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BackgroundAcute-on-chronic liver failure (ACLF) is a form of liver disease with high short-term mortality. ACLF offers considerable potential to affect the cortical areas by significant tissue injury due to loss of neurons and other supporting cells. We measured changes in cortical thickness and metabolites profile in ACLF patients following treatment, and compared it with those of age matched healthy volunteers.MethodsFor the cortical thickness analysis we performed whole brain high resolution T1-weighted magnetic resonance imaging (MRI) on 15 ACLF and 10 healthy volunteers at 3T clinical MR scanner. Proton MR Spectroscopy ((1)H MRS) was also performed to measure level of altered metabolites. Out of 15 ACLF patients 10 survived and underwent follow-up study after clinical recovery at 3 weeks. FreeSurfer program was used to quantify cortical thickness and LC- Model software was used to quantify absolute metabolites concentrations. Neuropsychological (NP) test was performed to assess the cognitive performance in follow-up ACLF patients compared to controls.ResultsSignificantly reduced cortical thicknesses in multiple brain sites, and significantly decreased N-acetyl aspartate (NAA), myo-inositol (mI) and significantly increased glutamate/glutamine (glx) metabolites were observed in ACLF compared to those of controls at baseline study. Follow-up patients showed significant recovery in cortical thickness and Glx level, while NAA and mI were partially recovered compared to baseline study. When compared to controls, follow-up patients still showed reduced cortical thickness and altered metabolites level. Follow-up patients had abnormal neuropsychological (NP) scores compared to controls.ConclusionsNeuronal loss as suggested by the reduced NAA, decreased cellular density due to increased cerebral hyperammonemia as supported by the increased glx level, and increased proinflammatory cytokines and free radicals may account for the reduced cortical thickness in ACLF patients. Presence of reduced cortical thickness, altered metabolites and abnormal NP test scores in post recovery subjects as compared to those of controls is associated with incomplete clinical recovery. The current imaging protocol can be easily implemented in clinical settings to evaluate and monitor brain tissue changes in patients with ACLF during the course of treatment.

An on-line survey was conducted among a university's department chairs in an effort to gain perspective on university-wide use of Experiential Learning (EL). While there were differences in cross-disciplinary definitions and perspectives regarding EL, ninety-one per cent of 35 department chairs indicated their department made use of EL with greatest use during the junior and senior years. EL is defined generally as a hands-on experience and/or learning by doing while cognitive activity, such as observation and reflection, is included in the definition by a third of the chairs. Eighty-eight per cent of the chairs believe students view EL as either "very beneficial" or "beneficial".

Colleges and universities have increasingly invested in specialized software and hardware designed to enhance and facilitate the instructional process for faculty and students. One type of technological assistance is commonly known as course management software (CMS). Once learned, these CMS packages can greatly enhance and enrich the classroom experience and provide internet based access to course materials, assignments, grades, supplementary materials, such as quizzes, PPTs, and study aids. Like all moderately complex software packages (Blackboard is proprietary software and Moodle is open source software), there is a learning curve involved in mastering the functionality of each CMS. This paper examines the process of changing from one type of CMS (Blackboard) to another (Moodle). Faulty (FT & PT) and students (graduate & undergraduate) were surveyed to obtain opinions about the transition from one CMS system to another. The goal is to identify issues that may be addressed by targeted training and insights which would improve the transition process.

Previous research in our Action Learning Program demonstrated that although undergraduates preferred the Action Learning mode to the traditional lecture and discussion mode of instruction, they missed the familiar structure of the more traditional pedagogy. Consequently increased structure was implemented in both an undergraduate and graduate marketing course utilizing the Action Learning mode. Students' reactions to the modified courses were assessed. Although both undergraduate and graduate approval of these courses was high, the reasons for the approval were quite different. The undergraduates placed significant emphasis on the pedagogical issues while graduate students focused on skills they obtained in the course and the fact that the course related to their career/job. These results have had significant impact on the redesign of both courses.

A large body of published work shows that proton (hydrogen 1 [(1)H]) magnetic resonance (MR) spectroscopy has evolved from a research tool into a clinical neuroimaging modality. Herein, the authors present a summary of brain disorders in which MR spectroscopy has an impact on patient management, together with a critical consideration of common data acquisition and processing procedures. The article documents the impact of (1)H MR spectroscopy in the clinical evaluation of disorders of the central nervous system. The clinical usefulness of (1)H MR spectroscopy has been established for brain neoplasms, neonatal and pediatric disorders (hypoxia-ischemia, inherited metabolic diseases, and traumatic brain injury), demyelinating disorders, and infectious brain lesions. The growing list of disorders for which (1)H MR spectroscopy may contribute to patient management extends to neurodegenerative diseases, epilepsy, and stroke. To facilitate expanded clinical acceptance and standardization of MR spectroscopy methodology, guidelines are provided for data acquisition and analysis, quality assessment, and interpretation. Finally, the authors offer recommendations to expedite the use of robust MR spectroscopy methodology in the clinical setting, including incorporation of technical advances on clinical units.

Chronic subdural hematoma (CSDH) is one of the most commonly encountered emergencies in neurosurgery practice. Burr hole with drainage of hematoma has been a time-tested standard treatment with good results and in itself a simple procedure to relieve patient clinical status. However, apparently simple surgery may at times have an unexpected surgical outcome of bilateral vision loss. All bilateral CSDHs should be treated diligently with early recognition of any visual deterioration in post-operative phase if any and due to possible interventions to be offered to the patients for prevention of permanent vision loss. [ABSTRACT FROM AUTHOR]

Background: Solitary fibrous tumors (SFT) are the rare mesenchymal tumors originally described in the pleura. SFT of breast is even rarer and to the best of our knowledge about 35 cases are reported to date, including only six malignant SFT cases. Case presentation: We report a case of a 52-year-old lady with a large left breast mass involving all the quadrants. The tumor was diagnosed as malignant SFT in a core needle biopsy which was later confirmed on the resection specimen. Conclusion: Herein, we describe the approach and importance of optimal utilization of immunohistochemistry for diagnosing such rare tumors of the breast, particularly, when clinical presentation, radiology and fine needle aspiration cytology are incongruous. [ABSTRACT FROM AUTHOR]

AbstractBackgroundCase descriptionConclusionsPrimary leptomeningeal lymphoma (PLML) without brain parenchymal involvement or systemic disease is very rare, comprising of approximately 7% of all primary central nervous system lymphomas (PCNSL). PLML is a diagnosis of exclusion which should be confirmed on biopsy after ruling out metastasis from systemic lymphomas and dissemination from PCNSL.A 21-year-old patient presented with the chief complaints of headache, diplopia, decreased vision for five months, and a swelling on the left side of the forehead for four months. On radiology, a large, lobulated, extra-axial mass lesion along the left frontal region with its base towards dura noted. No parenchymal or subependymal CNS lesions were found on CT/MRI. Histopathology was reported as primary leptomeningeal CD30 positive diffuse large B cell lymphoma.PLML is a very rare meningeal tumor that requires a very high index of suspicion and is always a diagnosis of exclusion. [ABSTRACT FROM AUTHOR]

Background: Globally ovarian tumor is one of the leading causes of cancer death among women. It can present in childhood to postmenopausal age group and accounts for the most prevalent cause of hospital admissions. Ovarian tumor has varied histogenesis, clinical behavior and malignant potential. Aim and Objectives: This study was done to analyse the frequency of ovarian lesions, their clinicohistological features in a tertiary care center. Materials and Methods: Prospective hospital based study conducted in the department of pathology in tertiary care hospital in central India over a period of 1 year. All the relevant clinical data of patients who were treated surgically for suspected benign lesions of ovary were analysed. Results: Out of the total of 120 cases, 92 cases were classified as benign, accounting for 76.6% of the cases. There were 4 cases classified as borderline, representing 3.28% of the cases. The remaining 24 cases were classified as malignant, making up 20.12% of the cases. Serous cystadenoma is a frequently observed benign tumour. Serous cystadenocarcinoma is a frequently observed malignant tumour. The younger age group predominantly exhibited benign tumours, while malignant tumours were more prevalent among the senior age group. Malignant ovarian tumours are most frequently observed in women who have never given birth. Conclusion: Ovarian tumours of the surface epithelium were the most prevalent. Typically observed in individuals aged 40 to 59 years. The highest incidence of malignant ovarian tumours occurred in individuals over the age of 50. [ABSTRACT FROM AUTHOR]