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aprincesadegales · 2 years

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Retratos oficiais, sessões de fotos e afins: 188 / ∞

Retrato compartilhado em 20.06.2021, em comemoração ao Dia dos Pais no Reino Unido. Tirado no Trooping the Colour | 08.06.2019

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railwaysupply · 4 months

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#CăileFerateRomâne(CFR)

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degibusdesigns · 1 year

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Check out this listing I just added to my Poshmark closet: Merrell Moab 2 Mid Waterproof Wide Hiking Boots 8W.

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cknightleyart · 3 years

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#roku isasayin #cknightleyart

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billget-blog · 3 years

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True Love Has No AgeLimits:19 Year Old BoyCauses Stir On Social MediaAs He Marries A 39 YearOld Woman

When it comes to matters of the heart, alot of things don’t matter especially whena couple wants to fight the status quo tobe together. That being said, a Teenager of19 years has defied all odds to marry a 39-year-old woman.In some photos posted online, the couple isseen smooching each other showing howmuch they love each other.A lot of people have wondered why a youngboy will decide to marry an…

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#BEAUTIFULL #billmwangi #FRIENDS #KENYA #love #love money #MAPENZI #MONEY #MUSIC #nigeria #SCUM #TRUE LOVE HAS NO AGE LIMITS 19YRS OLD BOY CAUSES STIR ONLINE AS HE MARRIES A 39 YEARS OLD #WOMAN #youtube billmwangi

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dpharaoh2590-blog · 4 years

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TheGreatFall of19

ThEUPsIdE

Let me tell you a story about a boy. He didn’t know the world was the way it was. Many reasons for this, But this is a story for another time, Another place. Hence he went out into the world, seeing all the flowers and the jewels of the world. Until one day he found one of the most precious things the world ever offer. It was shiny and made all the finds he ever sought after seem…

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juniperpublishersophthalmology · 5 years

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Sudden Ocular Pain: An Unusual Debut of a Ciliary Body Melanoma-Juniper Publishers

Abstract

The Ciliary body is an unusual location of uveal melanomas and usually these kinds of tumors appear with a reduction of vision due to the formation of sectorial cataract or retinal detachment when the tumor spread to a posterior position. We present a 57 years old woman with sudden and severe ocular pain. Ophthalmologic examination showed a hyper mature cataract and superior displacement of the lens with sectorial angular block. The intraocular pressure was 22 mmHg. After papillary dilation aciliary body tumor was observed. The ultrasound study and magnetic resonance imaging confirmed the diagnosis of uveal melanoma.

Keywords: Ocular Pain; Melanoma; Ciliary Body; Cataract

Abbreviations: BCVA: Best-Corrected Visual Acuity; NMR: Nuclear Magnetic Resonance

Introduction

Uveal melanomas are the most frequent intraocular primary tumors in adulthood. However, ciliary body location is very uncommon regarding iris or choroidal melanomas. Furthermore, ciliary body location gives symptoms later, which also gives a worse prognosis.

Materials and Methods

Materials and Methods Biomicroscopy, dilated indirect ophthalmoloscopy, Goldmanntonomter, B-Mode echography and ultrasound biomicroscopy were performed. Subsequent RMN imaging was also obtained.

Case report

We report a case of a 57 years old woman who came to the emergency department with a sudden and severe pain in her right eye. The patient also related that she had had a decrease in her visual acuity for last two months. She was a nonsmoker, but would occasionally drink alcohol. Family history was unremarkable for malignancy. Medical history only included controlled hypertension and cholesterolemia. Best-corrected visual acuity (BCVA) at first was 20/200 in the right eye and 20/30 in the left eye.

The examination of the right eye showed a brown pigmented lesion in the lower region of iris, without satellites lesions or papillary deformity. She also presented a hyper mature cataract antero-superiorly displaced endangering the anterior chamber space and the iridocorneal angle (Figure 1). The intraocular pressure was 22 mmHg in the right eye and 16 mmHg in the left eye. After papillary dilation, we found a pigmented tumoral mass behind the iris which was situated between 4 to 6 hours and produced the dislocation of the lens (Figure 2).The retinal examination was of no value because of the presence of the mature cataract. The ophthalmoscopic examination of the left eye was normal.

Results

The study with B-Mode echography and ultrasound biomicroscopy (OTI HF 35-50 Ultrasound System ®) demonstrated a 15 X 10 mm tumor which came from ciliary body and displaced the lens (Figure 3). The nuclear magnetic resonance (NMR) with gadoline confirmed the existence of an intraocular tumor with hyper intense signal in T1 and hypo intense in T2 (Figure 4) with a size of 15 x 10 x 8 mm and heterogeneous catchment of contrast (Figure 5). With these results a ciliary body melanoma was suspiciously diagnosed. The extensive study was negative and a brachytherapy with of iodine 125 (I125) treatments was decided. Actually and after cataract surgery our patient is asymptomatic and without signs of recurrence.

Discussion

Ocular melanoma is the most common intraocular primary tumor in adulthood, which mainly affects white males between fifty and sixty years old. It represents 3.7% of cases of melanoma and it is the second most usual location after cutaneous melanoma [1]. Its incidence is nearby 4.3 cases per million populations [2]. And its most common position is the uveal tract, which is supposed the origin of the 82.5% of intraocular melanomas [1]. Although inside this rate, ciliary body melanoma only represents 12% of uveal melanomas its location is a factor of poor prognosis [3].

The majority of these tumors are asymptomatic until their growth produces a decrease of visual acuity due to the formation of a sectorial cataract or retinal detachment [2]. The presence of dilated episcleral vessels near the tumor (sentinel vessels) is also frequent [4]. Unusually these tumors may also produce an increase in intraocular pressure because of the angular closing by the pigment dispersion produced by myeloma [5] a uveitis due to necrosis of tumor [6] or aleukocoria in children [7]. There is no existing record of a case of ciliary body melanoma that appears with sudden and severe eye pain without a significant increase of intraocular pressure. In the case I am talking about this circumstance happens as well as other manifestations like the presence of a mature cataract, lens subluxation and a sectorial angular closure.

The diagnosis of this pathology is clinical using the slit lamp, accompanied by additional tests such as mode A ultrasound (presence of kappa angle); mode B ultrasound or ultrasonic biomicroscopy (the size, location and extent of tumor is characterized) and orbital NMR (show tumor mass as a hyper intense on T1 and hypo intense on T2) [8]. The confirmation of the diagnosis is obtained by the histological study of the lesion.

Pathological study is also important to establish the prognosis of these melanomas because there are some factors that can add to a worse prognosis for this kind of tumors like epithelioid cell line, high mitotic activity, necrosis of tumor, lymphocytic infiltration or extra sclera extension [9]. Genetic factors are other important prognostic. The mutation in genes 3 and 8 is related to poor prognosis in these tumors [10].

Regarding the treatment of these tumors, there are several alternatives such as radiotherapy, brachytherapy or external beam radiation; local excision (iridocyclectomy) or enucleation. Depending on the size of the tumor and the presence or absence of distant metastases we would choose a treatment or another. Our patient has been treated with brachytherapy due to the characteristics of the tumor and the absence of extraocular disease.

Ciliary body melanomas have a rate of distant metastasis of19% and 33% at 5 and 10 years respectively, being the most frequent liver, lung or bones metastases [1]. This rate is the highest of uveal melanomas, which makes the survival from these tumors, also lower [3].

Conclusion

In conclusion we suggest that sudden ocular pain is a very unusual presentation of already unusual ciliary body melanoma. The objective of this article is describing this way of atypical debut. These tumors are the most metastatic inside the group of intraocular melanomas. However the brachytherapy treatment can be a good choice for this kind of tumors if we detect them before extra ocular dissemination.

For more Open Access Journals in Juniper Publishers please click on: https://juniperpublishers.com

For more articles in JOJ Ophthalmology please click on: https://juniperpublishers.com/jojo/index.php

For more Open Access Journals please click on: https://juniperpublishers.com

#Ocular Pain #Melanoma #Ciliary Body #Cataract #Juniper Publishers

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fortheking16 · 5 years

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New Free Historical Records on FamilySearch: Week of 19 August 2019

I saw last night on FamilySearch -New Free Historical Records on FamilySearch: Week of19 August 2019: https://media.familysearch.org/new-free-historical-records-on-familysearch-week-of-19-august-2019/

New Free Historical Records on FamilySearch: Week of 19 August 2019

FamilySearch added over 7 million U.S. World War II draft registration cards this week. More historical records from C…

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#FamilySearch #Kansas #WBTS/ACW

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cosmic-biscuit · 6 years

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Hatteras, Hydra-Sports & Javelin Fishing Boats

Hatteras Fishing Boats

Hatteras Fishing Boats is a tradition of innovation since 1960. It has broken out of convention by using a new material, fiberglass, in the 1960s. Until today, it is defining the boat building industry.

Over the years, Hatteras has remained constant. It has continued to set the benchmark for the industry standard for high performance and rugged perfection on waters. It has built all its boats with solid fiberglass hull bottom. Only Hatteras gives a 5 year warranty, a true evidence of its durability.

It is committed to superior design and craftsmanship. This is simple choice for both sports fishing and recreational motor yacht. All Hatteras sport fishing boats come with the "renowned Hatteras ride" and delivers comfort and style.

A used Hatteras aluminum fishing boat is for sale for $59,500,000. It is located in Wrightsville Beach, NC. The hull is made up of reinforced fiberglass and has the length of 50 feet. The boat utilizes diesel and has an extended warranty.

Another great is the 1973 HATTERAS Double Cabin Motor Yacht. This is up for sale at the price of $114,900.00. The boat has been designed by J. Hargrave. It has a beam of 14 feet and length of 43 feet.

The bridge clearance is 17 feet and 10 inches while the draft is 3 feet 5 inches. The engine model is Detroit and has 285 Horsepower. It has a cruising speed of 14 knots and has the maximum speed of19 knots.

It has twin-type propulsion and the hull material is made of fiberglass. The fuel capacity is 400 gallons and has a holding of 70 gallons. The water it can store is 130 gallons.

Its accommodations include a classic double cabin flybridge motor yacht that can sleep six with two staterooms and convertible sofa. There is a new inner spring mattresses with custom covers and matching drapes. Moreover, it has two heads with stall showers and new Raritan Atlantic toilets.

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Hydra-Sports Fishing Boats

The 2004 Hydra-Sports Sport Vector is for sale at US$89,000.00. This Hydra-Sports Vector Fishing Boat runs on gas and has a total horsepower of 250. It has a dry weight of 7,700 lbs.

The fuel tank can hold 284 gallons while its water tank can hold 29 gallons. The cruising speed is 32mph while its maximum speed is 55mph. This is awesome boat for the ultimate offshore high-performance fishing.

It has a large open cockpit with fishing room fore and aft with all the amenities required for bountiful fishing. This used Hydra-Sports fishing boat, is powered by twin 250 horsepower Yamahas. It comes with transferable engine and hull warranties.

Other features include Fresh and Salt Water Washdown, Illuminated Live Well with Twin Pumps, Double Rigged Taco Telescoping Outriggers, Bait & Prep Station with Sink, and Concealed Rod Storage. Also it comes with these items such as Cockpit Bolsters, Rod Holders, Tackle Drawers, Transom Door, and Center Console with T-Top to name a few.

The electronics that are available are Raymarine 215 VHF Radio, and Garmin 4208 Network with Twin Screens, Sonar, Charts, Special Blue-chip Fish Finder, and XM Weather.

Moreover, what is included is the canvas package that is worth $10,000.00. It comes with a center Console Wrap-around with "Bat Wings" for bad weather, custom Dodger with Tonneau Cover for Bow Seating, and Canvas Cover for Forward Console Seat

Plus it has these included like the Center Console Cover, Leaning Post Cover, Engine Covers, Custom Two-piece Mooring Cover, and All Canvas Includes Storage Bags and Covers.

Javelin Fishing Boats

A used Javelin fishing boat like the 2002 Javelin 21 MSX DC is for sale at US $18,999.00. It is currently located at Kalamazoo, MI. It has the length of 20 feet.

The beam is 8 feet and 1 inch and its dry weight is 2150 lbs. This Javelin small fishing boat can seat a maximum of 6 people. It runs on a 225 total maximum horsepower and has one engine.

This bass boat has a 225 hp Yamaha 4-stroke outboard and an 8 hp Yamaha 4-stoke kicker. Both come with a power trim. Its features include full walk-thru windshield, Lowrance LMS-240 fish finder with GPS and removable bracket and cover, and bow Lowrance X-65 fish finder with removable bracket.

Also it comes with a Minn Kota Maxxum 74-lb. thrust trolling motor, bow trolling motor plug, Maxxima AM/FM/cassette player, 4 marine speakers, Standard Horizon VHF radio with antenna, and Ritchie compass.

Also it comes with a console Teleflex digital flasher, and gauges including speedometer, tachometer, fuel, volts, water pressure, and trim position. This comes with a custom tandem-axle Javelin trailer with surge brakes, tongue jack, 14in tires, spare tire and carrier, bearing buddies, diamond-plated step fenders, and ratchet tie-down straps. All in all, this package is in great condition though with a minimal upholstery repair required.

Relevant Resource: http://mosquitotrecker.blog.fc2.com/blog-entry-1.html

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aprincesadegales · 2 years

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Os 4 anos do Príncipe Louis em Retratos Oficiais

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melissbright-blog · 6 years

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The Amazing Michael Kors Handbags

One designer brand have recently caught my eye. He is Michael Kors. I'm so getting the Hamilton Bag from his collection.

A little background on this amazing man. Mr Kors began his career in fashion at the age of19. Designing and merchandisng a collection for the renowned boutique Lothar's in New York City. The success of these clothes caught the attention of the fashion press, prompting him to strike out on his own. In 1981,The Cheap Michael Kors Purses label was formed.

His handbags have become the up and coming brand to watch out for. And they all have this amazing traits that is they catches your eye immediately with their luxurious styles and designs. Their surface will charm you so much you won't want to put it down. The colors they appear in are in the most amazing colors that you can dream off. The yellow, orange, navy, purple, gunmetal and many unique and beautiful colors that are so hot and sexy. And there are so many occasions that you can use them for, weddings, work, parties, dates and many more.

Best of all they will not burn a big hole in your pocket. Michael Kors handbags are now easy to purchase as you can buy from any super stores and departmental stores. If you do not have time to go shopping downtown, you can get yours now online. The photos, features and prices are all clearly stated in websites which save you time.

Many trendy and fashionable women are buying them now like Knockoff Coach Purses. Why wait? Get one today.

Storming for the latest fashion. Visit Replica Designer Handbags Online.

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steveliz · 6 years

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North India below chilly wave, Kargil freezes at -9.6°

Dense fog ends in cancellation of19 put collectively products and services Read More

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#freezes #Kargil

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yellonolang · 7 years

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why are all the translations of ks so radically different? like is it hard to tell who’s speaking sometimes in korean, as in it’s supposed to be implied and translators just don’t get it? in the fan translated 18 i read, in the bathroom sangwoo was like, “don’t hate ME too much, even though I’M torturing you like this,” but in another one and in the official translation, he says, “don’t hate THEM too much, even though THEY’RE torturing you like this.” and i just read 2 different translations for the end of19 that imply completely different things, because in one it seems like sangwoo is talking about how it was difficult for HIM to act innocent, and in another one he’s giving bum sympathy, saying it was ok for him to kill jieun because he was the victim of so much pain and it was time for him to let the anger out, to stop acting innocent. so like... these things are RADICALLY different. i know translating is hard, but is there something about korean that makes pronouns difficult? because this seems to be the biggest problem between translations, but it’s a pretty important thing.

i feel like i can’t trust any of the translations, including lezhin’s, but i don’t speak/read korean in any way shape or form so it is what it is.

#texts

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aprincesadegales · 2 years

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Os 7 anos da Princesa Charlotte em Retratos Oficiais

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aprincesadegales · 3 years

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Bisnetxs da Rainha Elizabeth II e do Príncipe Philip

[5/9] Princesa Charlotte: nasc. 2 de maio de 2015 (5 anos) | Filha de William e Kate

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aprincesadegales · 3 years

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Catálogo de Looks da Duquesa de Cambridge

Blusa: J.Crew Brincos: Kiki McDonough

Fotografia disponibilizada em 9 de fevereiro de 2019 em antecipação à Exposição de Flores de Chelsea, organizada anualmente pela Sociedade Real de Horticultura (RHS). Na edição de 2019, Kate apresentou o jardim “Back to Nature”, que projetou e construiu em parceria com os arquitetos paisagistas Adam White e Andrée Davies.

[Fontes: katescloset.com.au | catherine-middleton.com]

#kate middleton #duquesa de cambridge #duchess of cambridge #j crew #kiki mcdonough #back to nature #royal fashion #Kate Middleton style #kate middleton fashion #oficial #of19 #catálogolooks #cl19

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