ABSTRACT
Aircraft noise can disrupt sleep and impair recuperation. The last U.S. investigation into the effects of aircraft noise on sleep dates back more than 20 years. Since then, traffic patterns and the noise levels produced by single aircraft have changed substantially. It is therefore important to acquire current data on sleep disturbance relative to varying degrees of aircraft noise exposure in the U.S. that can be used to check and potentially update the existing noise policy. This manuscript describes the design, procedures, and analytical approaches of the FAA's National Sleep Study. Seventy-seven U.S. airports with relevant nighttime air traffic from 39 states are included in the sampling frame. Based on simulation-based power calculations, the field study aims to recruit 400 participants from four noise strata and record an electrocardiogram (ECG), body movement, and sound pressure levels in the bedroom for five consecutive nights. The primary outcome of the study is an exposure-response function between the instantaneous, maximum A-weighted sound pressure levels (dBA) of individual aircraft measured in the bedroom and awakening probability inferred from changes in heart rate and body movement. Self-reported sleep disturbance due to aircraft noise is the secondary outcome that will be associated with long-term average noise exposure metrics such as the Day-Night Average Sound Level (DNL) and the Nighttime Equivalent Sound Level (Lnight). The effect of aircraft noise on several other physiological and self-report outcomes will also be investigated. This study will provide key insights into the effects of aircraft noise on objectively and subjectively assessed sleep disturbance.
Subject(s)
Noise, Transportation , Sleep Wake Disorders , Humans , Noise, Transportation/adverse effects , Environmental Exposure , Sleep/physiology , Polysomnography , Aircraft , Sleep Wake Disorders/epidemiology , Sleep Wake Disorders/etiologyABSTRACT
BACKGROUND: Retrorectal hamartoma, also known as tailgut cyst, is a rare tumor that arises from remnants of the embryonic postanal gut. The tumor occurs in the retrorectal space and may undergo malignant degeneration. METHODS: The clinical information on a single patient with pseudomyxoma peritonei associated with a tailgut cyst was reviewed and a literature review of the subject performed. RESULTS: In this patient there was malignant degeneration of a tailgut cyst localized to the pelvis. Twenty months later a local recurrence in the pelvis and pseudomyxoma peritonei widely distributed in the abdomen were successfully treated by cytoreductive surgery and perioperative chemotherapy. CONCLUSION; Tailgut cyst may, if resected with tumor spillage, result in pseudomyxoma peritonei. Our treatment--which has maintained a disease-free status for one year--was cytoreductive surgery plus perioperative chemotherapy.
Subject(s)
Adenocarcinoma, Mucinous/complications , Hamartoma/complications , Neoplasms, Multiple Primary/complications , Peritoneal Neoplasms/complications , Pseudomyxoma Peritonei/complications , Rectal Diseases/complications , Adenocarcinoma, Mucinous/pathology , Adult , Antineoplastic Agents/therapeutic use , Combined Modality Therapy , Digestive System Surgical Procedures , Female , Hamartoma/pathology , Hamartoma/therapy , Humans , Neoplasms, Multiple Primary/pathology , Peritoneal Neoplasms/pathology , Peritoneal Neoplasms/therapy , Pseudomyxoma Peritonei/pathology , Pseudomyxoma Peritonei/therapy , Rectal Diseases/pathology , Rectal Diseases/therapy , Tomography, X-Ray ComputedSubject(s)
Autopsy , Forensic Pathology , Autopsy/history , Autopsy/legislation & jurisprudence , Autopsy/methods , Cause of Death , Coroners and Medical Examiners/organization & administration , Death Certificates , Forensic Pathology/history , Forensic Pathology/legislation & jurisprudence , Forensic Pathology/methods , History, 15th Century , History, 16th Century , History, 17th Century , History, 18th Century , History, 19th Century , History, 20th Century , History, Ancient , History, Medieval , Humans , Informed Consent , Practice Guidelines as Topic , United StatesABSTRACT
Hepatic amyloid deposition in the form of globular inclusions is a rare occurrence. Only 24 such cases have been reported to date. Its clinical and pathological significance are undefined. Unawareness of such a pattern can cause diagnostic confusion. We herein describe a case of globular hepatic amyloid in a patient with a B-cell lymphoma and chronic hepatitis C. The findings in our case support the literature data in that (1) it is often an incidental finding during workup for other coexisting conditions and (2) its morphology is peculiar but can be recognized with ease if one is aware of its existence. Our case also provides new insights into this condition. First, it represents the first nonautopsy case to demonstrate that globular hepatic amyloid is an indication of systemic amyloidosis, thus emphasizing the clinical importance of the recognition of this condition. Second, in our case, there was a coexisting B-cell lymphoma, the constituent cells of which showed immunoglobulin lambda light chain restriction, and patient's serum lambda light chain was elevated. However, light chain restriction was not demonstrated in the globular inclusions, and there was no evidence of monoclonal gammopathy by serum electrophoresis. Whether immunoglobulin light-chain abnormality played a causal role in this condition is to be determined.
