Near fatal posterior reversible encephalopathy syndrome complicating chronic liver failure and treated by induced hypothermia and dialysis: a case report

<p>Abstract</p> <p>Introduction</p> <p>Posterior reversible encephalopathy syndrome is a clinico-neuroradiological entity characterized by headache, vomiting, altered mental status, blurred vision and seizures with neuroimaging studies demonstrating white-gray matter edema involving predominantly the posterior region of the brain.</p> <p>Case presentation</p> <p>We report a 47-year-old Caucasian man with liver cirrhosis who developed posterior reversible encephalopathy syndrome following an upper gastrointestinal hemorrhage and who was managed with induced hypothermia for control of intracranial hypertension and continuous veno-venous hemodiafiltration for severe hyperammonemia.</p> <p>Conclusion</p> <p>We believe this is the first documented case report of posterior reversible encephalopathy syndrome associated with cirrhosis as well as the first report of the use of induced hypothermia and continuous veno-venous hemodiafiltration in this setting.</p

AUTOMATIC PROXY GENERATION AND LOAD-BALANCING-BASED DYNAMIC CHOICE OF SERVICES

The paper addresses the issues of invoking services from within workflows which are becoming an increasingly popular paradigm of distributed programming. The main idea of our research is to develop a facility which enables load balancing between the available services and their instances. The system consists of three main modules: a proxy generator for a specific service according to its interface type, a proxy that redirects requests to a concrete instance of the service and load-balancer (LB) to choose the least loaded virtual machine (VM) which hosts a single service instance. The proxy generator was implemented as a bean (in compliance to EJB standard) which generates proxy according to the WSDL service interface description using XSLT engine and then deploys it on a GlassFish application server using GlassFish API, the proxy is a BPEL module and load-balancer is a stateful Web Service

Changes of Sagittal Spinopelvic Parameters in Normal Koreans with Age over 50

Study Design A prospective comparative study. Purpose To describe the changes in the spinopelvic parameters on normal Koreans more than 50 years of age. Overview of Literature There are differing opinions regarding the changes in the thoracic kyphosis, lumbar lordosis, C7 plumb with age in the elderly population. Methods Sagittal standing radiographs of the whole spine including the pelvis in 132 Korean adult male volunteers more than 50 years of age were evaluated prospectively. Volunteers with a history of spine operation, spinal disease, pain in their back or legs, scoliosis, spondylolisthesis, monosegment disc space narrowing, or compression fracture in radiographs were excluded. The following parameters were included: thoracic kyphosis (T5 upper end plate [UEP]-T12 lower end plate [LEP]), thoracolumbar kyphosis (T10 UEP-L2 LEP), lumbar lordosis (T12 LEP-S1 UEP), lower lumbar lordosis (L4 UEP-S1 UEP), sacral slope, pelvic incidence, and the distances from the C7 plumb to the posterosuperior endplate of S1. These parameters in the 6th, 7th and 8th decade groups were compared and the changes in these parameters according to age were examined. Results The thoracic kyphosis demonstrated significant differences in the in the three age groups (p = 0.019), and increased with age (r = 0.239, p < 0.006). The other parameters did not show any significant difference or correlation. Conclusions Similar global sagittal balances and spinopelvic parameters may be observed in Korean males older than 50 years, with a trend towards increasing thoracic kyphosis with age

Posterior reversible encephalopathy syndrome in an untreated hypertensive patient after spinal surgery under general anesthesia -A case report-

Posterior reversible encephalopathy syndrome (PRES) is an unfamiliar term to anesthesiologists, and this is characterized by neurologic symptoms that include mental change, headache, seizure and visual disturbance and also abnormal neuroimaging finding. A 71-year-old female patient was operated on for posterior decompression and total laminectomy under general anesthesia for the spinal stenosis. After the operation, she developed generalized tonic-clonic seizure and a stuporous mentality in the recovery room. The magnetic resonance imaging (MRI) revealed swelling and increased signal intensity at the deep gray nuclei, cerebral cortex and cerebellum. After one week, she returned to an alert mentality and then she was diagnosed with PRES. She was discharged without any neurologic deficit on postoperative day 20. This report describes our experience with PRES after spinal surgery was performed under general anesthesia on a suspected untreated hypertensive patient

Band structure effects on the Be(0001) acoustic-surface-plasmon energy dispersion

We report first-principles calculations of acoustic surface plasmons on the (0001) surface of Be, as obtained in the random-phase approximation of many-body theory. The energy dispersion of these collective excitations has been obtained along two symmetry directions. Our results show a considerable anisotropy of acoustic surface plasmons, and underline the capability of experimental measurements of these plasmons to {\it map} the electron-hole excitation spectrum of the quasi two-dimensional Shockley surface state band that is present on the Be(0001) surface.Comment: 9 pages, 2 figure