Schwannomas are the most common mediastinal neurogenictumors; they are usually benign and slow growing and frequentlyarise from a spinal nerve root, but may involve any thoracicnerve.

Macrophage stimulating protein (MSP) was discovered as a serum protein
affecting macrophage motility, and found to be similar with a hepatocyte
growth factor (HGF)-family molecule, HGF-liked protein (HLP). MSP/HLP
has 45% sequence similarity with HGF. Inactive pro-MSP is synthesized by
hepatocytes and released into the circulating blood, and its activation is
regulated in disease pathologies such as in inflammation and cancer
progression. Through binding to the RON receptor, MSP acts in innate- immune
responses and anti- inflammation, and prevents the induction of iNOS, COX-2,
and PGE2 in response to endotoxin and interferoncrucial
regulator of inflammation in multiple animal disease models of the liver,
kidney, lung, gut and other organs. Also, MSP suppresses glucose production
and negatively regulates the expression of gluconeogenic enzymes. HGF-Met
and MSP-Ron signaling have analogous functions. In future, MSP/RON
signaling becomes a new important drug target, especially for excess
inflammation, and the inhibition of Ron inhibitors is expected for cancer
therapy.

allergic rhinitis and asthma (ARIA) – disease of inflammatory genesis and often associated with lack of control of these diseases that cause a significant reduction in quality of life for the patient and important social and economic burden [1,2]. According to international recommendations, disease control is a major challenge in the treatment of allergic diseases of respiratory way [1,3]. Guidelines "Allergic rhinitis and its impact on asthma (ARIA)" [1] stressed the importance of a comprehensive approach for assessment and control of ARA. Thus, in the fight against disease, the problem should be considered at the same time as the pathology of the upper and lower respiratory ways [4].Based on definition of control of asthma from the Global initiative of asthma [3], control over a chronic disease can be characterized so: patients feel the minimum symptoms, seldom need preparations of so-called ambulance, all physiological functions are close to norm, so patients don't experience restrictions in activity and extremely seldom have aggravations.By 2009 some questionnaires on quality of life of the patient, symptoms and weight in points [5-9], also some questionnaires were developed for an assessment of control of a disease [10-13]. To a lesser extent the same occurred and for allergic rhinitis [14-16]. Nevertheless, it wasn't developed any questionnaire for simultaneous control of asthma and allergic rhinitis. Actually, only Rhinasthma [15] made attempt, but the questionnaire was intended for an assessment of the quality of life connected with influence of these diseases.

Diabetes mellitus is a major cause of avoidable blindness in both the developing and the developed countries. Significant technological advances have taken place to improve the diagnostic accuracy of diabetic retinopathy. In the last three decades, the treatment strategies have been revised to include, besides laser photocoagulation, early surgical interventions and pharmacotherapies.

To decrease un-safe cut in of kindergarten bus to the traffic, we evaluated stress during driving and other mental and physical factors which adversely influences driver’s driving performance, cognition and decision making etc. by the 24 hour’s measurement with M-BIT.For bus drivers, the most stressful situation was turning to move to the standby position in narrow and crowded kindergarten’s parking lot, in this case. And this stress caused “un safe cut in” of kindergarten bus. To reduce these, structured parking in the parking lot and effective cooperation of bus drivers and attendant teachers had started. These efforts may decrease drivers stress, and thus, improve the safety of kindergarten bus. Other risky-factors for driving, the occurrence of arrhythmia due to driving, and frequent occurrence of apnea during sleeping were also detected.

Background:Recent data suggest that Bivalirudin provides ischemic protection
superior to Heparin,and comparable to Heparin plus glycoprotein
IIb/IIIa inhibitors, with significantly fewer bleeding complications. Whetherthis
advantage persists in large population has not beenfully defined.
Objective: This study systematically evaluates clinical outcomes of treatment
with Bivalirudinvs Heparin in patients of acute coronary syndrome undergoing
Percutaneous coronary interventions (PCI).
Methods: We analyzed prospective, randomized controlled trials via electronic
searches that have reported clinical outcomes at 7 and 30 days. The
outcomes were major bleeding, net clinical outcomes and Major Adverse
Cardiac Events – MACE. Data from individual trials were combined by a
meta analysis method of Mantel-Haenszelcalculate a relative risk (RR) and
95% confidence interval (95%CI) across the studies.Theheterogeneity across
the trials was assessed through χ2 statistic, I2 andvisual inspection of the forest
plots.
Results: This meta-analysis involved a total of 30,088 patients (Bivalirudin,
n=15,105; Heparin, n=14,983). Compared with Heparin, Bivalirudin was associated
with a lower risk of major bleeding (RR 0.38; 95%CI 0.29-0.48 at 7
days and RR 0.67;95%CI 0.60-0.75 at 30 days), net clinical outcomes (RR
0.56; 95%CI 0.47-0.66 at 7 days and RR 0.89; 95%CI 0.83-0.96 at 30 days)
and MACE (RR 0.78; 95%CI 0.63-0.96 at 7 days). There was no significant
difference in case of MACE at 30 days (RR 1.02; 95%CI 0.93-1.11). Heterogeneity
was observed across the trials that reported major bleeding
(χ2=14.71, 5 df, p=0.01, I2=66%) at 30 days, but not at 7 days for reported
major bleeding, and also for net clinical outcomes and MACE both at 7 days
and 30 days.
Conclusion: This analysis further supports that Bivalirudin provides significantimprovement
in net clinical outcomes and MACE with a significant reduction
of bleedingcomplications.

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Schwannomas are the most common mediastinal neurogenictumors; they are usually benign and slow growing and frequentlyarise from a spinal nerve root, but may involve any thoracicnerve

Angle of inclination of the acceleration vector , an extension of the concept of the
azimuth angle to the acceleration due to the resultant force of the gravitational
acceleration and the human body in motion . Flat ground walking , the slope of the
acceleration vector obtained by measuring the riser and down stairs in a three-axis
acceleration sensor , an attempt was made to identify the length of the azimuth angle
and vector . Flat ground walking , the down and climbing the stairs , have found the
inclination angle of the acceleration vector , a characteristic pattern that can be
identification of these walking to the time change of the azimuth angle and length .
Compared with the flat land walking , during stair climbing range of changes in tilt
angle shifts toward the smaller value , during down stairs increased vector length .

Aims: To investigate the effect of unilateral nasal packing on the correction of recurred septal deviation after septoplasty.
Materials and Methods: Twelve patients who had undergone septoplasty and developed septal deviation recurrence. Polyvinylacetate and Vaseline gauze were inserted into the nasal passage on the convex side of the septum for 4 days in order to shift the septum to the midline. We analyzed nasal symptoms, acoustic rhinometric results, and endoscopic findings before and after unilateral packing in order to evaluate the treatment outcomes.
Results:Ten (83%) out of 12 patients showed improvements in nasal obstruction, acoustic rhinometric results and endoscopic findings. The mean visual analogue scale (VAS) score for nasal obstruction was 5.25 ± 1.60 before and 2.08 ± 1.50 after packing (p = 0.004). The minimal cross-section area (MCA) values improved from 0.17 ± 0.14 to 0.27 ± 0.13 (p = 0.002). The mean endoscopic score also improved from 2.0 ± 0.43 to 1.08 ± 0.29 (p = 0.002).
Conclusion: Unilateral nasal packing was a safe, easy, and effective method for correcting recurred septal deviation after septoplasty.

Acute respiratory distress syndrome(ARDS) is a challenging disease process with high mortality. Airway pressure release ventilation(APRV) has been shown to potentially protect against development of ARDS.

Methods:

Observational study of all ventilated patients admitted to the surgical intensive care unit(SICU) at a single, tertiary center. Patients were assigned to APRV or conventional ventilation(CV). ARDS was defined using the Berlin definition. Primary outcomes included development of ARDS between ventilation modalities, ability of APRV to protect against ARDS in septic patients and ability of APRV to decrease mortality. Univariate and multivariate logistic regression models were utilized. Statistical significance was defined as p<0.05.

Results:

268 total patients enrolled. 141(52.6%) developed ARDS. 119(44.4%) patients were on APRV and 149(55.6%) were on CV. ARDS development was not statistically different between these two cohorts(p=0.732). 108(40.3%) patients were septic with 49(45.4%) on APRV and 59(54.6%) on CV. 33(67.3%) of APRV and 37(62.7%) of CV septic patients developed ARDS suggesting APRV is not protective against development of ARDS in this cohort(p=0.616). APRV use did not protect against 30-day mortality with rates of 53.5% versus 46.5% for patients on APRV versus CV respectively(p=0.191).

Conclusion:

APRV does not appear to be protective against development of ARDS, even in septic patients. APRV is not superior to CV in decreasing mortality.

This study is conducted to demonstrate the knowledge of intentional learning and incidental learning. Hypothesis of this experiment is intentional learning is better than incidental learning, participants were demonstrated and were asked to learn the 10 non sense syllables in a specific sequence from the colored cards in the end they were asked to recall the background color of each card instead of non-sense syllables. Independent variables of the experiment are the colored cards containing non-sense syllables which are to be memorized by the participant, dependent variables are the number of correct response made by the participant. The findings of the experiment concluded that intentional learning is better than incidental learning, hence hypothesis is proved.