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CONTOH FLOW CHART

What You Should Know about Cell Phone Towers?

http://www.wirelesscapital.com/short | If you are thinking about leasing your property for a cell tower, there are a variety of factors that you should consider to help you get the most money possible for your investment. For some, a lump sum payment is more beneficial, while others prefer a monthly payment to increase their cash flow.

Fact Sheet: Comparative Economic Analysis for Raleigh County

Significant Quotes from the Downstream Strategies Economic Study: Based on the findings of this report, state and local leaders should reconsider their singular focus on the extraction of coal resources in southern West Virginia and chart a common path forward with local citizens that not only preserves private profits, but also strives – as a central objective – to sustain the local economy over the long term.” “As demonstrated by these calculations (in the report), a wind farm on Coal River Mountain combined with a new local wind industry would provide the greatest long-term economic benefits to the citizens of Raleigh County. In contrast, mountaintop removal coal mines would provide larger short-term economic output and greater profits to the landholding companies that own the coal and the mining company poised to begin mining. But these profits would come at the cost of generating human health and environmental externalities.” “In short, the private interests of the landholding companies and the leaseholders suggest one course of action (MTR), while the long-term benefits to local citizens and the county suggest an alternative (wind).” “As shown (in the study), should a local turbine manufacturing (plant) be available, the number of jobs and the associated earnings and economic output would be much more significant (than the proposed MTR) for the Coal River Mountain wind farm. In the long-term (five investment cycles), the wind farm will generate 28% more jobs than the mountaintop removal. Jobs in the local wind industry scenario will generate 314% more jobs than the mountaintop removal.” The Full Report can be downloaded at www.CoalRiverWind.org

Washington National Cathedral Photo Policy

Usage Permissions Public access provided to Cathedral premises for the purpose of making photographs does not imply approval of their publication. The terms of approval for publication are to be agreed upon in writing between photographer or publisher and Cathedral representative prior to any publication. Requests for permission to reproduce photographic images of Washington National Cathedral in the form of products for resale and requests for other commercial photography of the Cathedral are to be addressed to the Department of Communications and Marketing. Commercial photography includes instances wherein there is an actual or intended exchange of money or favors for the use, usage rights, ownership, or copyright of images created in any form or medium. Requests to use photographs from the Cathedral’s photography archives may be made when the appearance of such an image or detail of the Cathedral’s artifacts is mutually beneficial to the Cathedral and the publication and represents the Cathedral in a positive image. Please make such requests via e-mail to the Communications and Marketing Department Press. For members of the press, permission to photograph or film Cathedral events and services may be given through the Department of Communications and Marketing. For most special services, members of the press will be in the south balcony. Access to areas not normally open to the public must be scheduled in advance, and a designated member of the Cathedral staff must accompany the photographer. Access to certain areas of the Cathedral premises at certain times may be restricted without notice as required to ensure the safety and convenience of Cathedral visitors and staff. A designated member of the Cathedral staff must be present if any equipment other than hand-held camera and lighting are to be used. Tripods and/or freestanding lighting equipment may create a safety hazard or impede efficient traffic flow in the Cathedral, and approval for their use and placement is at the discretion of the Cathedral staff.

chronic cerebrospinal venous insufficiency [CCSVI] - Blue Cross and ...

Chronic cerebrospinal venous insufficiency (CCSVI) may be associated with multiple sclerosis (MS), although this is controversial and an active area of research. Correction of CCSVI has been attempted via percutaneous venoplasty. The intent of this procedure is to relieve MS symptoms by improving venous drainage of the central nervous system. Correction of CCSVI by this method may be referred to as the “Liberation Procedure.” Background Multiple sclerosis (MS) is generally considered a chronic inflammatory demyelinating disease of the central nervous system (brain, spinal cord, optic nerve) felt to be triggered by an autoimmune response to myelin. However, in part due to the periventricular predilection of the lesions of multiple sclerosis, vascular etiologies (chronic cerebrospinal venous insufficiency [CCSVI]) have also been considered. An animal model for MS was developed by injecting obstructing agents into the venous sinuses. This etiology, and treatment approach, for MS had not been actively pursued for many years; recent reports by a European researcher have renewed interest in this topic. The core foundation of this vascular theory is that there is abnormal venous drainage from the brain due to outflow obstruction in the draining jugular vein and/or azygos veins. This abnormal venous drainage, which is characterized by special ultrasound criteria, is said to cause intracerebral flow disturbance or outflow problems that lead to periventricular deposits. In the CCSVI theory, these deposits have a similarity to the iron deposits seen around the veins in the legs in patients with chronic deep vein thrombosis. Those studying this theory have promoted balloon dilatation, with or without stenting, to treat the outflow problems, thereby curing CCSVI and by the same token alleviating MS complaints. The following 5 criteria were defined by Zamboni et al. as features of CCSVI. In order to make the diagnosis of CCSVI, at least 2 of the 5 criteria need to be present: …

Interventional Endovascular Management of Chronic Cerebrospinal ...

IT has been recently hypothesized that a phenomenon known as chronic cerebrospinal venous insufficiency (CCSVI) may play a significant role in the etiology, pathogenesis, and/or disease progression of multiple sclerosis (MS) (1,2). Preliminary studies suggest that anatomical and physiological abnormalities of venous blood flow are significantly more common in patients with clinical MS than in healthy control subjects or patients with other neurologic disorders (3– 6). Of particular interest has been the documentation of stenotic and occlusive lesions in the azygos and internal jugu- From the Mallinckrodt Institute of Radiology (S.V.), 510 S. Kingshighway Blvd., Box 8131, St. Louis, MO 63110-1076; Peripheral Vascular Laboratory (J.F.B.), Baptist Cardiac and Vascular Institute, Miami, Florida; Department of Medical Imaging (S.K.), Scarborough General Hospital; Department of Medical Imaging (K.J.M.), University of Toronto, Toronto, Ontario, Canada; Department of Radiology (C.M.B.), Utah Valley Regional Medical Center, Provo, Utah; and Department of Radiology (J.F.C.), Geisinger Health System, Danville, Pennsylvania. Received and accepted July 15, 2010. Address correspondence to S.V.; E-mail: vedanthams@mir.wustl.edu S.V. has received support for a NIH trial from Covidien and MEDRAD Interventional. None of the other authors have identified a conflict of interest. © SIR, 2010 DOI: 10.1016/j.jvir.2010.07.004

Diagnosis and Treatment of Chronic Cerebrospinal Venous ...

Chronic cerebrospinal venous insufficiency (CCSVI) may be associated with multiple sclerosis (MS), although this is controversial and an active area of research. Correction of CCSVI has been attempted via percutaneous venoplasty. The intent of this procedure is to relieve MS symptoms by improving venous drainage of the central nervous system. Correction of CCSVI by this method may be referred to as the “Liberation Procedure.” Background Multiple sclerosis (MS) is generally considered a chronic inflammatory demyelinating disease of the central nervous system (brain, spinal cord, optic nerve) felt to be triggered by an autoimmune response to myelin. However, in part due to the periventricular Current Procedural Terminology © American Medical Association. All Rights Reserved. Contains Public Information Diagnosis and Treatment of Chronic Cerebrospinal Venous Insufficiency in Multiple Sclerosis predilection of the lesions of multiple sclerosis, vascular etiologies (chronic cerebrospinal venous insufficiency [CCSVI]) have also been considered. An animal model for MS was developed by injecting obstructing agents into the venous sinuses. This etiology, and treatment approach for MS had not been actively pursued for many years; recent reports by a European researcher have renewed interest in this topic. The core foundation of this vascular theory is that there is abnormal venous drainage from the brain due to outflow obstruction in the draining jugular vein and/or azygos veins. This abnormal venous drainage, which is characterized by special ultrasound criteria, is said to cause intracerebral flow disturbance or outflow problems that lead to periventricular deposits. In the CCSVI theory, these deposits have a similarity to the iron deposits seen around the veins in the legs in patients with chronic deep vein thrombosis. Those studying this theory have promoted balloon dilatation, with or without stenting, to treat the outflow problems, thereby curing CCSVI and by the same token alleviating MS complaints.

Chronic cerebrospinal venous insufficiency in ... - BioMed Central

This study aimed to investigate the prevalence and clinical relevance of chronic cerebrospinal venous insufficiency (CCSVI) in multiple sclerosis (MS) patients and healthy controls using extra- and intracranial colour Doppler sonography. Methods: We examined 146 MS patients, presenting with a clinically isolated syndrome, relapsing-remitting, secondary progressive, or primary progressive MS, and 38 healthy controls. Sonographic examination was performed according to Zamboni’s protocol and was performed by three independent sonographers. The results of sonographic examination were compared with clinical and demographic characteristics of the patients. Results: CCSVI, defined as the presence of at least two positive Zamboni’s criteria, was found in 76% of MS patients and 16% of control subjects. B-mode anomalies of internal jugular veins, such as stenosis, malformed valves, annuli, and septa were the most common lesions detected in MS patients (80.8%) and controls (47.4%). We observed a positive correlation between sonographic diagnosis of CCSVI and the patients’ age (p = 0.003). However, such a correlation was not found in controls (p = 0.635). Notably, no significant correlations were found between sonographic signs of CCSVI and clinical characteristics of MS, except for absent flow in the jugular veins, which was found more often in primary (p<0.005) and secondary (p<0.05) progressive patients compared with non-progressive patients. Absent flow in jugular veins was significantly correlated with patients’ age (p < 0.0001). Conclusions: Sonographically defined CCSVI is common in MS patients. However, CCSVI appears to be primarily associated with the patient’s age, and poorly correlated with the clinical course of the disease. Keywords: Multiple sclerosis, Venous insufficiency, Ultrasonography ...

CCSVI- Chronic Cerebrospinal Venous Insufficiency - MS-MRI

CCSVI- Chronic Cerebrospinal Venous Insufficiency E. Mark Haacke, PhD McMaster University Hamilton, Ontario Wayne State University Detroit, Michigan 48201 Acknowledgements • David Hubbard, MD for MS data • Salvatore Sclafani, MD, for images • Monte Harvill, MD for slides • Liu Jiangtao, MD for MS data • Wei Feng, PhD for processing flow data • Gabriela Trifan, MD for image analysis • David Utriainen, for image analysis • Meng Li, MS, for perfusion TSM data • Jaladhar Neelavalli, PhD for SWIM support MULTIPLE SCLEROSIS In Canada: ►55,000-75,000 MS patients ► most common neurological disease affecting young adults ►~1,000 new cases of MS diagnosed each year ► Economic impact > $1 billion annually The symptoms - mild to debilitating : vision problems; loss of balance and/or coordination, extreme fatigue, speech or memory failure; muscle stiffness and paralysis. CCSVI Chronic cerebrospinal venous insufficiency Zamboni noted narrowing of the veins at the neck or spine was restricting blood flow and potentially high levels of iron were accumulating in the brain (65 case studies) ...

Extracranial Doppler sonographic criteria of chronic cerebrospinal ...

The aim of this open-label study was to assess extracranial Doppler criteria of chronic cerebrospinal venous insufficiency in multiple sclerosis patients. Methods. Seventy patients were assessed: 49 with relapsing-remitting, 5 with primary progressive and 16 with secondary progressive multiple sclerosis. The patients were aged 15-58 years and they suffered from multiple sclerosis for 0.5-40 years. Sonographic signs of abnormal venous outflow were detected in 64 patients (91.4%). Results. We found at least two of four extracranial criteria in 63 patients (90.0%), confirming that multiple sclerosis is stronghly associated with chronic cerebrospinal venous insufficiency. Additional transcranial investigations may increase the rate of patients found positive in our survey. Reflux in internal jugular and/or vertebral veins was present in 31 cases (42.8%), stenosis of internal jugular veins in 61 cases (87.1%), not detectable flow in internal jugular and/or vertebral veins in 37 cases (52.9%) and negative difference in cross-sectional area of the internal jugular vein assessed in the supine vs. sitting position in 28 cases (40.0%). Flow abnormalities in the vertebral veins were found in 8 patients (11.4%). Pathologic structures (membranaceous or netlike septa, or inverted valves) in the junction of internal jugular vein with brachiocephalic vein were found in 41 patients (58.6%), in 15 patients (21.4%) on one side only and in 26 patients (37.1%) bilaterally. Conclusion. Multiple sclerosis is highly correlated with chronic cerebrospinal venous insufficiency. These abnormalities in the extracranial veins draining the central nervous system can exist in various combinations. The most common pathology in our patients was the presence of an inverted valve or another pathologic structure (like membranaceous or netlike septum) in the area of junction of the IJV with the brachiocephalic vein. [Int Angiol 2010;29:109-14] Key words: Color Ultrasonography, Doppler, color - Multiple sclerosis - Venous insufficiency. Received on November 6, 2009; resubmitted on December 3, 2009; accepted for publication on December 30, 2009.

Association between chronic cerebrospinal venous insufficiency and ...

Background: It has been proposed by Zamboni and colleagues that multiple sclerosis is caused by chronic cerebrospinal venous insufficiency, a term used to describe ultrasound-detectable abnormalities in the anatomy and flow of intra- and extracerebral veins. We conducted a meta-analysis of studies that reported the frequency of chronic cerebrospinal venous insufficiency among patients with and those without multiple sclerosis. Methods: We searched MEDLINE and EMBASE as well as bibliographies of relevant articles for eligible studies. We included studies if they used ultrasound to diagnose chronic cerebrospinal venous insufficiency and compared the frequency of the venous abnormalities among patients with and those without multiple sclerosis. Results: We identified eight eligible studies: all included healthy controls, and four of them also included a control group of patients with neurologic diseases other than multiple sclerosis. Chronic cerebrospinal venous insufficiency was more frequent among patients with multiple sclerosis is a chronic demyelinating and degenerative disease of the central nervous system. The exact cause remains unknown, but most evidence favours an autoimmune mechanism.1 In 2006, Zamboni and colleagues proposed that multiple sclerosis is caused by abnormalities in the direction and pathway of cerebral venous flow, leading to deposition of iron in the brain, which triggers an autoimmune reaction.2 They reported that patients with multiple sclerosis had a higher frequency of abnormalities of anatomy and flow in the internal jugular, deep cerebral, vertebral and azygous veins than individuals without multiple sclerosis had.3,4 They called this condition chronic cerebrospinal venous insufficiency. They further described detection of this © 2011 Canadian Medical Association or its licensors

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