Color doppler us findings in the diagnosis of arterial occlusive disease of the lower limb

Peripheral arterial occlusive disease (PAOD) of the lower limb is a widely spread disease at the present time. After clinical examination, which includes a comprehensive history of the patient, different imaging modalities are competitive in the exact assessment of PAOD. Besides digital subtraction angiography and MR -angiography, color Doppler US is an established imaging modality in the diagnosis of PAOD. This article illustrates the typical color Doppler US findings in PAOD of the lower limb. Duplex images of normal and pathological findings are presented, and the limitations of the method are pointed out. Color Doppler US examination strategies in patients suffering of PAOD are outlined. </jats:p

Clinical manifestations and diagnosis of invasive aspergillosis in immunocompromised children

Invasive aspergillosis (IA) is a serious life-threatening complication in immunocompromised children. The commonest risk groups are children with acquired immunodeficiency syndrome, leukaemia, corticosteroid and other immunosuppressive therapy, chronic granulomatous disease and severe combined immunodeficiency as well as neonates. The clinical manifestations are heterogeneous and many organ systems can be involved. Diagnosis based on the clinical presentation alone is cumbersome. Innovative and sensitive laboratory test systems which detect fungal antigens or DNA in clinical specimens have been recently developed. Specific Aspergillus antibody detection using recombinant antigen technique has also been introduced. Although each individual technique has drawbacks, the combined use of culture with antigen and antibody ELISA as well as PCR should result in an earlier and more definitive diagnosis of IA in children presenting with clinical and/or radiological signs of aspergillosis. In high risk children these methods are valuable for serial screening and early detection of Aspergillus infection. The implementation of accurate diagnostic criteria and standardised diagnostic flow charts in children at risk will lead to a better outcome of IA in the future. Conclusion: definite, well-timed early diagnosis and sufficient therapy is elementary for a successful outcome of invasive aspergillosis in immunocompromised children. To date, the diagnosis of invasive aspergillosis remains a combination of clinical presentation, radiology and microbiological tests

Document collections, mobilized regulations, and the making of customary law at the end of the Middle Ages

Using late medieval examples from Switzerland, this paper argues that the emergence of formally organized archives around 1500 was part of an important shift in how documents could be deployed. However, this shift was not away from an oral and toward a literate culture, as argued in some earlier studies, but rather away from seeing documents as testimony that reminded a community about past authoritative actors, and toward relating the texts of documents to other texts, that is, to contexts. This shift took place largely through the appropriation of methods for using and organizing written material that had been developed in the realms of scholastic theology and liturgy, and applying them to secular lordship and administration. These methods provided new models for organizing collections of parchments and papers into connected archives and gave rise to new forms of text collection such as reorganized versions of law books (Spiegel, Coutumiers) containing new search tools such as tables of contents (capitulationes) and indices (abecedaria). Individual charters and scattered legal norms were also organized into textus–glossae structures in larger and smaller administrative units. In the Swiss case, the contextualization of legal texts was accompanied by an increased attribution of authority to ‘custom’ in general, because the community-oriented attribution of meaning found in earlier use was lost. Ultimately, recasting individual documents as part of larger textual contexts increased the power of rulers and ushered in an age of lawyers and of archives