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Mycotic hepatic artery aneurysms are rare. This report documents a case in which a mycotic hepatic artery aneurysm was associated with Crohn's disease, renal adenocarcinoma, and a urinary tract infection. Endovascular management of this mycotic hepatic artery aneurysm was successful in the setting of a hostile abdomen based on multiple previous operations, a stoma, and a scarred abdomen.
Like paratroopers in special operations, dendritic cells (DCs) can be deployed behind the enemy borders of malignant tissue to ignite an antitumour immune response. 'Cross-priming T cell responses' is the code name for their mission, which consists of taking up antigen from transformed cells or their debris, migrating to lymphoid tissue ferrying the antigenic cargo, and meeting specific T cells. This must be accomplished in such an immunogenic manner that specific T lymphocytes would mount a robust enough response as to fully reject the malignancy. To improve their immunostimulating activity, local gene therapy can be very beneficial, either by transfecting DCs with genes enhancing their performance, or by preparing tumour tissue with pro-inflammatory mediators. In addition, endogenous DCs from the tumour host can be attracted into the malignant tissue following transfection of certain chemokine genes into tumour cells. On their side, tumour stroma and malignant cells set up a hostile immunosuppressive environment for artificially released or attracted DCs. This milieu is usually rich in transforming growth factor-beta, vascular endothelial growth factor, and IL-10, -6 and -8, among other substances that diminish DC performance. Several molecular strategies are being devised to interfere with the immunosuppressive actions of these substances and to further enhance the level of anticancer immunity achieved after artificial release of DCs intratumourally.
The civil chaos created by a combination of drought and hostilities in the Ogaden region of southern Ethiopia during the past five years has caused the majority of the indigenous, principally nomadic population to flee the area and seek refuge either in Somali refugee camps or in Ethiopian shelters for displaced persons. This paper compares the provision of basic food rations, selective feeding programs, primary health care, and preventive health measures between the two groups. During 1980-1981 Somalia received more international assistance per capita than Ethiopia. Large numbers of Western personnel provided health and nutrition services in Somali refugee camps, whereas no foreigners were involved in Ethiopian shelters. These disparities were largely due to inadequate publicity concerning the problems Ethiopia faces, partly resulting from real and perceived political limitations related to the Soviet presence in that country. Refugee needs in Somalia have been publicized far more adequately, partly due to that country's alignment with the West. The Ethiopians nevertheless demonstrated greater efficiency in assisting their disaster victims; camp services comparable to those in Somalia were available despite greater logistic difficulties and fewer donated resources. The effectiveness of relief operations in Somalia was reduced by political constraints on governmental agencies.
Imaging equipment deployed with the combat support hospital in Afghanistan represented new technology not previously used in a hostile environment for a prolonged period. In general, the equipment performed well in a stationary location. Having computed tomography and ultrasound scans, in addition to plain radiographs, was very helpful for patient care. Redundancy of digital radiography and ultrasound systems proved prudent. It is recommended that a radiologist continue to be sent with the combat support hospital, particularly when computed tomography and ultrasound systems are in the deployment package. This report acquaints the medical community with information to aid in the planning and performance of future deployments that bring digital imaging to the battlespace.
Although the federal government and most states have enacted laws protecting healthcare providers' rights to refuse to provide or participate in procedures to which they have moral or religious objections, most such laws are deficient and many have been met with hostile judicial interpretations that have diminished their scope and strength. Deficiencies found in nearly all conscience clause laws include limitations on the specific conduct or procedures protected, restrictive definitions of the healthcare providers covered, and inadequate implementing procedures and remedies. Most conscience clause statutes fail to provide more than token protection for healthcare providers' rights of conscience. Increasing duress on healthcare providers who assert rights of conscience can be expected from three sources. First, some medical schools have considered refusal to participate as a negative factor in the admission process. Second, greater financial pressures on the American healthcare system may cause nonmonetary factors to be sacrificed to the exigencies of the moment. Third, all healthcare reform plans propose an increase in the federal government's role in providing healthcare. At present, the only federal statutory protection for healthcare providers' rights of conscience covers participants in only a few federal programs, is poorly conceived, and is sorely inadequate.
We develop the hypothesis that parasites do not invade extreme environments, i.e. hostile hosts, but rather 'create' them. We argue that parasites may have driven the evolution of the constitutive and adaptive immune system. This leads to several implications. First, parasites respond to 'genes to kill' by 'genes to survive' and this triggers an indefinite selection of measures and counter-measures. Second, these coevolutionary arms races may lead to local adaptation, in which parasite populations perform better on local hosts. Third, the evolution of the immune system, whose responses are predictable, may allow parasites to specialize, to evade and even to manipulate. Finally we show that the correlations between the increase in the antibody repertoire, the expansion of MHC loci and parasite pressures support our hypothesis that both host complexity and parasite pressures can be invoked to explain the diversity of antibodies, T-receptors and MHC molecules.
Understanding why patients act in a hostile manner is the first step in defusing a potentially violent situation and preventing injury to the patient and the security officer who may be called on to intervene.
The management of facial gunshot wounded patients requires the coordination of multiple surgical disciplines to optimize the functional and cosmetic outcome while minimizing overall morbidity and mortality. All reports indicate that early management of these patients must focus on the basis of resuscitation, with major attention given to the status of maintaining the airway, hemostasis and hemodynamic resuscitation. Subsequent management of these patients becomes more controversial in terms of surgical reconstruction: immediate or delayed. Involvement of the use of suicide bombers, the type of weapons used in the last 2 years were different than previously described. The injuries were inflicted by explosives mixed with nails bolts and stones, which caused different kinds of wounds ever described. Numerous series in the literature advocate early aggressive intervention of one-stage reconstruction of all involved structures. However, several series published in the literature favor a more conservative approach, some of them even advocating non-operative management of these injuries. We concluded that a delay in final reconstruction of facial fractures in the critically ill patient has an acceptably low complication rate and may be advantageous in decreasing operative risk. A carefully planned reconstruction schedule is required to achieve satisfactory function and appearance. It is our purpose in this report to indicate the difference of the gunshot wounds in the last 2 years of the hostilities in this part of the world and emphasize the function of the Oral & Maxillofacial Surgeons in treating these patients.
Nowadays, the animosity between medical scholars is seldom apparent. However, during the XIXth century it was not necessarily so. We find an example of this in Sappey's hostility against his colleague anatomist Gilbert Breschet. It concerned the discovery of the otoliths of the inner ear that Breschet attributed to himself. We present here Breschet's defence.
Fifty-two sterile couples, characterized by persistent and unexplained incompatibility between spermatozoa and cervical mucus, without any other evident factor to explain their sterility, were investigated for the possible role of blood group incompatibility as a cause of their sterility. After a study of the distribution of blood groups in sterile and fertile couples, the distribution of blood group substances in pairs of husbands and wives, and the effect of blood group antibodies on sperm migration, it seems highly unlikely that blood group incompatibility contributes significantly to cervical hostility and the resulting sterility.
After a historical review of the discussion of the concept of strangeness and alienation since the beginning of the 19th century, the question of the background of the current discussion of "the alien" arises. The assumption is that the experience of strangeness and self-alienation took a qualitative and quantitative leap at the point in technological development when the dialectic between human and machine was resolved in favor of the machine's domination, and when the "mega-machine" made the end of the human species conceivable and probable. Findings from empirical research on children and youth support this assumption. The causes are traced why the younger generation in particular is affected by the structural violence of strangeness that permeates all areas of life. Its inflating influence on the development of the ego and self is depicted. In accordance with the assumption, hostility toward and hatred of foreigners are to be grasped as symptoms of a loss of identity, caused by experiences of alienation deeper and more comprehensive than current societal triggers reveal.
Abnormal cervical mucus (CM) quality and quantity is considered one of the causes of infertility which occurs in only 2 to 8 per cent of infertile couples. The periovulatory mucus with its specific properties is necessary to determine a correct Post Coital Test (PCT). Twenty patients, with infertility for over 18 months and with a baseline negative PCT (repeated at least three times) for abnormal CM, were treated with pFSH. Our results show that the pFSH improves the quality and quantity of CM in all for our patients including an improvement of penetration and motility spermatozoa in 55 per cent of our cases. Therefore we suggest the routine pFSH use in case of cervical hostility and recurrent negative PCT.
In contrast to the non-Hodgkin's lymphomas, little is known regarding the origin, genetics, and function of the Reed-Sternberg cell of Hodgkin's disease. Unlike other cancers, the neoplastic cell of Hodgkin's disease, the Reed-Sternberg cell, is vastly outnumbered by a surrounding intense inflammatory infiltrate. How this rare neoplastic cell originates, persists, and disseminates in a presumably hostile cellular environment has remained a mystery. Understanding the biology of the Reed-Sternberg cell has been impeded by the rarity of the cell in tumor tissue. Herein, we describe how the application of single-cell genetic analysis has revealed a clonal and, possibly, germinal center B-cell origin of the Reed-Sternberg cell. By phenotype and function, Reed-Sternberg cells are highly interactive with their cellular microenvironment through cell-cell adhesion, expression of members of the tumor necrosis factor receptor superfamily, and elaboration of cytokines. Perhaps by their mimicry of immune system cells with antigen-presenting function, Reed-Sternberg cells mediate the unusual clinical and pathologic features of Hodgkin's disease: intense tissue inflammatory infiltrate, fibrosis, and constitutional symptoms.
Selected events in the history of biological weapons are highlighted to increase physicians' awareness of the threat of biological weapons. The hostile use of biological substances originated in antiquity and pervades the history of human conflict. Although difficult to verify at times, the use of such weaponry has not been limited to national militaries. Disgruntled civilians and even physicians have used biological weapons to promote their interests. Their potency, cost-effectiveness, and the ability to manufacture and deploy them with little sophistication, or under the semblance of legitimate commercial endeavors, will ensure that biological weapons remain a constant threat to public health.
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Explore the source record for details and available documents.