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There are two versions of this film. First, it was a made for TV film shown in the States. Second, a bit of new material was then added to it and the film was released theatrically in Europe. The version I saw is the longer European version. Perhaps, in hindsight, I should have seen the shorter version.The plot is simple. Some guy (Dennis Weaver) is on a business trip and driving on a lonely road out west. He encounters some truck going extremely slow and passes it...only to have the truck then pass him and begin playing a game of cat and mouse with him...hitting his car several times as well as forcing him off the road in his much smaller Plymouth Valiant. This happens again and again and the truck driver is apparently some sort of crazed sociopath bent on killing him!The problem with this film is that the plot is TOO simple...so the film was heavily padded. You hear the car driver talking to himself a lot, you have a lot of unnecessary scenes and the pacing is an issue. Additionally, to keep the film going, the film needs to repeatedly ignore various logical ways this duel could have been ended sooner. After all, at one point after he's forced off the road early in the movie, folks ask him if he's okay...and the car driver says he's fine and never mentions the crazed truck driver! He could have called the police as well...but didn't for the longest time. As for me, I sure as heck would NOT have gotten back in my car for a very, very long time after so many near-death experiences!! No one else ever seems to notice what is happening. The road is lonely...but not THAT lonely. And, when he meets up with a bus driver, he does an absolutely horrible job explaining what's been happening. None of this makes a lot of sense but the young director does his best with the material he's been given--I doubt if other directors could have done much better. However, I think it's odd that many folks give this a 10....even if Fellini, Hitchcock or Truffaut had directed this, it never could have come close to being a 10 due to the super- thin plot. It is, in spite of this, very tense, very interesting and yet very flawed.FYI--If you care, I used to drive an orange/red 1971 Valiant and it was an incredibly ugly but incredibly fast car. So the notion of a truck EASILY passing or catching up to it is really scary...and definitely hints at the supernatural!
Pyogenic liver abscess is a rare cause of hospitalization, related to a mortality rate ranging between 15% and 19%. Treatment of choice is represented by image-guided percutaneous drainage in combination with antibiotic therapy but, in some selected cases, surgical treatment is necessary. In extremely rare cases, spontaneous rupture of liver abscess may occur, free in the peritoneal cavity or in neighboring organs, an event which is generally considered a surgical emergency. A 95-years-old woman was hospitalized with fever, upper abdominal pain, mild dyspepsia and massive swelling of the anterior abdominal wall. Computed tomography revealed an oval mass located in the abdominal wall of 12cm14cm7cm, in continuity with an abscess of the left hepatic lobe. Because Proteus mirabilis was detected in both the liver abscess and the abdominal wall abscess, the patient was diagnosed with a ruptured pyogenic liver abscess. After spontaneous drainage to the exterior of the hepato-parietal abscess, she was successfully treated with antibiotics alone. Pyogenic liver abscess is a serious and life-threatening illness. Abscess rupture might occur. Many authors consider this complication a surgical emergency, but the site of abscess rupture changes the clinical history of the disease: in case of free rupture into the peritoneum, emergency surgery is mandatory, while a rupture localized in neighboring tissues or organs can be successfully treated by a combination of systemic antibiotics and fine needle aspiration and/or percutaneous drainage of the abscess. Copyright 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.
Ultrasound is increasingly becoming a 3D modality. Mechanical and matrix array transducers are able to deliver 3D images with good spatial and temporal resolution. The 3D imaging facilitates the application of automated image analysis to enhance workflows, which has the potential to make ultrasound a less operator dependent modality. However, the analysis of the more complex 3D images and definition of all examination standards on 2D images pose barriers to the use of 3D in daily clinical practice. In this paper, we address a part of the canonical fetal screening program, namely the localization of the abdominal cross-sectional plane with the corresponding measurement of the abdominal circumference in this plane. For this purpose, a fully automated pipeline has been designed starting with a random forest based anatomical landmark detection. A feature trained shape model of the fetal torso including inner organs with the abdominal cross-sectional plane encoded into the model is then transformed into the patient space using the landmark localizations. In a free-form deformation step, the model is individualized to the image, using a torso probability map generated by a convolutional neural network as an additional feature image. After adaptation, the abdominal plane and the abdominal torso contour in that plane are directly obtained. This allows the measurement of the abdominal circumference as well as the rendering of the plane for visual assessment. The method has been trained on 126 and evaluated on 42 abdominal 3D US datasets. An average plane offset error of 5.8 mm and an average relative circumference error of 4.9 % in the evaluation set could be achieved.
Upper abdominal sonography can help physicians to confirm the diagnosis of various hepatobiliary diseases. Teaching sonography skills to medical students is important because it may enhance their level of knowledge and overall development during their gastroenterology section rotation. Sonographic imaging is abstract and students can be easily confused when scanning the abdominal structures from different sites and directions. We used several modern teaching strategies to facilitate the learning of sonography skills. The year five medical students beginning a gastroenterology section rotation for their first-year clerkship were taught abdominal sonography skills. Abstract sonographic images were related to concrete objects and the surrounding structures were further indicated. Each of the images was given a specific name and was sorted according to the scanning site. A mnemonics system was designed to help students to memorize the names of these images. A badge was created to recognize the achievement of being able to complete a basic upper abdominal sonography. Students were free (i.e., not obligated) to request a demonstration opportunity to show their skills within 2 weeks after receiving tutelage. We recorded the number of students who received training and were able to successfully complete the task; these individuals then received a badge to be pinned onto their white coats. Sixty-three of 68 students (92.6%) requested evaluation and all of them passed. We have greatly simplified the process of learning about upper abdominal sonography by using andragogy to enhance learning, mnemonics to help memory, and a pin-badge reward system to stimulate incentives. Copyright 2013. Published by Elsevier B.V.
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