3,103 research outputs found
Emma Bell Miles journal, 1908-1911
No full textJournal authored by Walden's Ridge naturalist, artist, and author Emma Bell Miles from 1908 May 24 to 1911 April 25
Emma Bell Miles journal, 1911-1914
No full textJournal authored by Walden's Ridge naturalist, artist, and author Emma Bell Miles from 1911 January 9 to 1914 May 3
Emma Bell Miles journal, 1915-1918
No full textJournal authored by Walden's Ridge naturalist, artist, and author Emma Bell Miles from 1915 November 11 to 1918 August 8
Emma Bell Miles journal, 1915-1918
No full textJournal authored by Walden's Ridge naturalist, artist, and author Emma Bell Miles from 1915 November 11 to 1918 August 8
Emma Bell Miles journal, 1911-1914
No full textJournal authored by Walden's Ridge naturalist, artist, and author Emma Bell Miles from 1911 January 9 to 1914 May 3
Emma Bell Miles journal, 1908-1911
No full textJournal authored by Walden's Ridge naturalist, artist, and author Emma Bell Miles from 1908 May 24 to 1911 April 25
Emma Bell Miles journal, 1915
No full textJournal authored by Walden's Ridge naturalist, artist, and author Emma Bell Miles from 1915 June 15 to 1915 September 22. The journal also includes newspaper clippings of Miles' Fountain Square Conversation column authored for the Chattanooga News
Emma Bell Miles journal, 1915
No full textJournal authored by Walden's Ridge naturalist, artist, and author Emma Bell Miles from 1915 June 15 to 1915 September 22. The journal also includes newspaper clippings of Miles' Fountain Square Conversation column authored for the Chattanooga News
Colonoscopy is mandatory after <it>Streptococcus bovis </it>endocarditis: a lesson still not learned. Case report
No full textAbstract Background Even though the relationship between certain bacterial infections and neoplastic lesions of the colon is well-recognized, this knowledge has not been sufficiently translated into routine practice yet. Case presentation We describe the case of a 51-year-old man who was admitted to our Surgical Department due to rectal bleeding and abdominal pain. Preoperative colonoscopy, staging exams and subsequent surgery demonstrated a stenotic adenocarcinoma of the sigmoid colon, invading the left urinary tract and the homolateral bladder wall, with regional lymph nodes involvement and massive bilobar liver metastases (T4N1M1). After Hartmann's rectosigmoidectomy and despite systemic chemotherapy, a rapid progression occurred and the patient survived for only 5 months after diagnosis. Five years before detecting this advanced colonic cancer, the patient underwent aortic valve replacement due to a severe Streptococcus bovis endocarditis. Subsequent to this infection he never underwent a colonoscopy until overt intestinal symptoms appeared. Conclusion As this case illustrates, in the unusual setting of a Streptococcus bovis infection, it is necessary to timely and carefully rule out occult colon cancer and other malignancies during hospitalization and, if a tumor is not found, to schedule endoscopic follow-up. Rigorous application of these recommendations in the case described would have likely led to an earlier diagnosis of cancer and maybe saved the patient's life.</p
From CT scanning to 3-D printing technology for the preoperative planning in laparoscopic splenectomy
No full textBackground: Three-dimensional printing technology is rapidly changing the way we produce all sort of objects, having also included medical applications. We embarked in a pilot study to assess the value of patient-specific 3-D physical manufacturing of spleno-pancreatic anatomy in helping during patient’s counseling and for preoperative planning. Methods: Twelve patients scheduled for a laparoscopic splenectomy underwent contrast CT and subsequent post-processing to create virtual 3-D models of the target anatomy, and 3-D printing of the relative solid objects. The printing process, its cost and encountered problems were monitored and recorded. Patients were asked to rate the value of 3-D objects on a 1–5 scale in facilitating their understanding of the proposed procedure. Also 10 surgical residents were required to evaluate the perceived extra value of 3-D printing in the preoperative planning process. Results: The post-processing analysis required an average of 2; 20 h was needed to physically print each model and 4 additional hours to finalize each object. The cost for the material employed for each object was around 300 euros. Ten patients gave a score of 5, two a score of 4. Six residents gave a score of 5, four a score of 4. Conclusions: Three-dimensional printing is helpful in understanding complex anatomy for educational purposes at all levels. Cost and working time to produce good quality objects are still considerable. © 2015, Springer Science+Business Media New York
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