Proportional hazards models (PHMs) for the times between consecutive pipe breaks were constructed using case study water main break data. The 150 mm individual cast iron pipes in the case study water distribution system were categorized into seven groups according to the past break history to construct a distinct PHM for each group. During the modeling process the assumption of the proportional hazards of covariates was examined to include the time-dependent effects of covariates on the failure hazard in the models. By analyzing the baseline hazard rates, the hazards of the third through the seventh break were found to follow a form similar to a bath-tub. The estimated regression coefficients and the hazard ratios of the selected covariates were used to analyze the variations in the factors and their effects, including the timedependent effects on the pipe failures. The changes in the relative hazards of the covariates were also analyzed according to the number of breaks. The constructed PHMs were verified by analyzing the deviance residuals of each model.
Cholesterol granuloma is a histological term used for the description of a tissue response to a foreign body such as cholesterol crystals. Cholesterol granuloma is histologically characterized as fibrous granulation tissue containing cholesterol crystals within surrounding giant cells. Cases of cholesterol granuloma of the pancreas are very rare. We report a case of a 47-year old male who had a cholesterol granuloma of the pancreas. Abdominal CT showed 24 mm-sized cyst in the pancreas and peri-pancreatic regional mass infiltrating to the stomach. PET-CT revealed increased 18F-FDG uptake at the cyst and peri-pancreatic mass. Thus, Whipple's operation was done. The disease was confirmed by surgical pathologic examination of the tissue. Pathologic examination of resected specimen showed numerous cholesterol crystals surrounded by multinucleated foreign body giant cells. We report on this case and give a brief review of the literature.
Purpose: Hypoxic-ischemic brain injuries influence the mechanisms of signal transduction, including mitogen-activated protein kinase (MAPK) that regulates gene expression through transcription factor activity. Several attempts have been made to use bee venom (BV) to treat neurological diseases. However, limited data are available for brain injuries such as neonatal hypoxic-ischemic encephalopathy (HIE) and neurodegenerative disorders. The purpose of this study was to investigate the neuroprotective effects of BV by determining the expression of activated MAPK pathways. Methods: We examined activation and cell viability in hypoxia (1% O 2 , 5% CO 2 , 94% N 2) in low glucose-treated (H+low G) neuronal cells and astrocytes in the presence and absence of BV. After they were subjected to hypoxic conditions and treated with low glucose, the cells were maintained for 0, 6, 15, and 24 h under normoxic conditions. Results: Extracellular-signal-regulated kinases 1/2 (ERK1/2), p38 MAPK, and stressactivated protein kinases (SAPK)/Jun amino-terminal kinases (JNK) were activated in H+low G conditions. Particularly, phosphorylation of ERK1/2 was maximized 6 h after exposure to H+low G condition. BV specifically inhibited the phosphorylation of ERK1/2. However, BV had no effect on p38 MAPK or SAPK/JNK. In addition, BV improved neuronal cell and astrocytes viability following exposure to H+low G. Conclusion: ERK inactivation is known to mediate protective effects in hypoxic brain injury. Taken together, these results suggest that treatment with BV may be helpful in reducing hypoxic injury in neonatal HIE through the ERK signaling pathway.
Graves' disease (GD) can lead to specific eye afflictions including proptosis, periorbital swelling, conjunctival injection, chemosis, and opthalmoplegia, which then become a condition called Graves' ophthalmopathy or thyroid-associated ophthalmopathy (TAO). A carotid cavernous fistula (CCF) is an abnormal vascular communication between the carotid artery and the cavernous sinus. The clinical signs of CCF are very similar to TAO and should be considered as a differential diagnosis of TAO. We would like to present an interesting case of a bilateral ophthalmopathy induced by CCF in a GD patient. A 54-year-old man with a 6-year history of GD presented with bilateral exophthalmos and conjunctival injection for two months. The orbital CT scan findings were consistent with CCF, and an angiography revealed bilateral CCF. He received a bilateral coil embolization for the CCF and his ophthalmic signs were immediately improved. We recommend orbital imaging to exclude other coexisting diseases in patients who are suspected of TAO, especially when the diagnosis is uncertain or when determining whether medical or surgical intervention is appropriate. (Endocrinol Metab 26:335-339, 2011)
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