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To help you get started, Photoshop's help system provides thousands of tutorials online, often on Adobe's website. You can also find many tutorials on DVD or CD. As shown in Figure 3-2, an image can be assembled using layers, and you can perform many image adjustments with layers such as filtering, adjustment layers, and layer masks. The image in Figure 3-3 has a Background layer selected, and the original image is visible in the Layers palette. Photoshop CS5 has the ability to save a session so that you can save every change you make to an image. When you save a session, Photoshop automatically saves a file with the name of the original file. Save a session (or protect it if you want to save just the layers that are used) by choosing File⇒Save, and then choose Save Session or Save As from the menu. Photoshop saves the entire session at the bottom of the Layers palette; after a little while, a dialog box appears, as shown in Figure 3-4. In this dialog box, the Current Session box shows the current file name, and the Path box shows the path to the active file. The Save box opens to the Save As dialog box, where you can save the session as the current or any previous file. By default, when you save a session, an automatic new file name is created. You can customize the new file name to include any unique attributes you want to identify the image. The ability to save a session is an efficient way to save a series of raster images. Often, you can improve an image by using an adjustment layer on a layer mask to subtract pixels, change color, apply a filter, or even clone and distort part of the image. When you add many adjustment layers to an image, Photoshop creates a layer mask for each layer to allow you to quickly hide or show adjustments on individual layers. Save a session as often as you need to identify changes to the image. You can save a session when you are working on images, and it saves you the time of having to deal with identifying layers and saving each image. As you can see in Figure 3-4, the file that Photoshop saves is the most recent file that you saved, even if you had saved a session for an earlier image. If you save a session for an image, Photoshop saves the session's entire file at the bottom of the Layers palette. **Figure 3-2:** L



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What are the features of Photoshop? If you are a professional graphic designer, photographer, or video editor then you need the full version of Photoshop. You won’t use anything but the full Photoshop as it has all of the features that you need to design, create, and edit high-quality images. If you’re a hobbyist who doesn’t need to create a high-quality image right away, then you will be happy to use the starter version of Photoshop that has been stripped down to include only what you need to modify photos. This starter version of Photoshop is called Photoshop Elements and it is great for editing images, creating new ones, or both. Photoshop Elements doesn’t have the full feature set that Photoshop does, but it still has some features that will make your image editing experience more convenient. What are Photoshop Elements’ features? Here’s a list of the features of Photoshop Elements that can help you make your images more professional-looking. Fast, easy image creation with Photoshop Elements You can create and edit photos, create or edit all sorts of multimedia files, insert objects into photos, work with video and sound, or select and edit layers. You can use the following features in Photoshop Elements: Create photo collages Use Photoshop Elements to create images that look like a multipage collage. To do this, you can drag photos from your photo collection or folders into an image that is already open. You can use this method to create images that feature images of various sizes. Create web images You can use Photoshop Elements to make web images, design web pages, and create a site for your business. Create graphics or web pages You can use Photoshop Elements to create various forms of graphics, whether they be websites, logos, logos, or stickers. If you want to create a website, use Photoshop Elements to create a blank canvas and then add a background image, any text boxes, and any elements that you want to be part of the layout. Add text to a photo You can use Photoshop Elements to modify the text on an image. You can edit text boxes and add text to an existing image or you can make a new text box and enter text in it. Add shapes to an image You can add many types of shapes to an image. You can create lines, circles, rectangles, a681f4349e



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Radical mastectomy and splenectomy or splenorrhaphy in the management of breast carcinoma. Radical mastectomy and splenectomy was performed in 127 cases and was compared with splenorrhaphy in 186 cases. The complication rate was higher in the group undergoing splenectomy. The incidence of wound infection, especially in those operated on under emergency conditions, was higher in the group undergoing splenectomy. However, none of the splenectomised patients developed overwhelming postsplenectomy haemorrhage (OPH) and life threatening haemorrhage was infrequent. Thus, the indications for splenectomy are limited to those cases where OPH develops, in which conservative treatment fails to control the haemorrhage. The need for more definitive data before this therapeutic option can be considered more widely is evident.the ground that an amended complaint (like the first complaint) made no prayer for damages when the complaint was filed would have been untenable as a matter of law when the plaintiff filed the amended complaint.’’ (Footnote omitted.) Id., 312–13. It is clear that the financial transfers by the defen- dant to his wife and children cannot be considered in a derivative claim brought on behalf of the corpora- tion by the plaintiff for the violation of § 36-498. Such a claim is derivative, the elements of which correlate to ‘‘the claim of [the alleged] wrongdoer’’ and ‘‘the interests of the corporation....’’ (Internal quotation marks omitted.) Bernstein v. Kotler, supra, 263 Conn. 129. By its very nature, such a claim cannot lie against one other than the defendant. See General Statutes § 34-124 (‘‘[a]ny domestic corporation... or a foreign corpora- tion... claiming any right or privilege incident to its existence’’) (emphasis added); see also Mattu- chiana v. Prouty, supra, 289 Conn. 411 (‘‘[t]he claim for breach of fiduciary duty is derivative in nature and requires a breach of fiduciary duty on the part of... the... [individual] directors to the



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Improved Outcomes with Intravenous Immunoglobulin Over Supportive Care for Severe Acute Pancreatitis. To compare 30-day mortality between patients with severe acute pancreatitis (SAP) treated with intravenous immunoglobulin (IVIG) versus those treated with supportive care. Using the California State Inpatient Database, all SAP inpatients hospitalized from 2006 to 2009 were identified. Patients were evaluated for demographics, comorbidities, etiology, treatment, and outcomes. Statistical analysis was completed using SPSS software. In all, 5,305 patients were evaluated; 93 were identified as patients with severely elevated (SRE) or local intra-abdominal infection (LIACI), of which 52 received IVIG. Patients with SRE or LIACI had a significant increase in 30-day mortality with 30-day mortality of 11.5% versus 61.5% (P = 0.001). Patients with SRE or LIACI who received IVIG had no difference in 30-day mortality, with 30-day mortality of 25.0% versus 24.6% (P = 0.90). Univariate analysis demonstrated no significant difference in the use of surgery, ventilator-free days, and ICU-free days among patients with LIACI, but patients with LIACI who did not receive IVIG had a significantly increased 30-day mortality, and all patients with LIACI who did not receive IVIG received ventilator support (P = 0.002). When adjusted for other variables, patients with LIACI who did not receive IVIG were 12.4 times (95% CI, 1.5-101.2) more likely to die during hospitalization, and 16.0 times (95% CI, 2.0-130.2) more likely to require ventilator support than patients with LIACI who received IVIG. Intravenous immunoglobulin therapy is associated with improved mortality in patients with severe acute pancreatitis, regardless of their initial infection status. Furthermore, patients with severe acute pancreatitis who have LIACI but do not receive IVIG remain at increased risk for a higher mortality. In addition to standard care for established infection, patients with LIACI should be monitored for sepsis, and adequate hemodynamic, respiratory, and metabolic monitoring should be instituted. Further randomized trials should be conducted to determine whether adjuvant immunotherapy should be considered for all patients with LIAC



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