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Search Results: 1 - 10 of 1832 matches for " Neal Wilkinson "
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Hepatobiliary Cystadenocarcinoma
Neal Wilkinson
Case Reports in Hepatology , 2012, DOI: 10.1155/2012/298957
Abstract: Biliary cystadenocarcinomas are rare tumors that are poorly understood. Preoperative imaging is imprecise and treatment is not standardized. We describe the presentation and treatment of one of these rare tumors and review the limited published literature.
Hepatobiliary Cystadenocarcinoma
Neal Wilkinson
Case Reports in Hepatology , 2012, DOI: 10.1155/2012/298957
Abstract: Biliary cystadenocarcinomas are rare tumors that are poorly understood. Preoperative imaging is imprecise and treatment is not standardized. We describe the presentation and treatment of one of these rare tumors and review the limited published literature. 1. Case Report A 61-year-old male with no previous medical history, presented with right upper quadrant pain and mild elevation of total bilirubin to 2.9 and Ca 19-9 was elevated at 559?u/mL. All other laboratory values were within normal limits. Evaluation included a right upper quadrant ultrasound (U/S) and computed tomography (CT), which demonstrated left intrahepatic bile duct dilatation. No stones were noted in the biliary system or gallbladder. ERCP and MRCP demonstrated a mural nodule arising from confluence of the left hepatic duct and the common hepatic duct (Figure 1). Brushings were nondiagnostic. During staging laparotomy, what initially appeared to be metastatic satellite lesions proved to be dilated intra-hepatic biliary system (Figure 2, arrow head). The planned surgical resection was undertaken with curative intent: resection of the common bile duct with en bloc left hepatectomy, caudate resection, and regional lymphadenectomy. Reconstruction was performed with a Roux en Y hepaticojejunostomy to the secondary right hepatic bile ducts. Two exophytic polypoid tumor masses were identified within the left intrahepatic bile ducts, 2.5 and 2.9 centimeter in size (Figure 3). Microscopic analysis demonstrated well-differentiated adenocarcinoma arising within a hepatobiliary cystadenoma (Figure 4). Multifocal severe dysplasia was seen within the left intrahepatic biliary tree without evidence of invasive carcinoma. The remaining right biliary ducts and distal common bile duct were uninvolved. A 1?mm focus of metastatic disease was identified in the regional nodes (1/13). Figure 1: MRI demonstrates left hepatic biliary system is narrowed/occluded although a discrete mass is not well seen. MRCP demonstrates the cystic/dilated left biliary system with stricture/mass noted at the left and common bile duct junction (arrow). Figure 2: At exploration numerous cystic abnormalities were seen at the liver capsule (arrows). Initial impression was that these represented metastatic satellite lesion but proved to be simply ductal dilatation (a). Resection of the common bile duct with en bloc left hepatectomy, caudate resection, and regional lymphadenectomy was performed with a Roux en Y hepaticojejunostomy (b). Figure 3: Resected specimen showing polypoid mass arising from a dilated biliary system (arrow).
The hydrochemistry of the headwaters of the River Severn, Plynlimon
C. Neal,J. Wilkinson,M. Neal,M. Harrow
Hydrology and Earth System Sciences (HESS) & Discussions (HESSD) , 1997,
Abstract: Water quality data spanning 13 years and covering an extensive range of major, minor and trace elements in rain and stream waters at Plynlimon in mid Wales, are presented. Rainfall water chemistry is highly variable due to varying proportions of marine and pollutant derived constituents associated with patterns of atmospheric circulation. Stream waters, being composed of different proportions of waters from three chemically distinct sources at any one time (atmospheric deposition, the soil system and deeper groundwaters), are also chemically highly variable. For example, components predominantly derived from deposition such as chloride change only in response to sea-salt deposition episodes. Solutes associated with bedrock weathering such as calcium, magnesium, and alkalinity decrease with increasing flow, those associated with the upper soil layers such as aluminium, many transition metals, dissolved organic carbon and hydrogen ions increase with increasing flow. The nutrients (e.g. nitrate, boron, bromide and iodine) exhibit strong seasonal cycles associated with cycles of vegetation growth and decay. The changes in stream water chemistry resulting from tree harvesting in the Afon Hore catchment are shown to have run their course within a period of eight years. Nutrient increases in the first few years following the commencement of felling have returned to or fallen below pre-felling values. Aluminium changes are shown to be complicated by changes in nitrate and calcium. Aluminium concentrations initially increased and have fallen below their pre-felling value. Data for chloride suggest a reduction in capture of dry and mist deposition; this indicates the importance of understanding reduced deposition as a result of felling. Felling has also affected the soil micro-climate which experiences greater fluctuations in temperature and an increase in the concentration of constituents associated with organic matter. Input-output mass balance estimates show that atmospheric inputs of many constituents are retained strongly by the catchment (e.g. ammonium, phosphate, barium, boron, lead and iodine). In contrast, many of the transition elements as well as divalent base cations, aluminium and alkalinity show a net release from the catchment. Conservative constituents such as chloride and sodium show a net input-output balance.
Major, minor and trace element composition of cloudwater and rainwater at Plynlimon
J. Wilkinson,B. Reynolds,C. Neal,S. Hill
Hydrology and Earth System Sciences (HESS) & Discussions (HESSD) , 1997,
Abstract: The composition of cloudwater samples collected at Plynlimon, Mid Wales by the Institute of Hydrology is described based on one of the most comprehensive chemical records for deposition in the UK. Comparison with bulk rainwater samples for the same area demonstrates a tenfold enrichment of most elements in cloudwater. Large variations in cloudwater composition occur due to variations in marine and terrestrial/anthropogenic sources, general weather patterns, atmospheric circulation and seasonal effects. All trace metal concentrations are associated with anthropogenic contamination. The lanthanides La, Cc and Pr, and Y are highly correlated in ratios associated with lithogenic sources and fossil fuel combustion. Outliers suggest the influence of catalysts used in the petrochemical cracking process. Plantation forestry significantly enhances the annual deposition of solutes from cloudwater; between 15 and 40% of most constituents to upland forested catchments and around 50% for NO3, B and Cd come from cloud deposition. In upland moorland areas, only 10% of the annual deposited load of inorganic constituents comes from cloudwater.
The impacts of conifer harvesting on runoff water quality: a regional survey for Wales
C. Neal,B. Reynolds,J. Wilkinson,T. Hill
Hydrology and Earth System Sciences (HESS) & Discussions (HESSD) , 1998,
Abstract: Major, minor and trace element chemistry of runoff at stormflow and baseflow from 67 catchments (2 to 5 ha in area) has been determined to investigate the effects of clear felling and replanting of conifers on stream water quality across Wales. Samples, collected by local forestry workers (Forest Enterprise staff) on a campaign basis on up to eight occasions, were for 16 mature first rotation standing forest: the remainder represented areas completely clear felled from less than one to up to forty years previously. As the waters drain acidic and acid sensitive soils, acidic runoff is often encountered. However, higher pH values with associated positive alkalinities and base cation enrichments are observed due to the influence of weathering reactions within the bedrock. There is little systematic variation in water quality between baseflow and stormflow for each site indicating a complex and erratic contribution of waters from the soil and underlying parent material. 80% or more of the data points show hardly any changes with felling time, but there are a few outlier points with much higher concentrations that provide important information on the processes operative. The clearest outlier felling response is for nitrate at five of the more recently felled sites on brown earth, gley and podzolic soil types. ANC, the prime indicator of stream acidity, shows a diverse response from both high to low outlier values (>+400 to -300 μEq/l). In parallel to nitrate, aluminium, potassium and barium concentrations are higher in waters sampled up to 4 years post felling, but the time series response is even less clear than that for nitrate. Cadmium, zinc and lead and lanthanides/actinides show large variations from site to site due to localized vein ore-mineralization in the underlying bedrock. The survey provides a strong indication that forest harvesting can have marked local effects on some chemical components of runoff for the first four years after felling but that this is confined to a small number of sites where nitrate production and aluminium leaching are high. In general, deforestation leads to a reversal of acidification when the nitrate pulse is low. The variability in water quality from catchment to catchment is too high for generalized conclusions to be made over the extent of the potential changes from site to site. The value of an organised campaign of opportunistic sampling using an infrastructure of enthusiastic staff from regionally dispersed organisations associated with environmental matters (in this case the forestry industry) is highlighted.
Determining patient and primary care delay in the diagnosis of cancer – lessons from a pilot study of patients referred for suspected cancer
Richard D Neal, Diana Pasterfield, Clare Wilkinson, Kerenza Hood, Matthew Makin, Helen Lawrence
BMC Family Practice , 2008, DOI: 10.1186/1471-2296-9-9
Abstract: Development of a postal questionnaire tool to measure patient and primary care time responses to key symptoms and signs. The pilot questionnaire was sent to 184 patients with suspected cancer.The response rate was only 85/184 (46.2%). Anxiety was cited as one reason for this low response. Patients returning questionnaires were more likely to be women and more likely to be younger. 84/85 (98.8%) provided consent to access medical records, and questions regarding health profile, smoking and socio-economic profile were answered adequately. Outcome data on their cancer diagnosis was linked satisfactorily and the question about GP-initiated investigations was answered well. Estimated dates for symptom duration were preferred for patient delays, but exact dates were preferred for primary care delays; however there was a significant amount of missing data.A more personal approach to the collection of data about the duration of symptoms in this group of people is needed other than a postal questionnaire. However elements of this piloted questionnaire are likely to figure strongly in future development and evaluation of this tool.Mortality from cancer is worse in the UK than most other European countries [1]. Whilst there are several reasons for this, diagnostic delays and later stage at diagnosis are likely to be contributory factors. Interventions leading to reduced diagnostic delays and less advanced stage at diagnosis are therefore likely to lead to improved cancer survival figures and reduced morbidity. However delays at various points in the cancer diagnostic journey need mapping prior to the development and evaluation of such interventions. Diagnostic delays (perhaps better referred to as 'time to diagnosis' since there is not always a 'delay') may occur at any point in the cancer journey and can be divided into: pre-symptomatic delays, patient delays, primary care delays, referral delays, and secondary care delays [2,3]. The majority of cancer diagnoses are made in p
Chiral Interactions of Histidine in a Hydrated Vermiculite
Donald G. Fraser,H. Christopher Greenwell,Neal T. Skipper,Martin V. Smalley,Michael A. Wilkinson,Bruno Demé,R. K. Heenan
Quantitative Biology , 2010, DOI: 10.1039/c0cp01387k
Abstract: Recent work suggests a link between chiral asymmetry in the amino acid iso-valine extracted from the Murchison meteorite and the extent of hydrous alteration. We present the results of neutron scattering experiments on an exchanged, 1-dimensionally ordered n-propyl ammonium vermiculite clay. The vermiculite gel has a (001) d-spacing of order 5nm at the temperature and concentration of the experiments and the d-spacing responds sensitively to changes in concentration, temperature and electronic environment. The data show that isothermal addition of D-histidine or L-histidine solutions produces shifts in the d-spacing that are different for each enantiomer. This chiral specificity is of interest for the question of whether clays could have played an important role in the origin of biohomochirality.
Perforated diverticulum of the transverse colon
Wilkinson Triloksingh,Wilkinson Anne
Saudi Journal of Gastroenterology , 2007,
Abstract: Diverticula on the left side of the colon, especially in the sigmoid colon are a common occurrence in the West. However, right-sided diverticula are less common, being reported from Asian countries like China, Hong Kong, Japan, Singapore and India. Diverticula of the transverse colon are very rare with very few cases reported in literature. We report a case of perforated true diverticulum of the transverse colon in a sixty-two year-old lady.
Gbrowse Moby: a Web-based browser for BioMoby Services
Mark Wilkinson
Source Code for Biology and Medicine , 2006, DOI: 10.1186/1751-0473-1-4
Abstract: Gbrowse Moby is a low-throughput, exploratory tool specifically aimed at non-informaticians. It provides a straightforward, minimal interface that enables a researcher to query the BioMoby Central web service registry for data retrieval or analytical tools of interest, and then select and execute their chosen tool with a single mouse-click. The data is preserved at each step, thus allowing the researcher to manually "click" the data from one service to the next, with the Gbrowse Moby application managing all data formatting and interface interpretation on their behalf. The path of manual exploration is preserved and can be downloaded for import into automated, high-throughput tools such as Taverna. Gbrowse Moby also includes a robust data rendering system to ensure that all new data-types that appear in the BioMoby registry can be properly displayed in the Web interface.Gbrowse Moby is a robust, yet facile entry point for both newcomers to the BioMoby interoperability project who wish to manually explore what is known about their data of interest, as well as experienced users who wish to observe the functionality of their analytical workflows prior to running them in a high-throughput environment.The BioMoby Project [1-3] was initiated in late 2001 as an open-source initiative within the model organism database and partner community with the goal of identifying standards and/or conventions that would aid interoperability between the diverse bioinformatics resources currently available online. The BioMoby Web Service interoperability platform [4,5] is now used to expose more than 680 bioinformatics data and analytical resources throughout North America, Europe, and Asia, with participants from South America and Australia now beginning to come on-line.The interest in BioMoby-based services stems from its ability to identify service providers that are capable of consuming a particular in-hand data-type, manipulating it in a particular way, and producing a well-defined
Conceptualization about internalizing problems in children and adolescents
Ciência & Saúde Coletiva , 2009, DOI: 10.1590/S1413-81232009000200007
Abstract: this review will discuss the concept of internalizing disorders. it will describe the two main types of internalizing disorder: depressive and anxiety disorders. it will discuss how they have much in common, but that there are also key differences. the review will use data from modern studies of symptom factor analysis, aetiology, treatment and prognosis to illustrate the commonalities and differences. it will conclude by trying to answer where internalizing disorders should be placed in future diagnostic classification schemes.
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