2019, Southern Methodist University, Knut's review: "Buy cheap Suhagra no RX - Discount Suhagra online".
It is indicated for generalised tonic-clonic seizures order genuine suhagra on-line erectile dysfunction drug related, partial seizures buy 100mg suhagra otc erectile dysfunction review, paroxysmal pain (e proven 100mg suhagra erectile dysfunction after 70. It should be stopped if there is an allergic skin reaction or deterioration in liver function. Routine liver function tests may be performed more often for legal reasons rather than for cost-effectiveness and some experts suggest that hepatoxicity, a rare phenomenon with anticonvulsants, may be picked up more readily by clinical examination than by laboratory examination. It may be safer to ask patients to report pyrexia, pharyngitis, other infection, petechiae, or weakness and pallor. Non-progressive or fluctuating leucopaenia (and anaemia), often early in treatment, is common and usually harmless. Serious side effects, such as agranulocytosis and aplastic anaemia, occur in 3051 only 1 in 10,000 to 120,000 treated patients. The half-life of 3048 There are many causes of cognitive dysfunction in association with epilepsy: primary brain dysfunction, brain damage caused by seizures including status, head injury, medication, other drugs including alcohol, and the psychosocial difficulties that may accompany the disorder. Between 10-20% of epileptic children have persistent or progressive intellectual impairment, especially when seizures are poorly controlled and when there are adverse psychosocial circumstances. Anticonvulsant drugs, by inducing liver enzymes, may increase circulating levels of sex hormone-binding globulin with consequent reduction in levels of unbound testosterone. Phenobarbital, phenytoin and carbamazepine are particularly likely to do this, but lamotrigine is unlikely to do so. Valproate raises the concentration of the toxic 10,11-epoxide metabolite of carbamazepine so that while carbamazepine levels may be normal the patient may toxic since the metabolite is not being measured. Carbamazepine induces liver enzymes and can reduce the effectiveness of some drugs, e. Contraceptive drugs may show reduced efficacy and there may be breakthrough bleeding or spotting; it is recommended that a pill containing at least 50 mcg of oestrogen is used or that another method of contraception is employed. Weigh regularly (to detect fluid retention) if there is cardiac insufficiency/failure. May render anovulants ineffective (may need higher potency contraceptive or supplementation with barrier method). Liscarbazepine is an active metabolite of oxcarbazepine which has been tried for mania with little success. Eslicarbazepine, an isomer of liscarbazepine, is being studied as a possible mood stabiliser. Common problems: fatigue, asthenia, dizziness, headache, somnolence, agitation, apathy, amnesia, ataxia, impaired concentration, confusion, depression, nervousness, nystagmus, tremor, nausea, vomiting, constipation, diarrhoea, abdominal pain, hyponatraemia (espc. Uncommon: leucopaenia, increased transaminases +/- alkaline phosphatase, urticaria. Between 25-31% of patients with allergy to either oxcarbazepine or carbamazepine are allergic to both drugs. Sulthiame (Ospolot): Sulthiame, an anti-epileptic sulphonamide like acetazolamide, may increase phenytoin levels into the toxic range. Barbiturates: These can cause hyperactivity, attention deficit disorders, behavior disorder, and cognitive deficits. Phenytoin (Epanutin): May act by limiting the spread of discharge, probably by membrane stabilisation. Chronic encephalopathy can occur with high therapeutic levels, and acute delirium (especially in the elderly) is also described. There have been some cases of fatal acute liver disease, usually when given with other anticonvulsants. Sulphonamides decrease phenytoin metabolism and may precipitate phenytoin toxicity. Thrombocytopaenia is a relatively frequent side effect of valproate in the elderly. Ethosuximide: This succinimide may be associated with psychosis, especially in young adolescents. Intravenous lorazepam may provide a more prolonged anticonvulsant effect than is achieved with intravenous diazepam. There may be increased aggressiveness or children may become irritable and hyperactive. Clobazam (Frisium) is often better tolerated than clonazepam but it has the same problem of tolerance, but it may be of use for special occasions, catamenial seizures, or for seizures occurring in clusters. Status affects 1 in 20 adults during life, but the figure for children is one-quarter. Lamotrigine inhibits excitatory presynaptic neurotransmitter release, especially glutamate. A limited number of reports of breakthrough seizures, unexpected pregnancies and of menstrual bleeding disorders (such as breakthrough bleeding) have been reported to GlaxoSmithKline in women on a combination of lamotrigine and the contraceptive pill. Anovulants decrease serum levels of lamotrigine and such levels may there rise on stopping the contraceptive pill. Rare associated problems are severe allergic skin rash (Stevens Johnson or toxic epidermal necrolysis/Lyell syndrome) and psychiatric (sometimes aggressive) reactions. Drugs that induce liver enzymes like carbamazepine or phenytoin can halve the half-life of lamotrigine, while sodium valproate, which inhibits its metabolism, can double the half-life of lamotrigine. Side effects include rashes, headache, nausea and vomiting, dizziness, diplopia, ataxia, and, in high doses, tremor. Lamotrigine has been reported to cause a condition resembling Tourette’s syndrome in children that is reversible on stopping the drug. Vigabatrin has been suggested as an add-on treatment for partial seizures, with/without secondary generalisation, uncontrolled by other drugs or monotherapy for infantile spasms. In practice, its use is restricted because of ophthalmic problems to very severe epilepsy (e. The latter appear to be more likely in babies receiving doses of at least 125 mg/kg/day. It can cause drowsiness, fatigue, nervous irritability, aggression and psychosis (especially if there is a history), depression, disturbed vision (irreversible visual field defects in one-third of cases – may take months or years to develop) and memory, excitement and agitation in children, and increased frequency of (especially myoclonic) seizures. All patients should be screened at the start of treatment and regularly thereafter for visual field defects. Lacosamide (Vimpat) is an adjunctive treatment for partial-onset seizures with/without secondary generalisation in epileptic patients aged at least 16 years. It may be associated with depression, headache, somnolence, asthenia/fatigue, dizziness/vertigo, problems with balance/gait (may fall), pruritus, nausea/vomiting/constipation/flatulence, tremor, nystagmus, double and blurred vision, memory/cognitive impairment, and skin laceration. It is used as an add-on drug for partial seizures, with/without secondary generalisation. It can cause sedation, fatigue, ataxia, dizziness, nystagmus, headache, tremor, nausea and vomiting, diplopia, amblyopia, rhinitis, pharyngitis, dysarthria, nervousness, dyspepsia, amnesia and myalgia. Rare associations include pancreatitis, increased liver enzymes, erythema multiforme, Stevens Johnson syndrome, and (of unproven association) unexplained death. An add-on therapy for partial seizures, with/without secondary generalisation, it does not interact with oral contraceptive drugs, and predictable effects are due to linear pharmacokinetics. Topiramate, an add-on therapy for epilepsy, has a 3064 spectrum similar to phenytoin or carbamazepine. Acute myopia and secondary angle-closure glaucoma have been reported, typically within first month of therapy (acute onset of decreased visual acuity and/or ocular pain with myopia, redness, shallow anterior chamber, raised intraocular pressure with or without mydriasis: stop the drug quickly and treat any raised intraocular pressure).
It should be highlighted that all the compound variants – bone-marrow stromal stem cell buy suhagra once a day erectile dysfunction drugs free trial, bone marrow stromal cell purchase suhagra 100mg impotence at 18, skeletal stem cell cheap suhagra 100 mg on line erectile dysfunction nursing interventions, bone marrow-derived stromal cell – in S1 are assigned to the same term mesenchymal stem cell. The main dif- ference between the truncated forms in S1 and in S2 is that most trun- cated forms in S2 belong to most known types of cells as they are hy- peronyms of many other specific types (e. All the compounds from the resulting data have been further subclassified according to the process terms have gone through to result in alternative denominations. The greatest number of compounds has been found in S2 (47), and there- fore they have been described in the first place: ● 18 variants out of 52 (34%) reproduce compounds built from Greek or Latin roots in the English language (e. Different words are 1 In this study, truncation is understood as a formal means by which a lexematic unit is reduced to an acronym or an abbreviated form. Discussion In agreement with already cited authors such as Gaudin (1990), Sager (1990), Bowker and Hawkins (2006), neither terms nor their variants are context free. Specifically, variants in these registers are trig- gered by the intention of the writers and the level of knowledge of the recipients in each situation type. Based on the results extracted from our corpus it seems to be possible to infer regular patterns of variation and the specific motiva- tions behind term choice. Scientific popularization implies a reformulation pro- cess in which most Greco-Latin terms have at least an alternative Formation Patterns of Denominative Variants in Biomedicine 81 expression. In this sense, Gotti (2014: 19) states that popula- rization “does not alter the disciplinary content […] as much as its lan- guage, which needs to be remodeled to suit a new target audience”. The aim of experts and semi-experts writing for a lay audience is that recipients can continue reading without finding conceptual barriers and that they overall understand the message. In order to achieve their aim, they use above all paraphrases; secondly they use English coun- terparts which sometimes strictly follow the order of Greco-Latin roots of terms, and others are reduced forms. The description of variants in this study shows hints of the appropriateness of variants in certain settings characterized by different users and a particular purpose. The methodology carried out in this study can be applied to other specialized languages and the resulting variants can contribute to the improvement of terminology-oriented applications: 82 Paula De Santiago González specialized dictionaries, computer-assisted translations, etc. In Cabré, María Teresa / Feliu, Judit (eds) La ter- minología científico-técnica: reconocimiento, análisis y extrac- ción de información formal y semántica. Introduction In the last decades, several studies have been concerned with the analysis of the discourse of popularization (see for example Shinn/ Whitley 1985; Gregory/Miller 1998; Myers 1997, 2003; Ciapuscio 2003; Calsamiglia/Van Dijk 2004). Many scholars have been interest- ed in the language adopted by journalists and media professionals when dealing with scientific research articles and have focused in particular on the linguistic features of popularizing texts. This line of research has often analysed journalists’ products in comparison with the original research articles in scientific journals, pointing out several differences at various levels, such as textual, syntactic and rhetorical levels (Myers 1990, 1991, 1994; Calsamiglia 2003). Furthermore, par- ticular interest has been placed on those linguistic strategies enacted in order to enhance lay readers’ comprehension such as the use of meta- phors (Gülich 2003) and other expressive functions (e. As far as the definition of popularization is concerned, this pro- cess has often been identified as a ‘social operation’ aimed at commu- nicating lay versions of scientific knowledge among the public at large (Jacobi 1999; Calsamiglia/Van Dijk 2004). The discourse of populari- zation is a pluricode discourse in which text, images, stylesheets and colours semantically interact (Lemke 1998; Miller 1998) through a multimodal approach (Gotti 2013). As Bontems (2013: 103) argues, images are fundamental to the construction of scientific knowledge for a lay audience since they influence the reader’s sensitivity, thus 88 Silvia Cavalieri enhancing comprehension. The journalist is the mediator between science and its popularization and he/she chooses the right images and, in the case of complex technical ones, he/she adapts them to the supposed background knowledge of their public (Jacobi 1999; Bontems 2013). Even though in the last years many studies have claimed the im- portance of images in the field of science popularization (see among others Jacobi 1999; Bontems 2013; Dondero 2013; Lathene-Da Cunha 2013), little attention has been paid to the role of captions in the pro- cess of conveying specialist knowledge for a wider audience of non- specialists (Myers 1997). In order to fill this gap in the literature, the present work aims at providing an introductory description of captions in the discourse of medicine through the media, focusing in particular on three comparable corpora of news collected from the medicine sec- tions of French, English and Italian online magazines of science popu- larization. To be more specific, the study deals with the popularizing strategies used in the captions and their relation with the news and the image they refer to. Moreover, the use of captions is compared in the three languages to highlight similarities or differences in their use in order to see what strategies are typical of popularization discourse in different cultures As for the organization of the chapter, the first part will focus on the materials and methods used for the analysis, the second will deal with the findings deriving from an in-depth observation of corpus data and, in the final section, results will be discussed and conclusions will be drawn in the light of the previous analysis. Materials and Methods The present study has focused on scientific popularization discourse (Calsamiglia/Van Dijk 2004; Desmet 2005) aimed at transferring gen- eral medical information to a target public of educated laymen inter- ested in the latest science news. The articles chosen are texts adapted Popularizing Medical Discourse: The Role of Captions 89 to the editorial board policies by journalists, in which the presence of graphs, images and illustrations is pervasive. More specifically, the analysis was carried out on three comparable corpora of science news articles collected from the medicine sections of six online magazines of science popularization, namely Futura-Sciences and Science et ave- nir for the French corpus, Le Scienze and Focus for the Italian corpus, and Scientific American and Science Daily for the English corpus. As for the number of articles published, data show a sharp difference among the various online magazines and, in particular, between the Italian ones and the others. Moreover, it is worth noting a difference in the number of images used: English magazines tend to use one image per article while in French and Italian magazines we find an average of two images. The images found in the corpus are mainly of two types: 1) direct representations of the object described in the article, in which the similarity between the representamen and the object relies on simple qualities or properties (Lathene-Da Cunha 2013); 90 Silvia Cavalieri 2) diagrams and graphs, i. According to Myers (1997: 98) in scientific popularization articles “the text directs us to the picture, which leads us back to the caption, which leads to the picture, which leads back to the text”. So, first of all, we decided to consider the rela- tionship between the captions, the image and the article and we identi- fied what part of the article the caption anchors to. Thirdly, we analysed the most frequent popularizing strategies employed in the captions in order to enhance readers’ comprehension of the scientific knowledge reported following the framework pro- posed by Garzone (2006). Finally, a contrastive analysis of the use of captions in the three languages selected is provided and differences and similarities are outlined and discussed. A classification of captions in comparable corpora of science popularization news Considering the quantitative presence of captions in comparable cor- pora, a first interesting observation that can be made concerns the fact that only 28 images out of 448 do not present captions. As regards the typology outlined in Section 2, data show that the most frequent category of captions found in the three corpora is the summa- rizing one (197 out of 448). Des études suggèrent par ex- emple […]; More than 8,000 different phenolic compounds have been Popularizing Medical Discourse: The Role of Captions 93 identified […]). The Italian caption of Focus is the most summarized one, since it begins with a nominalization (allattamento) to introduce the main topic and then gives only the main gist of what the text is about (il latte materno […] è pericoloso) The second most frequent category of captions identified in the three corpora is that of descriptive captions (109 out of 448). Descrip- tive captions are directly linked to the picture they refer to and they provide a description of the element depicted in the picture or of the data represented in a graph. The following extracts, taken from the three corpora, are representative examples of this type of captions in the different languages: (4) Ce schéma explique les mécanismes en jeu dans cette expérience. Massa/Yale, Science Daily) As we can see in the examples above, the captions signal the relation with the described picture through textual metadiscursive devices (‘endophoric markers’, Hyland 2005) such as ce schema (Futura- Sciences), miniature (Le Scienze), microscope image (Science Daily). Moving on to the third most preferred category of captions, what emerges from the three corpora is a hybrid type of caption mer- ging the two previous categories, i. They are characterized by a first part that anchors the explana- tion to the pictorial representation by means of a description and, then, by a second part in which the content of the science popularization ar- ticle is presented. Examples (7-9) show instances of this type of re- sources found in the three corpora: Popularizing Medical Discourse: The Role of Captions 95 (7) On peut apercevoir des bactéries (en vert) emprisonnées dans une cage en forme de donut (en rouge). Cette expérience, loin d’être farfelue, devrait permettre de mieux comprendre comment les communautés microbiennes communiquent au sein des environnements et développent des infections. Solo centri dotati di queste struttu- re sono abilitati a ospitare e studiare virus altamente letali come quello di Ebola (© Christian Charisius/dpa/Corbis, Le Scienze) (9) Minamata Bay at Dusk: From 1932 to 1968, Chisso Corp. Minamata Bay at Dusk; Un laboratorio con livello di biosicurezza 4) often by making reference to physical characteristics such as colours and forms and by using verbs of perception (e. In fact, in our corpora we found: 1) captions using a paragraph (24 out of 448), 2) captions using the news’ title (15 out of 448), and 3) captions using quotations from the article (16 out of 448).
Impact 3 with the cytokine release syndrome manifested by of body weight on long-term survival after lung hypotension buy 100mg suhagra erectile dysfunction treatment cincinnati, noncardiogenic pulmonary edema order 100mg suhagra amex erectile dysfunction books download free, transplantation suhagra 100 mg on-line erectile dysfunction in diabetes pdf. Infection the activation of T cells, B cells, and other cell lines with Burkholderia cepacia in cystic ﬁbrosis: outcome by cytokines and growth factors, thus preventing following lung transplantation. The use of sirolimus in vival of lung transplant patients with cystic ﬁbrosis the immediate posttransplant period is discour- harboring panresistant bacteria other than Burk- aged because of the association with bronchial holderia cepacia, compared with patients harboring anastomotic dehiscence when used in combination sensitive bacteria. Impact of a thrombocytopenia and leukopenia), hyperlipid- lung transplantation donor-management protocol emia, arthralgias, and interstitial pneumonitis, on lung donation and recipient outcomes. A survey try of the International Society for Heart and Lung of clinical practice of lung transplantation in North Transplantation: twenty-ﬁfth ofﬁcial adult lung and America. Eur Respir J 2003; 22:1007–1018 and for clinical staging of chronic dysfunction in A review article discussing pathogenesis, risk factors, clinical lung allografts: International Society for Heart and presentation, diagnosis, and treatment of bronchiolitis oblit- Lung Transplantation. It presents data on after onset of bronchiolitis obliterans syndrome in lung indications, numbers, survival, rates of morbidity and mortal- transplant recipients. A survey cepacia complex genomovars and pulmonary transplan- of clinical practice of lung transplantation in North tation outcomes in patients with cystic ﬁbrosis. Chest 2001; 119:169–175 A review of the immunology of graft rejection, including a This article reviews the various presentations of Aspergillus discussion on humoral rejection. Single vs bilat- 1996 working formulation for the standardization of eral, sequential lung transplantation for end-stage nomenclature in the diagnosis of lung rejection. Bilateral Chest 2003; 124:1689–1693 versus single lung transplantation for chronic obstructive This article describes the prevalence and possible etiologies of pulmonary disease: intermediate-term results. These variations in etiology characterized by dense alveolar inﬁltrates, incidence by sex may reﬂect differences in smok- subacute course, and excellent responsiveness to 1 ing habits of the populations studied. Pneumothora- that was disproportionate to the degree of pul- ces occur in 6 to 20% of patients and may be the monary functional impairment or hypoxemia. In individual mononuclear phagocytes with moderate amounts patients, several histologic features may be present of eosinophilic cytoplasm, a prominently grooved, concomitantly (eg, histiocytic proliferation, granulo- folded nucleus, inconspicuous nucleoli, and ﬁnely matous inﬂammation, ﬁbrosis, healing, and repair). Large numbers of macrophages may be lung parenchyma, can be seen under low-power prominent in the alveolar spaces and interstitium, magniﬁcation (Fig 8). More than Large aggregates of S100-positive histiocytes 90% of patients are smokers,3-7,13,20 and constitu- in stellate nodules or granulomatous lesions are ents of cigarette smoke are known to serve as 590 Rare Interstitial Lung Diseases (Lynch) T-cell mitogens, stimulate macrophage cytokine honeycombing on chest radiographs; severe production,41 and induce epithelial cell produc- reductions in Dlco, extremes of age; and mul- tion of cytokines (eg, granulocyte-macrophage tiple pneumothoraces. Note that cysts are scattered a history of recurrent pneumothoraces shows numerous well- relatively evenly throughout the lung, with neither peripheral deﬁned cysts scattered throughout the lung parenchyma. A diffuse background haze (ground-glass opaciﬁcation) ing multiple thin-walled cystic radiolucencies throughout lung is present, which is consistent with alveolar hemorrhage. Open-lung biopsy speci- thin-walled cysts within lung, renal parenchyma, men demonstrating the proliferation of atypical smooth-muscle uterus, or affected organs. Neoplasms and dysplasias occur when lations: myoﬁbroblast-like spindle-shaped cells somatic “second-hit” mutations result in loss and epithelioid-like polygonal cells. The com- retrospective reviews79,81 cited 5- and 10-year bination of oophorectomy and progesterone was survival rates of only 60% and 20%, respectively. Sirolimus, a macrolide with immunosup- tamoxifen and progesterone in 2, progesterone in pressive properties, inhibits the activity of the 1, and oophorectomy in 1. Thoracostomy tubes may be massive operative hemorrhage caused by adequate for pneumothorax or chylothorax in some extensive pleural adhesions, pneumothorax patients, but recurrences are common. Dietary fat restriction, perito- in 13 of 45 patients with previous pleurodesis neal-jugular shunts, and sclerosing agents have compared with 1 of 35 without prior pleurode- been tried but are usually ineffectual. The approach should be chain triglycerides, progesterone, thoracic duct individualized, taking into account the severity or ligation, pleurodesis, and pleurectomy. Posteroanterior chest radiograph demon- strating extensive patchy alveolar inﬁltrates in the left lung and a patchy inﬁltrate in the right lower lobe in a 58-year-old man. Top, A: posteroanterior chest radiograph into the area of consolidation or nodular opacity from a 75-year-old woman with a 6-month history of recurrent may be seen. A peribronchiolar inflammatory cellular myoﬁbroblasts, and ﬁbroblasts plug the terminal inﬁltrate is present extending into the alveolar interstitium bronchioles (Fig 20, 21). A peribronchiolar inflammatory cellular inﬁltrate is present extending into the alveolar interstitium Pathogenesis (hematoxylin-eosin, low-power magniﬁcation). In early studies, initial treat- were more frequent in patients with more severe ment with high dose prednisone (1 mg/kg/d) hypoxemia at initial presentation. Given the favor- delay between first symptoms and treatment able side effect proﬁle of macrolide antibiotics, 608 Rare Interstitial Lung Diseases (Lynch) oral macrolides are logical therapeutic agents for histiocytosis in the adult. Is high- syndrome is rare; only 10 such patients were iden- resolution computed tomography a reliable tool to tiﬁed in a retrospective analysis at three medical predict the histopathological activity of pulmonary centers from 1979 to 1992. Langer- factors included underlying connective tissue hans’-cell histiocytosis (histiocytosis X)–a clonal pro- disease (n 3) and exposure to drugs or environ- liferative disease. Groupe d’Etude en Pa- methylprednisolone (1,000 mg daily for 3 days), thologie Interstitielle de la Societe de Pathologie Tho- following by high-dose prednisone (1 mg/kg/d racique du Nord. Surface hans’ cell granulomatosis and malignant lymphoma phenotype of Langerhans cells and lymphocytes may take different forms: report of seven cases in granulomatous lesions from patients with pul- with a review of the literature. Correlation Increased pulmonary neuroendocrine cells with between high-resolution computed tomography bombesin-like immunoreactivity in adult patients 610 Rare Interstitial Lung Diseases (Lynch) with eosinophilic granuloma. Lang- histiocytosis in adults: a clinical and therapeutic erhans cell histiocytosis in adults: report from the analysis of 11 patients from a single institution. Langerhans cell istry of the International Society for Heart and Lung histiocytosis: retrospective evaluation of 123 patients Transplantation: introduction to the 2005 annual at a single institution. Downregulation abnormal smooth muscle cells, and impairment of of estrogen and progesterone receptors in the gas exchange as predictors of outcome in lymphan- abnormal smooth muscle cells in pulmonary gioleiomyomatosis. Lung transplantation for cystic lung endothelial growth factor-D is increased in serum diseases: lymphangioleiomyomatosis, histiocytosis of patients with lymphangioleiomyomatosis. Extrapulmo- to treatment with an analog of the luteinizing- nary lymphangioleiomyomatosis and lymphangi- hormone- releasing hormone in a patient with omatous cysts in tuberous sclerosis complex. Effect of a tic criteria: tuberous sclerosis complex: report of the gonadotrophin-releasing hormone analogue on Diagnostic Criteria Committee of the National lung function in lymphangioleiomyomatosis. Cryptogenic amelioration of clinical symptoms of recurrent organizing pneumonia: a report of 25 cases and a lymphangioleiomyomatosis after living-donor review of the literature. An sus-host disease and bronchiolitis obliterans orga- unusual radiographic manifestation of bronchiol- nizing pneumonia in recipients of hematopoietic itis obliterans organizing pneumonia. Bronchiolitis tial lung disease associated with juvenile dermato- obliterans organizing pneumonia syndrome myositis: clinical features and efﬁcacy of cyclosporin primed by radiation therapy to the breast: the A. Bronchiolitis oblit- Idiopathic bronchiolitis obliterans with organizing erans organizing pneumonia: clinicopathologic pneumonia presenting with adult respiratory dis- review of a series of 45 Korean patients including tress syndrome. Although the number of cases in the United States has been decreasing, the proportion of cases in the foreign-born population has increased from 27% in 1992 to 59% in 2008. The development of an be produced by aerosol treatments, sputum induc- immune response, heralded by the development tion, aerosolization during bronchoscopy, manipu- of delayed-type hypersensitivity during the next lation of lesions, or processing of tissue or secretions 4 weeks, leads to granuloma formation with a in the hospital or laboratory. An example would be a per- ﬁt into these categories should be judged to have a son who had an initial false-negative reaction positive reaction with indurations of 15 mm.