A 36-year-old female presented with a left popliteal mass. The differential diagnosis for the fine needle aspiration of the mass included chondroma and chondrosarcoma. The diagnosis from the cytopathology conference was chondrosarcoma.
MELAS Syndrome is a mitochondrial cytopathy characterized by mitochondrial encephalopathy, lactic acidosis, and stroke-like episodes. Sensorineural hearing loss is a frequent symptom, occurring in 44-75% of patients. The document discusses the role of otologists in diagnosing and managing MELAS, including screening all patients for hearing loss and following up regularly as hearing loss is a cardinal feature and patients require multidisciplinary treatment and guidance.
This document summarizes the key differences between primary and secondary angiosarcoma (AS) of the breast. Primary AS typically affects younger women (median age 40) and presents as masses within the breast parenchyma, while secondary AS affects older women (median age 67-71) and develops in irradiated breast skin and subcutaneous tissue 7-10 years after radiation therapy. Both forms have a poor prognosis. Surgical management often involves mastectomy but optimal margins are unclear. Adjuvant chemotherapy and radiation have shown mixed results, and larger randomized trials are needed to determine their effectiveness for AS of the breast.
Pleomorphic lobular carcinoma in situ (PLCIS) is a recently characterized entity distinguished from classic LCIS by its more dyshesive, pleomorphic cells and association with markers of poorer prognosis. [PLCIS exhibits loss of E-cadherin and beta-catenin expression as well as genomic alterations linked to aggressiveness.] While long-term outcomes are unknown, available evidence suggests PLCIS may have higher recurrence rates than classic LCIS if margins are positive after excision. Current recommendations include surgical excision of PLCIS lesions with negative margins of 2mm or more and consideration of adjuvant hormonal or radiation therapy based on tumor biomarkers.
The document discusses the treatment of medulloblastoma, a type of brain tumor. It provides details on the role of radiotherapy in treatment, including:
1) Radiotherapy has historically been the most effective treatment when combined with surgery, improving survival rates from 1 in 61 to 25% at 10 years with craniospinal irradiation.
2) Several studies evaluated reducing craniospinal irradiation doses and adding chemotherapy, finding equivalent survival but reduced side effects.
3) Current standard treatment involves 23.4Gy craniospinal irradiation with chemotherapy, followed by a posterior fossa boost to 55.8Gy.
- A 45-year-old female presented with a tumor on her fibula. An initial biopsy showed spindle-shaped cells forming interlacing fascicles with areas of nuclear pleomorphism. This was diagnosed as an atypical fibrous histiocytoma.
- The tumor was then excised. The excised specimen showed variably pleomorphic cells, mitotic figures, and necrosis. Differential diagnoses included malignant peripheral nerve sheath tumor, synovial sarcoma, and fibrosarcoma.
- Immunohistochemistry showed the tumor was positive for EMA and patchy positive for S-100, suggesting synovial sarcoma or malignant peripheral nerve sheath tumor. It was negative for TLE-
This document defines and describes extraskeletal Ewing sarcoma, a rare malignant small round blue cell neoplasm originating from mesenchymal stem cells or neural crest stem cells. It most commonly occurs in the second decade of life and presents with swelling, pain, and constitutional symptoms. Treatment involves chemotherapy followed by surgery and/or radiation. Prognosis is poor with metastasis, large tumor size, or older patient age. Molecular testing reveals gene fusions between FET family genes like EWSR1 and ETS family genes in most cases.
This document discusses several unusual types of gliomas, including subependymal giant cell astrocytoma, angiocentric glioma, astroblastoma, and pilomyxoid astrocytoma. It provides details on their characteristics, imaging appearance, pathology, management, and outcomes. Everolimus is also discussed as a potential alternative to surgery for subependymal giant cell astrocytoma.
Cancer cells develop extra and intracellularly as well as in nuclear regions under conditions of deep oxidative metabolic stress according to the Efruzhu Cancer Carcinogenesis Theory. The theory proposes that cancer forms in cells experiencing high levels of oxidative stress at the extracellular, intracellular, cytoplasmic, and nuclear levels.
MELAS Syndrome is a mitochondrial cytopathy characterized by mitochondrial encephalopathy, lactic acidosis, and stroke-like episodes. Sensorineural hearing loss is a frequent symptom, occurring in 44-75% of patients. The document discusses the role of otologists in diagnosing and managing MELAS, including screening all patients for hearing loss and following up regularly as hearing loss is a cardinal feature and patients require multidisciplinary treatment and guidance.
This document summarizes the key differences between primary and secondary angiosarcoma (AS) of the breast. Primary AS typically affects younger women (median age 40) and presents as masses within the breast parenchyma, while secondary AS affects older women (median age 67-71) and develops in irradiated breast skin and subcutaneous tissue 7-10 years after radiation therapy. Both forms have a poor prognosis. Surgical management often involves mastectomy but optimal margins are unclear. Adjuvant chemotherapy and radiation have shown mixed results, and larger randomized trials are needed to determine their effectiveness for AS of the breast.
Pleomorphic lobular carcinoma in situ (PLCIS) is a recently characterized entity distinguished from classic LCIS by its more dyshesive, pleomorphic cells and association with markers of poorer prognosis. [PLCIS exhibits loss of E-cadherin and beta-catenin expression as well as genomic alterations linked to aggressiveness.] While long-term outcomes are unknown, available evidence suggests PLCIS may have higher recurrence rates than classic LCIS if margins are positive after excision. Current recommendations include surgical excision of PLCIS lesions with negative margins of 2mm or more and consideration of adjuvant hormonal or radiation therapy based on tumor biomarkers.
The document discusses the treatment of medulloblastoma, a type of brain tumor. It provides details on the role of radiotherapy in treatment, including:
1) Radiotherapy has historically been the most effective treatment when combined with surgery, improving survival rates from 1 in 61 to 25% at 10 years with craniospinal irradiation.
2) Several studies evaluated reducing craniospinal irradiation doses and adding chemotherapy, finding equivalent survival but reduced side effects.
3) Current standard treatment involves 23.4Gy craniospinal irradiation with chemotherapy, followed by a posterior fossa boost to 55.8Gy.
- A 45-year-old female presented with a tumor on her fibula. An initial biopsy showed spindle-shaped cells forming interlacing fascicles with areas of nuclear pleomorphism. This was diagnosed as an atypical fibrous histiocytoma.
- The tumor was then excised. The excised specimen showed variably pleomorphic cells, mitotic figures, and necrosis. Differential diagnoses included malignant peripheral nerve sheath tumor, synovial sarcoma, and fibrosarcoma.
- Immunohistochemistry showed the tumor was positive for EMA and patchy positive for S-100, suggesting synovial sarcoma or malignant peripheral nerve sheath tumor. It was negative for TLE-
This document defines and describes extraskeletal Ewing sarcoma, a rare malignant small round blue cell neoplasm originating from mesenchymal stem cells or neural crest stem cells. It most commonly occurs in the second decade of life and presents with swelling, pain, and constitutional symptoms. Treatment involves chemotherapy followed by surgery and/or radiation. Prognosis is poor with metastasis, large tumor size, or older patient age. Molecular testing reveals gene fusions between FET family genes like EWSR1 and ETS family genes in most cases.
This document discusses several unusual types of gliomas, including subependymal giant cell astrocytoma, angiocentric glioma, astroblastoma, and pilomyxoid astrocytoma. It provides details on their characteristics, imaging appearance, pathology, management, and outcomes. Everolimus is also discussed as a potential alternative to surgery for subependymal giant cell astrocytoma.
Cancer cells develop extra and intracellularly as well as in nuclear regions under conditions of deep oxidative metabolic stress according to the Efruzhu Cancer Carcinogenesis Theory. The theory proposes that cancer forms in cells experiencing high levels of oxidative stress at the extracellular, intracellular, cytoplasmic, and nuclear levels.
Medulloblastoma- A primitive neuroectodermal tumors (PNETs) is the most common malignant brain tumor of childhood (WHO IV)
arising from the vermis in the inferior medullary velum.
It comprises up to 18% of all pediatric brain tumors.
WNT and Shh pathway plays major role in its pathogenesis.
c-erbB-2 (HER2/neu) oncogene expression has prognostic value. Norcantharidin, Vismodegib, Sonidegib are the future in medulloblastoma.
Diagnosis and treatment of the main gynaecological diseasesShirley Dee
This document discusses the diagnosis and treatment of several common gynecological diseases in women. It covers endometriosis, uterine fibroids, ectopic pregnancy, cervical cancer, and cervical carcinoma in pregnancy. For each condition, it describes pathogenesis, symptoms, diagnostic methods like pelvic exam, ultrasound, and biopsy, as well as surgical and medical management options. Screening and prevention of cervical cancer is also addressed, including pap smears, HPV vaccination, colposcopy, and diagnostic cone biopsy. Staging and treatment approaches for different stages of cervical cancer are outlined.
The document provides information on neuroblastoma, including its origin from neural crest cells, sites of occurrence, clinical presentation, diagnosis, staging systems, prognostic factors, and management. It notes that neuroblastoma is the most common extracranial solid tumor in children and occurs most often in children under 5 years old. The diagnosis involves imaging tests like CT/MRI to identify the primary tumor and metastases, biopsy for histopathological examination, and urine and bone marrow tests. Staging systems include the International Neuroblastoma Staging System and International Neuroblastoma Risk Group system. Prognostic factors include the child's age, tumor biology markers like MYCN amplification, and response to initial treatment. Management involves surgery, chemotherapy,
The document discusses current treatment options for low grade oligodendroglioma and the significance of 1p/19q loss of heterozygosity. It reviews evidence that surgical resection provides better outcomes than observation alone. Chemotherapy with procarbazine, lomustine, and vincristine or temozolomide is effective particularly for tumors with 1p/19q codeletion, while radiotherapy improves progression-free survival after incomplete resection but not overall survival. There is no consensus on the optimal treatment approach due to lack of prospective randomized controlled trials.
This document describes a case of neuroblastoma in a 16-month-old boy presenting with fever, poor appetite, and abdominal distension. Imaging including ultrasound, CT, and MRI revealed a large heterogeneous mass arising from the left adrenal gland, compressing local structures. Biopsy showed poorly differentiated neuroblastoma. Treatment and prognosis depend on risk stratification based on age, stage, biology. High-risk disease requires intensive chemotherapy with stem cell transplant while low-risk cases may only require surgery or observation.
The document reports a case of a 65-year-old man who presented with a large liposarcoma tumor arising from the spermatic cord that measured 20x12 cm. He underwent a radical orchiectomy and wide local excision to remove the tumor. Histopathological examination found it to be a well-differentiated myxoid liposarcoma, a rare type of liposarcoma occurring in the spermatic cord.
A 64-year-old female presented with a left breast mass. The differential diagnosis included colloid carcinoma, mucocele with an intraductal papilloma, or fibroadenoma with mucoid stromal degeneration. The clinicians were tasked with making a diagnosis based on the information provided.
This document provides an overview of neuroblastoma, including:
- It is the most common extracranial solid tumor in children, arising from neural crest cells in the sympathetic nervous system.
- Presentation varies depending on location but may include abdominal mass, bone pain, opsoclonus, or Horner's syndrome.
- Staging uses the International Neuroblastoma Staging System and ranges from localized (Stage 1) to disseminated disease (Stage 4).
- Treatment involves surgery, chemotherapy, and sometimes radiation therapy. Prognostic factors include age at diagnosis and disease stage.
- Diffuse intrinsic pontine glioma (DIPG) is a leading cause of brain tumor-related death in children and has a median survival of 9-12 months even with treatment.
- Molecular studies have found that 80% of DIPGs have mutations in histone H3 variants, including the K27M mutation, which leads to aberrant demethylation.
- Clinical trials are investigating molecularly targeted therapies such as inhibitors of ALK, which is downstream of the ACVR1 pathway that is mutated in 25% of DIPGs. Immunotherapies targeting IL13Rα2, EphA2, and survivin are also being studied.
This study aimed to evaluate the role of delayed primary excision (DPE) surgery after induction chemotherapy in localized nonmetastatic adult head and neck rhabdomyosarcoma. The study retrospectively analyzed 24 patients treated with either DPE followed by surgery, radiotherapy and chemotherapy or chemoradiotherapy without surgery. It found that 59% of DPE patients had a complete resection but 82% had residual viable tumors. Response to chemotherapy significantly impacted local control, with 100% local control for good responders versus 33% for poor responders. In good responders, DPE resulted in significantly better local control than chemoradiotherapy alone. However, treatment modality did not impact overall survival. Distant metastases
This case report describes an 84-year old female patient with a neuroendocrine carcinoma of the breast diagnosed by fine needle aspiration cytology. The smears showed discohesive polygonal cells with abundant cytoplasm and eosinophilic granules. Histology confirmed a solid type neuroendocrine carcinoma with metastasis to lymph nodes. Immunohistochemistry was positive for markers like chromogranin and synaptophysin. Neuroendocrine carcinomas are rare breast tumors that can be diagnosed on cytology by observing characteristic cytoplasmic granules, though they may otherwise appear as invasive ductal carcinoma. Recognition of this rare tumor is important for prognosis and management.
Alberto Pappo, MD, St. Jude Children’s Hospital, Memphis TN
Presented at the 2010 Texas Adolescent and Young Adult Oncology Conference hosted by Methodist Healthcare-San Antonio. October 2010.
1. Brainstem gliomas are tumors that arise within the brainstem and can be diffuse or focal. Diffuse infiltrating pontine gliomas (DIPGs) represent 60-75% of pediatric brainstem gliomas and typically present with cranial nerve palsies, ataxia, and long tract signs.
2. Magnetic resonance imaging is the preferred method for diagnosis and shows characteristic features for DIPGs including diffuse enlargement and T2 hyperintensity of the pons.
This document provides an overview of spinal cord tumors, including:
- They constitute 3-4% of all CNS tumors and 6% of pediatric CNS tumors.
- The most common types are astrocytomas and ependymomas.
- Treatment involves surgical resection followed by radiation therapy if needed.
- Prognostic factors include tumor type/grade, extent, and patient age/function.
The document summarizes key facts about eye cancer, including:
- Welders, farmers, fishermen and chemical workers have a higher risk of developing eye cancer. Whites also have a higher risk than African Americans.
- In 2008, there were 2,390 new eye cancer cases and 240 deaths in the US. Approximately 1,340 men and 1,050 women are diagnosed each year. 325 children are also diagnosed annually with eye tumors.
- Common symptoms of eye cancer include bulging of the eye, vision loss, eye pain, watery eyes, blurred vision, dark spots on the eye, and flashing lights or blurry lines.
This is a powerpoint(case presentation) for radiology and imaging resident.There are many animations used inside this presentation so to see all the pictures which are placed layer by layer with the help of animations you simple need to download this presentation first.... Thanx.
The Sustainable Body: The body of today cannot sustain us in the future, pump...tmhsweb
The document discusses the development of an augmented and sustainable future body through nanotechnology and other advanced technologies. It proposes augmenting the body's immune system, skin, brain and nervous system with nanorobots, nanosensors, and other enhancements. It also discusses organizational frameworks for developing the future body and notes that experience, even bad experiences, will help designers build the future body.
The document discusses various factors related to assessing risk of coronary heart disease (CHD), including:
1) A 58-year-old man's risk factors including family history of heart disease, blood pressure, cholesterol levels, and current risk assessment scoring.
2) Methods for assessing absolute 10-year CHD risk such as the Framingham Risk Score and counting individual risk factors.
3) Newer tests beyond traditional risk factors like C-reactive protein and lipoprotein-associated phospholipase A2 that may help identify risk of heart attack or stroke.
Advanced Well Construction Techniques Utilizing Solid Expandable Technologies...tmhsweb
The document discusses advanced well construction techniques using solid expandable technologies (SET) for oil and gas wells. It provides an overview of expandable casing statistics and operating envelopes. Key points include that SET can be used at high inclinations up to 100 degrees, in high temperature environments up to 400 degrees Fahrenheit, and at great depths up to 28,750 feet. The document also presents case studies where SET helped overcome challenges and increased cost savings in deep shelf Gulf of Mexico wells and high pressure wells.
Ultra-Sensitive Microsensors for Chemical Analysis, pumpsandpipesmdhctmhsweb
Micro-cantilever sensors can provide ultra-sensitive chemical analysis with potential applications in medical diagnostics. They can detect mass changes at the picogram level and respond selectively to different chemicals by functionalizing one side with self-assembled monolayers. Large arrays of redundant micro-cantilevers allow analysis of small samples and could enable applications requiring portable, low-power chemical sensors.
Development of an Axial Flow Left Ventricular Assist Device (LVAD) from Incep...tmhsweb
1. The document discusses the development and clinical applications of axial flow left ventricular assist devices (LVADs) from their inception to help treat the increasing number of heart failure patients.
2. It describes the history and outcomes of various LVAD models used at the Methodist Hospital including the DeBakey-Noon VAD which was licensed from NASA and has been implanted in over 400 patients internationally.
3. The document outlines ongoing engineering improvements to LVAD designs through computational fluid dynamics and animal testing, including a smaller pediatric version, to provide longer and better quality of life support for heart failure patients.
Seismic imaging is used in oil and gas exploration to determine reservoir geometry and properties by analyzing acoustic echo reflections from subsurface layers. It is a two-step process that first uses varying source-receiver separations and tomography to determine subsurface velocities, and then backpropagates measured sound waves to form images. Advancements include more accurate imaging algorithms, improved velocity modeling tools, and increased data acquisition apertures, but challenges remain such as illumination limitations, complex velocity models, imaging steep dips and structures, and issues of resolution and noise.
Medulloblastoma- A primitive neuroectodermal tumors (PNETs) is the most common malignant brain tumor of childhood (WHO IV)
arising from the vermis in the inferior medullary velum.
It comprises up to 18% of all pediatric brain tumors.
WNT and Shh pathway plays major role in its pathogenesis.
c-erbB-2 (HER2/neu) oncogene expression has prognostic value. Norcantharidin, Vismodegib, Sonidegib are the future in medulloblastoma.
Diagnosis and treatment of the main gynaecological diseasesShirley Dee
This document discusses the diagnosis and treatment of several common gynecological diseases in women. It covers endometriosis, uterine fibroids, ectopic pregnancy, cervical cancer, and cervical carcinoma in pregnancy. For each condition, it describes pathogenesis, symptoms, diagnostic methods like pelvic exam, ultrasound, and biopsy, as well as surgical and medical management options. Screening and prevention of cervical cancer is also addressed, including pap smears, HPV vaccination, colposcopy, and diagnostic cone biopsy. Staging and treatment approaches for different stages of cervical cancer are outlined.
The document provides information on neuroblastoma, including its origin from neural crest cells, sites of occurrence, clinical presentation, diagnosis, staging systems, prognostic factors, and management. It notes that neuroblastoma is the most common extracranial solid tumor in children and occurs most often in children under 5 years old. The diagnosis involves imaging tests like CT/MRI to identify the primary tumor and metastases, biopsy for histopathological examination, and urine and bone marrow tests. Staging systems include the International Neuroblastoma Staging System and International Neuroblastoma Risk Group system. Prognostic factors include the child's age, tumor biology markers like MYCN amplification, and response to initial treatment. Management involves surgery, chemotherapy,
The document discusses current treatment options for low grade oligodendroglioma and the significance of 1p/19q loss of heterozygosity. It reviews evidence that surgical resection provides better outcomes than observation alone. Chemotherapy with procarbazine, lomustine, and vincristine or temozolomide is effective particularly for tumors with 1p/19q codeletion, while radiotherapy improves progression-free survival after incomplete resection but not overall survival. There is no consensus on the optimal treatment approach due to lack of prospective randomized controlled trials.
This document describes a case of neuroblastoma in a 16-month-old boy presenting with fever, poor appetite, and abdominal distension. Imaging including ultrasound, CT, and MRI revealed a large heterogeneous mass arising from the left adrenal gland, compressing local structures. Biopsy showed poorly differentiated neuroblastoma. Treatment and prognosis depend on risk stratification based on age, stage, biology. High-risk disease requires intensive chemotherapy with stem cell transplant while low-risk cases may only require surgery or observation.
The document reports a case of a 65-year-old man who presented with a large liposarcoma tumor arising from the spermatic cord that measured 20x12 cm. He underwent a radical orchiectomy and wide local excision to remove the tumor. Histopathological examination found it to be a well-differentiated myxoid liposarcoma, a rare type of liposarcoma occurring in the spermatic cord.
A 64-year-old female presented with a left breast mass. The differential diagnosis included colloid carcinoma, mucocele with an intraductal papilloma, or fibroadenoma with mucoid stromal degeneration. The clinicians were tasked with making a diagnosis based on the information provided.
This document provides an overview of neuroblastoma, including:
- It is the most common extracranial solid tumor in children, arising from neural crest cells in the sympathetic nervous system.
- Presentation varies depending on location but may include abdominal mass, bone pain, opsoclonus, or Horner's syndrome.
- Staging uses the International Neuroblastoma Staging System and ranges from localized (Stage 1) to disseminated disease (Stage 4).
- Treatment involves surgery, chemotherapy, and sometimes radiation therapy. Prognostic factors include age at diagnosis and disease stage.
- Diffuse intrinsic pontine glioma (DIPG) is a leading cause of brain tumor-related death in children and has a median survival of 9-12 months even with treatment.
- Molecular studies have found that 80% of DIPGs have mutations in histone H3 variants, including the K27M mutation, which leads to aberrant demethylation.
- Clinical trials are investigating molecularly targeted therapies such as inhibitors of ALK, which is downstream of the ACVR1 pathway that is mutated in 25% of DIPGs. Immunotherapies targeting IL13Rα2, EphA2, and survivin are also being studied.
This study aimed to evaluate the role of delayed primary excision (DPE) surgery after induction chemotherapy in localized nonmetastatic adult head and neck rhabdomyosarcoma. The study retrospectively analyzed 24 patients treated with either DPE followed by surgery, radiotherapy and chemotherapy or chemoradiotherapy without surgery. It found that 59% of DPE patients had a complete resection but 82% had residual viable tumors. Response to chemotherapy significantly impacted local control, with 100% local control for good responders versus 33% for poor responders. In good responders, DPE resulted in significantly better local control than chemoradiotherapy alone. However, treatment modality did not impact overall survival. Distant metastases
This case report describes an 84-year old female patient with a neuroendocrine carcinoma of the breast diagnosed by fine needle aspiration cytology. The smears showed discohesive polygonal cells with abundant cytoplasm and eosinophilic granules. Histology confirmed a solid type neuroendocrine carcinoma with metastasis to lymph nodes. Immunohistochemistry was positive for markers like chromogranin and synaptophysin. Neuroendocrine carcinomas are rare breast tumors that can be diagnosed on cytology by observing characteristic cytoplasmic granules, though they may otherwise appear as invasive ductal carcinoma. Recognition of this rare tumor is important for prognosis and management.
Alberto Pappo, MD, St. Jude Children’s Hospital, Memphis TN
Presented at the 2010 Texas Adolescent and Young Adult Oncology Conference hosted by Methodist Healthcare-San Antonio. October 2010.
1. Brainstem gliomas are tumors that arise within the brainstem and can be diffuse or focal. Diffuse infiltrating pontine gliomas (DIPGs) represent 60-75% of pediatric brainstem gliomas and typically present with cranial nerve palsies, ataxia, and long tract signs.
2. Magnetic resonance imaging is the preferred method for diagnosis and shows characteristic features for DIPGs including diffuse enlargement and T2 hyperintensity of the pons.
This document provides an overview of spinal cord tumors, including:
- They constitute 3-4% of all CNS tumors and 6% of pediatric CNS tumors.
- The most common types are astrocytomas and ependymomas.
- Treatment involves surgical resection followed by radiation therapy if needed.
- Prognostic factors include tumor type/grade, extent, and patient age/function.
The document summarizes key facts about eye cancer, including:
- Welders, farmers, fishermen and chemical workers have a higher risk of developing eye cancer. Whites also have a higher risk than African Americans.
- In 2008, there were 2,390 new eye cancer cases and 240 deaths in the US. Approximately 1,340 men and 1,050 women are diagnosed each year. 325 children are also diagnosed annually with eye tumors.
- Common symptoms of eye cancer include bulging of the eye, vision loss, eye pain, watery eyes, blurred vision, dark spots on the eye, and flashing lights or blurry lines.
This is a powerpoint(case presentation) for radiology and imaging resident.There are many animations used inside this presentation so to see all the pictures which are placed layer by layer with the help of animations you simple need to download this presentation first.... Thanx.
The Sustainable Body: The body of today cannot sustain us in the future, pump...tmhsweb
The document discusses the development of an augmented and sustainable future body through nanotechnology and other advanced technologies. It proposes augmenting the body's immune system, skin, brain and nervous system with nanorobots, nanosensors, and other enhancements. It also discusses organizational frameworks for developing the future body and notes that experience, even bad experiences, will help designers build the future body.
The document discusses various factors related to assessing risk of coronary heart disease (CHD), including:
1) A 58-year-old man's risk factors including family history of heart disease, blood pressure, cholesterol levels, and current risk assessment scoring.
2) Methods for assessing absolute 10-year CHD risk such as the Framingham Risk Score and counting individual risk factors.
3) Newer tests beyond traditional risk factors like C-reactive protein and lipoprotein-associated phospholipase A2 that may help identify risk of heart attack or stroke.
Advanced Well Construction Techniques Utilizing Solid Expandable Technologies...tmhsweb
The document discusses advanced well construction techniques using solid expandable technologies (SET) for oil and gas wells. It provides an overview of expandable casing statistics and operating envelopes. Key points include that SET can be used at high inclinations up to 100 degrees, in high temperature environments up to 400 degrees Fahrenheit, and at great depths up to 28,750 feet. The document also presents case studies where SET helped overcome challenges and increased cost savings in deep shelf Gulf of Mexico wells and high pressure wells.
Ultra-Sensitive Microsensors for Chemical Analysis, pumpsandpipesmdhctmhsweb
Micro-cantilever sensors can provide ultra-sensitive chemical analysis with potential applications in medical diagnostics. They can detect mass changes at the picogram level and respond selectively to different chemicals by functionalizing one side with self-assembled monolayers. Large arrays of redundant micro-cantilevers allow analysis of small samples and could enable applications requiring portable, low-power chemical sensors.
Development of an Axial Flow Left Ventricular Assist Device (LVAD) from Incep...tmhsweb
1. The document discusses the development and clinical applications of axial flow left ventricular assist devices (LVADs) from their inception to help treat the increasing number of heart failure patients.
2. It describes the history and outcomes of various LVAD models used at the Methodist Hospital including the DeBakey-Noon VAD which was licensed from NASA and has been implanted in over 400 patients internationally.
3. The document outlines ongoing engineering improvements to LVAD designs through computational fluid dynamics and animal testing, including a smaller pediatric version, to provide longer and better quality of life support for heart failure patients.
Seismic imaging is used in oil and gas exploration to determine reservoir geometry and properties by analyzing acoustic echo reflections from subsurface layers. It is a two-step process that first uses varying source-receiver separations and tomography to determine subsurface velocities, and then backpropagates measured sound waves to form images. Advancements include more accurate imaging algorithms, improved velocity modeling tools, and increased data acquisition apertures, but challenges remain such as illumination limitations, complex velocity models, imaging steep dips and structures, and issues of resolution and noise.
Downhole Coring and Sampling, pumpsandpipesmdhctmhsweb
The document discusses downhole coring and sampling challenges and technologies. It describes increasing pressures and temperatures in new wells that push technological limits. It also discusses issues like fluid contamination, heterogeneous rock formations, and fractured or unconsolidated rocks. The document emphasizes that proper core processing is important for reliable lab measurements. It then outlines various downhole coring and sampling objectives, tools, and methods like conventional coring, specialized tools, and planning needed for high quality cores.
Pumps & Pipes 11 12 07 By Angela, pumpsandpipesmdhctmhsweb
The document summarizes research and academic activities at the University of Houston for 2006-2007. It outlines the university's research clusters in areas like bio-medicine, energy, and nanomaterials. Specific examples are given of biomedical research projects in areas like aneurysm prediction, stent design, and ultrasound imaging. It also discusses the Lone Star Wind Alliance partnership aimed at developing wind energy in Texas.
The document discusses various pumping systems used in oil and gas extraction. It lists several common pumping methods including gas lift, plunger lift, sucker rod pumps, electric submersible pumps, hydraulic jet pumps, progressing cavity pumps, and notes that the challenge is efficiently transferring energy to deeper pumps in increasingly difficult environments. It concludes by inviting questions about oilfield pumping equipment photos.
A multilateral well connects two or more standard well types, such as vertical, deviated, or horizontal wells. It allows multiple production laterals to be drilled from a single surface location. The value to customers is that multilateral wells can significantly increase production from a field by drilling more reservoir contact from fewer well pads and surface locations. There are different technical levels for multilateral wells based on how the junctions between the main and lateral bores are constructed and supported. Higher technical levels provide more completion flexibility but also more complex construction.
Pumps and Pipes: Medical Imaging, pumpsandpipesmdhctmhsweb
1. Medical imaging has come a long way from its beginnings and is now considered one of the greatest engineering achievements of the 20th century.
2. Modern medical imaging techniques like computed tomography, magnetic resonance imaging, ultrasound, and positron emission tomography use pumps, pipes, and computers to generate digital images of the inside of the body.
3. Future interventional medicine may involve seamless integrated platforms using visualization, robotics, treatment planning, and monitoring with feedback loops to precisely target and treat areas of the body.
The Rock: Geology and Physics of Hydrocarbon Production or the Top Ten Reason...tmhsweb
The document discusses the similarities between geology and physics related to hydrocarbon production and medicine. It provides 10 reasons why the two fields are related, such as how they both study imaging techniques, drilling operations, flow through tubes, pumps, connections, and molecular engineering. The overarching point is that the fields share a focus on extracting and transporting fluids through a series of processes and systems.
This document discusses corrosion and scale in pipes and pumps used in the fluids industry. It outlines different types of corrosion like pitting and cracking, and their various causes related to electrochemistry, water chemistry, and stress factors. The document also discusses strategies for managing corrosion through conditioning fluids, using corrosion resistant materials, inhibitors, coatings, and coupons. It notes ongoing challenges in developing truly corrosion-free or impervious materials and coatings. Mineral scale, wax, gas hydrates, and produced water issues are also outlined as challenges for the oil and gas industry pipelines.
A Brief Introduction to Coiled Tubing: What is it? What to do with it?, pumps...tmhsweb
This document provides an overview of coiled tubing, including its history, equipment, and applications. It discusses how coiled tubing originated from military projects during World War II and was first used in the oilfield in 1962. The key components of a coiled tubing unit are described, including the injector, reel, control house, and other equipment. Common applications of coiled tubing in the oil and gas industry involve well intervention operations such as drilling, logging, perforating, and more. A comparison is made between addressing blockages in wells and arteries.
Computational Biomedicine Lab: Current Members, pumpsandpipesmdhctmhsweb
The Computational Biomedicine Lab has the following members: a director, research scientists, PhD students, an MSc student, and undergraduate students. The lab's mission is to develop algorithms to analyze multidimensional data and extract relevant information to aid humans. The lab aims to establish interdisciplinary collaboration and work on "grand challenge problems".
This document discusses the history and evolution of percutaneous coronary intervention (PCI) procedures such as angioplasty and stenting to repair coronary arteries. It covers the initial development of balloon angioplasty, the issues it posed around restenosis and abrupt closure, and how stents helped address these issues but introduced the new problem of in-stent restenosis. Drug-eluting stents were then developed to significantly reduce restenosis rates by preventing cell replication through the local delivery of drugs. The document discusses ongoing research to develop newer stent materials, polymers, drug coatings, and bioabsorbable technologies to continue improving PCI outcomes and safety.
Atherectomy and Plaque Analysis, pumpsandpipesmdhctmhsweb
The document discusses different methods for removing plaque from arteries, including atherectomy. Surgical endarterectomy is an invasive approach that led to the development of less invasive atherectomy techniques like laser atherectomy and remote endarterectomy. Excisional atherectomy uses devices like the Silverhawk to remove plaque but can send debris downstream and have high recurrence rates. The goal is to find more effective mechanical and biological plaque removal and prevention methods.
This document summarizes three cytopathology cases:
1) A 55-year-old female diagnosed with cervical adenocarcinoma in situ based on crowded stratified strips and rosettes in the thinprep.
2) A 64-year-old female with a history of breast mass, suspected to have a mucinous neoplasm or lesion based on the FNA.
3) A 55-year-old male with a right inguinal lymph node FNA, initially diagnosed as a high-grade mostly necrotic malignant neoplasm which was later determined to be vimentin-positive.
This document discusses a case of pericardial fluid from a 36-year old female with lupus and a pericardial effusion. A special stain was performed which led to a diagnosis of Mycobacterium mucogenicum pericarditis. M. mucogenicum is a nontuberculous mycobacterium that can cause nosocomial infections after surgery or in patients on hemodialysis. It is identified through its unique 16s ribosomal unit and resistant to certain antibiotics but susceptible to others.
A 54-year-old female presented with multiple lung nodules. The differential diagnoses included carcinoma ex pleomorphic adenoma, adenoid cystic carcinoma, and pleomorphic adenoma. The diagnosis was adenoid cystic carcinoma, a malignant salivary gland tumor that can occur primarily in the lungs arising from the trachea or main bronchi. It typically presents as either a nodular polypoid projection or a subepithelial growth along the long axis of the bronchus.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
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