has replaced LP for ning in six of the seven patients, and it was this indication. In this review we shall outline suspected in the remaining patient who stop- the reasons for this change in diagnostic ped breathing at the end of the procedure.5 approach. In the first place, there are draw- Rebleeding may have occurred in some ofthese backs in starting with an LP. One of these is patients. that patients with SAH may harbour an We therefore agree with Hillman that it is intracerebral haematoma, even if they are fully advisable to perform a CT scan first in all conscious, and that withdrawal of cerebro- patients who present within 72 hours of a spinal fluid (CSF) may occasionally precipitate suspected SAH, even if this requires referral to brain shift and herniation. Another disadvan- another centre.4 tage of LP is the difficulty in distinguishing It could be argued that by first performing between a traumatic tap and true subarachnoid CT the diagnosis may be delayed and that this haemorrhage. -
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PDS 102047 © Phone Directory Services 2016 Wexford/Missaukee A-ADAMS 1 Alphabetical Listings Area Telephone Prefixes A Buckley 269 Hoxeyville 862 Marion 743 Cadillac 775 Irons 266 McBain 825 Cadillac 779 Lake City 839 Merritt 328 Cadillac 876 LeRoy 768 Mesick 885 Falmouth 826 Luther 797 Moorestown 229 Harrietta 389 Manton 824 Tustin 829 ALL AREA CODES 231 UNLESS OTHERWISE LISTED Town Listed Is Not Necessarily The Mailing Address If your listing is incorrect, please contact your Local Service Provider to make a correction. Changes not made with your Local Service Provider will need to be updated annually with PDS Phone Directory Services. Abbie’s First Cut Barber Shop 101 E Pine St Cadillac ������ 775-9306 Abbott James S Elk Twp ������������������������������������������������������ 266-2074 A Abel Casey T 681 S Lachonce Rd Lake Twp ����������������������� 775-5839 Abel Mike 112 E Edward St Mesick ��������������������������������������� 885-1424 A A A Self Storage 7500 E 34 Rd Cadillac 775-2448 ��������������������������� Abel Richard 7205 N 11 Rd Mesick �������������������������������������� 885-2097 A A R Cadillac Manufacturing 201 Haynes St Cadillac 779-8800 ������ Abel Russ & Venita 3902 N 15 Rd Mesick �������������������������� 885-2633 A B C Warehouse 8719 E 34 Rd Cadillac 779-8955 ���������������������������� Abney Jeannette 10761 N Wilson Rd Lake City ������������������ 229-4387 A B C’s Baby Shop 7530 E Boon Rd Haring Twp 775-7008 ���������������� Abonmarche Consultants Inc 361 First St Manistee ����������723-1198 A Booth Plumbing -
Cerebrospinal Fluid in Critical Illness
Cerebrospinal Fluid in Critical Illness B. VENKATESH, P. SCOTT, M. ZIEGENFUSS Intensive Care Facility, Division of Anaesthesiology and Intensive Care, Royal Brisbane Hospital, Brisbane, QUEENSLAND ABSTRACT Objective: To detail the physiology, pathophysiology and recent advances in diagnostic analysis of cerebrospinal fluid (CSF) in critical illness, and briefly review the pharmacokinetics and pharmaco- dynamics of drugs in the CSF when administered by the intravenous and intrathecal route. Data Sources: A review of articles published in peer reviewed journals from 1966 to 1999 and identified through a MEDLINE search on the cerebrospinal fluid. Summary of review: The examination of the CSF has become an integral part of the assessment of the critically ill neurological or neurosurgical patient. Its greatest value lies in the evaluation of meningitis. Recent publications describe the availability of new laboratory tests on the CSF in addition to the conventional cell count, protein sugar and microbiology studies. Whilst these additional tests have improved our understanding of the pathophysiology of the critically ill neurological/neurosurgical patient, they have a limited role in providing diagnostic or prognostic information. The literature pertaining to the use of these tests is reviewed together with a description of the alterations in CSF in critical illness. The pharmacokinetics and pharmacodynamics of drugs in the CSF, when administered by the intravenous and the intrathecal route, are also reviewed. Conclusions: The diagnostic utility of CSF investigation in critical illness is currently limited to the diagnosis of an infectious process. Studies that have demonstrated some usefulness of CSF analysis in predicting outcome in critical illness have not been able to show their superiority to conventional clinical examination. -
Pancreatic Pseudocyst with Mediastinal Extension Presenting As Pseudo-Kirklin Sign—Multimodality Imaging
Published online: 2020-05-07 THIEME S54 PancreaticCase Report Pseudocyst with Mediastinal Extension Presenting as Pseudo-Kirklin Sign Udayakumar et al. Pancreatic Pseudocyst with Mediastinal Extension Presenting as Pseudo-Kirklin Sign—Multimodality Imaging Harshini Udayakumar1 Venkatraman Indiran1 Kalaichezhian Mariappan1 Prabakaran Maduraimuthu1 1Department of Radiodiagnosis, Sree Balaji Medical College and Address for correspondence Venkatraman Indiran, MD, DNB, Hospital, Chennai, Tamil Nadu, India Department of Radiodiagnosis, Sree Balaji Medical College and Hospital, 7 Works Road, Chromepet, Chennai, Tamil Nadu 600044, India (e-mail: [email protected]). J Gastrointestinal Abdominal Radiol ISGAR:2020;3(suppl S1):S54–S57 Abstract A mass lesion of the gastric cardia or fundus causing an alteration in the normal regu- lar, translucent gastric fundal air shadow on a frontal erect chest radiograph is referred to as “the Kirklin sign.” Here we present “Pseudo-Kirklin sign” observed on the frontal radiograph of a 46-year-old male patient due to a soft tissue shadow/contour deformi- ty of the fundal gas shadow caused by pseudocyst of the pancreas. We evaluated the Keywords patient using plain radiography, contrast enhanced computed tomography, magnetic ► Kirklin sign resonance imaging, and endoscopic ultrasound (EUS) with the cyst drained under EUS ► pancreatic pseudocyst guidance. So far only two cases of mediastinal pseudocysts have been drained success- ► chronic pancreatitis fully by EUS-guided aspiration. Introduction smoker for the past 20 years. He was a diabetic patient for the past 5 years on irregular treatment and an old case of pulmo- “The Kirklin sign” was described by radiologist Dr. B.R. Kirklin nary tuberculosis. in his article on the radiologic features of cancer of the cardia, Renal function test, complete blood count, and serum 1,2 in 1939. -
POZNATKY PORKANOVYCH SLOUCENIN Chernik, Ktery Dosud Neslysel 0 Chemii Porkanil. Tento Spccialni Obor Organicke a Bioorganicke Ch
POZNATKY PORKANOVYCH SLOUCENIN MICHAL LEBL, PAVEL DRASAR, HENRYK KORONIAK, JAN MILECKI a OGNIAN C. IKONOMOV Eoropsksi rada porkanooe chemic. Fterninqovo lUim. 2, 16610 Praha 6 Doglc dne L IV. 1985 VenOU(/IIO panuitce ieskeho badatele Jar)' da Cimrmana, pridcopnilca nepochvbne i porkanone chemic I kdyz se to muze zdat absurdni, neni zcela vylouceno, ze i dnes se miiie najit chernik, ktery dosud neslysel 0 chemii porkanil. Tento spccialni obor organicke a bioorganicke chemie neni totif dosud dostatecne obsirne zahrnut V bezne dostup nych ucebnicich, prestoze na poli vyzkumu porkanovych sloucenin pracuje dnes velmi intenzivne fada svetovych Iaboratofi, Nazorne se to ukazalo napfiklad na konferenci 0 organicke a bioorganicke chemii mladych vedeckych pracovnikil konane loni v lete v Bechyni, kde prakticky kazdy participant (nektery mozna neumyslne) prokazal, ze se vice nebo mene problematikou porkanu zabyva, V literature lze zmln ky 0 porkanoidnich sloueeninach nalezt pouze sporadicky, zi'ejme v dilsledku ptlsneho utajeni veskereho vyzkumu, nebo proto, ze dosazene vysledky jsou natolik nekla sicke, ze Ziidny casopis je neni ochoten uvefejnit", Prvni zminku 0 porkanu (I), zakladnl sloucenine, od ktere je veskere dalsi zlehco vani chemie odvozeno, Ize nalezt v italske praci' z roku1956. Byla v ni popsana izola ce porkodiolu (l,l,2,2,3-pentamethylbicyklo[2,l,0]pentan-3,5-diolu) z nezmydelni telneho podilu veproveho siidla. Nazev teto bicyklicke slouceniny byl zi'ejme zvolen na zaklade pouzite vychozf suroviny, i kdyz nelze vyloucit jinou genezi - prvy z ital skych autoru rna az napadne vhodne pi'ijmeni. Jiste vahani nad uvefitelnosti struktu ry I s petivaznyrn uhlikem se odraz! napfiklad i v tom, ze latku I nelze dosud nalezt v Chemical Abstracts (coz vsak muze take svedcit 0 casovem skluzu, ktery tento casopis rna). -
Thunderclap Headache and Subarachnoid Hemorrhage
Thunderclap Headache and Subarachnoid Hemorrhage W David Freeman, MD No conflicts of interest or disclosures Subarachnoid Hemorrhage Neurocrit Care. 2017 Sep;27(Suppl 1):116- 123. doi: 10.1007/s12028-017-0458-8. Objectives •Recognize the symptoms (thunderclap headache) and Subarachnoid signs of SAH Hemorrhage •Initiate workup for suspected SAH •Initial management of SAH patient Case • 39 year old woman presents with severe headache, uncertain time of onset, associated with nausea • PMH: long history of migraine headaches • Meds: • Reports taking ibuprofen prior to ED, with moderate improvement of headache • Taking warfarin for a pelvic DVT - year prior during pregnancy • Exam: sleepy, yet follows commands, left eye droop and dilated pupil, moving all extremities • BP 160/95 mmHg, RR 24/min, HR 98/min • Breathing shallow and rapid, airway protection uncertain Initial Checklist in Emergency Dept. ☐ Brain Imaging ☐ Labs: PT/PTT, CBC, electrolytes, BUN, Cr, troponin, toxicology screen ☐ 12 lead ECG ☐ Blood pressure goal established ☐ Consult neurosurgery ☐ Address hydrocephalus SAH Algorithm Neurocrit Care. 2017 Sep;27(Suppl 1):116- 123. doi: 10.1007/s12028-017-0458-8. SAH Symptoms and Signs CLASSIC NOT-SO-CLASSIC Abrupt onset of severe headache (HA), HA is not reported as abrupt (patient may i.e. thunderclap not remember event well) “Worst or first” headache of one’s life HA responds well to non-narcotic that is instantaneously maximal at onset analgesics (“thunderclap” after lightening strike) May have nausea, vomiting and neck pain HA -
Intrahepatic Pancreatic Pseudocyst: Case Series
JOP. J Pancreas (Online) 2016 Jul 08; 17(4):410-413. CASE SERIES Intrahepatic Pancreatic Pseudocyst: Case Series Dhaval Gupta, Nirav Pipaliya, Nilesh Pandav, Kaivan Shah, Meghraj Ingle, Prabha Sawant Department of Gastroenterology, Lokmanya Tilak Municipal Medical College &Hospital, Sion, Mumbai, India ABSTRACT Intrahepatic pseudocyst is a very rare complication of pancreatitis. Lack of experience and literature makes diagnosis and management of intrahepatic pseudocyst very difficult. Majority of published cases were managed by either percutaneous or surgical drainage. Less than 30 cases of intrahepatic pseudocysts have been reported in the literature and there is not a single report of endoscopic ultrasound guided management of intrahepatic pseudocysts. Here we report a case series of 2 patients who presented with intrahepatic pseudocysts and out of which first case was successfully managed by EUS guided drainage. Our second case is also the youngest patient presented with intrahepatic pseudocyst till now. INTRODUCTION abdominal distention since last 1 month. However he did located in or around t not have significant weight loss, gastrointestinal bleeding, A pancreatic pseudocyst is a collection of pancreatic fluid pedal edema, jaundice, fever. His past medical history and he pancreas. Pancreatic pseudocysts family history was not significant. He was chronic alcoholic are encased by a non-epithelial lining of fibrous, necrotic since last 15 years with intake of approximately 90 gram and granulation tissue secondary to pancreatic injury. -
Effect of Methemoglobin Formation on the MR Appearance of Subarachnoid Hemorrhage1
William G. Bradley, Jr., M.D., Ph.D. Effect of Methemoglobin Formation Paul G. Schmidt, Ph.D. on the MR Appearance of Subarachnoid Hemorrhage1 Subarachnoid hemorrhage has a much T HE EARLIEST reports of magnetic resonance (MR) images of in- higher intensity in magnetic resonance tracranial hemorrhage (1, 2) suggested a relatively intense ap- (MR) images with the passage of time. peanance of the hemorrhage relative to the surrounding brain. This Acute subarachnoid hemorrhage is diff i- was attributed to the short Ti relaxation time of the presumably cult to see; within 1 week its appearance paramagnetic, iron-containing hemoglobin. Figure 1 illustrates this has become intensified on Ti-weighted appearance in a patient imaged 1 week after rupture of an aneurysm images. Different concentrations of blood in an anterior communicating artery, with resulting intraparenchy- and lysed red blood cells in cerebrospinal mal hematoma and subarachnoid hemorrhage. The short Ti charac- fluid (CSF) were examined spectroscopi- ten of the injured area is enhanced relative to surrounding brain on cally but did not significantly alter Ti a Ti-weighted spin-echo image. and T2 relaxation of CSF acutely. Ultra- As experience was gained, subsequent reports (3, 4) indicated violet visible spectroscopy of bloody CSF that acute intracranial hemorrhage could be much more difficult to stored hypoxically for 3 days showed the detect on MR images. This was attributed by Sipponen et al. (3) to a presence of methemoglobin. The iron in lack of Ti shortening during the acute phase; however, they at- methemoglobin is paramagnetic; in com- tempted no explanation of this phenomenon. -
International Research and Exchanges Board Records
International Research and Exchanges Board Records A Finding Aid to the Collection in the Library of Congress Prepared by Karen Linn Femia, Michael McElderry, and Karen Stuart with the assistance of Jeffery Bryson, Brian McGuire, Jewel McPherson, and Chanté Wilson-Flowers Manuscript Division Library of Congress Washington, D.C. 2011 International Research and Exchanges Board Records Page ii Collection Summary Title: International Research and Exchanges Board Records Span Dates: 1947-1991 (bulk 1956-1983) ID No: MSS80702 Creator: International Research and Exchanges Board Creator: Inter-University Committee on Travel Grants Extent: 331,000 items; 331 cartons; 397.2 linear feet Language: Collection material in English and Russian Repository: Manuscript Division, Library of Congress, Washington, D.C. Abstract: American service organization sponsoring scholarly exchange programs with the Soviet Union and Eastern Europe in the Cold War era. Correspondence, case files, subject files, reports, financial records, printed matter, and other records documenting participants’ personal experiences and research projects as well as the administrative operations, selection process, and collaborative projects of one of America’s principal academic exchange programs. International Research and Exchanges Board Records Page iii Contents Collection Summary .......................................................... ii Administrative Information ......................................................1 Organizational History..........................................................2 -
CT and MR Imaging Features of a Non-Pancreatic Pseudocyst of the Mesentery
CT And MR Imaging Features of a Non-Pancreatic Pseudocyst of the Mesentery Sevdenur Çizginer1, Servet Tatlı1, Eric L. Snyder2, Joel E. Goldberg3, Stuart G. Silverman1 Brigham and Women’s Hospital, Harvard Medical School,Division of Abdominal Imaging and Intervention, Department of Radiology1, Departments of Pathology2 and General Surgery3, Boston, MA Wide range of congenital and acquired cysts that arise from various tissue linings of the abdomen are grouped as mesenteric cysts. A non-pancreatic pseudocyst of the mesentery is an uncommon, acquired pathologic entity, developing secondary to trauma or infection. Awareness of the imaging features of non- pancreatic pseudocyst may help radiologists to differentiate them other abdominal neoplastic processes and may prevent unnecessary surgery. We report CT and MR imaging features of a non-pancreatic pseudocyst of the mesentery. Key words: Pseudocyst, mesentery, CT, MR Eur J Gen Med 2009; 6(1):49-51 INTRODUCTION Five months later, the patient was admitted A non-pancreatic pseudocyst of the to the emergency room again for a sudden mesentery is an uncommon, acquired onset of left upper quadrant pain and nausea. pathologic entity, developing secondary to He denied fever. His biochemical laboratory trauma or infection (1-3). These mesenteric values were within normal limits. On physical cysts are unrelated to pancreatitis and the wall examination, he exhibited involuntary of a pseudocyst is composed of fibrous tissue guarding, rebound, and tenderness over the rather than epithelial lining that are seen in epigastrium and left upper quadrant. Bowel true cysts (2, 3). It may be difficult to make sounds were normal. CT scan of the abdomen an accurate preoperative diagnosis of a non- demonstrated interval increase size of the left pancreatic pseudocyst from other mesenteric upper quadrant fatty mass measuring 6.4×4.5 cysts or neoplasms (1). -
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Zał ączniki do postanowienia Komisarza Wyborczego w Bydgoszczy I z dnia 1 pa ździernika 2018 r. Zał ącznik nr 1 gm. Białe Błota Obwodowa Komisja Wyborcza Nr 1, SZKOŁA PODSTAWOWA, Białe Błota ul. CENTRALNA 27, 86- 005 BIAŁE BŁOTA: Obwodowa Komisja Wyborcza ds. Przeprowadzenia Głosowania 1. Bo żena Gralak , zgłoszona przez KWW HENRYKA SYKUTA RAZEM DLA GMINY, zam. Białe Błota 2. Robert Piotr Kasperczyk , zgłoszony przez KKW PLATFORMA.NOWOCZESNA KOALICJA OBYWATELSKA, zam. Białe Błota 3. Magdalena Maria K ątnik , zgłoszona przez KWW EL ŻBIETY DŁUGOŁ ĘCKIEJ PRZYJAZNE MIEJSCE, zam. Łochowo 4. Dominika Kozłowska , zgłoszona przez KWW NASZ POWIAT BYDGOSKI (uzupełnienie składu), zam. Białe Błota 5. Irena Kozłowska , zgłoszona przez KW PRAWO I SPRAWIEDLIWO ŚĆ , zam. Białe Błota 6. Aleksandra Agata Lewandowska , zgłoszona przez KWW WYBIERAM MAISON, zam. Białe Błota 7. Lucyna Piaskowska , zgłoszona przez KWW FUNDATOR ZAFUNDUJ SOBIE LEPSZĄ PRZYSZŁO ŚĆ , zam. Ciele 8. Teresa Szaefer , zgłoszona przez KWW HENRYKA SYKUTA RAZEM DLA GMINY (uzupełnienie składu), zam. Białe Błota 9. Ewa Maria Wilk , zgłoszona przez KOMITET WYBORCZY PSL, zam. Białe Błota Obwodowa Komisja Wyborcza ds. Ustalenia Wyników Głosowania 1. Patrycja Bartoszak , zgłoszona przez KWW EL ŻBIETY DŁUGOŁ ĘCKIEJ PRZYJAZNE MIEJSCE, zam. Barcin 2. Anna Agnieszka Hasiak , zgłoszona przez KOMITET WYBORCZY PSL, zam. Ciele 3. Remigiusz Kryger , zgłoszony przez KWW WYBIERAM MAISON, zam. Białe Błota 4. Dorota Ma ćkowska , zgłoszona przez KWW HENRYKA SYKUTA RAZEM DLA GMINY, zam. Białe Błota 5. Radosław Marach , zgłoszony przez KKW PLATFORMA.NOWOCZESNA KOALICJA OBYWATELSKA, zam. Bydgoszcz 6. Aleksandra Katarzyna Marecka , zgłoszona przez KWW FUNDATOR ZAFUNDUJ SOBIE LEPSZ Ą PRZYSZŁO ŚĆ , zam. Bydgoszcz 7. Justyna Anna Rzempowska , zgłoszona przez KWW HENRYKA SYKUTA RAZEM DLA GMINY (uzupełnienie składu), zam. -
Surname Index to Schenectady Births 1940-1953
Grems-Doolittle Library Schenectady County Historical Society 32 Washington Ave. Schenectady, NY 12305 Surname Index to Schenectady Births 1940-1953 Abare Abele Ackley Abba Abele Ackroyd Abbale Abeles Ackroyd Abbale Abeles Ackroyd Abbale Abell (probably Abeel) Ackroyd Abbatiello Abelone (probably Acord Abbatiello Abelove) Acree Abbatiello Abelove Acree (probably Abbatiello Aberbach or Aberback Aeree) Abbato Aberback Acton Abbato Abercrombie Acton Abbato Aboudara Acucena Abbe Abraham Adack Abbott Abrahamson (not - Adack or Adach Abbott nson) Adair Abbott Abrams Adair Abbott Abrams Adair Abbott Abramson Adair Abbott Abrofsky Adair Abbott Abt Adair Abbott Aceto Adam Abbott Aceto Adamczak Abbott Aceto Adamec Abbott Aceto Adamec Abbott Acken Adamec Abbott Acker Adamec Abbott Acker Adamek Abbott Acker Adamek Abbzle = ? spelling Acker Adamkiewicz unclear Acker Adamkiewicz Abeel Ackerle Adams Abeel Ackerman Adams Abeel Ackerman Adams Abeel Ackerman Adams Abeel Ackerman Adams Abel Ackley Adams Grems-Doolittle Library Schenectady County Historical Society 32 Washington Ave. Schenectady, NY 12305 Surname Index to Schenectady Births 1940-1953 Adams Adamson Ahl Adams Adanti Ahles Adams Addis Ahman Adams Ademec or Adamec Ahnert Adams Adinolfi Ahren Adams Adinolfi Ahren Adams Adinolfi Ahrendtsen Adams Adinolfi Ahrendtsen Adams Adkins Ahrens Adams Adkins Ahrens Adams Adriance Ahrens Adams Adsit Aiken Adams Aeree Aiken Adams Aernecke Ailes = ? Adams Agans Ainsworth Adams Agans Aker (or Aeher = ?) Adams Aganz (Agans ?) Akers Adams Agare or Abare = ? Akerson Adams Agat Akin Adams Agat Akins Adams Agen Akins Adams Aggen Akland Adams Aggen Albanese Adams Aggen Alberding Adams Aggen Albert Adams Agnew Albert Adams Agnew Albert or Alberti Adams Agnew Alberti Adams Agostara Alberti Adams Agostara (not Agostra) Alberts Adamski Agree Albig Adamski Ahave ? = totally Albig Adamson unclear Albohm Adamson Ahern Albohm Adamson Ahl Albohm (not Albolm) Adamson Ahl Albrezzi Grems-Doolittle Library Schenectady County Historical Society 32 Washington Ave.