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Neoplastic and Infectious Diseases of the Spine (See Also Chap 44) Metastatic carcinoma (breast, bronchus, prostate, thyroid, kidney, stomach, uterus), multiple myeloma, and lymphoma are the common malignant tumors that involve the spine The primary lesion may be small and asymptomatic, and the rst manifestation of the tumor may be pain in the back due to metastatic deposits The pain is described as constant and dull; it is often unrelieved by rest and is generally worse at night, often interrupting sleep Radicular pain may be added, as described earlier in this chapter At the time of onset of the back pain, there may be no radiographic changes; when such changes do appear, they usually take the form of destructive lesions in one or several vertebral bodies with little or no involvement of the disc space, even in the face of a compression fracture Before such destructive changes become evident, a CT or radioactive isotope scan may be helpful in detecting areas of osteoblastic activity due to neoplastic or in ammatory disease and characteristic changes are also evident on MRI Infection of the vertebral column, osteomyelitis, is usually caused by staphylococci and less often by coliforms and mycobacteria The patient complains of pain in the back, of subacute or chronic nature, which is exacerbated by movement but not materially relieved by rest Motion becomes limited, and there is percussioninduced tenderness over the spine in the involved segments and pain with jarring of the spine, as occurs when the heels strike the oor Often these patients are afebrile and do not have a leukocytosis The erythrocyte sedimentation rate is elevated as a rule Highly characteristic is the demonstration by CT scanning and MRI of involvement of both the vertebral body and the adjacent intervertebral disc the nding of a breached disc space is one of the features that differentiates infectious from neoplastic diseases of the spine A paravertebral mass is often found, indicating an abscess, which may, in the case of tuberculosis, drain spontaneously at sites quite remote from the vertebral column We have also encountered a number of patients with subacute bacterial endocarditis who complained of severe midline thoracic and lumbar back pain but had no evident infection of the spine Tuberculous spinal infection and the resultant kyphotic deformity (Pott disease) represent a special condition that is common in developing countries (see pages 611 and 1061) Special mention should be made of spinal epidural abscess, which necessitates urgent surgical treatment Indeed, in some series, failure to properly identify this lesion has led to cases of paraplegia or death from sepsis Most often this is due to staphylococcal infection, which is carried in the bloodstream from a septic focus (eg, furuncle) or is introduced into the epidural space from an osteomyelitic lesion Another important avenue of infection is the intravenous self-administration of adulterated drugs and use of contaminated needles Rarely the infection is introduced in the course of a lumbar puncture, epidural injection, or laminectomy for disc excision In some instances the source of the epidural infection cannot be ascertained The main symptoms are fever, leukocytosis, and persistent and severe localized pain, intensi ed by percussion and pressure over the vertebral spines; additionally the pain may acquire a radicular radiation These symptoms mandate immediate investigation by MRI or CT myelography and surgical intervention, preferably before the signs of paraplegia, sphincter dysfunction, and sensory loss become manifest Exceptionally small abscesses can be treated successfully with antibiotics alone This process is discussed further on page 1060 A nonin ammatory form of acute epidural compression may be due to hemorrhage (anticoagulant therapy, vascular malformation) and, in the cervical region, to rheumatoid arthritis (see further on). mvc open pdf in browser How can I upload a pdf file? - Stack Overflow
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I would like to embed the pdf onto a new window and add some other html ... How can I point to a Rendered pdf file in an mvc action with ... Backup and high availability strategies are important in large-scale data warehousing where the warehouses are used for tactical business decisions, as they are in other enterprise databases A sound backup strategy for data in the data warehouse is critical to making such a warehouse recoverable in a reasonable amount of time Reloads from source systems and re-creating complex data transformations that occurred over time are an impractical approach to recovery However, even where backups are efficiently taken, the reload process might be too lengthy to meet business service-level requirements In such scenarios, providing high availability by deploying and maintaining both primary and secondary data warehouses can be justified While we cover high availability strategies in 2, some considerations are especially relevant where a large-scale data warehouse is deployed Part of a sound backup strategy for a data warehouse includes careful consideration of how data changes over time Where the data birt ean 128, birt upc-a, birt ean 13, birt data matrix, birt code 39, birt code 128 how to open a .pdf file in a panel or iframe using asp.net c# PDF Viewer Partial View | ASP.NET MVC (Classic) Forums | Syncfusion
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Spire. PDFViewer for ASP . NET . This PDF viewer control enables developers to load ... NET Only; Developed entirely in C# , being 100% managed code; Totally ... THOMAS JE, MILLER RH: Lipomatous tumors of the spinal canal Mayo Clin Proc 48:393, 1973 TOSI L, RIGOLI G, BELTRAMELLO A: Fibrocartilaginous embolism of the spinal cord: A clinical and pathogenetic consideration J Neurol Neurosurg Psychiatry 60:55, 1996 UTTLEY D, MONRO P: Neurosurgery for cervical spondylosis Br J Hosp Med 42:62, 1989 VALLEE B, MERCIER P, MENEI P, et al: Ventral transdural herniation of the thoracic cord: surgical treatment in four cases and review of the literature Acta Neurochir 141:907, 1999 WADIA NH: Myelopathy complicating congenital atlanto-axial dislocation (a study of 28 cases) Brain 90:449, 1967 WEIDAUER S, NICHTWEISS M, LANFERMANN H, et al: Spinal cord infarction: MR imaging and clinical features in 16 cases Neuroradiology 44:851, 2002 WEISMAN AD, ADAMS RD: The neurological complications of dissecting aortic aneurysm Brain 67:69, 1944 WESTENFELDER GO, AKEY DT, CORWIN SJ, et al: Acute transverse myelitis due to Mycoplasma pneumoniae infection Arch Neurol 38:317, 1981 WHITELY AM, SWASH M, URICH H: Progressive encephalomyelitis with rigidity Brain 99:27, 1976 WILKINSON M: Cervical Spondylosis, 2nd ed Philadelphia, Saunders, 1971 WILKINSON PA, VALENTINE A, GIBBS JM: Intrinsic spinal cord lesions complicating epidural anaesthesia and analgesia: Report of three cases J Neurol Neurosurg Psychiatry 72:537, 2002 mvc pdf viewer free Pdf API for .NET: Reading and Modifying Existing PDF Files
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