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Sample records for paraneoplastic pemphigus pnp

  1. Follicular non-Hodgkin's lymphoma with refractory paraneoplastic pemphigus : Case report with review of novel treatment modalities

    NARCIS (Netherlands)

    Van Rossum, MM; Verhaegen, NTM; Jonkman, MF; Mackenzie, MA; Koster, A; Van der Valk, PGM; Span, LFR

    2004-01-01

    In this paper a patient with a non-Hodgkin's lymphoma (NHL) and paraneoplastic pemphigus (PNP) is described. PNP is a very rare, painful mucocutaneous intraepithelial blistering disease associated with occult or confirmed malignancy. Patients with PNP show severe, progressive mucocutaneous disease

  2. Paraneoplastic pemphigus associated with inflammatory myofibroblastic tumour of the mediastinum: A favourable response to treatment and review of the literature.

    Science.gov (United States)

    Ghandi, Narges; Ghanadan, Alireza; Azizian, Mohammad-Reza; Hejazi, Pardis; Aghazadeh, Nessa; Tavousi, Parvin; Daneshpazhooh, Maryam

    2015-05-01

    Paraneoplastic pemphigus (PNP) is an autoimmune blistering disorder that occurs in association with an underlying neoplasm. Inflammatory myofibroblastic tumour (IMT) is a rare low-grade sarcoma of fibroblasts and myofibroblasts associated with inflammatory cells, most commonly occurring in the lung. In this study, a case of PNP associated with IMT of the mediastinum is reported. The patient had a favourable outcome following surgical resection and treatment with a systemic steroid, azathioprine, and i.v. immunoglobulin. The occurrence of PNP with sarcomas, specifically IMT, is noteworthy although it is not well studied in the existing literature. © 2014 The Australasian College of Dermatologists.

  3. Multidisciplinary Clinical Management of Paraneoplastic Pemphigus – A Case Report

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    Sadaksharam Jayachandran

    2017-10-01

    Full Text Available Paraneoplastic pemphigus is a rare immunobullous disorder commonly associated with lymphoproliferative neoplasms and less commonly in carcinomas with a poor prognosis. The neoplasms produce autoantibodies that react with members of plakin family to produce a suprabasilar split and varied clinical presentations in the skin and mucous membrane. Oral erosions are the first manifestation most resistant to treatment and persist even after the underlying tumour has been resected or treated. We report here a rare case of paraneoplastic pemphigus with an underlying squamous cell carcinoma of the oesophagus that constitutes only 8% of the neoplasms associated with this condition. It was successfully managed by a multidisciplinary approach involving the Departments of Dermatology, Surgical Oncology and Oral Medicine. The oral erosions were resistant to treatment however, a patient-tailored treatment was advocated using professionally administered debridement with hydrogen peroxide diluted with hypotonic saline, high potency topical steroids, analgesic oral rinses and topical anaesthetics with systemically administered immunomodulators. Hence, management of such cases exhibiting systemic and oral manifestations require a multidisciplinary team approach to improve the quality of life of the patients.

  4. Castleman′s Disease Presenting as Localized Abdominal Mass and Paraneoplastic Pemphigus

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    Santosh Kumar

    2016-01-01

    Full Text Available Castleman′s disease is a rare, benign lymphoproliferative disorder of unknown origin. Paraneoplastic pemphigus is a common association which presents as oral mucosal ulcerations. Abdominal and retroperitoneal Castleman′s disease present either as a localized disease or as a systemic disease. We hereby present a 15-year-old male patient with oral mucosal lesions with localized vague right lower abdominal mass who was diagnosed to have Castleman′s disease with paraneoplastic pemphigus which was surgically excised.

  5. Paraneoplastic pemphigus: A retrospective case series in a referral center in northern Taiwan

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    Yung-Tsu Cho

    2014-03-01

    Conclusion: PNP in Taiwanese patients has a high association with Castleman’s disease or malignant thymoma. Complete laboratory examinations and thorough investigations for occult neoplasms are mandatory to establish a diagnosis in patients with clinical suspicions of PNP.

  6. Pemphigus

    Science.gov (United States)

    ... Bullosa Lichen Sclerosus Pachyonychia Congenita Pemphigus Psoriasis Raynaud’s Phenomenon Rosacea Vitiligo All Diseases and Conditions Kids Pages ... not appear to be passed from parent to child. But some people’s genes put them more at ...

  7. Paraneoplastic pruritus and paraneoplastic erythroderma

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    Erkan Alpsoy

    2013-12-01

    Full Text Available Pruritus and erythroderma could be a presenting sign of numerous internal malignancies. These symptomes can occur in the early stages of internal malignancies or precede them by months. On the other hand, these symptoms can also be caused by various other common conditions; therefore they are not specific for paraneoplastic diseases. This review overviews the current state of knowledge regarding paraneoplastic pruritus and paraneoplastic erythroderma, and highlights the association between these conditions and internal malignancies together with their epidemiological, clinical and diagnostic features. Paraneoplastic pruritus is often generalized with intractable and chronic course. Nocturnal pruritus can be a significant problem for these patients. Patients may present with secondary skin changes including excoriations, hyperpigmentation, lichenification and prurigo nodules. Paraneoplastic pruritus is more commonly known to be in association with Hodgkin lymphoma and other lymphomas, leukemia and polycythemia vera. Paraneoplastic erythroderma is more agressive and resistant to standart treatment modalities. Weakness, and significant weight loss are frequently seen as additional findings. It can be associated with fine scaling and hyperpigmentation (melanoerythroderma. Papuloerythroderma of Ofuji is distinct and rare clinical entity presenting with erythroderma. It is characterized by intensely pruritic and widespread red flat-topped papules. Cutaneous T-cell lymphoma, especially its leukemic variant Sézary syndrome are the most common cause of paraneoplastic erythroderma. A detailed and meticulous medical history, dermatologic and physical examination including an exam for lymph nodes should be the first step in the evaluation of paraneoplastic pruritus and erythroderma. Subsequent diagnostic testing must be directed in the light of clinical findings, and especially lymphoproliferative diseases should be carefully evaluated. Such a review

  8. Paraneoplastic neuropathies.

    Science.gov (United States)

    Antoine, Jean-Christophe; Camdessanché, Jean-Philippe

    2017-10-01

    To review recent advances in paraneoplastic neuropathies with emphasis on their definition, different forms and therapeutic development. A strict definition of definite paraneoplastic neuropathies is necessary to avoid confusion. With carcinoma, seronegative sensory neuronopathies and neuronopathies and anti-Hu and anti-CV2/Contactin Response Mediator Protein 5 antibodies are the most frequent. With lymphomas, most neuropathies occur with monoclonal gammopathy including AL amyloidosis, Polyneuropathy-Organomegaly-Endocrinopathy-M component-Skin changes (POEMS) syndrome, type I cryoglobulinemia and antimyelin-associated glycoprotein (MAG) neuropathies and Waldenström's disease. Neuropathies improving with tumor treatment are occasional, occur with a variety of cancer and include motor neuron disease, chronic inflammatory demyelinating neuropathy and nerve vasculitis. If antibodies toward intracellular antigens are well characterized, it is not the case for antibodies toward cell membrane proteins. Contactin-associated protein-2 antibodies occur with neuromyotonia and thymoma with the Morvan's syndrome in addition to Netrin 1 receptor antibodies but may not be responsible for peripheral nerve hyperexcitability. The treatment of AL amyloidosis, POEMS syndrome, anti-MAG neuropathy and cryoglobulinemia is now relatively well established. It is not the case with onconeural antibodies for which the rarity of the disorders and a short therapeutic window are limiting factors for the development of clinical trials. A strict definition of paraneoplastic neuropathies helps their identification and is necessary to allow an early diagnosis of the underlying tumor.

  9. Paraneoplastic syndromes

    Energy Technology Data Exchange (ETDEWEB)

    Weller, R.E.

    1994-03-01

    Paraneoplastic syndromes (PNS) comprise a diverse group of disorders that are associated with cancer but unrelated to the size, location, metastases, or physiologic activities of the mature tissue of origin. They are remote effects of tumors that may appear as signs, symptoms, or syndromes which can mimic other disease conditions encountered in veterinary medicine. Recognition of PNS is valuable for several reasons: the observed abnormalities may represent tumor cell markers and facilitate early diagnosis of the tumor; they may allow assessment of premalignant states; they may aid in the search metastases; they may help quantify and monitor response to therapy; and, they may provide insight into the study of malignant transformation and oncogene expression. This review will concentrate on the pathophysiology, diagnosis, and treatment of some of the common PNS encountered in veterinary medicine.

  10. Pemphigus vegetans of hallopeau

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    Nanda Soni

    2005-01-01

    Full Text Available A 42 year old male had pemphigus vegetans of Hallopeau of groin and perianal area for the last 4 months. He also had lesions on scalp and mouth. Histology showed intraepidermal eosinophilic abscess.

  11. Paraneoplastic pemphigus as the initial presentation of chronic lymphocytic leukemia

    NARCIS (Netherlands)

    van Mook, WNKA; Fickers, MMF; Theunissen, PHMH; vander Kley, JAMJ; Duijvestijn, JA; Pas, HH; Flikweert, DC

    The case history of a 61-year-old male patient is described, who presented with severe stomatitis, conjunctivitis and leukocytosis. The diagnosis chronic lymphocytic leukemia (CLL) stage A (0) was made, for which no treatment was necessary. Progression of stomatitis and conjunctivitis and

  12. Risk Factors in Pemphigus

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    Gülşen Tükenmez Demirc

    2011-09-01

    Full Text Available Background and Design: There have been reports suggesting the involvement of environmental factors in the disease process of pemphigus. In this study, we aimed to find out the risk factors which could play role in the etiopathogenesis in our pemphigus patients.Material and method: A total of 42 patients (15 male and 27 female who were diagnosed as pemphigus with histopathological and direct immunoflurosence examinations in our clinic between the years 1998-2004, were interviewed for assessment of regarding with the subjects of the demographic properties, occupational groups, educational level, the number of pregnancies, stressfull life events, diet habits, smoking and alcohol consumption before the onset of the disease and the results were compared to 42 age and gender-matched controls with similar socioeconomic circumstances. Results: Working in agriculture and livestock, multi-parity, absence of smoking and stressfull life events were found to be statistically significant in pemphigus patients than in controls. Conclusion: Working in agriculture and livestock, multi-parity, absence of smoking and stressfull life events were assumed to play role in the etiopathogenesis and course of pemphigus.

  13. Paraneoplastic autoimmune movement disorders.

    Science.gov (United States)

    Lim, Thien Thien

    2017-11-01

    To provide an overview of paraneoplastic autoimmune disorders presenting with various movement disorders. The spectrum of paraneoplastic autoimmune disorders has been expanding with the discovery of new antibodies against cell surface and intracellular antigens. Many of these paraneoplastic autoimmune disorders manifest as a form of movement disorder. With the discovery of new neuronal antibodies, an increasing number of idiopathic or neurodegenerative movement disorders are now being reclassified as immune-mediated movement disorders. These include anti-N-methyl-d-aspartate receptor (NMDAR) encephalitis which may present with orolingual facial dyskinesia and stereotyped movements, CRMP-5 IgG presenting with chorea, anti-Yo paraneoplastic cerebellar degeneration presenting with ataxia, anti-VGKC complex (Caspr2 antibodies) neuromyotonia, opsoclonus-myoclonus-ataxia syndrome, and muscle rigidity and episodic spasms (amphiphysin, glutamic acid decarboxylase, glycine receptor, GABA(A)-receptor associated protein antibodies) in stiff-person syndrome. Movement disorders may be a presentation for paraneoplastic autoimmune disorders. Recognition of these disorders and their common phenomenology is important because it may lead to the discovery of an occult malignancy. Copyright © 2017 Elsevier Ltd. All rights reserved.

  14. Pemphigus Foliaceus In Pregnancy

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    Krishnan S G S

    1997-01-01

    Full Text Available A 35 year old female developed pemphigus foliaceus for the first time during her second pregnancy. Ultrasonogram done at the hospital had revealed a single live fetus of 28 weeks. But the pregnancy terminated in premature labour and still birth. Baby apparently did not have any skin lesion but was not available for examination or investigation.

  15. A Clinicopathological Study Of Pemphigus

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    Huda M.M

    2001-01-01

    Full Text Available A clinic pathological study was conducted on 50 patients of pemphigus of various types attending skin OPD. Assam Medical College in last two years. There were 20 males and 30 females. Pemphigus vulgaris, the commonest type was seen in 42 patients. Majority of the patients were from 31 to 50 years of age groups and belonged to lower socioeconomic status. Pemphigus vulgaris was the most severe variety and secondary bacterial infection was the commonest complication. Bacterial pathogen commonly involved was coagulase positive staphylococcus aureus. Oral mucosal involvement was noted in 39 patients. Cutaneous lesions were seen 4.5 months (average after initiation of oral lesions.

  16. Paraneoplastic brain stem encephalitis.

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    Blaes, Franz

    2013-04-01

    Paraneoplastic brain stem encephalitis can occur as an isolated clinical syndrome or, more often, may be part of a more widespread encephalitis. Different antineuronal autoantibodies, such as anti-Hu, anti-Ri, and anti-Ma2 can be associated with the syndrome, and the most frequent tumors are lung and testicular cancer. Anti-Hu-associated brain stem encephalitis does not normally respond to immunotherapy; the syndrome may stabilize under tumor treatment. Brain stem encephalitis with anti-Ma2 often improves after immunotherapy and/or tumor therapy, whereas only a minority of anti-Ri positive patients respond to immunosuppressants or tumor treatment. The Opsoclonus-myoclonus syndrome (OMS) in children, almost exclusively associated with neuroblastoma, shows a good response to steroids, ACTH, and rituximab, some patients do respond to intravenous immunoglobulins or cyclophosphamide. In adults, OMS is mainly associated with small cell lung cancer or gynecological tumors and only a small part of the patients show improvement after immunotherapy. Earlier diagnosis and treatment seem to be one major problem to improve the prognosis of both, paraneoplastic brain stem encephalitis, and OMS.

  17. Fulminante, rituximab-resistente, mucocutane pemphigus vulgaris

    NARCIS (Netherlands)

    Gostyński, A.; Ammatuna, E.; Huls, G.; Wouthuyzen-Bakker, M.; Jonkman, M. F.; Horváth, B.

    2017-01-01

    Pemphigus vulgaris is an autoimmune disease mediated by auto-antibodies against desmoglein 1 and 3. First line treatment for pemphigus consists of systemic corticosteroids and anti-CD20 therapy (rituximab) to eliminate B-cells. Since 2005, more than 100 patients with pemphigus have been treated with

  18. Cardiac Autoantibodies from Patients Affected by a New Variant of Endemic Pemphigus Foliaceus in Colombia, South America

    Science.gov (United States)

    Howard, Michael S.; Jiao, Zhe; Gao, Weiqing; Yi, Hong; Grossniklaus, Hans E.; Duque-Ramírez, Mauricio; Dudley, Samuel C.

    2012-01-01

    Several patients affected by a new variant of endemic pemphigus foliaceus in El Bagre, Colombia (El Bagre-EPF) have experienced a sudden death syndrome, including persons below the age of 50. El Bagre-EPF patients share several autoantigens with paraneoplastic pemphigus patients, such as reactivity to plakins. Further, paraneoplastic pemphigus patients have autoantibodies to the heart. Therefore, we tested 15 El Bagre-EPF patients and 15 controls from the endemic area for autoreactivity to heart tissue using direct and indirect immunofluorescence, confocal microscopy, immunohistochemistry, immunoblotting, and immunoelectron microscopy utilizing heart extracts as antigens. We found that 7 of 15 El Bagre patients exhibited a polyclonal immune response to several cell junctions of the heart, often colocalizing with known markers. These colocalizing markers included those for the area composita of the heart, such as anti-desmoplakins I and II; markers for gap junctions, such as connexin 43; markers for tight junctions, such as ezrin and junctional adhesion molecule A; and adherens junctions, such pan-cadherin. We also detected colocalization of the patient antibodies within blood vessels, Purkinje fibers, and cardiac sarcomeres. We conclude that El Bagre-EPF patients display autoreactivity to multiple cardiac epitopes, that this disease may resemble what is found in patients with rheumatic carditis, and further, that the cardiac pathophysiology of this disorder warrants further evaluation. PMID:21796504

  19. Diffusion pipes at PNP switching transistors

    International Nuclear Information System (INIS)

    Sachelarie, D.; Postolache, C.; Gaiseanu, F.

    1976-01-01

    The appearance of the ''diffusion pipes'' greatly affects the fabrication of the PNP high-frequency/very-fast-switching transistors. A brief review of the principal problems connected to the presence of these ''pipes'' is made. A research program is presented which permitted the fabrication of the PNP switching transistors at ICCE-Bucharest, with transition frequency fsub(T) = 1.2 GHz and storage time tsub(s) = 4.5 ns. (author)

  20. Prostate cancer may trigger paraneoplastic limbic encephalitis

    DEFF Research Database (Denmark)

    Jakobsen, Jakob Kristian; Zakharia, Elias Raja; Boysen, Anders Kindberg Fossø

    2013-01-01

    -Hu antibody test the patient was diagnosed with paraneoplastic limbic encephalitis related to prostate cancer. The patient died within 6 months. We review the literature on prostate cancer-related paraneoplastic limbic encephalitis. High-risk prostate cancer can trigger paraneoplastic limbic encephalitis...

  1. Pemphigus Vulgaris with Solitary Toxic Thyroid Nodule

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    Mostafa Alfishawy

    2014-01-01

    Full Text Available Background. Pemphigus vulgaris is an autoimmune vesiculobullous disease, affecting the skin and mucous membranes. It is reported to be associated with other autoimmune diseases including autoimmune thyroid diseases. However we report herein a case of pemphigus vulgaris associated with autonomous toxic nodule. Case Presentation. A 51-year-old woman was evaluated for blisters and erosions that develop on her trunk, face, and extremities, with a five-year history of progressively enlarging neck mass, and a past medical history of pemphigus vulgaris seven years ago. The condition was associated with palpitation, dyspnea, and heat intolerance. Thyroid function tests and thyroid scan were compatible with the diagnosis of thyrotoxicosis due to autonomous toxic nodule. Exacerbation of pemphigus vulgaris was proved by skin biopsy from the patient which revealed histologic picture of pemphigus vulgaris. Conclusion. Autoimmune thyroid diseases are reported to associate pemphigus vulgaris. To our knowledge, this case is the first in the English literature to report association between pemphigus vulgaris and autonomous toxic nodule and highlights the possibility of occurrence of pemphigus vulgaris with a nonautoimmune thyroid disease raising the question: is it just a coincidence or is there an explanation for the occurrence of both conditions together?

  2. Evaluation of pemphigus cases involving oral mucosa.

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    Karagöz, Gizem; Bektaş-Kayhan, Kivanç; Ünür, Meral

    2014-09-01

    Pemphigus, defines a group of disorders in autoimmune etiology which could be life-threatening and clinical manifestations are mainly epithelial blistering affecting cutaneous and/or mucosal surfaces including oral mucosa. The aim of our study is to evaluate the clinical appearance of pemphigus with oral involvement by reported 15 pemphigus cases. This retrospective study of 15 cases of pemphigus obtained over a period of 7 years from 2006 to 2013 in Istanbul University, Dentistry Faculty, Oral Medicine and Surgery Department was designed. Age distribution of pemphigus was from 15 to 59 years with an average age of 41.3 years. Of the 15 patients, the male:female ratio was 1:2.75 (4 male, 11 female). The most common clinical various of pemphigus was pemphigus vulgaris, diagnosed in all patients. The buccal mucosa (34.3%) was the most commonly affected site followed by tongue (20%), gingiva (17.1%), palate (11.4%), lips (11.4%) and floor of mouth (5.7%). Our explanation of this conclusion, while speculative, is that socioeconomic situation related stress in males and hormonal changes like pregnancy and menostasis in females; systemic disease and using drugs; dental trauma and bruxism could be responsible for flare up in the disease.

  3. Paraneoplastic jaundice and prostate cancer.

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    Vieira, Ana Claudia; Alvarenga, Maria Joana; Santos, Jose Carlos; Silva, Alberto Mello

    2017-04-22

    Cholestasis has numerous causes. We present the case of a 78-year-old man with a common diagnosis in this age group and gender but with an unusual presentation. There are only 11 articles published of patients with jaundice due to a paraneoplastic syndrome associated with prostate cancer. Interleukin 6 and other proinflammatory cytokines appear to contribute to the pathophysiology of this syndrome. Our patient remains symptom free 4 months after treatment initiation. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  4. Aspects epidemiologiques et cliniques des pemphigus au Senegal [Epidemiological and clinical aspects of pemphigus in Senegal

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    Moussa Diallo

    2017-11-01

    Full Text Available Background: The purpose of this study was to specify the epidemiological and clinical characteristics of pemphigus in the Department of Dermatology of the University Hospital of Dakar. Patients and Methodology: All medical records of patients seen for pemphigus in our department over a 11-year period were analyzed retrospectively. Results: We collected 105 cases of pemphigus, corresponding to a frequency of 10 cases/year and a hospital prevalence of 2.7%. Thus, pemphigus held the second rank of blistering autoimmune bullous diseases after bullous pemphigoid. The mean age of patients was 47.62 years and the age group [40-59 years] was predominantly affected (28 cases; 45 %. There were 41 femeles and 21 men (F/M ratio: 2. We did not find an endemic focus in our country. Clinical forms were dominated by pemphigus foliaceus (30 cases; 48.5 %, followed by pemphigus vulguaris (19 cases; 30.6 % and finally by pemphigus erythematosus (13 cases; 21%. In 16 cases (25 %, the pemphigus had begun after the consumption of a traditional medicinal plant (8 cases. An associated toxidermia was found in12 cases. Pruritus was present in 43 patients (69.35%. Discussion: In Senegal, pemphigus are common diseases, but without however an endemic focuc. They occur in young women, with a predominance of superficial forms, especially pemphigus foliaceus. The presence of pruritus and associated toxidermia to traditional medicinal plants are common. RÉSUMÉ Introduction: L’objectif de cette étude était de préciser les aspects épidémiologiques et cliniques des pemphigus au CHU de Dakar. Patients et Méthodes: Tous les dossiers des malades admis pour pemphigus ont été analysé de façon rétrospective sur une période de 11 ans. Résultats: Nous avons colligé 105 cas de pemphigus, correspondant à une fréquence de 10 cas/an et une prévalence hospitalière de 2,7 %. Les pemphigus occupaient le 2° rang des dermatoses bulleuses auto-immunes après la pemphigoide

  5. Pulse therapy in pemphigus: report of 11 cases

    OpenAIRE

    Fernandes, Nurimar Conceicao; Menezes, Mariana

    2013-01-01

    In this study, five cases of pemphigus vulgaris and two cases of pemphigus foliaceus were treated with cyclophosphamide pulse therapy associated with prednisone, resulting in the need for a smaller maintenance dose of prednisone. In three cases of pemphigus vulgaris and one case of pemphigus foliaceus, dexamethasone and cyclophosphamide pulse therapy associated with prednisone helped the lesions to heal more rapidly. Neither treatment however prevented the recurrence of the disease. Amenorrhe...

  6. Paraneoplastic Cushing Syndrome Due To Wilm's Tumor.

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    Faizan, Mahwish; Manzoor, Jaida; Saleem, Muhammad; Anwar, Saadia; Mehmood, Qaiser; Hameed, Ambreen; Ali, Agha Shabbir

    2017-05-01

    Paraneoplastic syndromes are rare disorders that are triggered by an altered immune system response to neoplasm. Paraneoplastic syndromes may be the first or the most prominent manifestations of cancer. Wilm's tumor is the most frequent pediatric renal malignancy and usually presents with abdominal mass. Unusual presentations like acquired von Willebrand disease, sudden death due to pulmonary embolism and Cushing syndrome have been described in the literature. Cushing syndrome, as the presenting symptom of a malignant renal tumor in children, is a very rare entity. Few case reports are available in the literature exploring the option of preoperative chemotherapy as well as upfront nephrectomy. We report a rare case of paraneoplastic Cushing syndrome due to a Wilm's tumor. Based on gradual decrease of postoperative weight, blood pressure, serum adrenocorticotropic hormone, and plasma cortisol levels, along with histological confirmation of Wilm's tumor, paraneoplastic Cushing syndrome due to Wilm's tumor was confirmed.

  7. Paraneoplastic cushing syndrome due to wilm's tumor

    International Nuclear Information System (INIS)

    Faizan, M.; Anwar, S.; Hameed, A.; Manzoor, J.; Saleem, M.; Mehmood, Q.; Ali, A. S.

    2017-01-01

    Paraneoplastic syndromes are rare disorders that are triggered by an altered immune system response to neoplasm. Paraneoplastic syndromes may be the first or the most prominent manifestations of cancer. Wilm's tumor is the most frequent pediatric renal malignancy and usually presents with abdominal mass. Unusual presentations like acquired von Willebrand disease, sudden death due to pulmonary embolism and Cushing syndrome have been described in the literature. Cushing syndrome, as the presenting symptom of a malignant renal tumor in children, is a very rare entity. Few case reports are available in the literature exploring the option of preoperative chemotherapy as well as upfront nephrectomy. We report a rare case of paraneoplastic Cushing syndrome due to a Wilm's tumor. Based on gradual decrease of postoperative weight, blood pressure, serum adrenocorticotropic hormone, and plasma cortisol levels, alongwith histological confirmation of Wilm's tumor, paraneoplastic Cushing syndrome due to Wilm's tumor was confirmed. (author)

  8. Multiplex serology of paraneoplastic antineuronal antibodies

    NARCIS (Netherlands)

    P. Maat (Peter); E. Brouwer (Eric); E. Hulsenboom (Esther); M.M. van Duijn (Martijn); M.W.J. Schreurs (Marco); H. Hooijkaas (Herbert); P.A. Smitt (Peter)

    2013-01-01

    textabstractParaneoplastic neurological syndromes (PNS) are devastating neurological disorders secondary to cancer, associated with onconeural autoantibodies. Such antibodies are directed against neuronal antigens aberrantly expressed by the tumor. The detection of onconeural antibodies in a patient

  9. Prototype plant for nuclear process heat (PNP)

    International Nuclear Information System (INIS)

    Duerrfeld, R.; Kraut-Giesen, G.

    1982-01-01

    1. Goals: Verification of owner's interests during experimental and engineering phase of nuclear coal gasification. 2. Method: 2.1 Witnessing and evaluating of experimental results from running test facilities. 2.2 Influencing experimental program. 2.3 Participation in important meetings of PNP-project. 3. Results: From present point of view the realization of nuclear coal gasification with a nuclear high temperature reactor (HTR) in accordance with the present technical status as well as meeting the existing safety regulations seems to be feasable. R+D-work will be needed for affirmation of design. The gasification of hard coal basing on the allothermal principal has proved to be possible. The examination of the gasifier on a pilot scale is not yet done. The design work for the pilot plant should be started immediately, particularly keeping in mind the decision for erection of PNP in 1990. The calculation of production costs in comparison to autothermal gasification processes is promising better economics, if uncertainties of investment calculation are deemed to be neglectable. (orig.) [de

  10. Paraneoplastic digital necrosis associated with rectum carcinoma

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    Ali Alkan

    2015-12-01

    Full Text Available Paraneoplastic vascular pathologies are rare in daily practice. There is limited data about this phenomenon. Patient with a diagnosis of metastatic rectum carcinoma presented with digital necrosis. The work up for vascular and rheumatological pathology was inconclusive. Lesions progressively improved with steroid therapy. Paraneoplastic vascular lesions are rare in oncology practice. Our case points out important parts of a rare clinical entity. J Clin Exp Invest 2015; 6 (4: 391-392

  11. [Autoantibodies in Paraneoplastic Neurological Syndrome].

    Science.gov (United States)

    Kawachi, Izumi

    2018-04-01

    Paraneoplastic neurological syndromes (PNS) are caused by immune responses against neuronal antigens expressed by the tumor. Based on the immunological pathomechanisms and responsiveness of treatments, onconeuronal antibodies are divided into two categories: 1) antibodies against neural intracellular antigens and 2) antibodies against neuronal surface or synaptic antigens. The recent discovery of onconeuronal antibodies have radically changed concepts of CNS autoimmunity, including PNS. The recognition of PNS provides a foundation for the early detection of underlying tumors and initiations of prompt treatments, which can result in substantial improvement. We here review the characteristic onconeuronal antibodies, including anti-Hu, anti-Ma2, and anti-N-methyl-D-aspartate receptor, and discuss the algorithm for the diagnosis of PNS.

  12. Pemphigus : A clinical study of 109 cases from Tripoli, Libya

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    Shafi M

    1994-01-01

    Full Text Available From 1981 to 1992, 109 cases (90 females and 19 males of pemphigus were seen in the Department of Dermatology, Central Hospital Tripoli, Libya. Age of onset of the disease varied from 17 to 85 years, while duration of the disease at the time of presentation varied from 3 days to 13 days. On the basis of clinical features and routine histological findings the cases were divided into various subtypes as : pemphigus foliaceus 65 cases, pemphigus vulgaris 34 patients, pemphigus erythematosus 5, herpetiform pemphigus 3 and vegetans type 2 cases. Three of our patients had diabetes mellitus preceding pemphigus, while 12 patients developed steroid induced diabetes. Significant secondary bacterial infection occurred in all cases at some stage of the disease while oral candidiasis occurred in 15 cases. Eczema herpeticum was seen in 4 patients, while 2 had extensive tinea corporis. One of 4 patients of pemphigus vulgaris had complete shedding of nail and 1 female patient had alternate phases of pemphigus foliaceus and generalized pustular psoriasis. The features in our cases of pemphigus foliaceus were somewhat similar to Brazilian pemphigus foliaceus and we had more cases of pemphigus foliaceus, almost exclusively affecting females.

  13. Radiation-induced pemphigus vulgaris of the breast; Pemphigus vulgaire radio-induit du sein

    Energy Technology Data Exchange (ETDEWEB)

    Vigna-Taglianti, R.; Russi, E.G. [Department of radiotherapy, Santa Croce e Carle general hospital, Via M. Coppino, 12100 Cuneo (Italy); Denaro, N. [Oncology department, university of Messina, Via consolare Valeria no 1, 98100 Messina (Italy); Numico, G. [Department of medical oncology, U. Parini hospital, 11100 Aosta (Italy); Brizio, R. [Department of histopathology, Santa Croce e Carle general hospital, Via M. Coppino, 12100 Cuneo (Italy)

    2011-07-15

    Pemphigus vulgaris is a rare autoimmune muco-cutaneous bullous disease. Patients with a history of pemphigus vulgaris - who need radiotherapy - may show a long lasting bullous cutaneous manifestation, typical of pemphigus, within radiation fields. The literature describes fewer than 20 radio-induced cases. While systematic corticosteroid therapy has proven to be useful, topical treatment used in association with corticosteroid therapy is rarely described. To our knowledge the use of modern dressing products has never been described. We report our experience in a case in which modern dressing products were usefully associated to systemic therapy. (authors)

  14. Paraneoplastic syndromes and autoimmune encephalitis

    Science.gov (United States)

    Rosenfeld, Myrna R.; Titulaer, Maarten J.

    2012-01-01

    Summary We review novel findings in paraneoplastic syndromes including the Lambert-Eaton myasthenic syndrome, and then focus on the novel disorders associated with antibodies against cell surface antigens, discussing the importance and caveats of antibody testing, and providing an algorithm for interpretation of results. In anti-NMDAR encephalitis 2 novel findings include the recognition of a characteristic EEG pattern (“extreme delta brush”) in 30% of patients and the demonstration of a fronto-temporo-occipital gradient of glucose metabolism that correlates with disease activity. In limbic encephalitis, antibodies to GABA(B) receptor are the most frequently detected in patients with small-cell lung cancer who are anti-Hu negative, and antibodies to mGluR5 distinctively associate with Hodgkin lymphoma (Ophelia syndrome). We also address the syndromes associated with “VGKC-complex antibodies,” a problematic term that groups well-characterized immune-mediated disorders (LGI1, Caspr2) with others that lack syndrome specificity, are less responsive to treatment, and for which the target antigens are unknown. PMID:23634368

  15. A clinico-pathological study of 70 cases of pemphigus

    Directory of Open Access Journals (Sweden)

    Arya S

    1999-01-01

    Full Text Available A clinicopalhological study of 70 cases of pemphigus observed over a span of four and a half years from January 1992 to June 1996 at the Sir J.J. Group of Hospitals and Grant Medical College, Mumbai is reported. Pemphigus vulgaris constituted the single largest group of 43 cases, followed by pemphigus foliaceus (25 cases and pemphigus vegetans (2 cases. Majority of the cases were seen in the age group of 21-60 years, with a slight male predominance. The youngest patient was 14 years while the eldest was aged 75 years. Mucosal involvement was seen in 31 cases of pemphigus vulgaris, as opposed to only 5 cases of pemphigus foliaceus. Flaccid bullae were present in 100% cases. Pruritus was complained of in 14 cases, though it was more common in pemphigus vegetans and vulgaris. Salient histopathological features of pemphigus vulgaris observed were (I intraepidermal suprabasal blisters (35 cases, (2 presence of acantholytic cells (40 cases, (3 "Row of tombstone appearance" (I8 cases and (4 acantholysis involving follicular sheath (20 cases. Main histopathological features of pemphigus foliaceus were (1 subcorneal blister (15 case, (2 acantholysis (24 cases and (3 bulla cavity containing inflammatory infiltrate (12 cases. Both cases of pemphigus vegetans showed hyperkeratosis, papillomatosis and irregular acanthosis with intra-epidermal eosinophilic abscesses besides suprabasal lacunae.

  16. Paraneoplastic Ischemic Stroke: Case Report and Review

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    Murat Sumer

    2008-10-01

    Full Text Available OBJECTIVE: Paraneoplastic etiology is not frequent among cerebrovascular disorders. This rare disorder is interesting with different mechanisms, clinical manifestations and treatment options. Diagnosis may be overlooked for its rarity. We present a paraneoplastic ischemic stroke patient with its clinical and imaging characteristics for recalling this rare disease. CASE: A sixty years old woman with a history of ovarian and colon cancer and liver metastasis admitted with acute left sided hemiplegia. Brain magnetic resonance imaging showed multiple ischemic lesions at the same age. Laboratory findings were compatible with chronic disseminated intravascular coagulopathy. She was anticoagulated but the clinical findings were not changed. She died one month after her discharge from the hospital. CONCLUSIONS: Paraneoplastic ischemic stroke is rare and it should be recognized by the clinician to differentiate from other ischemic strokes by its different mechanisms, imaging characteristics and treatment modalities. Prognosis depends on the characteristics of the primary tumor

  17. Evaluation of cases of pemphigus vulgaris and pemphigus foliaceus from a reference service in Pará state, Brazil.

    Science.gov (United States)

    Pires, Carla Andréa Avelar; Viana, Viviane Brito; Araújo, Fernando Costa; Müller, Silvia Ferreira Rodrigues; Oliveira, Miguel Saraty de; Carneiro, Francisca Regina Oliveira

    2014-01-01

    Pemphigusis a bullous, rare and chronic autoimmune disease. There are two major forms of pemphigus: vulgaris and foliaceus. Epidemiological data and clinical outcome in patients diagnosed in the Brazilian Amazon states are still rare. To study the occurrence of the disease during the study period and analyze the epidemiological profile of patients, the most common subtype of pemphigus, and the clinical evolution of patients. Retrospective analysis of medical records of hospitalized patients with pemphigus foliaceus and pemphigus vulgaris in the period from 2003 to 2010 in Dermatology Service of Hospital Fundação Santa Casa de Misericórdia do Pará, Belém, Northern Brazil. We found a total of 20 cases of pemphigus during the study period, 8 of which were of foliaceus pemphigus and 12 of vulgaris pemphigus. Pemphigus foliaceus had the predominance of male patients (75%), showed satisfactory clinical evolution, and was characterized by absence of pediatric cases. Pemphigus vulgaris affected more women (66.7%), showed mean hospital stay of 1 to 3 months (50%), and there were three cases of death (25%). The prescribed immunosuppressive drugs included prednisone with or without combination of azathioprine and/or dapsone. Sepsis was associated with 100% of the deaths. The occurrence of the disease is rare, there are no familiar/endemic outbreaks in the sample. Evolution is usually favorable, but secondary infection is associated with worse prognosis. The choice of best drugs to treat pemphigus remains controversial.

  18. Childhood pemphigus foliaceus. Report of a case.

    Science.gov (United States)

    Sotiriou, L; Herszenson, S; Jordon, R E

    1980-06-01

    A case is reported of a 4-year-old black boy with pemphigus foliaceus. The patient is unusual because of age, sex, race, and distribution of lesions, Confirmation of diagnosis was made by both routine histopathology and direct immunofluorescence microscopy. The patient responded rapidly to prednisone therapy.

  19. [Curative effect of ozone hydrotherapy for pemphigus].

    Science.gov (United States)

    Jiang, Fuqiong; Deng, Danqi; Li, Xiaolan; Wang, Wenfang; Xie, Hong; Wu, Yongzhuo; Luan, Chunyan; Yang, Binbin

    2018-02-28

    To determine clinical curative effects of ozone therapy for pemphigus vulgaris.
 Methods: Ozone hydrotherapy was used as an aid treatment for 32 patients with pemphigus vulgaris. The hydropathic compression of potassium permanganate solution for 34 patients with pemphigus vulgaris served as a control. The main treatment for both groups were glucocorticoids and immune inhibitors. The lesions of patients, bacterial infection, usage of antibiotics, patient's satisfaction, and clinical curative effect were evaluated in the 2 groups.
 Results: There was no significant difference in the curative effect and the average length of staying at hospital between the 2 groups (P>0.05). But rate for the usage of antibiotics was significantly reduced in the group of ozone hydrotherapy (P=0.039). The patients were more satisfied in using ozone hydrotherapy than the potassium permanganate solution after 7-day therapy (P>0.05).
 Conclusion: Ozone hydrotherapy is a safe and effective aid method for pemphigus vulgaris. It can reduce the usage of antibiotics.

  20. Imaging of limbic para-neoplastic encephalitis

    International Nuclear Information System (INIS)

    Rimmelin, A.; Sellat, F.; Morand, G.; Quoix, E.; Clouet, P.L.; Dietemann, J.L.

    1997-01-01

    Para-neoplastic limbic encephalitis is a rare syndrome mostly associated with small cell lung cancer. We present the case of a 69-year-old man with selective amnesia suggesting limbic encephalitis. A neuroendocrine cell lung cancer was found, confirming the diagnostics of para-neoplastic limbic encephalitis. Contrast-enhanced cerebral CT was normal whether magnetic resonance imaging showed signal abnormalities of the medial part of temporal lobes and hippocampal regions. Because neurologic improvement may follow treatment of the primary tumor, early diagnosis is important. (authors)

  1. Structural bioinformatics study of PNP from Schistosoma mansoni

    International Nuclear Information System (INIS)

    Silveira, Nelson Jose Freitas da; Uchoa, Hugo Brandao; Canduri, Fernanda; Pereira, Jose Henrique; Camera, Joao Carlos; Basso, Luiz Augusto; Palma, Mario Sergio; Santos, Diogenes Santiago; Filgueira de Azevedo, Walter

    2004-01-01

    The parasite Schistosoma mansoni lacks the de novo pathway for purine biosynthesis and depends on salvage pathways for its purine requirements. Schistosomiasis is endemic in 76 countries and territories and amongst the parasitic diseases ranks second after malaria in terms of social and economic impact and public health importance. The PNP is an attractive target for drug design and it has been submitted to extensive structure-based design. The atomic coordinates of the complex of human PNP with inosine were used as template for starting the modeling of PNP from S. mansoni complexed with inosine. Here we describe the model for the complex SmPNP-inosine and correlate the structure with differences in the affinity for inosine presented by human and S. mansoni PNPs

  2. Pnp gene modification for improved xylose utilization in Zymomonas

    Science.gov (United States)

    Caimi, Perry G G; Qi, Min; Tao, Luan; Viitanen, Paul V; Yang, Jianjun

    2014-12-16

    The endogenous pnp gene encoding polynucleotide phosphorylase in the Zymomonas genome was identified as a target for modification to provide improved xylose utilizing cells for ethanol production. The cells are in addition genetically modified to have increased expression of ribose-5-phosphate isomerase (RPI) activity, as compared to cells without this genetic modification, and are not limited in xylose isomerase activity in the absence of the pnp modification.

  3. Trauma-induced pemphigus: a case series of 36 patients.

    Science.gov (United States)

    Daneshpazhooh, Maryam; Fatehnejad, Mina; Rahbar, Ziba; Balighi, Kamran; Ghandi, Narges; Ghiasi, Maryam; Abedini, Robabeh; Lajevardi, Vahideh; Chams-Davatchi, Cheyda

    2016-02-01

    Pemphigus is a group of autoimmune diseases characterized by intraepidermal acantholytic blisters. Isomorphic responses, or Koebner phenomenon (KP), defined as the appearance of typical lesions of a disease following trauma are rarely reported in pemphigus. Our aim was to present patients who developed new pemphigus lesions as a result of skin trauma. The medical files of pemphigus patients from the Autoimmune Bullous Diseases Research Center, who had a history of trauma before the onset or flare of their disease, between 1999 and 2013 were reviewed. Thirty-six pemphigus vulgaris (PV) patients had a history of trauma. Thirteen patients developed new-onset PV and the other 23 had previously been diagnosed with PV. Pemphigus lesions developed most often following major surgeries including abdominal, orthopedic, and chest surgeries as well as dental procedures, blunt physical trauma, and skin surgeries. Moreover, post-cataract laser surgery, burns, radiation therapy, and physiotherapy were also shown to induce pemphigus. Mean time between trauma and lesions was 4.7 weeks for recurrent PV and 15.0 weeks for new-onset PV. Unnecessary surgery and blunt trauma should be avoided in pemphigus patients. Furthermore, posttraumatic pemphigus should be suspected in poorly healing surgical wounds and confirmatory biopsies are mandatory. © 2016 Deutsche Dermatologische Gesellschaft (DDG). Published by John Wiley & Sons Ltd.

  4. Paraneoplastic Antibodies : Molecular and clinical studies

    NARCIS (Netherlands)

    P. Maat (Peter)

    2016-01-01

    markdownabstractParaneoplastic neurological syndromes (PNS) are remote effects of cancer. These are not caused by invasion of the tumor or its metastasis nor by other direct effects of the tumor or its treatment. PNS are rare, affecting less than 0.1% of all cancer patients. PNS have a subacute

  5. Pemphigus erythematosus relapse associated with atorvastatin intake

    Directory of Open Access Journals (Sweden)

    Lo Schiavo A

    2014-09-01

    Full Text Available Ada Lo Schiavo,1 Rosa Valentina Puca,1 Francesca Romano,1 Roberto Cozzi2 1Department of Dermatology, Second University of Naples, Naples, Italy; 2Department of Dermatology, AORN "A Cardarelli", Naples, Italy Abstract: Statins, also known as 3-hydroxy-3-methylglutaril-CoA reductase inhibitors, are well-tolerated drugs used for prevention of atherosclerosis and cardiovascular events. Although they are generally considered safe, some serious adverse effects, such as myositis, myopathy, and rhabdomyolysis can rarely occur. Furthermore, recent data from long-term follow-up on patients who have been taking statins for a long period of time suggest that prolonged exposure to statins may trigger autoimmune reactions. The exact mechanism of statin-induced autoimmune reactions is unclear. Statins, as proapoptotic agents, release nuclear antigen into the circulation and may induce the production of pathogenic autoantibodies. Herein we report the case of a 70 year-old man who developed a relapse of pemphigus erythematosus, a syndrome with features of both lupus erythematosus and pemphigus, after atorvastatin intake. Keywords: pemphigus erythematosus, autoimmune disease, treatment, pathogenesis, statins

  6. Paraneoplastic disorders of hair, nails, oral mucosa and pigmentation

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    Ayşe Kavak

    2013-12-01

    Full Text Available In this section, paraneoplastic entites of hair, nail, oral mucosa and pigmentation changes have been discussed. Some skin findings are “strong” indicator of a malignancy whereas others are not. Readers will encounter some “coincidental” or “common” entities as well as more “severe” changes for a paraneoplastic sign. In addition, it is crucial that some paraneoplastic lesions may predict for a recurrence of malignancy.

  7. Radiation effect of gate controlled lateral PNP BJTs

    International Nuclear Information System (INIS)

    Xi Shanbin; Zhou Dong; Lu Wu; Ren Diyuan; Wen Lin; Sun Jing; Wang Zhikuan

    2012-01-01

    Design and fabricate a new test structure of bipolar device: the gate controlled later PNP bipolar transistor (GCLPNP BJT), then sealed it together with the normal lateral PNP bipolar transistor which is made under the same manufacture process. Then 60 Co-γ radiation effects and annealing behaviors of these two structures are investigated. The results show that the response about base current, collector current, access base current and normalized current gain of GCLPNP bipolar transistor are almost identical to the normal one. Radiation induced defects in the GCLPNP bipolar transistor is separated quantitatively. Studying on the quantitative change of radiation induced defects in the domestic gate controlled bipolar transistor should be a useful way to research the change of radiation induced charges of normal PNP bipolar transistor. (authors)

  8. Limbic Encephalitis Driven by a Pleural Mesothelioma: A Paraneoplastic Complication

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    Jacob O. Day

    2016-10-01

    Full Text Available Paraneoplastic neurological syndromes have only been described with pleural mesothelioma in five cases. We have described a 72-year-old man who developed anterograde amnesia 27 months after diagnosis of epithelioid pleural mesothelioma. Investigations revealed a limbic encephalitis with no alternative causes identified. Limbic encephalitis is a classical paraneoplastic syndrome and presentation within five years of a cancer with no other causes identified is sufficient to diagnose a paraneoplastic etiology. This is the first case of isolated paraneoplastic limbic encephalitis driven by a pleural mesothelioma.

  9. [Pemphigus and herpes: Multicentre survey and literature review].

    Science.gov (United States)

    Merlant, M; Seta, V; Bernard, P; Fourati, S; Meritet, J-F; Wolkenstein, P; Dupin, N; Joly, P; Chosidow, O; Ingen-Housz-Oro, S

    2018-06-01

    Although herpes superinfection is a well-known complication of pemphigus, it has not been widely investigated. To investigate the frequency and features of herpes infection in patients with ongoing pemphigus. We carried out a multicenter retrospective study between 2008 and 2016 in patients with newly diagnosed pemphigus presenting active herpes infection. Clinical, virological, immunological and therapeutic data were collated. We performed a literature review for pemphigus and herpes. Among the 191 pemphigus patients, screening for herpes (PCR or culture) was carried out in 11 to 71 % of subjects, depending on the center in question. Twenty-four patients (12 women, mean age 58 years) presented at least one episode of herpes infection. The frequency of positivity ranged from 0 to 42 % by center. Twenty-one cases consisted of pemphigus vulgaris and infection occurred at a mucosal site in 19 patients. Herpes infection was identified at the time of diagnosis in 15 patients and 17 patients received no specific treatment for their pemphigus. The virus was identified using PCR in 23 cases. Ten patients subsequently received prophylactic treatment for herpes. The mean duration of follow-up was 36 months (0-89 months). Thirteen of the 24 patients had 23 relapses of pemphigus; PCR testing for herpes was performed 19 times and was positive in 6 cases (31.5 %). Our study showed wide variation in the incidence of herpes superinfection in patients with pemphigus, reflecting the different screening approach at each center (being performed either routinely or only in the event of strong suspicion). The prognostic value of routine screening for herpes in patients with active pemphigus lesions remains to be demonstrated by further prospective investigations. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

  10. Movement disorders in paraneoplastic and autoimmune disease

    Science.gov (United States)

    Panzer, Jessica; Dalmau, Josep

    2013-01-01

    Purpose of review The most relevant advances in immune-mediated movement disorders are described, with emphasis on the clinical–immunological associations, novel antigens, and treatment. Recent findings Many movement disorders previously considered idiopathic or degenerative are now recognized as immune-mediated. Some disorders are paraneoplastic, such as anti-CRMP5-associated chorea, anti-Ma2 hypokinesis and rigidity, anti-Yo cerebellar ataxia and tremor, and anti-Hu ataxia and pesudoathetosis. Other disorders such as Sydenham's chorea, or chorea related to systemic lupus erythematosus and antiphospholipid syndrome occur in association with multiple antibodies, are not paraneoplastic, and are triggered by molecular mimicry or unknown mechanisms. Recent studies have revealed a new category of disorders that can be paraneoplastic or not, and associate with antibodies against cell-surface or synaptic proteins. They include anti-N-methyl-d-aspartate receptor (anti-NMDAR) encephalitis, which may cause dyskinesias, chorea, ballismus or dystonia (NMDAR antibodies), the spectrum of Stiff-person syndrome/muscle rigidity (glutamic acid decarboxylase, amphiphysin, GABAA-receptor-associated protein, or glycine receptor antibodies), neuromyotonia (Caspr2 antibodies), and opsoclonus–myoclonus–ataxia (unknown antigens). Summary Neurologists should be aware that many movement disorders are immune-mediated. Recognition of these disorders is important because it may lead to the diagnosis of an occult cancer, and a substantial number of patients, mainly those with antibodies to cell-surface or synaptic proteins, respond to immunotherapy. PMID:21577108

  11. Efficient Fludarabine-Activating PNP From Archaea as a Guidance for Redesign the Active Site of E. Coli PNP.

    Science.gov (United States)

    Cacciapuoti, Giovanna; Bagarolo, Maria Libera; Martino, Elisa; Scafuri, Bernardina; Marabotti, Anna; Porcelli, Marina

    2016-05-01

    The combination of the gene of purine nucleoside phosphorylase (PNP) from Escherichia coli and fludarabine represents one of the most promising systems in the gene therapy of solid tumors. The use of fludarabine in gene therapy is limited by the lack of an enzyme that is able to efficiently activate this prodrug which, consequently, has to be administered in high doses that cause serious side effects. In an attempt to identify enzymes with a better catalytic efficiency than E. coli PNP towards fludarabine to be used as a guidance on how to improve the activity of the bacterial enzyme, we have selected 5'-deoxy-5'-methylthioadenosine phosphorylase (SsMTAP) and 5'-deoxy-5'-methylthioadenosine phosphorylase II (SsMTAPII), two PNPs isolated from the hyperthermophilic archaeon Sulfolobus solfataricus. Substrate specificity and catalytic efficiency of SsMTAP and SsMTAPII for fludarabine were analyzed by kinetic studies and compared with E. coli PNP. SsMTAP and SsMTAPII share with E. coli PNP a comparable low affinity for the arabinonucleoside but are better catalysts of fludarabine cleavage with k(cat)/K(m) values that are 12.8-fold and 6-fold higher, respectively, than those reported for the bacterial enzyme. A computational analysis of the interactions of fludarabine in the active sites of E. coli PNP, SsMTAP, and SsMTAPII allowed to identify the crucial residues involved in the binding with this substrate, and provided structural information to improve the catalytic efficiency of E. coli PNP by enzyme redesign. © 2015 Wiley Periodicals, Inc.

  12. Proteomic definition of a desmoglein linear determinant common to Pemphigus vulgaris and Pemphigus foliaceous

    Directory of Open Access Journals (Sweden)

    Sinha Animesh A

    2006-08-01

    Full Text Available Abstract Background A number of autoimmune diseases have been clinically and pathologically characterized. In contrast, target antigens have been identified only in a few cases and, in these few cases, the knowledge of the exact epitopic antigenic sequence is still lacking. Thus the major objective of current work in the autoimmunity field is the identification of the epitopic sequences that are related to autoimmune reactions. Our labs propose that autoantigen peptide epitopes able to evoke humoral (autoimmune response are defined by the sequence similarity to the host proteome. The underlying scientific rationale is that antigen peptides acquire immunoreactivity in the context of their proteomic similarity level. Sequences uniquely owned by a protein will have high potential to evoke an immune reaction, whereas motifs with high proteomic redundancy should be immunogenically silenced by the tolerance phenomenon. The relationship between sequence redundancy and peptide immunoreactivity has been successfully validated in a number of experimental models. Here the hypothesis has been applied to pemphigus diseases and the corresponding desmoglein autoantigens. Methods Desmoglein 3 sequence similarity analysis to the human proteome followed by dot-blot/NMR immunoassays were carried out to identify and validate possible epitopic sequences. Results Computational analysis led to identifying a linear immunodominant desmoglein-3 epitope highly reactive with the sera from Pemphigus vulgaris as well as Pemphigus foliaceous. The epitopic peptide corresponded to the amino acid REWVKFAKPCRE sequence, was located in the extreme N-terminal region (residues 49 to 60, and had low redundancy to the human proteome. Sequence alignment showed that human desmoglein 1 and 3 share the REW-KFAK–RE sequence as a common motif with 75% residue identity. Conclusion This study 1 validates sequence redundancy to autoproteome as a main factor in shaping desmoglein peptide

  13. Pênfigo vegetante: relato de caso Pemphigus vegetans: case report

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    Juvenal da Rocha Torres Neto

    2010-06-01

    Full Text Available Pênfigo é uma doença bolhosa auto-imune. É uma doença rara, mas potencialmente fatal. Existem quatro variantes clínicas e patológicas: o pênfigo vulgar (PV, o pênfigo vegetante (PVg, o pênfigo foliáceo (PF, o pênfigo eritematoso. Ao exame histo-patológico o achado comum a todos os tipos de pênfigo é a acantólise. Relatamos o caso de um paciente de 43 anos com lesões ano-perineais cujo diagnóstico final foi de pênfigo vegetante, associado à HPV (Papiloma Vírus Humano, com revisão da literatura.Pemphigus is a bollous auto-immune disease. It's a rare disease, but potentially fatal. There are four clinical and pathological variants: pemphigus vulgaris, pemphigus vegetans, pemphigus foliaceus and pemphigus erythematosus. Through the histopathological exam, the common characteristic to all types of pemphigus is the acantholyse. It's reported a case of a pacient of 43 years old with anal and perineal blesses witch final diagnosis was pemphigus vegetans, associated to HPV (Human Papilloma Virus, with literature review.

  14. Electrocatalytic Azide Oxidation Mediated by a Rh(PNP) Pincer Complex

    NARCIS (Netherlands)

    Rebreyend, Christophe; Gloaguen, Yann; Lutz, Martin; Van Der Vlugt, Jarl Ivar; Siewert, Inke; Schneider, Sven; Bruin, Bas De

    2017-01-01

    One-electron oxidation of the rhodium(I) azido complex [Rh(N3)(PNP)] (5), bearing the neutral, pyridine-based PNP ligand 2,6-bis(di-tert-butylphosphinomethyl)pyridine, leads to instantaneous and selective formation of the mononuclear rhodium(I) dinitrogen complex [Rh(N2)(PNP)]+ (9+). Interestingly,

  15. Electrocatalytic Azide Oxidation Mediated by a Rh(PNP) Pincer Complex

    NARCIS (Netherlands)

    Rebreyend, C.; Gloaguen, Y.; Lutz, M.; van der Vlugt, J.I.; Siewert, I.; Schneider, S.; de Bruin, B.

    2017-01-01

    One-electron oxidation of the rhodium(I) azido complex [Rh(N3)(PNP)] ( 5 ), bearing the neutral, pyridine-based PNP ligand 2,6-bis(di-tert-butylphosphinomethyl)pyridine, leads to instantaneous and selective formation of the mononuclear rhodium(I) dinitrogen complex [Rh(N2)(PNP)]+ ( 9 +).

  16. Vascular cognitive impairment in Pemphigus vulgaris: a case report

    Directory of Open Access Journals (Sweden)

    José Ibiapina Siqueira- Neto

    Full Text Available ABSTRACT Pemphigus vulgaris is a systemic auto-immune medical condition that mainly manifests with changes in skin and vasculopathy. This is a case report of a 69-year-old male with confirmed histopathologic diagnosis of Pemphigus vulgaris presenting ulterior Cognitive Impairment, mostly in executive function. The patient was treated using steroids, immunomodulatory therapy, fluoxetine and galantamine. Neuropsychological testing and magnetic resonance (MRI were performed. This is the first report of correlational cognitive impairment with Pemphigus vulgaris in the literature. Physicians should be aware of vascular causes for cognitive impairment in patients presenting auto-immune conditions.

  17. Pemphigus and smoking- insights from a big data analysis.

    Science.gov (United States)

    Kridin, Khalaf; Comaneshter, Doron; Batat, Erez; Cohen, Arnon D

    2018-04-28

    We have read with great interest the manuscript written by Lai et al.(1). The authors performed a systematic review and pooled-analysis aiming to summarize the current knowledge regarding the prevalence of smoking among patients with pemphigus relative to control subjects. By summarizing the findings of 13 observational studies comprising 3046 pemphigus patients, a pooled OR of 0.9 (95% CI, 0.82-0.99; Peffect against the development of pemphigus(1). This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  18. Monopathogenic vs multipathogenic explanations of pemphigus pathophysiology

    DEFF Research Database (Denmark)

    Ahmed, A Razzaque; Carrozzo, Marco; Caux, Frédéric

    2016-01-01

    This viewpoint highlights major, partly controversial concepts about the pathogenesis of pemphigus. The monopathogenic theory explains intra-epidermal blistering through the "desmoglein (Dsg) compensation" hypothesis, according to which an antibody-dependent disabling of Dsg 1- and/or Dsg 3...... mechanisms regulating and/or mediating intercellular adhesion of KCs is necessary to disrupt epidermal integrity. The major premise for a multipathogenic theory is that a single type of autoantibody induces only reversible changes, so that affected KCs can recover due to a self-repair. The damage, however...

  19. Renal paraneoplastic vasculitis complicating lung adenocarcinoma

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    Besma Ben Dhaou

    2014-01-01

    Full Text Available Renal paraneoplastic vasculitis (RNPV is rare. It can be revealed by glomerulonephritis, microaneurysms or renal failure. RPNV may precede the onset of the primary tumor, and treatment and prognosis depend on the etiology (primary tumor. A 54-year-old man who had a primary lung adenocarcinoma was admitted for nephrotic syndrome. The investigations revealed RNPV. The patient was treated with corticosteroids at high dose and cyclophosphamide with improvement of the renal condition; however, the patient died from worsening of his pulmonary neoplasia.

  20. A Case of Paraneoplastic Demyelinating Motor Polyneuropathy

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    Sohrab Mostoufizadeh

    2012-04-01

    Full Text Available Peripheral neuropathy is commonly accompanied by cancer but demyelinating ones are not commonly reported. We report the clinical, neurophysiological, and biological characteristics of an 82-year-old patient who presented with a demyelinating motor neuropathy and high titre of anti-ganglioside antibodies associated with oesophageal cancer. The neurological course worsened rapidly despite immunotherapy, leading to a bedridden status. We propose to suspect a paraneoplastic origin in older patients or when the clinical course progresses rapidly within a few weeks or months.

  1. Immune response in pemphigus and beyond: progresses and emerging concepts.

    Science.gov (United States)

    Di Zenzo, Giovanni; Amber, Kyle T; Sayar, Beyza S; Müller, Eliane J; Borradori, Luca

    2016-01-01

    Pemphigus vulgaris (PV) and pemphigus foliaceus (PF) are two severe autoimmune bullous diseases of the mucosae and/or skin associated with autoantibodies directed against desmoglein (Dsg) 3 and/or Dsg1. These two desmosomal cadherins, typifying stratified epithelia, are components of cell adhesion complexes called desmosomes and represent extra-desmosomal adhesion receptors. We herein review the advances in our understanding of the immune response underlying pemphigus, including human leucocyte antigen (HLA) class II-associated genetic susceptibility, characteristics of pathogenic anti-Dsg antibodies, antigenic mapping studies as well as findings about Dsg-specific B and T cells. The pathogenicity of anti-Dsg autoantibodies has been convincingly demonstrated. Disease activity and clinical phenotype correlate with anti-Dsg antibody titers and profile while passive transfer of anti-Dsg IgG from pemphigus patients' results in pemphigus-like lesions in neonatal and adult mice. Finally, adoptive transfer of splenocytes from Dsg3-knockout mice immunized with murine Dsg3 into immunodeficient mice phenotypically recapitulates PV. Although the exact pathogenic mechanisms leading to blister formation have not been fully elucidated, intracellular signaling following antibody binding has been found to be necessary for inducing cell-cell dissociation, at least for PV. These new insights not only highlight the key role of Dsgs in maintenance of tissue homeostasis but are expected to progressively change pemphigus management, paving the way for novel targeted immunologic and pharmacologic therapies.

  2. Pemphigus Vulgaris and Infections: A Retrospective Study on 155 Patients

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    Nafiseh Esmaili

    2013-01-01

    Full Text Available Background. Autoimmune process and immunosuppressive therapy of pemphigus vulgaris would predispose the patients to infections. Aim. We aimed to study the prevalence of infection and pathogenic agents in pemphigus vulgaris patients admitted to dermatology service. Material and methods. This retrospective study was conducted on 155 pemphigus vulgaris patients (68 males, 87 females admitted to dermatology service between 2009 and 2011. In this study, the diagnosis of pemphigus vulgaris was confirmed by light microscopic and direct immunofluorescence findings. Data were collected through a questionnaire. Results. Of 155 pemphigus vulgaris patients, 33 had infection at admission and 9 acquired nosocomial infection. In addition, 37 cases of oral candidiasis and 15 cases of localized herpes simplex were recorded. Totally, 94 cases of infection were recorded. The occurrence of infection was significantly related to the severity of disease, number of hospital admissions, and presence of diabetes mellitus. The most common pathogenic germs isolated from cultures were Staphylococcus aureus and Escherichia coli. Conclusion. Severity of pemphigus vulgaris and diabetes were directly related with tendency to infections. Staphylococcus aureus and Escherichia coli were the most common pathogenic agents. Due to limitations of retrospective study, a prospective study is recommended.

  3. Ballistic transport of graphene pnp junctions with embedded local gates

    International Nuclear Information System (INIS)

    Nam, Seung-Geol; Ki, Dong-Keun; Kim, Youngwook; Kim, Jun Sung; Lee, Hu-Jong; Park, Jong Wan

    2011-01-01

    We fabricated graphene pnp devices, by embedding pre-defined local gates in an oxidized surface layer of a silicon substrate. With neither deposition of dielectric material on the graphene nor electron-beam irradiation, we obtained high-quality graphene pnp devices without degradation of the carrier mobility even in the local-gate region. The corresponding increased mean free path leads to the observation of ballistic and phase-coherent transport across a local gate 130 nm wide, which is about an order of magnitude wider than reported previously. Furthermore, in our scheme, we demonstrated independent control of the carrier density in the local-gate region, with a conductance map very much distinct from those of top-gated devices. This was caused by the electric field arising from the global back gate being strongly screened by the embedded local gate. Our scheme allows the realization of ideal multipolar graphene junctions with ballistic carrier transport.

  4. Cutaneous Paraneoplastic Manifestation (Morphea, Lichen Sclerosus – Two Case Reports

    Directory of Open Access Journals (Sweden)

    Pappova T.

    2017-04-01

    Full Text Available Internal malignancy may be presented in the form of paraneoplastic syndromes, which may indicate either formation or recurrence of a previously treated malignancy. Furthermore cutaneous paraneoplastic disorders often precede a diagnosis of cancer. We present 2 unique case reports with cutaneous paraneoplastic manifestations. The first one describes a patient with sudden progression of long-term stabilized morphea in connection with newly diagnosed hepatocellular carcinoma (HCC. The second one describes female patient with breast cancer preceded by the development of extragenital lichen sclerosus (LS with typical sclerotic lesions and hemorrhagic bullae.

  5. Towards understanding the E. coli PNP binding mechanism and FRET absence between E. coli PNP and formycin A.

    Science.gov (United States)

    Prokopowicz, Małgorzata; Greń, Bartosz; Cieśla, Joanna; Kierdaszuk, Borys

    2017-11-01

    The aim of this study is threefold: (1) augmentation of the knowledge of the E. coli PNP binding mechanism; (2) explanation of the previously observed 'lack of FRET' phenomenon and (3) an introduction of the correction (modified method) for FRET efficiency calculation in the PNP-FA complexes. We present fluorescence studies of the two E. coli PNP mutants (F159Y and F159A) with formycin A (FA), that indicate that the aromatic amino acid is indispensable in the nucleotide binding, additional hydroxyl group at position 159 probably enhances the strength of binding and that the amino acids pair 159-160 has a great impact on the spectroscopic properties of the enzyme. The experiments were carried out in hepes and phosphate buffers, at pH7 and 8.3. Two methods, a conventional and a modified one, that utilizes the dissociation constant, for calculations of the energy transfer efficiency (E) and the acceptor-to-donor distance (r) between FA and the Tyr (energy donor) were employed. Total difference spectra were calculated for emission spectra (λ ex 280nm, 295nm, 305nm and 313nm) for all studied systems. Time-resolved techniques allowed to conclude the existence of a specific structure formed by amino acids at positions 159 and 160. The results showed an unexpected pattern change of FRET in the mutants, when compared to the wild type enzyme and a probable presence of a structure created between 159 and 160 residue, that might influence the binding efficiency. Additionally, we confirmed the indispensable role of the modification of the FRET efficiency (E) calculation on the fraction of enzyme saturation in PNP-FA systems. Copyright © 2017 Elsevier B.V. All rights reserved.

  6. Paraneoplastic syndromes revealing ovarian teratoma in young and ...

    African Journals Online (AJOL)

    Paraneoplastic syndromes revealing ovarian teratoma in young and menopausal women: report of two cases. Majdouline Boujoual, Ihsan Hakimi, Farid Kassidi, Youssef Akhoudad, Nawal Sahel, Adil Rkiouak, Mohamed Allaoui, Hafsa Chahdi, Mohamed Oukabli, Jaouad Kouach, Driss Rahali Moussaoui, Mohamed ...

  7. Diagnostic Approach to a Patient With Paraneoplastic Neurological Syndrome.

    Science.gov (United States)

    Mahta, Ali; Vijayvergia, Namrata; Bhavsar, Tapan M; Ward, Lawrence D

    2012-10-01

    Herein, we discussed a case of an otherwise healthy man who presented with progressive gait imbalance and ataxia, found to have small cell lung cancer. Based upon our clinical findings and laboratory data, a diagnosis of paraneoplastic cerebellar degeneration was made. Paraneoplastic neurological syndromes (PNS) are relatively rare but diverse and always should be considered in differentials. A diagnostic algorithm along with appropriate work up is discussed here.

  8. Multiplex serology of paraneoplastic antineuronal antibodies.

    Science.gov (United States)

    Maat, Peter; Brouwer, Eric; Hulsenboom, Esther; VanDuijn, Martijn; Schreurs, Marco W J; Hooijkaas, Herbert; Smitt, Peter A E Sillevis

    2013-05-31

    Paraneoplastic neurological syndromes (PNS) are devastating neurological disorders secondary to cancer, associated with onconeural autoantibodies. Such antibodies are directed against neuronal antigens aberrantly expressed by the tumor. The detection of onconeural antibodies in a patient is extremely important in diagnosing a neurological syndrome as paraneoplastic (70% is not yet known to have cancer) and in directing the search for the underlying neoplasm. At present six onconeural antibodies are considered 'well characterized' and recognize the antigens HuD, CDR62 (Yo), amphiphysin, CRMP-5 (CV2), NOVA-1 (Ri), and Ma2. The gold standard of detection is the characteristic immunohistochemical staining pattern on brain tissue sections combined with confirmation by immunoblotting using recombinant purified proteins. Since all six onconeural antibodies are usually analyzed simultaneously and objective cut-off values for these analyses are warranted, we developed a multiplex assay based on Luminex technology. Reaction of serial dilutions of six onconeural standard sera with microsphere-bound antigens showed lower limits of detection than with Western blotting. Using the six standard sera at a dilution of 1:200, the average within-run coefficient of variation (CV) was 4% (range 1.9-7.3%). The average between-run within-day CV was 5.1% (range 2.9-6.7%) while the average between-day CV was 8.1% (range 2.8-11.6%). The shelf-life of the antigen coupled microspheres was at least two months. The sensitivity of the multiplex assay ranged from 83% (Ri) to 100% (Yo, amphiphysin, CV2) and the specificity from 96% (CV2) to 100% (Ri). In conclusion, Luminex-based multiplex serology is highly reproducible with high sensitivity and specificity for the detection of onconeural antibodies. Conventional immunoblotting for diagnosis of onconeural antibodies in the setting of a routine laboratory may be replaced by this novel, robust technology. Copyright © 2013 Elsevier B.V. All rights

  9. Isotypes and antigenic profiles of pemphigus foliaceus and pemphigus vulgaris autoantibodies.

    Science.gov (United States)

    Hacker, Mary K; Janson, Marleen; Fairley, Janet A; Lin, Mong-Shang

    2002-10-01

    In this study we systematically characterized isotype profiles and antigenic and tissue specificity of antidesmoglein autoantibodies from patients with pemphigus foliaceus (PF) and pemphigus vulgaris (PV) using enzyme-linked immunoabsorbent assays (ELISA), indirect immunofluorescence (IIF) staining, and immunoblotting (IB). In PF, we found that IgG1 antidesmoglein-1 (Dsg1) reacts with a linear epitope(s) on the ectodomain of Dsg1, while its IgG4 counterpart recognizes a conformational epitope(s). These two subclasses of anti-Dsg1 are both capable of recognizing tissues from monkey esophagus and adult human skin, but IgG1 is not able to react with mouse skin, which may explain why this isotype of anti-Dsg1 failed to induce PF-like lesions in the passive transfer animal model. In mucosal PV patients, we found that both IgG1 and IgG4 only recognized monkey esophagus tissue by IIF, except in one patient, indicating that these antibodies react with a unique conformational epitope(s) that is present in mucosal but not skin tissue. In generalized PV, IgG1 anti-Dsg3 autoantibodies appeared to recognize a linear epitope(s) on the Dsg3 ectodomain. In contrast, IgG4 anti-Dsg3 antibodies recognized both linear and conformational epitopes on the Dsg3 molecule. Interestingly, the IgG1 anti-Dsg3 antibodies failed to react with human and mouse skin tissues, suggesting that this subclass of autoantibodies may not play an essential role in the development of PV suprabasilar lesions. In summary, we conclude that this study further elucidates the pathological mechanisms of PF and PV autoantibodies by revealing their distinct isotype and antigenic profiles. This information may help us to better understand the autoimmune mechanisms underlying the development of pemphigus.

  10. Calculation of cut-off values based on the Autoimmune Bullous Skin Disorder Intensity Score (ABSIS) and Pemphigus Disease Area Index (PDAI) pemphigus scoring systems for defining moderate, significant and extensive types of pemphigus.

    Science.gov (United States)

    Boulard, C; Duvert Lehembre, S; Picard-Dahan, C; Kern, J S; Zambruno, G; Feliciani, C; Marinovic, B; Vabres, P; Borradori, L; Prost-Squarcioni, C; Labeille, B; Richard, M A; Ingen-Housz-Oro, S; Houivet, E; Werth, V P; Murrell, D F; Hertl, M; Benichou, J; Joly, P

    2016-07-01

    Two pemphigus severity scores, Autoimmune Bullous Skin Disorder Intensity Score (ABSIS) and Pemphigus Disease Area Index (PDAI), have been proposed to provide an objective measure of disease activity. However, the use of these scores in clinical practice is limited by the absence of cut-off values that allow differentiation between moderate, significant and extensive types of pemphigus. To calculate cut-off values defining moderate, significant and extensive pemphigus based on the ABSIS and PDAI scores. In 31 dermatology departments in six countries, consecutive patients with newly diagnosed pemphigus were assessed for pemphigus severity, using ABSIS, PDAI, Physician's Global Assessment (PGA) and Dermatology Life Quality Index (DLQI) scores. Cut-off values defining moderate, significant and extensive subgroups were calculated based on the 25th and 75th percentiles of the ABSIS and PDAI scores. The median ABSIS, PDAI, PGA and DLQI scores of the three severity subgroups were compared in order to validate these subgroups. Ninety-six patients with pemphigus vulgaris (n = 77) or pemphigus foliaceus (n = 19) were included. The median PDAI activity and ABSIS total scores were 27·5 (range 3-84) and 34·8 points (range 0·5-90·5), respectively. The respective cut-off values corresponding to the first and third quartiles of the scores were 15 and 45 for the PDAI, and 17 and 53 for ABSIS. The moderate, significant and extensive subgroups were thus defined, and had distinguishing median ABSIS (P cut-off values of 15 and 45 for PDAI and 17 and 53 for ABSIS, to distinguish moderate, significant and extensive pemphigus forms. Identifying these pemphigus activity subgroups should help physicians to classify and manage patients with pemphigus. © 2016 British Association of Dermatologists.

  11. Oral Lesions: The Clue to Diagnosis of Pemphigus Vulgaris.

    Science.gov (United States)

    Kuriachan, Diana; Suresh, Rakesh; Janardhanan, Mahija; Savithri, Vindhya

    2015-01-01

    Pemphigus is a group of potentially fatal dermatoses with both cutaneous and oral manifestations. Characterized by the appearance of vesicle or bullae, their manifestations in the oral cavity often precede those on the skin by many months or may remain as the only symptoms of the disease. It is therefore important that the oral manifestations of the disease are recognized on time, to make a proper diagnosis and initiate timely treatment. Here we present a case of Pemphigus Vulgaris (PV) that presented with oral lesions at multiple sites including tongue, to highlight the importance of timely recognition of the oral lesions during routine dental practice for the diagnosis and management of this disease.

  12. Endemic pemphigus over a century: Part II.

    Science.gov (United States)

    Abréu-Vélez, Ana María; Roselino, Ana Maria; Howard, Michael S; Reason, Iara J de Messias

    2010-03-01

    Endemic pemphigus foliaceus (EPF) is an autoimmune disease, classically occurring in a restricted geographic area. Foci of EPF have been described in several Central and South American countries, often affecting young people and Amerindians, with some female predilection. Although most American EPF cases have been documented in Brazil, cases have been reported in Peru, Paraguay, El Salvador and Venezuela. An additional variant of EPF has been described in El Bagre, Colombia, (El Bagre-EPF) affecting older men and a few post-menopausal females. Finally, one additional type of EPF has been described in nomadic tribes affecting females of child bearing age in Tunisia, Africa. The main aim of this review is to summarize current knowledge about autoantigens, and immunologic and genetic studies in EPF. We utilized a retrospective review of the literature, aiming to compile and compare the multiple geographic foci of EPF. The primary autoantigens in EPF are still considered to be desmogleins in the case of the Tunisian and all American cases, in contradistinction to plakins and desmogleins in El Bagre-EPF. Although several autoantigens are been suggested, their biochemical nature needs further elucidation. Current knowledge still supports the concept that an antibody mediated immune response represents the principal pathophysiology in all variants of EPF. A strong genetic susceptibility appears to contribute to disease development in several people affected by these diseases; however, no specific genes have been confirmed at present. We conclude that further investigation is necessary to define these disorders immunologically and genetically.

  13. Synthesize and preliminary biodistribution of 99Tcm(CO)3-PNP5

    International Nuclear Information System (INIS)

    Chu Jinfeng; Kong Dejing; Li Bin; Wang Xuebin

    2007-01-01

    99 Tc m (CO) 3 -PNP5 (PNP5: bis (dimethoxypropylphosphinoethyl) ethoxyethyl- amine) is synthesized through a simple two-step procedure by ligand exchange reaction and its biological characters are studied. Labelling conditions of 99 Tc m (CO) 3 -PNP5 are optimized. Its labelling yield and radio chemical purity are all over 90% determined by TLC. The results of partition coefficient, charge character and stability studies indicate that 99 Tc m (CO) 3 -PNP5 is a lipophilic cation ligand with complex with positiue charge and good stability. Biological properties of 99 Tc m (CO) 3 -PNP5 and 99 Tc m (CO) 3 -PNP5 (T) (adding Tween) are valued contrastively in mice. The results show that 99 Tc m (CO) 3 -PNP5(T) have higher myocardial uptake, lower liver uptake, and higher heart-to-liver ratio. It indicats that the biological properties of 99 Tc m (CO) 3 -PNP5 are improved obviously by adding Tween-80. (authors)

  14. Evaluation of temperature-enhanced gain degradation of verticle npn and lateral pnp bipolar transistors

    International Nuclear Information System (INIS)

    Witczak, S.C.; Lacoe, R.C.; Galloway, K.F.

    1997-01-01

    The effect of dose rate on radiation-induced gain degradation is compared for verticle npn and lateral pnp bipolar transistors. High dose rate irradiations at elevated temperatures are more effective at simulating low dose rate degradation in the lateral pnp transistors

  15. Metabolic anatomy of paraneoplastic cerebellar degeneration

    International Nuclear Information System (INIS)

    Anderson, N.E.; Posner, J.B.; Sidtis, J.J.; Moeller, J.R.; Strother, S.C.; Dhawan, V.; Rottenberg, D.A.

    1988-01-01

    Eleven patients with acquired cerebellar degeneration (10 of whom had paraneoplastic cerebellar degeneration [PCD]) were evaluated using neuropsychological tests and 18 F-fluorodeoxyglucose/positron emission tomography to (1) quantify motor, cognitive, and metabolic abnormalities; (2) determine if characteristic alterations in the regional cerebral metabolic rate for glucose (rCMRGlc) are associated with PCD; and (3) correlate behavioral and metabolic measures of disease severity. Eighteen volunteer subjects served as normal controls. Although some PCD neuropsychological test scores were abnormal, these results could not, in general, be dissociated from the effects of dysarthria and ataxia. rCMRGlc was reduced in patients with PCD (versus normal control subjects) in all regions except the brainstem. Analysis of patient and control rCMRGlc data using a mathematical model of regional metabolic interactions revealed two metabolic pattern descriptors, SSF1 and SSF2, which distinguished patients with PCD from normal control subjects; SSF2, which described a metabolic coupling between cerebellum, cuneus, and posterior temporal, lateral frontal, and paracentral cortex, correlated with quantitative indices of cerebellar dysfunction. Our inability to document substantial intellectual impairment in 7 of 10 patients with PCD contrasts with the 50% incidence of dementia in PCD reported by previous investigators. Widespread reductions in PCD rCMRGlc may result from the loss of cerebellar efferents to thalamus and forebrain structures, a reverse cerebellar diaschisis

  16. Analytical solution of the PNP equations at AC applied voltage

    International Nuclear Information System (INIS)

    Golovnev, Anatoly; Trimper, Steffen

    2012-01-01

    A symmetric binary polymer electrolyte subjected to an AC voltage is considered. The analytical solution of the Poisson–Nernst–Planck equations (PNP) is found and analyzed for small applied voltages. Three distinct time regimes offering different behavior can be discriminated. The experimentally realized stationary behavior is discussed in detail. An expression for the external current is derived. Based on the theoretical result a simple method is suggested of measuring the ion mobility and their concentration separately. -- Highlights: ► Analytical solution of Poisson–Nernst–Planck equations. ► Binary polymer electrolyte subjected to an external AC voltage. ► Three well separated time scales exhibiting different behavior. ► The experimentally realized stationary behavior is discussed in detail. ► A method is proposed measuring the mobility and the concentration separately.

  17. Forged hollows (alloy 617) for PNP-hot gas collectors

    International Nuclear Information System (INIS)

    Hofmann, F.

    1984-01-01

    When the partners in the PNP-Project decided to manufacture components, such as gas collectors, from material of type alloy 617, the problem arose that required semi-fabricated products, especially forged hollows weighing several tons each, were not available. As VDM (Vereinigte Deutsche Metallwerke AG) had already experience in production of other semi-fabricated products of this alloy, attempts were made based on this knowledge, to develop manufacturing methods for forged hollows. The aim was to produce hollows as long as possible, and to keep the welding cost minimum. Welded seams are always critical during fabrication, as well as during later inspection under actual operating conditions. The three stage plan used to perform the above task illustrates the development aims is described

  18. Paraneoplastic Sjogren’s syndrome in gastric cancer

    Directory of Open Access Journals (Sweden)

    R F Khamitov

    2018-04-01

    Full Text Available In clinical practice, various masks of oncological diseases are often found. Some of them can manifest as a variety of syndromes or symptom complexes that resemble many non-oncologic diseases, including diffuse connective tissue diseases. In some cases, paraneoplastic syndrome facilitates diagnosing a malignant neoplasm in the early stages, but, unfortunately, can also mimic the tumor process by its more prominent manifestations, which lead to late establishment of the true cause of the disease, and therefore postpone specific treatment, creating significant clinical problems. Aim of the study was to reveal pathogenetic relationship between cancer and paraneoplastic syndrome on the example of our clinical observation. A clinical case of diagnosed paraneoplastic syndrome in the form of secondary Sjogren's syndrome, which developed long before the diagnosis of stomach cancer was made, as well as the results of clinical, instrumental, and laboratory examination of the patient, are presented. Questions of epidemiology, etiopathogenesis, and clinical picture of paraneoplastic syndrome are covered. The presented clinical case made it possible to outline the features of the course of paraneoplastic Sjogren's syndrome in gastric cancer and to identify a number of criteria for the diagnostic algorithm of this nosology. In particular, such criteria include general pathogenetic mechanisms, development only in malignant tumors, nonspecific clinical and laboratory manifestations, lack of parallelism with local symptoms of the tumor, the possibility of occurrence of paraneoplastic Sjogren's syndrome before development of local tumor symptoms and reappearance after its relapse. Oncologic diseases are characterized not only by specific symptoms characteristic for a certain organ damage (pain, bleeding, dysfunction, etc., but also by a variety of nonspecific manifestations (fatigue, subfebrile temperature, weight loss, etc. regardless of the nature, location and

  19. Laryngeal carcinoma presenting as polymyositis: A paraneoplastic syndrome

    Directory of Open Access Journals (Sweden)

    Ritesh Sahu

    2016-01-01

    Full Text Available Laryngeal carcinoma is rarely associated with paraneoplastic syndrome. Inflammatory myopathy presenting as paraneoplastic event is commonly associated with carcinomas of ovary, lung, pancreas, stomach, colorectal, and non-Hodgkin′s lymphoma. We report a case of elderly male, who presented with proximal muscle weakness and found to be associated with laryngeal carcinoma. Diagnosis of polymyositis (PM was confirmed based on clinical features, laboratory test, and muscle biopsy. Exclusion of other commonly associated malignancies was done. This patient improved gradually after 6 months of immunosuppressive therapy and management of underlying cancer.

  20. Elucidation of the Signal Transduction Pathways Activated by the Plant Natriuretic Peptide AtPNP-A

    KAUST Repository

    Turek, Ilona

    2014-11-01

    Plant natriuretic peptides (PNPs) comprise a novel class of hormones that share some sequence similarity in the active site with their animal analogues that function as regulators of salt and water balance. A PNP present in Arabidopsis thaliana (AtPNP-A) has been assigned a role in abiotic and biotic stress responses, and the recombinant protein has been demonstrated to elicit cyclic guanosine monophosphate (cGMP)-dependent stomatal guard cell opening, regulate ion movements, and induce osmoticum-dependent water uptake. Although the importance of the hormone in maintaining ion and fluid homeostasis has been established, key components of the AtPNP-A-dependent signal transduction pathway remain unknown. Since identification of the binding partners of AtPNP-A, including its receptor(s), is fundamental to understanding the mode of its action at the molecular level, comprehensive protein-protein interaction studies, involving yeast two-hybrid screening, affinity-based assays, protein cross-linking and co-immunoprecipitation followed by mass spectrometric (MS) analyses have been performed. Several candidate binding partners of AtPNP-A identified with at least two independent methods were subsequently expressed as recombinant proteins, purified, and the specificity of their interactions with the recombinant AtPNP-A was verified using surface plasmon resonance. Several specific binary interactants of AtPNP-A were subjected to functional assays aimed at unraveling the consequences of the interactions in planta. These experiments have revealed that reactive oxygen species (ROS) are novel secondary messengers involved in the transduction of AtPNP-A signal in suspension-cultured cells of A. thaliana (Col-0). Further insight into the AtPNP-A dependent signalling events occurring in suspension-cultured cells in ROS-dependent or ROS-independent manner have been obtained from the large-scale proteomics study employing tandem mass tag (TMT) labelling followed by MS analysis to

  1. Paraneoplastic neurologic syndrome: A practical approach

    Directory of Open Access Journals (Sweden)

    Sudheeran Kannoth

    2012-01-01

    Full Text Available Paraneoplastic neurological syndromes (PNS are rare disorders associated with cancer, not caused by direct invasion, metastasis or consequences of treatment. They are usually autoimmune in nature. Often, PNS precedes the manifestations of cancer. Onconeural antibodies are important in the diagnosis and management of these disorders. These antibodies are specific for the malignancy rather than for a particular neurological syndrome. Often, there are different antibodies associated with the same syndrome. Multiple antibodies are also known to coexist in a given patient with malignancy. While investigating a patient for suspected PNS, the entire gamut of onconeural antibodies should be investigated so as not to miss the diagnosis. In 30-40% of the cases, PNS can occur without antibodies. Investigations for identifying the underlying cancer can be directed by the antibody panel. If conventional screening for cancer is negative, a positron emission scanning/computed tomography scan can be useful. Patients need follow-up surveillance for cancer if not detected in the first instance. Cancer detection and treatment, immunotherapy and supportive care are important components of treatment of PNS. Immunotherapy is very effective in PNS associated with cell membrane-associated antibodies like voltage-gated potassium channel complex, NMDA receptor antibodies and voltage-gated calcium channel antibodies. Immunotherapy includes steroids, IVIgG, plasmaphereis, cytotoxic medications and rituximab. Supportive therapy includes symptomatic treatment with antiepileptic and analgesic medications, physiotherapy, speech therapy and occupational therapy. PNS can mimic any neurologic syndrome. A high index of clinical suspicion is important for early diagnosis and prompt management and better outcome.

  2. Paraneoplastic erythroderma in a prostate cancer patient

    Energy Technology Data Exchange (ETDEWEB)

    Momm, F.; Lutterbach, J. [Dept. of Radiation Therapy, Univ. Clinic Freiburg (Germany); Pflieger, D. [Dept. of Dermatology, Univ. Clinic Freiburg (Germany)

    2002-07-01

    Background: Erythroderma is an inflammation of the skin, which can be triggered by various diseases as psoriasis, allergies, side effects of medication, infections or malignant tumors. Caused by these various etiologic possibilities patients require extensive diagnostic effort. Patient: We report a case of a 71-year-old man presenting with an erythroderma of unknown etiology. Therapy with corticosteroids was not successful. A complete remission was reached by therapy with cyclosporine A, 350 mg/day. Finally, an increased prostate specific antigene (PSA) value was found and a prostate cancer was diagnosed in the patient. Results: After definitive radiotherapy of the carcinoma (total dose 74 Gy, 5 x 2 Gy/week), the cyclosporine A was displaced without recurrence of erythroderma. Conclusion: In this case, we consider the erythroderma to have been a paraneoplastic effect of the prostate carcinoma. In male patients with erythroderma an early PSA test should be performed. (orig.) [German] Hintergrund: Die Erythrodermie ist eine entzuendliche Reaktion der Haut, die durch verschiedene Grunderkrankungen wie Psoriasis, Allergien, Infektionen, Nebenwirkungen von Medikamenten oder paraneoplastisch in Erscheinung treten kann. Wegen dieser vielfachen aetiologischen Moeglichkeiten erfordern Erythrodermiepatienten eine aufwaendige Diagnostik. Patient: Wir berichten ueber einen 71-jaehrigen Patienten mit einer Erythrodermie zunaechst unbekannter Aetiologie. Durch die Gabe von Cyclosporin A in einer Dosis von 350 mg/Tag konnte eine Remission erreicht werden. Schliesslich wurde bei dem Patienten ein erhoehter Wert des prostataspezifischen Antigens (PSA) im Blut gefunden und daraufhin ein Prostatakarzinom diagnostiziert. Ergebnisse: Nach primaerer perkutaner Strahlentherapie des Prostatakarzinoms (Gesamtdosis 74 Gy, 5 x 2 Gy/Woche) konnte das Cyclosporin A abgesetzt werden, ohne dass ein weiterer Schub der Erythrodermie auftrat. Schlussfolgerung: Wir halten die Erythrodermie bei

  3. Management of pemphigus vulgaris during acute phase

    Directory of Open Access Journals (Sweden)

    Kar P

    2003-03-01

    Full Text Available We present our experience with 21 patients of pemphigus vulgaris seen over a period of 10 years managed in service hospitals during acute phase of the disease. Age groups of patients ranged from 25-45 years. Eighteen (85.7% were young adults, 30-40 years of age. Fifteen (71.4% were men and 6(28.6% were women. All the cases were hospitalized in ICU, till the acute phase of the disease subsided. Complete hematological profile, urinalysis, serum biochemistry and repeated bacterial cultures from the skin were carried out in all patients at the time of admission and thereafter weekly. The treatment comprised of potassium permanganate lotion bath (1:10000 and 1 framycetin gauze dressing of the denuded areas, maintenance of fluid and electrolyte balance. All suspected infections and septicemia were treated with appropriate antibiotics. The corticosteroids were usually administered as a single dose of prednisolone 1 mg/kg/day. Cyclophosphamide was given at an initial dose of 50mg/day and the dose was escalated to 100mg/day. Once the bulk of the lesions were healed, the dose of corticosteroids was gradually lowered by approximately 50% every two weeks and cyclophosphamide was continued till patients were symptomfree. Out of 21 patients receiving corticosteroids, cyclophosphamide and other supportive therapy, 20(95% had undergone clinical resolution of the disease. During follow up study 15(71.4% patients remained symptom-free and undergone clinical remission. Five patients (23.8% had relapse, out of which 4(19% remained symptom free, after subsequent treatment. There was one death (4.7% in our study.

  4. Paraneoplastic Scleroderma: Are There Any Clues?

    Science.gov (United States)

    Jedlickova, Hana; Durčanská, Veronika; Vašků, Vladimír

    2016-04-01

    Dear Editor, Scleroderma associated with neoplasia is rare, with only a small number of cases reported. We describe 4 patients with paraneoplastic scleroderma who were treated at the I. Department of Dermatovenereology, St. Anna Hospital, during the period between 2004 and 2014. The patients were diagnosed with cholangiogenic carcinoma, endometrial carcinoma, prostatic adenocarcinoma, and adenoma of the suprarenal gland. In the case of concurrent scleroderma and tumor, four situations may occur: they can develop independently of each other; scleroderma may be induced by the tumor; the tumor can develop in the scleroderma; or the tumor can be induced by immunosuppressive therapy. Sclerotization of the skin was described in association with lung cancer, carcinoid, plasma cell dyscrasia, cancer of the ovary, cervix, breast, esophagus, stomach, nasopharynx, melanoma, and sarcoma (1,2,5,7,10). Symptoms may be induced by substances secreted by the tumor (hormones, cytokines, etc.) (9). Tumorous cells further induce cytotoxic and autoantibody response. Scleroderma is characterized by immunological dysregulation, vasculopathy, and hyperproduction of the extracellular matrix by activated fibroblasts. Endothelial, inflammatory, and mesenchymal cells produce cytokines, chemokines, and growth factors e.g. Interleukin-1 (IL1), Interleukin-6 (IL6), tumor necrosis factor alpha (TNF α), collagen alpha 1, connective tissue growth factor (CTGF) (3), and basic fibroblast growth factor (bFGF). This factor is also produced by lung cancer cells (4). The clinical picture of scleroderma and paraneoplastic scleroderma is similar. Diffuse thickening of the skin and/or sclerodermatous plaques can be seen. The histological picture is consistent with scleroderma. Capillaroscopy changes, antinuclear antibodies (ANA), sclerodactyly, and Raynaud phenomenon suggest the diagnosis of systemic scleroderma (SS) (4). Our patients did not fulfill enough of the criteria for SS. Both diffuse and

  5. Evaluation of prolactin levels in patients with newly diagnosed pemphigus vulgaris and its correlation with pemphigus disease area index

    Directory of Open Access Journals (Sweden)

    Vahideh Lajevardi, MD

    2016-06-01

    Conclusion: In our study, 22% of patients had hyperprolactinemia, which was greater among females. The highest PRL level was detected in mucocutaneous group. Although serum PRL levels were higher in patients with a greater Pemphigus Disease Area Index, it did not reach statistical significance.

  6. Evaluation of prolactin levels in patients with newly diagnosed pemphigus vulgaris and its correlation with pemphigus disease area index.

    Science.gov (United States)

    Lajevardi, Vahideh; Hallaji, Zahra; Daneshpazhooh, Maryam; Ghandi, Narges; Shekari, Peyman; Khani, Sepideh

    2016-06-01

    Prolactin is a hormone; in addition to it known roles, it has immunomodulatory effects on lymphocytes maturation and immunoglobulins production. Hyperprolactinemia has been demonstrated in various autoimmune diseases such as systemic lupus erythematosus, rheumatoid arthritis, type I diabetes mellitus, and Graves' disease. In view of the prolactin immunomodulatory roles, studying prolactin levels in pemphigus as an autoimmune blistering disease may introduce new ways of understanding disease etiology and developing treatment strategies. Our purpose was to determine the prolactin levels in patients with newly diagnosed pemphigus vulgaris and study its correlation with pemphigus disease area index. Our study was limited by the lack of a control group. In this cross-sectional study, prolactin and anti-desmoglein 1 and 3 autoantibodies levels were measured in 50 patients with newly diagnosed pemphigus vulgaris in Razi Dermatology Hospital. Pemphigus severity and extent was estimated using the Pemphigus Disease Area Index. Of the 50 patients, 18 were male and 32 were female with a mean age of 41.56 ± 13.66 years. Mean prolactin (PRL) level was 15.60 ± 11.72 ng/ml (10.68 in males and 18.37 in females). Mean anti-desmoglein 1 and 3 autoantibodies were 135.8 ± 119.8 and 245.8 ± 157.4 U/ml, respectively. Eleven out of 50 patients had a higher than normal prolactin range. No relation was found between prolactin level and disease activity ( p = .982). Also, correlation studies show no relation between prolactin and anti-desmoglein 1 and 3 autoantibodies levels (respectively, p = .771 and .738). In comparing the extent of the disease between the two groups with normal and high prolactin, paired t-test showed no significance ( p = .204). In our study, 22% of patients had hyperprolactinemia, which was greater among females. The highest PRL level was detected in mucocutaneous group. Although serum PRL levels were higher in patients with a greater Pemphigus Disease Area Index

  7. Tumour necrosis factor-α polymorphism as one of the complex inherited factors in pemphigus

    Directory of Open Access Journals (Sweden)

    Jolanta Dorota Torzecka

    2003-01-01

    Full Text Available The aim of our study was to analyse a significance of tumour necrosis factor (TNF-α promoter gene polymorphisms in relation to the HLA-DR locus in genetic predisposition to pemphigus. TNF-α gene polymorphisms in position -238 and -308 were identified using a modified polymerase chain reaction-restriction fragment length polymorphism method in 53 patients with pemphigus (38 with pemphigus vulgaris, 15 with pemphigus foliaceus and 87 healthy controls. The HLA-DRB1 locus was typed using the polymerase chain reaction SSO method in all the patients and 152 population controls.

  8. Severe paraneoplastic hypereosinophilia in metastatic renal cell carcinoma

    Directory of Open Access Journals (Sweden)

    Todenhöfer Tilman

    2012-03-01

    Full Text Available Abstract Background Renal cell carcinoma can cause various paraneoplastic syndromes including metabolic and hematologic disturbances. Paraneoplastic hypereosinophilia has been reported in a variety of hematologic and solid tumors. We present the first case in the literature of severe paraneoplastic hypereosinophilia in a patient with renal cell carcinoma. Case presentation A 46 year-old patient patient with a history of significant weight loss, reduced general state of health and coughing underwent radical nephrectomy for metastasized renal cell carcinoma. Three weeks after surgery, the patient presented with excessive peripheral hypereosinophilia leading to profound neurological symptoms due to cerebral microinfarction. Systemic treatment with prednisolone, hydroxyurea, vincristine, cytarabine, temsirolimus and sunitinib led to reduction of peripheral eosinophils but could not prevent rapid disease progression of the patient. At time of severe leukocytosis, a considerable increase of cytokines associated with hypereosinophilia was measurable. Conclusions Paraneoplastic hypereosinophilia in patients with renal cell carcinoma might indicate poor prognosis and rapid disease progression. Myelosuppressive therapy is required in symptomatic patients.

  9. Treatment of anti-Ma2/Ta paraneoplastic syndrome.

    Science.gov (United States)

    Kraker, Jessica

    2009-01-01

    The paraneoplastic syndrome caused by Ma2/Ta antibodies alone (not in conjunction with Ma1 or Ma3 antibodies) varies in presentation from classic limbic encephalitis. The Ma2 syndrome may present with symptoms referable to the brainstem, diencephalon, and limbic system. These clinical symptoms are accompanied by MRI changes and abnormal electroencephalographic findings. It is important to recognize when the encephalitic syndrome is secondary to Ma2 paraneoplastic antibodies, as the patients improve or stabilize most often when the underlying carcinoma is treated. Treatment of the paraneoplastic syndrome begins with recognition of the symptoms, such as memory impairment, seizures, sleep disturbances, bradykinesia or hypokinesia, and eye movement abnormalities. If a primary tumor is discovered during the workup, it should be removed and treated with the most up-to-date oncologic treatment available. In addition to oncologic treatment, the syndrome may be treated with an immunosuppressant regimen to optimize the neurologic outcome. Leaving the patient untreated will result in decline and eventual death from the cancer itself or from complications of the paraneoplastic syndrome.

  10. Deep vein thrombosis as a paraneoplastic syndrome

    Directory of Open Access Journals (Sweden)

    Klačar Marija

    2014-01-01

    Full Text Available Introduction: Several conditions represent the risk factor for deep vein thrombosis (DVT but sometimes it occurs with no apparent reason. DVT usually involve lower extremities. It can be a component of paraneoplastic syndrome, and occasionally it is the first manifestation of malignancy. Case report: Fifty-five years old male reported to his general practitioner with history of painless right leg swelling of three weeks duration. He denied leg trauma or any other hardship. The patient had a long history of hypertension and took his medications irregularly. Family history was positive for cardiovascular diseases but negative for metabolic diseases or malignancies. He was a smoker and physically active. Physical examination revealed right calf swelling without skin discoloration, distention of superficial veins or trophic changes. Pulses of magistral arteries of the leg were symmetrical, Homans' sign was positive on the right leg. The rest of the physical examination was normal, except for the blood pressure. He was referred to vascular surgeon with the clinical diagnosis of femoro- popliteal phlebothrombosis of the right leg. Vascular surgeon performed the Color duplex scan of the lower extremities which confirmed the diagnosis. The patient was treated with low-molecular-weight heparin. The swelling significantly subsided after two weeks of therapy, but then patient fell and fractured left ramus of ischial bone. X-ray examination of pelvis revealed both fracture line and osteoblastic deposits in pelvis and the fracture was pronounced pathological. In order to localize the primary tumor, subsequent tests included chest X-ray, abdominal and pelvic ultrasound and digitorectal examination of prostate were performed. The results of all of the above mentioned examinations were within normal ranges, including routine blood tests. Skeletal scintigraphy revealed multiple secondary deposits in pelvic bones, vertebral column and ribs. Tumor markers' values

  11. The effects of gamma irradiation on neutron displacement sensitivity of lateral PNP bipolar transistors

    International Nuclear Information System (INIS)

    Wang, Chenhui; Chen, Wei; Liu, Yan; Jin, Xiaoming; Yang, Shanchao; Qi, Chao

    2016-01-01

    The effects of gamma irradiation on neutron displacement sensitivity of four types of lateral PNP bipolar transistors (LPNPs) with different neutral base widths, emitter widths and the doping concentrations of the epitaxial base region are studied. The physical mechanisms of the effects are explored by defect analysis using deep level transient spectroscopy (DLTS) techniques and numerical simulations of recombination process in the base region of the lateral PNP bipolar transistors, and are verified by the experiments on gate-controlled lateral PNP bipolar transistors (GCLPNPs) manufactured in the identical commercial bipolar process with different gate bias voltage. The results indicate that gamma irradiation increases neutron displacement damage sensitivity of lateral PNP bipolar transistors and the mechanism of this phenomenon is that positive charge induced by gamma irradiation enhances the recombination process in the defects induced by neutrons in the base region, leading to larger recombination component of base current and greater gain degradation.

  12. The effects of gamma irradiation on neutron displacement sensitivity of lateral PNP bipolar transistors

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Chenhui, E-mail: wangchenhui@nint.ac.cn; Chen, Wei; Liu, Yan; Jin, Xiaoming; Yang, Shanchao; Qi, Chao

    2016-09-21

    The effects of gamma irradiation on neutron displacement sensitivity of four types of lateral PNP bipolar transistors (LPNPs) with different neutral base widths, emitter widths and the doping concentrations of the epitaxial base region are studied. The physical mechanisms of the effects are explored by defect analysis using deep level transient spectroscopy (DLTS) techniques and numerical simulations of recombination process in the base region of the lateral PNP bipolar transistors, and are verified by the experiments on gate-controlled lateral PNP bipolar transistors (GCLPNPs) manufactured in the identical commercial bipolar process with different gate bias voltage. The results indicate that gamma irradiation increases neutron displacement damage sensitivity of lateral PNP bipolar transistors and the mechanism of this phenomenon is that positive charge induced by gamma irradiation enhances the recombination process in the defects induced by neutrons in the base region, leading to larger recombination component of base current and greater gain degradation.

  13. Mechanisms of ionizing-radiation-induced gain degradation in lateral PNP BJTs

    International Nuclear Information System (INIS)

    Schmidt, D.M.; Wu, A.; Schrimpf, R.D.; Pease, R.L.; Combs, W.E.

    1996-01-01

    The physical mechanisms for gain degradation in laterals PNP bipolar transistors are examined experimentally and through simulation. The effect of increased surface recombination velocity at the base surface is moderated by positive oxide charge

  14. The effects of emitter-tied field plates on lateral PNP ionizing radiation response

    International Nuclear Information System (INIS)

    Barnaby, H.J.; Schrimpf, R.D.; Cirba, C.R.; Pease, R.L.; Fleetwood, D.M.; Kosier, S.L.

    1998-03-01

    Radiation response comparisons of lateral PNP bipolar technologies reveal that device hardening may be achieved by extending the emitter contact over the active base. The emitter-tied field plate suppresses recombination of carriers with interface traps

  15. Elucidation of the Signal Transduction Pathways Activated by the Plant Natriuretic Peptide AtPNP-A

    KAUST Repository

    Turek, Ilona

    2014-01-01

    Plant natriuretic peptides (PNPs) comprise a novel class of hormones that share some sequence similarity in the active site with their animal analogues that function as regulators of salt and water balance. A PNP present in Arabidopsis thaliana (At

  16. Oral Lesions: The Clue to Diagnosis of Pemphigus Vulgaris

    Directory of Open Access Journals (Sweden)

    Diana Kuriachan

    2015-01-01

    Full Text Available Pemphigus is a group of potentially fatal dermatoses with both cutaneous and oral manifestations. Characterized by the appearance of vesicle or bullae, their manifestations in the oral cavity often precede those on the skin by many months or may remain as the only symptoms of the disease. It is therefore important that the oral manifestations of the disease are recognized on time, to make a proper diagnosis and initiate timely treatment. Here we present a case of Pemphigus Vulgaris (PV that presented with oral lesions at multiple sites including tongue, to highlight the importance of timely recognition of the oral lesions during routine dental practice for the diagnosis and management of this disease.

  17. The efficacy of acyclovir in treatment of the pemphigus vulgaris

    Directory of Open Access Journals (Sweden)

    Fariba Iraji

    2013-01-01

    Full Text Available Background: Pemphigus is a group of autoimmune blistering diseases of the skin and mucous membranes caused by the presence of antibodies against adhesion molecules on the cell surface of keratinocytes. The possible role of herpes simplex virus infection in the pathogenesis of pemphigus vulgaris (PV has been suggested. In this study, we evaluated the impact of a course of acyclovir in improvement of the pemphigus patients and reduction of the hospitalization duration. Materials and Methods: A total of 30 patients with definitive diagnosis of PV were recruited in study. They were randomized in two groups. One group received routine treatment and another received the routine plus 2 week course of oral acyclovir (1200 mg/day. The improvement was defined as a more than 50% change in baseline severity score of the disease. All data was registered at the checklists and after follow-up period, the statistical analyses were performed by aid of t-test and Fisher′s exact test. Results: There was no statistically significant difference in mean severity score and improvement rates between two groups at the end of study (P > 0.05. Meanwhile, there was no statistical difference in duration of hospitalization in two groups (P > 0.05 though the severity score and hospitalization duration were apparently less in acyclovir-group than control group. Neither of the patients (in acyclovir group showed any side effect. Conclusion: We did not observe any difference between response to treatment and hospitalization period in the group that was treated with acyclovir as compared with control group. However, the partial and complete remissions were higher in patients on acyclovir therapy compared to controls. In those pemphigus patients who do not respond to sufficient immunosuppressive regimen or show a sudden relapse after reaching partial or complete clinical remission, a trial of oral acyclovir therapy may have promising result.

  18. Pemphigus: Our Clinical Experiences and Treatment Alternatives in the Resistant Cases

    Directory of Open Access Journals (Sweden)

    Soner Uzun

    2008-08-01

    Full Text Available Pemphigus is an autoimmune blistering disease affecting skin and mucous membranes which threatens the life. In our country it is the most common disease in this group. In our region, among the pemphigus cases, the most common variant is pemphigus vulgaris. Pemphigus vulgaris consists of the 80% of pemphigus cases and it occurs 10 times more than pemphigus foliaceus. Treatment of pemphigus is accepted as a miracle in clinical medicine. The disease, which had an almost always fatal outcome, had been turned to the disease which long-term remissions or “cure” can be achievable. However, in the past the cause of the death was the disease itself, nowadays, with decreasing frequency, all of the mortalities is due to the treatment side effects. In treatment of pemphigus which drug to use and when to use it has varieties according to the intended effect. Corticosteroids are the main treatment; besides IVIg, plasmapheresis or pulse steroid prefers to control the disease rapidly. Mainly immunosuppressive agents (azathioprine, methotrexate, cyclophosphamide, cyclosporine, and mycophenolate besides gold, dapsone, antibiotics or rituximab are using for late-term effect and to reduce the corticosteroid requirement.

  19. The steroid-sparing effect of long-term plasmapheresis in pemphigus

    DEFF Research Database (Denmark)

    Søndergaard, Klaus; Carstens, Jan; Jørgensen, Jan

    1995-01-01

    Glucocorticoids and immunosuppressive agents can induce remission in most patients with pemphigus, but mortality remains at 5 to 15% due to complications from these drugs. We reviewed the adjunctive effect of long-term plasmapheresis in 8 patients with pemphigus. Four cases had been resistant to ...... where cyclosporine was introduced. This first report of long-term plasmapheresis demonstrates clinical efficacy in pemphigus and a considerable steroid-sparing effect.......Glucocorticoids and immunosuppressive agents can induce remission in most patients with pemphigus, but mortality remains at 5 to 15% due to complications from these drugs. We reviewed the adjunctive effect of long-term plasmapheresis in 8 patients with pemphigus. Four cases had been resistant...

  20. Early diagnosis and successful treatment of paraneoplastic melanocytic proliferation.

    Science.gov (United States)

    Jansen, Joyce C G; Van Calster, Joachim; Pulido, Jose S; Miles, Sarah L; Vile, Richard G; Van Bergen, Tine; Cassiman, Catherine; Spielberg, Leigh H; Leys, Anita M

    2015-07-01

    Paraneoplastic melanocytic proliferation (bilateral diffuse uveal melanocytic proliferation, BDUMP) is a rare but devastating disease that causes progressive visual loss in patients who usually have an occult malignancy. Visual loss occurs as a result of paraneoplastic changes in the uveal tissue. In a masked fashion, the serum of two patients with BDUMP was evaluated for the presence of cultured melanocyte elongation and proliferation (CMEP) factor using cultured human melanocytes. We evaluated the efficacy of plasmapheresis as a treatment modality early in the disease in conjunction with radiation and chemotherapy. The serum of the first case patient was investigated after plasmapheresis and did not demonstrate proliferation of cultured human melanocytes. The serum of the second case was evaluated prior to treatment with plasmapheresis and did induce this proliferation. These findings are in accordance with the diminution of CMEP factor after plasmapheresis. Treatment with plasmapheresis managed to stabilise the ocular disease progression in both patients. In the past, visual loss due to paraneoplastic melanocytic proliferation was considered progressive and irreversible. We treated two patients successfully with plasmapheresis and demonstrated a relation between CMEP factor in the serum of these patients and proliferation of cultured melanocytes. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  1. Diffuse Muscular Pain, Skin Tightening, and Nodular Regenerative Hyperplasia Revealing Paraneoplastic Amyopathic Dermatomyositis due to Testicular Cancer

    Directory of Open Access Journals (Sweden)

    Sarah Norrenberg

    2012-01-01

    Full Text Available Paraneoplastic dermatomyositis (DM associated with testicular cancer is extremely rare. We report the case of a patient with skin tightening, polymyalgia, hypereosinophilia, and nodular regenerative hyperplasia revealing seminoma and associated paraneoplastic DM.

  2. A comparative study on electrical characteristics of 1-kV pnp and npn SiC bipolar junction transistors

    Science.gov (United States)

    Okuda, Takafumi; Kimoto, Tsunenobu; Suda, Jun

    2018-04-01

    We investigate the electrical characteristics of 1-kV pnp SiC bipolar junction transistors (BJTs) and compare them with those of npn SiC BJTs. The base resistance, current gain, and blocking capability are characterized. It is found that the base resistance of pnp SiC BJTs is two orders of magnitude lower than that of npn SiC BJTs. However, the obtained current gains are low below unity in pnp SiC BJTs, whereas npn SiC BJTs exhibit a current gain of 14 without surface passivation. The reason for the poor current gain of pnp SiC BJTs is discussed.

  3. The Spectrum of Paraneoplastic Cutaneous Vasculitis in a Defined Population

    Science.gov (United States)

    Loricera, Javier; Calvo-Río, Vanesa; Ortiz-Sanjuán, Francisco; González-López, Marcos A.; Fernández-Llaca, Hector; Rueda-Gotor, Javier; Gonzalez-Vela, Maria C.; Alvarez, Lino; Mata, Cristina; González-Lamuño, Domingo; Martínez-Taboada, Victor M.; González-Gay, Miguel A.; Blanco, Ricardo

    2013-01-01

    Abstract Cutaneous vasculitis may be associated with malignancies, and may behave as a paraneoplastic syndrome. This association has been reported in a variable proportion of patients depending on population selection. We conducted the current study to assess the frequency, clinical features, treatment, and outcome of paraneoplastic vasculitis in a large unselected series of 766 patients with cutaneous vasculitis diagnosed at a single university hospital. Sixteen patients (10 men and 6 women; mean age ± standard deviation, 67.94 ± 14.20 yr; range, 40–85 yr) presenting with cutaneous vasculitis were ultimately diagnosed as having an underlying malignancy. They constituted 3.80% of the 421 adult patients. There were 9 hematologic and 7 solid underlying malignancies. Skin lesions were the initial clinical presentation in all of them, and the median interval from the onset of cutaneous vasculitis to the diagnosis of the malignancy was 17 days (range, 8–50 d). The most frequent skin lesions were palpable purpura (15 patients). Other clinical manifestations included constitutional syndrome (10 patients) and arthralgia and/or arthritis (4 cases). Hematologic cytopenias (11 cases) as well as immature peripheral blood cells (6 cases) were frequently observed in the full blood cell count, especially in those with vasculitis associated with hematologic malignancies. Specific treatment for vasculitis was prescribed in 10 patients; nonsteroidal antiinflammatory drugs (4 patients), corticosteroids (3 patients), chloroquine (1 patient), antihistamines (1 patient), and cyclophosphamide (1 patient). Ten patients died due to the malignancy and 6 patients recovered following malignancy therapy. Patients with paraneoplastic vasculitis were older, more frequently had constitutional syndrome, and less frequently had organ damage due to the vasculitis than the remaining patients with cutaneous vasculitis. In summary, cutaneous paraneoplastic vasculitis is an entity not uncommonly

  4. Prototype plant for nuclear process heat (PNP), reference phase

    International Nuclear Information System (INIS)

    Fladerer, R.; Schrader, L.

    1982-07-01

    The coal gasification processes using nuclear process heat being developed within the framwork of the PNP project, have the advantages of saving feed coal, improving efficiency, reducing emissions, and stabilizing energy costs. One major gasification process is the hydrogasification of coal for producing SNG or gas mixture of carbon monoxide and hydrogen; this process can also be applied in a conventional route. The first steps to develop this process were planning, construction and operation of a semi-technical pilot plant for hydrogasification of coal in a fluidized bed having an input of 100 kg C/h. Before the completion of the development phase (reference phase) describing here, several components were tested on part of which no operational experience had so far been gained; these were the newly developed devices, e.g. the inclined tube for feeding coal into the fluidized bed, and the raw gas/hydrogenation gas heat exchanger for utilizing the waste heat of the raw gas leaving the gasifier. Concept optimizing of the thoroughly tested equipment parts led to an improved operational behaviour. Between 1976 and 1980, the semi-technical pilot plant was operated for about 19,400 hours under test conditions, more than 7,400 hours of which it has worked under gasification conditions. During this time approx. 1,100 metric tons of dry brown coal and more than 13 metric tons of hard coal were gasified. The longest coherent operational phase under gasification conditions was 748 hours in which 85.4 metric tons of dry brown coal were gasified. Carbon gasification rates up to 82% and methane contents in the dry raw gas (free of N 2 ) up to 48 vol.% were obtained. A detailed evaluation of the test results provided information of the results obtained previously. For the completion of the test - primarily of long-term tests - the operation of the semi-technical pilot plant for hydrogasification of coal is to be continued up to September 1982. (orig.) [de

  5. Geographic variations in epidemiology of two autoimmune bullous diseases: pemphigus and bullous pemphigoid.

    Science.gov (United States)

    Alpsoy, Erkan; Akman-Karakas, Ayse; Uzun, Soner

    2015-05-01

    Autoimmune bullous diseases are rare, organ-specific, a group of blistering disease of skin and mucous membranes. Recent studies suggest that the frequency of the autoimmune bullous diseases has been increasing. Pemphigus vulgaris and bullous pemphigoid are the most frequently reported autoimmune bullous diseases. High incidence of autoimmune bullous diseases in some ethnic groups such as pemphigus in Ashkenazi Jewish, or in some regions such as pemphigus foliaceus in Brazil has been shown to be related to genetic and environmental factors, respectively. Pemphigus has been reported more frequently in the female gender. Although it is most frequently diagnosed between the ages 50 and 60 in European countries, in the remaining countries in the world, it is seen between the ages of 30 and 50. Bullous pemphigoid is generally seen above 70 years of age. Although overall incidence is slightly higher in females, after the age of 80 years it is more frequent in males. Both pemphigus vulgaris and bullous pemphigoid has a chronic course with recurrences. Mortality risk of the patients with bullous pemphigoid was found at least 2 times higher and the mortality risk of the patients with pemphigus was found approximately 3 times higher than that of the general population. In this review, the results obtained from the epidemiological studies were analyzed according to geographic regions, and especially epidemiologic features of two prevalent autoimmune bullous diseases, pemphigus and bullous pemphigoid have been discussed.

  6. Pemphigus in North-Western Yemen: A therapeutic study of 75 cases.

    Science.gov (United States)

    Khatri, Mishri Lal

    2016-01-01

    The incidence of pemphigus, though not documented, seems to be quite high in Yemen. There is no universal consensus on the treatment of this disease. The aim was to evaluate the efficacy and side effects of different therapeutic regimens used in patients of pemphigus in North-Western Yemen. Seventy-five Yemeni patients (39 males and 36 females) were included. Diagnosis was based on clinical features, histopathology and the Tzanck test. Results of treatment with these different therapeutic regimens were compared: (1) dexamethasone-cyclophosphamide pulse (DCP), (2) dexamethasone pulse with oral azathioprine, (3) oral prednisolone with azathioprine, (4) oral prednisolone with oral cyclophosphamide, and (5) prednisolone monotherapy. Pemphigus vulgaris (PV) was diagnosed in 46 patients, pemphigus foliaceus (PF) in 23, pemphigus vegetans (PVEG) in 5 and pemphigus herpetiformis (PH) in one. Among the 16 patients who received regular DCP therapy, 13 were in remission for 6 months to 11 years without medications (phase 4). Remission without pharmacotherapy could not be achieved with the other regimens and steroid-induced side-effects appeared to be more than with DCP. Immunofluorescence was not available to confirm the diagnosis of pemphigus. Randomization was not done. The DCP regimen seemed to be superior to the other regimens used.

  7. Synthesis and reactivity of TADDOL-based chiral Fe(II) PNP pincer complexes-solution equilibria between κ(2)P,N- and κ(3)P,N,P-bound PNP pincer ligands.

    Science.gov (United States)

    Holzhacker, Christian; Stöger, Berthold; Carvalho, Maria Deus; Ferreira, Liliana P; Pittenauer, Ernst; Allmaier, Günter; Veiros, Luis F; Realista, Sara; Gil, Adrià; Calhorda, Maria José; Müller, Danny; Kirchner, Karl

    2015-08-07

    Treatment of anhydrous FeX2 (X = Cl, Br) with 1 equiv. of the asymmetric chiral PNP pincer ligands PNP-R,TAD (R = iPr, tBu) with an R,R-TADDOL (TAD) moiety afforded complexes of the general formula [Fe(PNP)X2]. In the solid state these complexes adopt a tetrahedral geometry with the PNP ligand coordinated in κ(2)P,N-fashion, as shown by X-ray crystallography and Mössbauer spectroscopy. Magnetization studies led to a magnetic moment very close to 4.9μB reflecting the expected four unpaired d-electrons (quintet ground state). In solution there are equilibria between [Fe(κ(3)P,N,P-PNP-R,TAD)X2] and [Fe(κ(2)P,N-PNP-R,TAD)X2] complexes, i.e., the PNP-R,TAD ligand is hemilabile. At -50 °C these equilibria are slow and signals of the non-coordinated P-TAD arm of the κ(2)P,N-PNP-R,TAD ligand can be detected by (31)P{(1)H} NMR spectroscopy. Addition of BH3 to a solution of [Fe(PNP-iPr,TAD)Cl2] leads to selective boronation of the pendant P-TAD arm shifting the equilibrium towards the four-coordinate complex [Fe(κ(2)P,N-PNP-iPr,TAD(BH3))Cl2]. DFT calculations corroborate the existence of equilibria between four- and five-coordinated complexes. Addition of CO to [Fe(PNP-iPr,TAD)X2] in solution yields the diamagnetic octahedral complexes trans-[Fe(κ(3)P,N,P-PNP-iPr,TAD)(CO)X2], which react further with Ag(+) salts in the presence of CO to give the cationic complexes trans-[Fe(κ(3)P,N,P-PNP-iPr,TAD)(CO)2X](+). CO addition most likely takes place at the five coordinate complex [Fe(κ(3)P,N,P-PNP-iPr,TAD)X2]. The mechanism for the CO addition was also investigated by DFT and the most favorable path obtained corresponds to the rearrangement of the pincer ligand first from a κ(2)P,N- to a κ(3)P,N,P-coordination mode followed by CO coordination to [Fe(κ(3)P,N,P-PNP-iPr,TAD)X2]. Complexes bearing tBu substituents do not react with CO. Moreover, in the solid state none of the tetrahedral complexes are able to bind CO.

  8. Epidemiology of pemphigus in northeast Iran: A 10-year retrospective study

    Directory of Open Access Journals (Sweden)

    Javidi Zari

    2007-01-01

    Full Text Available Pemphigus is an autoimmune blistering disease of the skin and mucous membranes with different reported epidemiological aspects from different countries. Aim: Our aim was to evaluate the epidemiological aspects of pemphigus in Mashhad city. This is the first report with regard to the characteristics of pemphigus in Khorasan province of Iran. Materials and Methods: In this cross-sectional study, all the patients with pemphigus, who were referred to the Dermatology Department of Imam Reza hospital of Mashhad, were examined over nine years, i.e., from May 1998 to March 2007. The data obtained through questionnaires, including age, sex, profession, mucosal or skin or the involvement of both, lag-time period between the onset of disease and the first presentation, gap between cutaneous and mucosal involvements, season of onset and family history, were analysed by using statistical tests of Chi square and Student′s t -test and the statistical software of SPSS. Results: In 178 patients with pemphigus, pemphigus vulgaris was the most common type (86.5%. Female to male ratio was 1.4. In pemphigus vulgaris patients, there was involvement of both the skin and mucosa in 64.3%, mucosal involvement in 14% and skin involvement in 21.7%. There was no mucosal involvement in patients with pemphigus foliaceus. Two patients (1.4% had a positive family history. Summer was the most common season for the onset of the disease (37.5%. Most of the patients were housewives in the premenopausal age group. Conclusion: The results reveal a high incidence of pemphigus in northeast Iran with an incidence of 20 patients per year.

  9. Electroconvulsive therapy in a pediatric patient with malignant catatonia and paraneoplastic limbic encephalitis.

    Science.gov (United States)

    Lee, Andrew; Glick, David B; Dinwiddie, Stephen H

    2006-12-01

    Paraneoplastic limbic encephalitis is a rare disorder that can cause memory loss, confusion, personality change, cognitive dysfunction, and psychosis. We present a case of an 11-year-old girl who was successfully treated with electroconvulsive therapy for a catatonic state associated with paraneoplastic limbic encephalitis caused by an ovarian teratoma.

  10. Mesothelioma and anti-Ma paraneoplastic syndrome; heterogeneity in immunogenic tumours increases.

    Science.gov (United States)

    Archer, Hilary Anne; Panopoulou, Aikaterini; Bhatt, Nidhi; Edey, Anthony James; Giffin, Nicola Jane

    2014-02-01

    We present a patient with opsoclonus and diffuse cerebellar signs who had an anti-Ma2 antibody-associated paraneoplastic syndrome secondary to a sarcomatoid mesothelioma. This case highlights the importance of early tumour detection, instigation of therapeutic measures, and the heterogeneity of underlying malignancies in neurological paraneoplastic syndromes.

  11. Importance of the dentist in early diagnosis of pemphigus vulgaris

    Directory of Open Access Journals (Sweden)

    Thiago de Santana Santos

    2009-10-01

    Full Text Available The vulgar pemphigus is a chronic, rare, vesicle-bubble disease of autoimmune origin and with a possibility of following a dangerous clinical course when it is not diagnosed and treated in its initial stage. It usually affects people from 40 to 60 years old, being rare in children. In the majority of cases, oral manifestations are the first signs of the disease, so that dentists play an important rol in its early diagnosis. The authors present a case report of vulgar pemphigus in a 17 year-old patient, attended by the Bucco-Maxillo-Facial Surgery Service of the “Fundação de Beneficência Hospital de Cirurgia” in Aracaju-SE, Brazil. The patient was admitted with a complaint of the presence of numerous scattered painful ulcers in the mouth that had developed in approximately two months, and reported that at first, blisters that broke quickly appeared, leading to extremely painful ulcerations. Incisional biopsies were performed in the jugal mucosa and retromolar regions, and also a complete hemogram to discard the hypothesis of leukemia. In view of the clinical and histopathological findings, the final diagnosis of pemphigus vulgaris was made. Before receiving specialized treatment, the patient presented marked worsening of the clinical condition, with exacerbation of intraoral signs and symptoms and development of skin lesions around the body surface. The patient was hospitalized in the “Hospital Universitário da Universidade Federal de Sergipe” and treated with prednisone, cimetidine and nystatin, showing significant improvement of symptoms in approximately two weeks. At present, the patient is under the care of an interdisciplinary team that includes dermatologists and dentists.

  12. Endemic pemphigus foliaceus in Venezuela: report of two children.

    Science.gov (United States)

    González, Francisco; Sáenz, Ana Maria; Cirocco, Antonietta; Tacaronte, Inés Maria; Fajardo, Javier Enrique; Calebotta, Adriana

    2006-01-01

    Two native Yanomami children from the Venezuelan Amazonia with erythroderma were hospitalized on our service. Clinical, histologic, and immunofluorescence studies diagnosed endemic pemphigus foliaceous. Human leukocyte antigen class II showed DRB1*04 subtype *0411, which has not been previously associated with this disease. However, it shares a common epitope with all the human leukocyte antigen DRB1 alleles that have been involved in this disease among Brazilian populations. Although this condition is endemic in Brazil, our patients are the first two reported in Venezuela.

  13. Formation of p-n-p junction with ionic liquid gate in graphene

    International Nuclear Information System (INIS)

    He, Xin; Tang, Ning; Duan, Junxi; Zhang, Yuewei; Lu, Fangchao; Xu, Fujun; Yang, Xuelin; Gao, Li; Wang, Xinqiang; Shen, Bo; Ge, Weikun

    2014-01-01

    Ionic liquid gating is a technique which is much more efficient than solid gating to tune carrier density. To observe the electronic properties of such a highly doped graphene device, a top gate made of ionic liquid has been used. By sweeping both the top and back gate voltage, a p-n-p junction has been created. The mechanism of forming the p-n-p junction has been discussed. Tuning the carrier density by ionic liquid gate can be an efficient method to be used in flexible electronics

  14. Experimental Human Cell and Tissue Models of Pemphigus

    Science.gov (United States)

    van der Wier, Gerda; Pas, Hendri H.; Jonkman, Marcel F.

    2010-01-01

    Pemphigus is a chronic mucocutaneous autoimmune bullous disease that is characterized by loss of cell-cell contact in skin and/or mucous membranes. Past research has successfully identified desmosomes as immunological targets and has demonstrated that acantholysis is initiated through direct binding of IgG. The exact mechanisms of acantholysis, however, are still missing. Experimental model systems have contributed considerably to today's knowledge and are still a favourite tool of research. In this paper we will describe to what extent human cell and tissue models represent the in vivo situation, for example, organ cultures of human skin, keratinocyte cultures, and human skin grafted on mice and, furthermore, how suitable they are to study the pathogenesis of pemphigus. Organ cultures closely mimic the architecture of the epidermis but are less suitable to answer posed biochemical questions. Cultured keratinocyte monolayers are convenient in this respect, but their desmosomal make-up in terms of adhesion molecules does not exactly reflect the in vivo situation. Reconstituted skin is a relatively new model that approaches organ culture. In models of human skin grafted on mice, acantholysis can be studied in actual human skin but now with all the advantages of an animal model. PMID:20585596

  15. Erosions on a prolapsed uterine in an old woman: an unusual manifestation of pemphigus vulgaris.

    Science.gov (United States)

    Ramezani, Ali; Ghandi, Narges; Akhyani, Maryam; Daneshpazhooh, Maryam; Naraghi, Zahra S; Chams-Davatchi, Cheyda

    2009-09-15

    Vaginal involvement in pemphigus vulgaris has previously been described. In all those cases a pelvic examination was needed to explore the lesions. We describe a patient with pemphigus vulgaris who had pemphigus erosions on a prolapsed uterus (i.e., on the everted surface of vagina). The patient had widespread lesions of pemphigus in other mucosal and cutaneous sites. Biopsy, antibodies against desmoglein 1 and 3, and direct and indirect immunofluorescence were confirming. The erosions on the prolapsed uterus were resistant to treatment; other mucosal and cutaneous lesions responded rapidly to prednisolone and azathioprine. After lowering the dose of prednisolone the patient was referred to a gynecologist for a vaginal hysterectomy. This case was unique because her vaginal lesions could be easily examined and followed.

  16. Dexamethasone cyclophosphamid pulse therapy in pemphigus-appraisal of its outcome

    Directory of Open Access Journals (Sweden)

    Prabhash Kulhari

    2012-01-01

    Full Text Available Introduction :- Pemphigus is the commonest autoimmune vesicobullous disorder on the the Indian subcontinent. the mainstay of treatment of the disease is systemic steroid and other immunosuppresive therapies. Dexamethasone-cyclophosphamide(DCP pulse therapy was designated by pasricha for pemphigus in 1981 with the aim of reducing toxicity of corticosteroid and also achieve better results. Method:- Thirty one patients admitted at department of dermatology ASSAM MEDICAL COLLEGE,DIBRUGARH were enrolled for study prospectively from 2008-2011.Diagnosis of pemphigus was based on clinical feature, tzanck smear and biopsy. Confirmation was carried out by direct immunofluorascence.DCP pulse was given to confirmed cases of pemphigus. we enrolled 31 patients with pemphigus for DCP pulse therapy in our hospital during this period out of which 27 patients were pemphigus vulgaris and 4 were pemphigus folIacious. male to female ratio was 1.2:1.Of 31 patients enrolled for this treatment,6 patients could not complete the treatment and 2 patient died due to cardiovascular failure(not related to treatment. Of remaining 23 patients ,15 have alredy completed the treatment and are free of disease even after withdrawl of all treatment. 5 patients are in remission but have not completed the treatment schedule whereas 3 patients are still having clinical evidence of disease although it has already become much milder .Various side effects seen in our patients were candidiasis (2,tuberculosis(1, acneiform eruption(2, osteoporosis(1, cataract(2, hair fall(2, gastritis(3, avascular necrosis(1.Our finding are very consistent with previous reports that DCP pulse therapy is very effective in pemphigus and having lesser side effects in comparison to daily steroid .

  17. Unravelling The Mechanism of Basic Aqueous Methanol Dehydrogenation Catalyzed By Ru-PNP Pincer Complexes

    DEFF Research Database (Denmark)

    Alberico, Elisabetta; Lennox, Alastair J. J.; Vogt, Lydia K.

    2016-01-01

    Ruthenium PNP complex 1a (RuH(CO)Cl(HN(C2H4Pi-Pr2)2)) represents a state-of-the-art catalyst for low-temperature (methanol dehydrogenation to H2 and CO2. Herein, we describe an investigation that combines experiment, spectroscopy, and theory to provide a mechanistic rationale...

  18. De-embedding and Modelling of pnp SiGe HBTs

    DEFF Research Database (Denmark)

    Hadziabdic, Dzenan; Jiang, Chenhui; Johansen, Tom Keinicke

    2007-01-01

    In this work we present a direct parameter extraction procedure for SiGe pnp heterojunction bipolar transistor (HBT) large-signal and small-signal models. Test structure parasitics are removed from the measured small-signal parameters using an open-short de-embedding technique, improved to accoun...

  19. Oxidative stress in patients with endemic pemphigus foliaceus and healthy subjects with anti-desmoglein 1 antibodies*

    Science.gov (United States)

    Gutierrez, Ericson Leonardo; Ramos, Willy; Seminario-Vidal, Lucia; Tello, Mercedes; Ronceros, Gerardo; Ortega-Loayza, Alex G.

    2018-01-01

    Background Previous studies have shown oxidative stress in pemphigus vulgaris and pemphigus foliaceus, nevertheless, it remains unknown whether a similar response is characteristic of endemic pemphigus foliaceus in Peru. Objectives To determine the oxidative stress response in endemic pemphigus foliaceus patients and subjects with positive for anti-desmoglein1 antibodies (anti-dsg1) from endemic areas of Peru. Subjects and Methods This is a cross-sectional study. The study population included 21 patients with Endemic Pemphigus foliaceus and 12 healthy subjects with anti-dsg1 antibodies from the Peruvian Amazon (Ucayali), as well as 30 healthy control subjects. Malondialdehyde, an indicator of lipid peroxidation by free radicals, was measured in serum. Results We collected 21 cases of endemic pemphigus foliaceus, 15 of them with active chronic disease and 6 in clinical remission. Serum malondialdehyde values in patients with chronic active evolution and healthy subjects with anti-dsg1 antibodies were statistically higher than those of healthy controls (p<0.001). There was no significant difference between serum values of localized and generalized clinical forms. Study limitations The main limitation of this present study is the small number of patients with endemic pemphigus and healthy subjects positive for desmoglein 1 antibodies. Conclusions The increased serum levels of malondialdehyde in patients with chronic active endemic pemphigus foliaceus and healthy subjects from endemic areas with anti-dsg1 antibodies may suggest a contribution of systemic lipid peroxidation in the pathogenesis of endemic pemphigus foliaceus. PMID:29723379

  20. A case of pemphigus foliaceus and pustular psoriasis A case of pemphigus foliaceus and pustular psoriasis with a brief review of literature

    Directory of Open Access Journals (Sweden)

    Darjani Abbas

    2017-10-01

    Full Text Available Rarely pemphigus foliaceus could be associated with generalized pustular psoriasis. A 66-year-old woman with diffuse flaccid bullae and erosions of pemphigus foliaceus underwent two sessions of pulse therapy of corticosteroid and oral prednisolone during the interval time. Two weeks after the second session of pulse therapy with improvement of the lesions, during tapered dosage of oral prednisolone, facial annular erythematous lesions appeared and were superimposed by generalized pustular eruptions. Skin biopsy of pustular lesions showed pustular psoriasis so intramuscular methotrexate was added. Two years later, during decreasing dosage of methotrexate and prednisolone, she had eruptive recurrence of pustules and flaccid bullae associated with erythroderma and fever which were controlled with increasing dosage of corticosteroid and starting oral retinoid. These hypotheses may explain co-occurring pemphigus foliaceus and pustular psoriasis: decreasing dosage of corticosteroid, interleukin-8 overproduction in keratinocytes and increased activity of plasminogen activator in skin lesions.

  1. Four cases of recalcitrant pemphigus vulgaris salvaged with rituximab

    Directory of Open Access Journals (Sweden)

    Samyak Ganjre

    2017-01-01

    Full Text Available Although the long-term use of immunosuppressives – supplemented with more aggressive treatments such as immunoadsorption, intravenous immunoglobulins, or plasmapheresis in recalcitrant cases has dramatically improved the prognosis of pemphigus vulgaris, opportunistic infections secondary to immunosuppression continue to cause significant mortality. We report four cases– three old ones, who had accumulated significant morbidities over their disease duration ranging from 5 to 10 years, and the fourth, a teenage female intolerant to corticosteroids and idiosyncratic to methotrexate– who achieved complete remission on administration of rituximab by the lymphoma protocol. One of the old cases who had recalcitrant mucositis experienced its complete subsidence without any adjuvant whatsoever. All continue to remain asymptomatic for 11–20 months. None had infusion reactions or any delayed side effects.

  2. Hepatic neosporosis in a dog treated for pemphigus foliaceus.

    Science.gov (United States)

    Hoon-Hanks, Laura L; Regan, Daniel; Dubey, Jitender P; Carol Porter, Merry; Duncan, Colleen G

    2013-11-01

    A 4-year-old, female, spayed Border Collie dog was presented for progressive lethargy, inappetence, and weakness of 4 days duration. The animal had been diagnosed with pemphigus foliaceus 3 months prior and was receiving combination immunosuppressive therapy. Serum biochemistry revealed severely elevated liver enzymes and bilirubin, and humane euthanasia was elected. Gross postmortem examination revealed a diffusely pale tan to slightly yellow, enlarged, markedly friable liver with an enhanced reticular pattern. Histologically, the hepatic changes consisted of multifocal to coalescing areas of severe vacuolar degeneration, numerous coalescing foci of hepatocellular necrosis, and myriad intra- and extracellular protozoa that reacted immunohistochemically with polyclonal antibodies to Neospora caninum, and not Toxoplasma gondii. Neosporosis in the current case is thought to be due to reactivation of latent N. caninum occurring with the administration of glucocorticoid therapy. The severe complication in the present case highlights the importance of early detection and mitigation of common infections in immunosuppressed animals.

  3. Autoantibodies other than anti-desmogleins in pemphigus vulgaris patients

    Directory of Open Access Journals (Sweden)

    Marwah Adly Saleh

    2017-01-01

    Full Text Available Background: Pemphigus vulgaris (PV is an immunoglobulin G-mediated autoimmune bullous skin disease. Nonorgan-specific antibodies were detected in Tunisian and Brazilian pemphigus patients with different prevalence. Materials and Methods: Fifty PV patients and fifty controls were screened for antinuclear antibodies (ANAs, anti-smooth muscle antibodies (ASMAs, anti-parietal antibodies (APAs, anti-mitochondrial antibodies, and Anti-nuclear cytoplasmic antibodies (ANCA by indirect immunofluorescence. Results: Thirty-nine patients were female and 11 were male. Fifteen patients did not receive treatment before while 35 patients were on systemic steroid treatment ± azathioprine. Twenty (40% of the PV patients and 1 (2% control had positive ANA. ANA was significantly higher in PV patients than controls, P< 0.0001. ASMAs were detected in 20 (40% PV patients and none of the controls. ASMA was significantly higher in PV patients than controls, P< 0.0001. No significant difference was detected between treated and untreated regarding ANA, P - 0.11. However, there was a significant difference between treated and untreated regarding ASMA, P- 0.03. Six patients (12% and none of the controls had positive APA. There was a significant difference between the patients and the controls in APA. P- 0.027. Conclusion: Egyptian PV patients showed more prevalent ANA, ASMA, and APA than normal controls. Follow-up of those patients is essential to detect the early development of concomitant autoimmune disease. Environmental factors might account for the variability of the nonorgan-specific antibodies among different populations.

  4. Anti-Ma2-antibody-associated encephalitis: An atypical paraneoplastic neurologic syndrome

    Directory of Open Access Journals (Sweden)

    Bogna Targonska

    2018-05-01

    Full Text Available Paraneoplastic syndromes are a heterogeneous group of conditions affecting cancer patients, where the signs and symptoms are not owing to the local effects of the tumour but instead owing to humoral or immunologic effects. We describe an unusual presentation of a paraneoplastic neurologic syndrome presenting with predominant involvement of the hypothalamus and deep grey nuclei secondary to an anterior mediastinal germinoma and associated with anti-Ma2 antibody.

  5. Limbic encephalitis and antibodies to Ma2: a paraneoplastic presentation of breast cancer

    OpenAIRE

    Sutton, I.; Winer, J.; Rowlands, D.; Dalmau, J.

    2000-01-01

    A patient with atypical medullary breast cancer is described who presented with symptoms of limbic encephalitis. The patient's serum and CSF contained antibodies that reacted with the nervous system and the tumour. These antibodies recognised Ma2, a neuronal protein related to paraneoplastic limbic and brainstem encephalitis in men with testicular tumours. This report highlights the importance of testing for paraneoplastic antineuronal antibodies in cases of unexplained l...

  6. Tumour-induced osteomalacia: An emergent paraneoplastic syndrome.

    Science.gov (United States)

    Alonso, Guillermo; Varsavsky, Mariela

    2016-04-01

    Endocrine paraneoplastic syndromes are distant manifestations of some tumours. An uncommon but increasingly reported form is tumour-induced osteomalacia, a hypophosphatemic disorder associated to fibroblast growth factor 23 (FGF-23) secretion by tumours. The main biochemical manifestations of this disorder include hypophosphatemia, inappropriately low or normal tubular reabsorption of phosphate, low serum calcitriol levels, increased serum alkaline phosphatase levels, and elevated or normal serum FGF-23 levels. These tumours, usually small, benign, slow growing and difficult to discover, are mainly localized in soft tissues of the limbs. Histologically, phosphaturic mesenchymal tumours of the mixed connective tissue type are most common. Various imaging techniques have been suggested with variable results. Treatment of choice is total surgical resection of the tumour. Medical treatment includes oral phosphorus and calcitriol supplements, octreotide, cinacalcet, and monoclonal antibodies. Copyright © 2015 SEEN. Published by Elsevier España, S.L.U. All rights reserved.

  7. Paraneoplastic neurological disorders in children with benign ovarian tumors.

    Science.gov (United States)

    Hsu, Mei-Hsin; Huang, Chao-Ching; Hung, Pi-Lien; Huang, Hsiu-Mei; Huang, Li-Tung; Huang, Chao-Cheng; Sheen, Jiunn-Ming; Huang, Song-Chei; Chang, Ying-Chao

    2014-03-01

    Paraneoplastic neurological diseases (PND) are rare, but potentially treatable disorders. Paraneoplastic encephalitis is rapidly emerging as an important but likely under-recognized condition in children. The aim of this study was to assess the prevalence and spectrum of PND in children with benign ovary tumor and the long-term outcome. We retrospectively reviewed the charts of all female patients below 18years of age diagnosed with a benign ovarian tumor proven by pathology between January 1993 and December 2010. All the clinical symptoms developed within 5years of tumor diagnosis and the related investigations were recorded. There were total 133 children and adolescents with benign ovarian tumors, mostly mature teratoma. Six patients (4.5%) had neuropsychiatric manifestations and all but one were beyond age 10years. The most common neuropsychiatric presentations were depression or low mood (84%), headache (50%), mutism (50%), hypoventilation (50%), seizures (30%), hallucination (30%), vomiting and hypersalivation (30%). Three patients (2.2%) had serious PND including acute disseminated encephalomyelitis in 1 and anti-N-methyl-d-aspartate receptor (NMDAR) encephalitis in 2. Although all of three improved after tumor removal, one without immunotherapy had neurological sequelae and prolonged ICU stay. The prevalence of PND in benign ovary tumor is not so uncommon in children. It is important to survey ovary tumors in female adolescents with subacute presentation of multiple-level involvement of neuraxis where no clear alternate diagnosis is possible. Treatment of serious PND associated with ovary tumors should include immunotherapy in addition to tumor removal. Copyright © 2013 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

  8. PARANEOPLASTIC DAMAGE TO THE CENTRAL AND PERIPHERAL NERVOUS SYSTEM IN BREAST CANCER: A CASE REPORT

    Directory of Open Access Journals (Sweden)

    E. S. Koroleva

    2017-01-01

    Full Text Available Paraneoplastic neurological syndrome involves the concurrent development of cancer and neurologicaldiseases. Breast cancer is the second most common cancer associated with paraneoplastic damage to the central and peripheral nervous system. Autoimmune genesis of the disease is characterized by the presence of highly specific onconeural antibodies, which selectively affect neurons in the brain cord, spinal cord and spinal ganglia, and cause the onset of neurological symptoms within 2 years before cancer is detected. Six well-characterized onconeural antibodies detected in the blood serum of breast cancer patients can be used for the laboratory diagnosis of paraneoplastic neurological syndrome. Of them, anti-Hu, anti-CV2 and anti-amphiphysin antibodies cause polyneuropathy most often. Anti-Yo antibody is usually associated with cerebellar degeneration. Multiple neuronal autoantibodies can be simultaneously detected in a patient. Removal of the tumor may lead to stabilization and even partial regression of the neurological symptoms in 70 % of patients. Therefore, the surgical treatment of cancer should consider not only the tumor extension, but also the severity and progression of neurological deficit. We present a case of paraneoplastic cerebellar degeneration and paraneoplastic polyneuropathy in a 50-year-old woman with the neurological symptoms appeared 5 months before breast infiltrating ductal carcinoma was detected. The current approaches to the diagnosis of paraneoplastic neurological syndrome, as well as feasibility of radical removal of the tumor due to progression of neurological deficit were discussed.

  9. Correlator receiver architecture with PnpN optical thyristor operating as optical hard-limiter

    Science.gov (United States)

    Kang, Tae-Gu; Ho Lee, Su; Park, Soonchul

    2011-07-01

    We propose novel correlator receiver architecture with a PnpN optical thyristor operating as optical hard-limiter, and demonstrate a multiple-access interference rejection of the proposed correlator receiver. The proposed correlator receiver is composed of the 1×2 splitter, optical delay line, 2×1 combiner, and fabricated PnpN optical thyristor. The proposed correlator receiver enhances the system performance because it excludes some combinations of multiple-access interference patterns from causing errors as in optical code-division multiple access systems with conventional optical receiver shown in all previous works. It is found that the proposed correlator receiver can fully reject the interference signals generated by decoding processing and multiple access for two simultaneous users.

  10. What a difference a 5f element makes: trivalent and tetravalent uranium halide complexes supported by one and two bis[2-(diisopropylphosphino)-4-methylphenyl]amido (PNP) ligands.

    Science.gov (United States)

    Cantat, Thibault; Scott, Brian L; Morris, David E; Kiplinger, Jaqueline L

    2009-03-02

    The coordination behavior of the bis[2-(diisopropylphosphino)-4-methylphenyl]amido ligand (PNP) toward UI3(THF)4 and UCl4 has been investigated to access new uranium(III) and uranium(IV) halide complexes supported by one and two PNP ligands. The reaction between (PNP)K (6) and 1 equiv of UI3(THF)4 afforded the trivalent halide complex (PNP)UI2(4-tBu-pyridine)2 (7) in the presence of 4-tert-butylpyridine. The same reaction carried out with UCl4 and no donor ligand gave [(PNP)UCl3]2 (8), in which the uranium coordination sphere in the (PNP)UCl3 unit is completed by a bridging chloride ligand. When UCl4 is reacted with 1 equiv (PNP)K (6) in the presence of THF, trimethylphosphine oxide (TMPO), or triphenylphosphineoxide (TPPO), the tetravalent halide complexes (PNP)UCl3(THF) (9), (PNP)UCl3(TMPO)2 (10), and (PNP)UCl3(TPPO) (11), respectively, are formed in excellent yields. The bis(PNP) complexes of uranium(III), (PNP)2UI (12), and uranium(IV), (PNP)2UCl2 (13), were easily isolated from the analogous reactions between 2 equiv of 6 and UI3(THF)4 or UCl4, respectively. Complexes 12 and 13 represent the first examples of complexes featuring two PNP ligands coordinated to a single metal center. Complexes 7-13 have been characterized by single-crystal X-ray diffraction and 1H and 31P NMR spectroscopy. The X-ray structures demonstrate the ability of the PNP ligand to adopt new coordination modes upon coordination to uranium. The PNP ligand can adopt both pseudo-meridional and pseudo-facial geometries when it is kappa3-(P,N,P) coordinated, depending on the steric demand at the uranium metal center. Additionally, its hemilabile character was demonstrated with an unusual kappa2-(P,N) coordination mode that is maintained in both the solid-state and in solution. Comparison of the structures of the mono(PNP) and bis(PNP) complexes 7, 9, 11-13 with their respective C5Me5 analogues 1-4 undoubtedly show that a more sterically congested environment is provided by the PNP ligand. The

  11. Impact of doped boron concentration in emitter on high- and low-dose-rate damage in lateral PNP transistors

    International Nuclear Information System (INIS)

    Zheng Yuzhan; Lu Wu; Ren Diyuan; Wang Yiyuan; Wang Zhikuan; Yang Yonghui

    2010-01-01

    The characteristics of radiation damage under a high or low dose rate in lateral PNP transistors with a heavily or lightly doped emitter is investigated. Experimental results show that as the total dose increases, the base current of transistors would increase and the current gain decreases. Furthermore, more degradation has been found in lightly-doped PNP transistors, and an abnormal effect is observed in heavily doped transistors. The role of radiation defects, especially the double effects of oxide trapped charge, is discussed in heavily or lightly doped transistors. Finally, through comparison between the high- and low-dose-rate response of the collector current in heavily doped lateral PNP transistors, the abnormal effect can be attributed to the annealing of the oxide trapped charge. The response of the collector current, in heavily doped PNP transistors under high- and low-dose-rate irradiation is described in detail. (semiconductor integrated circuits)

  12. Atomic Force Microscopy Provides New Mechanistic Insights into the Pathogenesis of Pemphigus

    Directory of Open Access Journals (Sweden)

    Franziska Vielmuth

    2018-03-01

    Full Text Available Autoantibodies binding to the extracellular domains of desmoglein (Dsg 3 and 1 are critical in the pathogenesis of pemphigus by mechanisms leading to impaired function of desmosomes and blister formation in the epidermis and mucous membranes. Desmosomes are highly organized protein complexes which provide strong intercellular adhesion. Desmosomal cadherins such as Dsgs, proteins of the cadherin superfamily which interact via their extracellular domains in Ca2+-dependent manner, are the transmembrane adhesion molecules clustered within desmosomes. Investigations on pemphigus cover a wide range of experimental approaches including biophysical methods. Especially atomic force microscopy (AFM has recently been applied increasingly because it allows the analysis of native materials such as cultured cells and tissues under near-physiological conditions. AFM provides information about the mechanical properties of the sample together with detailed interaction analyses of adhesion molecules. With AFM, it was recently demonstrated that autoantibodies directly inhibit Dsg interactions on the surface of living keratinocytes, a phenomenon which has long been considered the main mechanism causing loss of cell cohesion in pemphigus. In addition, AFM allows to study how signaling pathways altered in pemphigus control binding properties of Dsgs. More general, AFM and other biophysical studies recently revealed the importance of keratin filaments for regulation of Dsg binding and keratinocyte mechanical properties. In this mini-review, we reevaluate AFM studies in pemphigus and keratinocyte research, recapitulate what is known about the interaction mechanisms of desmosomal cadherins and discuss the advantages and limitations of AFM in these regards.

  13. Pemphigus vulgaris localized to the vagina presenting as chronic vaginal discharge.

    Science.gov (United States)

    Batta, K; Munday, P E; Tatnall, F M

    1999-05-01

    Involvement in pemphigus vulgaris of the female genital tract including the vulva, vagina and cervix has previously been described. In all these cases other cutaneous and mucosal sites have also been affected at some time. We describe a case of pemphigus vulgaris which only involved the vaginal mucosa. The patient presented with a persistent vaginal discharge and examination showed extensive vaginal erosions. Histology of vaginal biopsies was non-diagnostic. The recognition that the vaginal changes may represent an immunobullous disease led to further vaginal biopsies on which direct immunofluorescence studies were performed. These biopsies showed IgG and C3 in the intercellular epidermis, suggesting a diagnosis of pemphigus vulgaris. During the 3-year period that the patient has been under review there have never been any other cutaneous or mucosal lesions. To our knowledge, this is the first case of pemphigus vulgaris localized exclusively to the vaginal mucosa. There was considerable delay in diagnosis and this case highlights how important it is to recognize that chronic mucosal lesions at genital sites may be caused by immunobullous diseases such as cicatricial pemphigoid and pemphigus, and to institute appropriate investigations.

  14. Implemented Crime Prevention Strategies of PNP in Salug Valley, Zamboanga Del Sur, Philippines

    Directory of Open Access Journals (Sweden)

    Mark E. Patalinghug

    2017-05-01

    Full Text Available This study aimed primarily to determine the effectiveness of crime prevention strategies implemented by the Salug Valley Philippine National Police (PNP in terms of Police Integrated Patrol System, Barangay Peacekeeping Operation, Anti - Criminality Operation, Integrated Area Community Public Safety services, Bantay Turista and Scho ol Safety Project as evaluated by 120 inhabitants and 138 PNP officers from four Municipalities of Salug Valley Zamboanga del Sur. Stratified random sampling was utilized in determining the respondents. Index crime rate were correlated with the crime preve ntion strategies of the PNP in town of Salug Valley. A descriptive method of research was applied in this study utilizing self - made questionnaire. The data collected were analyzed using the main statistical tools like frequency count, percentage, mean com putation, Kruskal Wallis Analysis of Variance and simple correlation. Findings of the study revealed that the crime prevention strategies in four (4 municipalities were “much effective” to include Integrated Patrol System, Barangay Peace Keeping Operation s, Anti - Criminality Operations, Integrated Area Community Public Safety Services, Bantay Turista and School Safety Project in connection to the responses of 158 participants. There is a significant relationship between crime prevention strategies employed and index crime rate.

  15. A glass of red wine to keep vascular disease at bay, but what about pemphigus vulgaris?

    Science.gov (United States)

    Caldarola, Giacomo; Feliciani, Claudio

    2011-03-01

    Pemphigus vulgaris is a rare autoimmune blistering disease, involving the skin and mucous epithelia, which is characterized by flaccid blisters and erosions. It is caused by the presence of autoantibodies directed against desmoglein, a glycoprotein that plays a critical role in cell-cell attachment. Upon a predisposing genetic background, different agents have been shown to act as triggers for the pathogenesis of pemphigus. The most evident association is with drug intake, while the role of diet is often underestimated. The aim of this article is to review the possible role of tannins, a group of phenolic metabolites that are widely distributed in almost all plant foods and beverages, particularly red wine, as a trigger for pemphigus vulgaris.

  16. Neuroimaging in status epilepticus secondary to paraneoplastic autoimmune encephalitis

    International Nuclear Information System (INIS)

    Sarria-Estrada, S.; Toledo, M.; Lorenzo-Bosquet, C.; Cuberas-Borrós, G.; Auger, C.; Siurana, S.; Rovira, À.

    2014-01-01

    Aim: To describe the characteristic magnetic resonance imaging (MRI) findings of paraneoplastic autoimmune encephalitis in patients with new-onset status epilepticus. Materials and methods: The neuroimaging and clinical data of five patients with paraneoplastic autoimmune encephalitis debuting as status epilepticus were retrospectively reviewed. All patients met the criteria for definite paraneoplastic syndrome and all underwent brain MRI during the status epilepticus episode or immediately after recovery. Results: All patients showed hyperintense lesions on T2-weighted imaging (WI) involving the limbic structures, specifically the hippocampus. Three of them showed additional extra-limbic areas of signal abnormalities. The areas of T2 hyperintensity were related to the electroclinical onset of the seizures. In three patients, various techniques were used to study cerebral perfusion, such as arterial spin labelling MRI, single photon-emission computed tomography (SPECT) and 2-[ 18 F]-fluoro-2-deoxy-D-glucose (FDG)-positron-emission tomography (PET). Arterial spin labelling showed hyperperfusion overlapping the inflammatory lesions, whereas PET and SPECT disclosed increased perfusion and increased metabolism. The subtraction SPECT co-registered to MRI (SISCOM) demonstrated hypermetabolism outside the areas of encephalitis. After clinical recovery, follow-up MRI revealed the development of atrophy in the initially affected hippocampus. Two patients who had recurrent paraneoplastic autoimmune encephalitis manifesting as status epilepticus showed new T2 lesions involving different structures. Conclusion: The presence of limbic and extra-limbic T2 signal abnormalities in new-onset status epilepticus should suggest the diagnosis of a paraneoplastic syndrome, especially when status epilepticus is refractory to treatment. The lesions are consistently seen as hyperintense on T2WI. - Highlights: • New onset status epilepticus can be caused by paraneoplastic encephalitis.

  17. Neuroimaging in status epilepticus secondary to paraneoplastic autoimmune encephalitis

    Energy Technology Data Exchange (ETDEWEB)

    Sarria-Estrada, S., E-mail: ssarria@idi-cat.org [Magnetic Resonance Unit, Radiology Department, Vall d' Hebrón University Hospital, Barcelona (Spain); Toledo, M. [Epilepsy Unit, Neurology Department, Vall d' Hebrón University Hospital, Barcelona (Spain); Lorenzo-Bosquet, C.; Cuberas-Borrós, G. [Nuclear Medicine Department, Vall d' Hebrón University Hospital, Barcelona (Spain); Auger, C.; Siurana, S.; Rovira, À. [Magnetic Resonance Unit, Radiology Department, Vall d' Hebrón University Hospital, Barcelona (Spain)

    2014-08-15

    Aim: To describe the characteristic magnetic resonance imaging (MRI) findings of paraneoplastic autoimmune encephalitis in patients with new-onset status epilepticus. Materials and methods: The neuroimaging and clinical data of five patients with paraneoplastic autoimmune encephalitis debuting as status epilepticus were retrospectively reviewed. All patients met the criteria for definite paraneoplastic syndrome and all underwent brain MRI during the status epilepticus episode or immediately after recovery. Results: All patients showed hyperintense lesions on T2-weighted imaging (WI) involving the limbic structures, specifically the hippocampus. Three of them showed additional extra-limbic areas of signal abnormalities. The areas of T2 hyperintensity were related to the electroclinical onset of the seizures. In three patients, various techniques were used to study cerebral perfusion, such as arterial spin labelling MRI, single photon-emission computed tomography (SPECT) and 2-[{sup 18}F]-fluoro-2-deoxy-D-glucose (FDG)-positron-emission tomography (PET). Arterial spin labelling showed hyperperfusion overlapping the inflammatory lesions, whereas PET and SPECT disclosed increased perfusion and increased metabolism. The subtraction SPECT co-registered to MRI (SISCOM) demonstrated hypermetabolism outside the areas of encephalitis. After clinical recovery, follow-up MRI revealed the development of atrophy in the initially affected hippocampus. Two patients who had recurrent paraneoplastic autoimmune encephalitis manifesting as status epilepticus showed new T2 lesions involving different structures. Conclusion: The presence of limbic and extra-limbic T2 signal abnormalities in new-onset status epilepticus should suggest the diagnosis of a paraneoplastic syndrome, especially when status epilepticus is refractory to treatment. The lesions are consistently seen as hyperintense on T2WI. - Highlights: • New onset status epilepticus can be caused by paraneoplastic encephalitis

  18. Adverse effects of parenteral dexamethasone in the treatment of pemphigus vulgaris

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    Mohammad Jamal Uddin

    2016-08-01

    Full Text Available Background: Pemphigus vulgaris is associated with high morbidity as well as significant mortality rate. Today the risk of death in pemphigus from the side effect of oral prednisolone is greater than risk of death from the disease itself. Objec­tive: To observe the adverse effects of parenteral dexamethasone compared with oral prednisolone in the treatment of pemphigus vulgaris. Methods: An interventional study was carried out in the department of Dermatology and Venereol­ogy, Bangabandu Sheikh Mujib Medical University, Dhaka, Bangladesh. Total number of patients was thirty and among them fifteen patients were treated with parenteral dexamethasone (Group-A and other fifteen were treated with oral prednisolone (Group-B. Results: The study showed statistically significant differences of skin lesion as well as mucosal lesion of pemphigus after 6 weeks of therapy between of two groups (P<0.05. The most common adverse effects were increased body weight(40%, increased appetite(40%, and puffy face(40% in dexamethasone group. In prednisolone group, these side effects were 60% of the subjects. Other side effects in dexamethasone group were hyperglycemia (33.33%, hypertension (26.66%, and sleep disturbance (13.33%. In prednisolone group, other side effects were hyperglycemia(33.33%, hypertension(40%, gastritis (33.33%, nausea, vomiting (13.33% in each , reactivation of tuberculosis, herpes zoster infection, sleep disturbance, and mood change were 6.66% in each group. Conclusion: In the light of the findings of the study, we conclude that each of the treatment of dexamethasone group and prednisolone group is individually effective and safe in the treatment of pemphigus vulgaris but adverse effects are less in parenteral dexamethasone group than oral prednisolone group. So parenteral dexamethasone can be used as an alternative drug in the treatment of pemphigus vulgaris.

  19. The Oesophageal Involvement of Pemphigus Vulgaris Patients and Comparison with Skin Findings

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    Sıla Şeremet

    2008-10-01

    Full Text Available Background and Design: The pemphigus family includes a number of disease which feature intraepidermal blisters with acantholysis. Pemphigus vulgaris(PV is the most common form of pemphigus, affects the skin and mucous membranes. Although oral mucosa is the most commonly affected site, all stratified squamous epithelium can be involved like pharynx, larynx, oesophagus, conjunctiva, vaginal, penile, and anal mucosa. We planned our study aiming to find frequency of oesophagus involvement in PV patients and to compare them immunohistopathologically with skin findings.Material and Method: Twenty three female and seven male patients, who were admitted to The Health Ministry Vakıf Gureba Education and Research Hospital, Dermatology Clinic, in between January 2004 and March 2005, and were accepted as PV according to clinical and immunohistopathological findings. Mucosal biopsies were taken by oesophagoscopy from patients in the same time with skin biopsies for DIF examination. Antibody titers in serum was detected by indirect immunofluorescein method.Results: DIF was positive in twenty eight patients while two patients had negative results. During oesophagoscopy, macroscopically nine patients (%30 had esophageal lesions supporting pemphigus vulgaris.When a relationship were examined between dysphagia with endoscopic pemphigus vulgaris findings, skin involvement, oral mucosal involvement, genital mucosal involvement, skin DIF positivity, oesophagus DIF positivity, IIF positivity, no meaningful difference was found istatistically. In our study, four patients had endoscopic findings and nineteen patients had positive DIF results although they did not have gastrointestinal symptoms. When relationship between oesophageal DIF positivity and skin DIF positivity was examined, there was a positive correlation meaningfully. Conclusion: According to our article we believe that upper GI endoscopy is a useful and neccessary diagnostic method in pemphigus vulgaris

  20. Intermediate doses of rituximab used as adjuvant therapy in refractory pemphigus

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    Pradnya J Londhe

    2014-01-01

    Full Text Available Background: Rituximab, a monoclonal anti-CD20 antibody, has been used with encouraging results in pemphigus. We describe herein refractory cases of pemphigus vulgaris (n = 23 and pemphigus foliaceus (n = 1 treated with rituximab in addition to steroids and immunosuppressants. Aims: To assess the response to treatment, the duration of clinical remission, serology of the response and adverse effects of rituximab in pemphigus patients. Methods: We recorded observations of 24 patients with pemphigus having either refractory disease in spite of high dose of steroids and immunosuppressants, corticosteroid-dependent disease, strong contraindications to corticosteroids, or severe disease. The patients were treated with infusions of one injection per week for three consecutive weeks of 375 mg of rituximab per m 2 of body-surface area. One similar infusion was repeated after 3 months of 3 rd dose. We observed the clinical outcome after 6 months of 3 rd dose of rituximab and looked for complete healing of cutaneous and mucosal lesions (complete remission. Observations: After follow-up of 7-24 months, five patients showed only partial improvement while 19 of 24 patients had a complete remission 3 months after rituximab. Of these 19 patients, 12 patients achieved complete remission and are off all systemic therapy, and the rest are continuing with no or low dose of steroids with immunosuppressants. Two patients relapsed after initial improvement; one was given moderate dose of oral steroids and immunosuppressant and the other was given repeat single dose of rituximab to control relapse. Conclusion: Rituximab is able to induce a prolonged clinical remission in pemphigus after a single course of four infusions. The high cost and limited knowledge of long term adverse effects are limitations to the use of this biologic agent.

  1. Current Pathophysiological Aspects and Therapeutic Modalities for Pemphigus Vulgaris : A Review

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    J Raviraj

    2007-01-01

    Full Text Available Pemphigus vulgaris (PV is an autoimmune disorder manifesting primarily as blisters involving the mucocutaneous systems. The current medical literature indicates many breakthroughs in the research of pathophysiology and treatment aspects of PV. This article tries to describe some of the novel aspects briefing the role of nondesmoglein antibodies and the role of TNF-alpha in the etiopathogenesis of pemphigus vulgaris and the role of newer therapeutic modalities like Rituximab, Etanercept, intravenous Immunoglobulins, cholinergic drugs, arid the like in the treatment of PV.

  2. The Prevalence of Pemphigus (Razi Hospital and Department of Oral Pathology, Tehran University of Medical Sciences

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    Eshghyar N

    1999-12-01

    Full Text Available The aim of this retrospective statistical study was to determine the prevalcence and frequency of"nage and sex distributions of pemphigus disease. Pemphigus disease classified as autoimmune bullous"ndermatoses which is a chronic mucocutaneous disease."nThis study was performed in Razi Hospital and department of oral pathology of dental school, Tehran"nUniversity of Medical Sciences. The most frequently effected area was buccal moucosa of oral cavity. The"nmost rate of recurrence was found in oral cavity which being more common in middle age females (25-44"nyears.

  3. Loss of normal anagen hair in pemphigus vulgaris.

    Science.gov (United States)

    Daneshpazhooh, M; Mahmoudi, H R; Rezakhani, S; Valikhani, M; Naraghi, Z S; Mohammadi, Y; Habibi, A; Chams-Davatchi, C

    2015-07-01

    Pemphigus vulgaris (PV) is a known cause of loss of 'normal' anagen hair; that is, shedding of intact anagen hairs covered by root sheaths. However, studies on this subject are limited. To investigate anagen hair shedding in patients with PV, and ascertain its association with disease severity. In total, 96 consecutive patients with PV (new patients or patients in relapse) who were admitted to the dermatology wards of a tertiary hospital were enrolled in this study. Demographic data, PV phenotype, disease severity and presence of scalp lesions were recorded. A group of 10-20 hairs were pulled gently from different areas of the scalp (lesional and nonlesional skin) in all patients, and anagen hairs were counted. Disease severity was graded according to Harman score. Anagen hair was obtained by pull test in 59 of the 96 patients (61.5%), of whom 2 had normal scalp. The mean ± SD anagen hair count was 5.9 ± 7.6 (range 0-31). In univariate analysis, anagen hair loss (P hair count was significantly higher in the severe (mean 6.83 ± 7.89) than the moderate (mean 1.06 ± 1.94) subgroup (P hair loss (OR = 1.16, 95% CI = 1.05-1.28, P hair loss was an independent predictor of the disease severity. © 2015 British Association of Dermatologists.

  4. Endemic pemphigus foliaceus over a century: Part I.

    Science.gov (United States)

    Abréu-Vélez, Ana María; Reason, Iara J de Messias; Howard, Michael S; Roselino, Ana Maria

    2010-02-01

    Endemic pemphigus foliaceus (EPF) is the only known autoimmune disease presenting in circumscribed geographic areas. We aim to provide information concerning the natural course of EPF, including systemic compromise in the presteroid era, which has been largely unavailable in the current medical literature. MATERIAL #ENTITYSTARTX00026; By a retrospective review of the literature we aim to compile and compare the focus of EPF and the current knowledge about them. The main aim of this review is to summarize our current knowledge of EPF, including data described almost one century ago; and, to include several unindexed reports, which may have not been available to many current scientists and health care personnel. Foci of EPF have been described in several Central American and South American countries, affecting predominately young people and Amerindians, with an additional female predilection. Although most cases have occurred in Brazil, some cases have been reported in Peru, Paraguay, El Salvador, and Venezuela. Another variant of EPF has been described in El Bagre, Colombia, affecting older men and a few post-menopausal females. Finally, another type of EPF was described in nomadic tribes affecting females of child bearing age in Tunisia, Africa. Our understanding of EPF has been hampered by a lack of government attention to these diseases, especially in some South and Central American countries. Other factors that have made past studies of EPF difficult include 1) that the disease foci are often located in rural areas bordering the rain forest of underdeveloped countries; and 2) military conflicts in some of these areas.

  5. Paraneoplastic limbic encephalitis presenting as a neurological emergency: a case report

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    Mehta Brijesh P

    2010-03-01

    Full Text Available Abstract Introduction Paraneoplastic limbic encephalitis remains a challenging clinical diagnosis with poor outcome if it is not recognized and treated early in the course of the disease. Case Presentation A 65-year-old Caucasian woman presented with generalized tonic-clonic seizures and increasing confusion shortly after a lung biopsy that led to the diagnosis of small-cell lung cancer. She had a complicated hospital course, and had recurrent respiratory distress due to aspiration pneumonia, and fluctuating mental status and seizures that were refractory to anti-epileptic drug treatment. Routine laboratory testing, magnetic resonance imaging of the brain, electroencephalogram, lumbar puncture, serum and cerebrospinal fluid tests for paraneoplastic antibodies, and chest computed tomography were performed on our patient. The diagnosis was paraneoplastic limbic encephalitis in the setting of small-cell lung cancer with positive N-type voltage-gated calcium channel antibody titer. Anti-epileptic drugs for seizures, chemotherapy for small-cell lung cancer, and intravenous immunoglobulin and steroids for paraneoplastic limbic encephalitis led to a resolution of her seizures and improved her mental status. Conclusion Early recognition of paraneoplastic limbic encephalitis and prompt intervention with immune therapies at the onset of presentation will probably translate into more favorable neurological outcomes.

  6. Autoimmune neurological syndromes associated limbic encephalitis and paraneoplastic cerebellar degeneration.

    Science.gov (United States)

    Ayas, Zeynep Özözen; Kotan, Dilcan; Aras, Yeşim Güzey

    2016-10-06

    Autoimmune neurological syndrome is a group of disorders caused by cancer affecting nervous system by different immunological mechanisms. In this study, we aim to study the clinical symptoms, cerebrospinal fluid (CSF) findings, autoantibody tests, computed tomography (CT), magnetic resonance imaging (MRI) signs and treatment outcome of patients with autoimmune syndromes. In this study, 7 patients (4 male, 3 female) diagnosed with autoimmune neurological syndrome were retrospectively examined. Five of patients were diagnosed with limbic encephalitis, two of them were paraneoplastic cerebellar degeneration. Confusion and seizure were the most seen symptoms. Two patients had psychiatric disturbances (28,5%) followed by seizure. Headache was seen in 2 patients (% 28,5), disartria in 1 patient (% 14,2), and gait disorder in 2 patients (28,5%). The duration of symptoms was 46 (3-150) days on average. CSF abnormalities were detected in 2 patients. CT and MRI of the brain was available in all patients. Five patients had involvement of mesiotemporal region, two patients had diffuse cerebellar atrophy. One of patients had anti-GABAR B1 positivity. Tumors were detected in 2 patients while investigation for paraneoplasia screening. Remission is only possible with the detection and treatment of the malignancy. Early diagnosis and treatment are of paramount importance. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  7. Are Onconeural Antibodies a Clinical Phenomenology in Paraneoplastic Limbic Encephalitis?

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    Hongliang Zhang

    2013-01-01

    Full Text Available Paraneoplastic neurological syndromes (PNSs occur in patients with cancer and can cause clinical symptoms and signs of dysfunction of the nervous system that are not due to a local effect of the tumor or its metastases. Most of these clinical syndromes in adults are associated with lung cancer, especially small cell lung cancer (SCLC, lymphoma, and gynecological tumors. The finding of highly specific antibodies directed against onconeural antigens has revolutionized the diagnosis and promoted the understanding of these syndromes and led to the current hypothesis of an autoimmune pathophysiology. Accumulating data strongly suggested direct pathogenicity of these antibodies. The field of PNS has expanded rapidly in the past few years with the discovery of limbic encephalitis associated with glutamic acid decarboxylase (GAD 65, the voltage (VGKC-gated potassium channel complex, the methyl (N-NMDA-D-aspartate, alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA, and gamma aminobutyric acid (GABA (B receptors, and so forth. Despite this, the clinical spectrum of these diseases has not yet been fully investigated. The clinical importance of these conditions lies in their frequent response to immunotherapies and, less commonly, their association with distinctive tumors. This review provides an overview on the pathogenesis and diagnosis of PNS, with emphasis on the role of antibodies in limbic encephalitis.

  8. Unusual paraneoplastic syndromes of breast carcinoma: a combination of cerebellar degeneration and Lambert-Eaton Myasthenic Syndrome.

    LENUS (Irish Health Repository)

    Romics, L

    2011-06-01

    Paraneoplastic neurological disorders are rare complications of breast carcinoma. Lambert-Eaton Myasthenic Syndrome (LEMS) is most commonly associated with small cell lung cancer. However, a combination of LEMS and subacute cerebellar degeneration as paraneoplastic syndromes is extremely rare, and has never been described in association with breast cancer.

  9. AS3MT, GSTO, and PNP polymorphisms: impact on arsenic methylation and implications for disease susceptibility.

    Science.gov (United States)

    Antonelli, Ray; Shao, Kan; Thomas, David J; Sams, Reeder; Cowden, John

    2014-07-01

    Oral exposure to inorganic arsenic (iAs) is associated with adverse health effects. Epidemiological studies suggest differences in susceptibility to these health effects, possibly due to genotypic variation. Genetic polymorphisms in iAs metabolism could lead to increased susceptibility by altering urinary iAs metabolite concentrations. To examine the impact of genotypic polymorphisms on iAs metabolism. We screened 360 publications from PubMed and Web of Science for data on urinary mono- and dimethylated arsenic (MMA and DMA) percentages and polymorphic genes encoding proteins that are hypothesized to play roles in arsenic metabolism. The genes we examined were arsenic (+3) methyltransferase (AS3MT), glutathione-s-transferase omega (GSTO), and purine nucleoside phosphorylase (PNP). Relevant data were pooled to determine which polymorphisms are associated across studies with changes in urinary metabolite concentration. In our review, AS3MT polymorphisms rs3740390, rs11191439, and rs11191453 were associated with statistically significant changes in percent urinary MMA. Studies of GSTO polymorphisms did not indicate statistically significant associations with methylation, and there are insufficient data on PNP polymorphisms to evaluate their impact on metabolism. Collectively, these data support the hypothesis that AS3MT polymorphisms alter in vivo metabolite concentrations. Preliminary evidence suggests that AS3MT genetic polymorphisms may impact disease susceptibility. GSTO polymorphisms were not associated with iAs-associated health outcomes. Additional data are needed to evaluate the association between PNP polymorphisms and iAs-associated health outcomes. Delineation of these relationships may inform iAs mode(s) of action and the approach for evaluating low-dose health effects for iAs. Genotype impacts urinary iAs metabolite concentrations and may be a potential mechanism for iAs-related disease susceptibility. Published by Elsevier Inc.

  10. HLA class II alleles of susceptibility and protection in Brazilian and Dutch pemphigus foliaceus

    NARCIS (Netherlands)

    de Sena Nogueira Maehara, L; De-Souza-Santana, F C; Porro, A M; Marcos, E V C; Ura, S; Nolte, I M; Pas, H H; Jonkman, M F; Tomimori, J

    Pemphigus foliaceus (PF) is a worldwide chronic autoimmune bullous disease targeting desmoglein 1 (Dsg 1) on epithelial cell surface of skin and mucous membranes, causing lesions in skin but sparing mucosa, since the latter contain compensating desmoglein 3(1) . Several environmental triggers for

  11. Putative contact ketoconazole shampoo-triggered pemphigus foliaceus in a dog.

    Science.gov (United States)

    Sung, Hyun-Jeong; Yoon, In-Hwa; Kim, Jung-Hyun

    2017-09-01

    A 10-year-old spayed female cocker spaniel dog was referred for an evaluation of acute-onset generalized pustular cutaneous lesions following application of ketoconazole shampoo. Cytologic and histopathologic examinations of the lesions revealed intra-epidermal pustules with predominantly neutrophils and acantholytic cells. This is the first description of putative contact ketoconazole shampoo-triggered pemphigus foliaceus in a dog.

  12. Sarcomatoid carcinoma of kidney, presenting with leucocytosis as paraneoplastic syndrome: A case report and short review

    Directory of Open Access Journals (Sweden)

    Joydeep Ghosh

    2017-01-01

    Full Text Available Renal cell carcinoma is the ninth most common malignancy. The commonest histopathological type is clear cell carcinoma. The occurrence of sarcomatoid carcinoma is very rare and confers a very poor prognosis. Only 10-20% patients present with paraneoplastic syndromes. Out of the common paraneoplastic syndromes, leucocytosis is one of the least reported. Here, we present a case of sarcomatoid carcinoma of kidney who presented with low-grade fever and leucocytosis, followed by a short review of literature. This is one of the rare situations where a rare histologic variant presents with a rare finding.

  13. Autonomic dysfunction in Hodgkin and non-Hodgkin lymphoma. A paraneoplastic syndrome?

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    Franca Bilora

    2010-11-01

    Full Text Available We wanted to determine whether autonomic dysfunction in patients with lymphoma is related to chemotherapy or represent a paraneoplastic syndrome. 40 patients with current or cured Hodgkin or non-Hodgkin lymphoma and 40 healthy controls, matched for age, gender, hypertension and diabetes mellitus underwent autonomic evaluation (Deep Breath, Valsalva Maneuver, Hand Grip, Lying to Standing, Tilt Test. Current patients also suffering from diabetes or hypertension, or still on chemotherapy revealed autonomic changes, while cured or healthy subjects did not. Autonomic dysfunction in lymphoma is a transient manifestation of a paraneoplastic syndrome.

  14. Imaging of limbic para-neoplastic encephalitis; Imagerie de l`encephalite limbique paraneoplastique

    Energy Technology Data Exchange (ETDEWEB)

    Rimmelin, A.; Sellat, F.; Morand, G.; Quoix, E.; Clouet, P.L.; Dietemann, J.L. [Centre Hospitalier Universitaire, 67 - Strasbourg (France)

    1997-09-01

    Para-neoplastic limbic encephalitis is a rare syndrome mostly associated with small cell lung cancer. We present the case of a 69-year-old man with selective amnesia suggesting limbic encephalitis. A neuroendocrine cell lung cancer was found, confirming the diagnostics of para-neoplastic limbic encephalitis. Contrast-enhanced cerebral CT was normal whether magnetic resonance imaging showed signal abnormalities of the medial part of temporal lobes and hippocampal regions. Because neurologic improvement may follow treatment of the primary tumor, early diagnosis is important. (authors). 10 refs.

  15. Limbic encephalitis and antibodies to Ma2: a paraneoplastic presentation of breast cancer.

    Science.gov (United States)

    Sutton, I; Winer, J; Rowlands, D; Dalmau, J

    2000-08-01

    A patient with atypical medullary breast cancer is described who presented with symptoms of limbic encephalitis. The patient's serum and CSF contained antibodies that reacted with the nervous system and the tumour. These antibodies recognised Ma2, a neuronal protein related to paraneoplastic limbic and brainstem encephalitis in men with testicular tumours. This report highlights the importance of testing for paraneoplastic antineuronal antibodies in cases of unexplained limbic encephalitis and suggests screening for breast cancer in women with antibodies predominantly directed to Ma2.

  16. Paraneoplastic syndrome in urothelial carcinoma of the kidney: difficulty in diagnosis and deterioration in prognosis

    Directory of Open Access Journals (Sweden)

    I. E. Mamaev

    2015-01-01

    Full Text Available Paraneoplastic syndrome is not a common concomitance of urothelial tumors. The literature describes a few tens of clinical cases in which urothelial cancer has become a cause of marked nonspecific tumor-associated reactions, associated with the presence of the tumor. Bladder tumors are at stake in all cases. The given clinical observation describes paraneoplastic manifestations in high-grade urothelial carcinoma of the kidney. It demonstrates difficulties in differential diagnosis and gives a retrospective estimate of diagnostic and therapeutic tactics.

  17. The Aluminum-Free P-n-P InGaAsN Double Heterojunction Bipolar Transistors

    Energy Technology Data Exchange (ETDEWEB)

    CHANG,PING-CHIH; LI,N.Y.; BACA,ALBERT G.; MONIER,C.; LAROCHE,J.R.; HOU,H.Q.; REN,F.; PEARTON,S.J.

    2000-08-01

    The authors have demonstrated an aluminum-free P-n-P GaAs/InGaAsN/GaAs double heterojunction bipolar transistor (DHBT). The device has a low turn-on voltage (V{sub ON}) that is 0.27 V lower than in a comparable P-n-p AlGaAs/GaAs HBT. The device shows near-ideal D. C. characteristics with a current gain ({beta}) greater than 45. The high-speed performance of the device are comparable to a similar P-n-p AlGaAs/GaAs HBT, with f{sub T} and f{sub MAX} values of 12 GHz and 10 GHz, respectively. This device is very suitable for low-power complementary HBT circuit applications, while the aluminum-free emitter structure eliminates issues typically associated with AlGaAs.

  18. Singlet-to-triplet ratio in the deuteron breakup reaction pd → pnp at 585 MeV

    International Nuclear Information System (INIS)

    Uzikov, Yu.N.; Komarov, V.I.; Rathmann, F.; Seyfarth, H.

    2001-01-01

    Available experimental data on the exclusive pd → pnp reaction at 585 MeV show a narrow peak in the proton-neutron final-state interaction region. It was supposed previously, on the basis of a phenomenological analysis of the shape of this peak, that the final spin-singlet pn state provided about one third of the observed cross section. By comparing the absolute value of the measured cross section with that of pd elastic scattering using the Faeldt-Wilkin extrapolation theorem, it is shown here that the pd → pnp data can be explained mainly by the spin-triplet final state with a singlet admixture of a few percent. The smallness of the singlet contribution is compatible with existing pN → pNπ data and the one-pion exchange mechanism of the pd → pnp reaction

  19. Pemphigus foliaceus in dogs: a review of 37 cases.

    Science.gov (United States)

    Ihrke, P J; Stannard, A A; Ardans, A A; Griffin, C E

    1985-01-01

    Thirty-seven dogs with pemphigus foliaceus were seen over a span of 9 years in a veterinary medical teaching hospital. Four breeds of dogs (Bearded Collie, Akita, Newfoundland, Schipperke) were at significant elevated risk when compared with both the dermatology canine case population and the hospital canine population. The mean age of onset was 4.2 years. The dorsal part of the muzzle was the most common site of initial involvement in over 50% of the dogs, and lesions of the head were seen first in 81% of the dogs. Disease progression was gradual (greater than 3 months) in 73% of the dogs. Somewhat bilaterally symmetric scaling, crusting, and alopecia were seen in all of the dogs. Vesicles, pustules, and bullae were not seen commonly, but target lesions with peripheral collarettes were seen frequently. Most dogs had characteristic footpad lesions, with erythematous swelling at the pad margins, cracking, and villous hypertrophy. Generalized exfoliative dermatitis was seen in dogs with widespread disease. Pruritus was noted in less than one half of the dogs. Typical histopathologic findings included subcorneal and intragranular cell layer epidermal pustules, or intrafollicular pustules with prominent acantholysis. Direct immunofluorescence in an intercellular pattern was noted in 76% of the dogs tested and indirect immunofluorescence was noted in 75% of a much smaller sample. Thirty-nine percent of the dogs responded to corticosteroid therapy alone, and 50% and 55% responded, respectively, to prednisone and cytotoxic drugs, and to prednisone with aurothioglucose. Aurothioglucose was successful alone in 27% of the dogs. One-year survival was achieved in 53% of the dogs.

  20. Crystal structures of carbamate kinase from Giardia lamblia bound with citric acid and AMP-PNP.

    Directory of Open Access Journals (Sweden)

    Kap Lim

    Full Text Available The parasite Giardia lamblia utilizes the L-arginine dihydrolase pathway to generate ATP from L-arginine. Carbamate kinase (CK catalyzes the last step in this pathway, converting ADP and carbamoyl phosphate to ATP and ammonium carbamate. Because the L-arginine pathway is essential for G. lamblia survival and absent in high eukaryotes including humans, the enzyme is a potential target for drug development. We have determined two crystal structures of G. lamblia CK (glCK with bound ligands. One structure, in complex with a nonhydrolyzable ATP analog, adenosine 5'-adenylyl-β,γ-imidodiphosphate (AMP-PNP, was determined at 2.6 Å resolution. The second structure, in complex with citric acid bound in the postulated carbamoyl phosphate binding site, was determined in two slightly different states at 2.1 and 2.4 Å resolution. These structures reveal conformational flexibility of an auxiliary domain (amino acid residues 123-170, which exhibits open or closed conformations or structural disorder, depending on the bound ligand. The structures also reveal a smaller conformational change in a region associated the AMP-PNP adenine binding site. The protein residues involved in binding, together with a model of the transition state, suggest that catalysis follows an in-line, predominantly dissociative, phosphotransfer reaction mechanism, and that closure of the flexible auxiliary domain is required to protect the transition state from bulk solvent.

  1. [Anti-Ma2-associated encephalitis and paraneoplastic limbic encephalitis].

    Science.gov (United States)

    Yamamoto, Tomotaka; Tsuji, Shoji

    2010-08-01

    Anti-Ma2-associated encephalitis (or anti-Ma2 encephalitis) is a paraneoplastic neurological syndrome (PNS) characterized by isolated or combined limbic, diencephalic, or brainstem dysfunction. Anti-Ma2 antibodies detected in the serum or cerebrospinal fluid of patients are highly specific for this disease entity and belong to a group of well-characterized onconeuronal antibodies (or classical antibodies). The corresponding antigen, Ma2 is selectively expressed intracellularly in neurons and tumors as is the case with other onconeuronal antigens targeted by classical antibodies. However, in most cases the clinical pictures are different from those of classical PNS and this creates a potential risk of underdiagnosis. Although limbic dysfunction is the most common manifestation in patients with anti-Ma2 encephalitis which is one of the major causes of paraneoplastic limbic encephalitis (LE), it has been reported that less than 30% of the patients with anti-Ma2 LE exhibit clinical presentations typical of the classical description of LE. Of the remaining, many exhibit excessive daytime sleepiness, vertical ophthalmoparesis, or both associated with LE, because of frequent involvement of the diencephalon and/or upper brainstem. Anti-Ma2 LE can also be manifested as a pure psychiatric disturbance such as obsessive-compulsive disorder in a few cases. Some patients develop mesodiencephalic encephalitis with minor involvement of the limbic system, and some may manifest severe hypokinesis. About 40% of the patients with anti-Ma2 antibodies also have antibodies against different epitopes on Ma1, a homologue of Ma2. These patients may have predominant cerebellar and/or brainstem dysfunctions due to more extensive involvement of subtentorial structures. Anti-Ma2 encephalitis is outstanding among other PNS associated with classical antibodies in that the response rate to treatment is relatively high. While it can cause severe neurological deficits or death in a substantial

  2. GIANT CELL AORTITIS DIAGNOSED WITH PET/CT - PARANEOPLASTIC SYNDROME?

    Science.gov (United States)

    Bakula, Marija; Cerovec, Mislav; Mayer, Miroslav; Huić, Dražen; Anić, Branimir

    2016-05-01

    Vasculitides are heterogenic group of autoimmune connective tissue diseases which often present difficulties in early diagnosing. Giant cell arteritis is vasculitis of large and medium arteries. It predominantly presents with symptoms of affection of the external carotid artery branches. Furthermore, the only symptoms can be constitutional. In clinical practice, vasculitides are sometimes considered as paraneoplastic, but no definite association with malignancies has been established and the mechanisms are still debated. The gold standard for diagnosing giant cell arteritis is a positive temporal artery biopsy, but the results can often be false negative. Additionally, more than half of the patients have aorta and its main branches affected. Considering aforementioned, imaging studies are essential in confirming large-vessel vasculitis, amongst which is highly sensitive PET/CT. We present the case of a 70-year-old female patient with constitutional symptoms and elevated sedimentation rate. After extensive diagnostic tests, she was admitted to our Rheumatology unit. Aortitis of the abdominal aorta has been confirmed by PET/CT and after the introduction of glucocorticoids the disease soon went into clinical and laboratory remission. Shortly after aortitis has been diagnosed, lung carcinoma was revealed of which the patient died. At the time of the comprehensive diagnostics, there was no reasonable doubt for underlying malignoma. To the best of our knowledge, there are no recent publications concerning giant cell arteritis and neoplastic processes in the context of up-to-date non-invasive diagnostic methods (i.e. PET/CT). In the light of previous research results, we underline that the sensitivity of PET/CT is not satisfactory when estimating cancer dissemination in non-enlarged lymph nodes and that its value can at times be overestimated.

  3. Molecular and clinical diversity in paraneoplastic immunity to Ma proteins.

    Science.gov (United States)

    Rosenfeld, M R; Eichen, J G; Wade, D F; Posner, J B; Dalmau, J

    2001-09-01

    Antibodies to Ma1 and Ma2 proteins identify a paraneoplastic disorder that affects the limbic system, brain stem, and cerebellum. Preliminary studies suggested the existence of other Ma proteins and different patterns of immune response associated with distinct neurologic symptoms and cancers. In this study, our aim was to isolate the full-length sequence of Ma2 and new family members, identify the major autoantigen of the disorder, and extend the dinical-immunological analysis to 29 patients. Sera from selected patients were used to probe a brainstem cDNA library and isolate the entire Ma2 gene and a new family member, Ma3. Ma3 mRNA is ubiquitously expressed in brain, testis, and several systemic tissues. The variable cellular expression of Ma proteins and analysis of protein motifs suggest that these proteins play roles in the biogenesis of mRNA. Immunoblot studies identify Ma2 as the major autoantigen with unique epitopes recognized by all patients' sera. Eighteen patients had antibodies limited to Ma2: they developed limbic, hypothalamic, and brainstem encephalitis, and 78% had germ-cell tumors of the testis. Eleven patients had antibodies to Ma2 and additional antibodies to Ma1 and/or Ma3; they usually developed additional cerebellar symptoms and more intense brainstem dysfunction, and 82% of these patients had tumors other than germ-cell neoplasms. Overall, 17 of 24 patients (71%) with brain magnetic resonance imaging studies had abnormalities within or outside the temporal lobes, some as contrast-enhancing nodular lesions. A remarkable finding of immunity to Ma proteins is that neurologic symptoms may improve or resolve. This improvement segregated to a group of patients with antibodies limited to Ma2.

  4. Paraneoplastic itch: an expert position statement from the Special Interest Group (SIG) of the International Forum on the Study of Itch (IFSI).

    Science.gov (United States)

    Weisshaar, Elke; Weiss, Melanie; Mettang, Thomas; Yosipovitch, Gil; Zylicz, Zbigniew

    2015-03-01

    In clinical practice, the term "paraneoplastic itch" is used to describe itch in patients with cancer. Patients with hematological or solid tumor malignancies can be affected. In general, paraneoplastic itch is considered a rare disorder. However, paraneoplastic itch in hematological malignancies such as polycythemia vera and lymphoma are relatively frequent while other forms of paraneoplastic itch are in fact extremely rare. The true frequency of this symptom is unclear, epidemiological data in this field are limited. Itch in malignant disease may additionally impair patients' quality of life. A population-based cohort study showed that chronic itch without concomitant skin changes is a risk factor for having undiagnosed hematologic and bile duct malignancies. Paraneoplastic itch is rather resistant to treatment. In 2012, an interdisciplinary interest group of physicians and researchers was founded, aiming to generate a clear definition of paraneoplastic itch. In this paper we briefly review the current knowledge and aim to define what can be summarized under the term "paraneoplastic itch".

  5. An Investigation on Micro-Raman Spectra and Wavelet Data Analysis for Pemphigus Vulgaris Follow-up Monitoring

    OpenAIRE

    Camerlingo, Carlo; Zenone, Flora; Perna, Giuseppe; Capozzi, Vito; Cirillo, Nicola; Gaeta, Giovanni Maria; Lepore, Maria

    2008-01-01

    A wavelet multi-component decomposition algorithm has been used for data analysis of micro-Raman spectra of blood serum samples from patients affected by pemphigus vulgaris at different stages. Pemphigus is a chronic, autoimmune, blistering disease of the skin and mucous membranes with a potentially fatal outcome. Spectra were measured by means of a Raman confocal microspectrometer apparatus using the 632.8 nm line of a He-Ne laser source. A discrete wavelet transform decomposition method has...

  6. The Arabidopsis thaliana natriuretic peptide AtPNP-A is a systemic regulator of leaf dark respiration and signals via the phloem

    KAUST Repository

    Ruzvidzo, Oziniel; Donaldson, Lara Elizabeth; Valentine, Alex J.; Gehring, Christoph A

    2011-01-01

    -molar concentrations. Here we show that a recombinant Arabidopsis thaliana PNP (AtPNP-A) rapidly increased the rate of dark respiration in treated leaves after 5 min. In addition, we observed increases in lower leaves, and with a lag time of 10 min, the effect spread

  7. Technique of forecasting the working capacity of horizontal p-n-p transistor for a given radiation level; Metodika prognozirovaniya rabotosposobnosti gorizontal`nogo p-n-p tranzistora na zadannyj uroven` izlucheniya

    Energy Technology Data Exchange (ETDEWEB)

    Pershenkov, V S; Sevast` yanov, A V

    1994-12-31

    Methods of forecasting the degradation of horizontal p-n-p transistors under the effect of ionizing radiation based on the principles of invariant topological approach are presented. Results are presented and analysis of experimental investigations into the real test structures performed in the same process cycle as the integral circuit under development is given.

  8. Rare Association of Anti-Hu Antibody Positive Paraneoplastic Neurological Syndrome and Transitional Cell Bladder Carcinoma

    Directory of Open Access Journals (Sweden)

    S. Lukacs

    2012-01-01

    Full Text Available Introduction. Paraneoplastic encephalomyelitis (PEM and subacute sensory neuronopathy (SSN are remote effects of cancer, usually associated with small-cell lung carcinoma and positive anti-Hu antibody. We describe the rare association of bladder transitional cell carcinoma (TCC with anti-Hu antibody positivity resulting in this paraneoplastic neurological syndrome. Patient. A 76-year-old female presented with bilateral muscle weakness and paraesthesia of the upper and lower limbs in a length-dependent “glove and stocking” distribution. Central nervous system symptoms included cognitive problems, personality change, and truncal ataxia. Case notes and the literature were reviewed. Result. Autoantibody screening was positive for anti-Hu antibody (recently renamed antineuronal nuclear antibody 1, ANNA-1. The diagnosis of PEM and SSN was supported by MRI and lumbar puncture results. A superficial bladder TCC was demonstrated on CT and subsequently confirmed on histology. No other primary neoplasm was found on full-body imaging. The neurological symptoms were considered to be an antibody-mediated paraneoplastic neurological syndrome and improved after resection of the tumour. Discussion. The association of anti-Hu positive paraneoplastic neurological syndrome and TCC has not been described in the literature previously. We emphasize the need for detailed clinical examination and the importance of a multidisciplinary thought process and encourage further awareness of this rare association.

  9. Paraneoplastic neurological syndromes with anti-hu antibodies : Pathogenesis and treatment

    NARCIS (Netherlands)

    A.H.C. de Jongste (Arjen)

    2015-01-01

    markdownabstract__Abstract__ Paraneoplastic neurological syndromes (PNS) are remote effects of cancer that are neither caused by invasion of the tumor or its metastasis, nor by infection, ischemia, metabolic and nutritional deficits, surgery or other forms of tumor treatment.1 PNS cause severe

  10. Polyneuropathy in a patient with malignant pleural mesothelioma: a paraneoplastic syndrome

    DEFF Research Database (Denmark)

    Bech, C.; Sørensen, Jens Benn

    2008-01-01

    Paraneoplastic syndromes have only been reported in malignant pleural mesothelioma (MPM) in a few cases. In this case, we describe a 57-year-old man with MPM who developed sensory-motor polyneuropathy 18 days after diagnosis. Thorough endocrinological, neurological, and paraclinical examinations...

  11. Paraneoplastic Choreoathetosis in a Patient with Small Cell Lung Carcinoma and Anti-CRMP5/CV2: A Case Report

    DEFF Research Database (Denmark)

    Lassen, Lisbeth Landschoff; Somnier, Finn; Aydin, Dogu

    2016-01-01

    Introduction: The occurrence of more or less monosymptomatic paraneoplastic choreoathetosis associated with anti-CRMP5/CV2 antibodies is rare. Typically, such autoantibodies are associated with a more classical syndrome - paraneoplastic encephalomyelitis. Frequently, small cell lung carcinoma (SCLC...... 14 months after the onset of the symptoms. Conclusion: We report paraneoplastic choreoathetosis associated with anti-CRMP5/CV2 antibodies. Such published case histories are rare. Although expected, we did not find any reduced signal intensity at the basal ganglia on the T1-weighted or increased...

  12. EPSTEIN-BARR VIRUS AND CYTOMEGALOVIRUS: IS THEIR ROLE IN PEMPHIGUS REALLY INCIDENTAL? A PRELIMINARY REPORT

    Directory of Open Access Journals (Sweden)

    N. V. Makhneva

    2016-01-01

    Full Text Available Background: Epstein-Barr (EBV and cytomegaloviral (CMV infections are among most prevalent in the population worldwide that are associated with autoimmune processes. However, conflicting data of the studies on the role of herpes viral infections in the etiology of autoimmune pemphigus does not allow for reliable recognition of these viruses as triggers in the development and course of this bullous dermatosis. Aim: To assess specific IgM and IgG antibodies to herpes virus infections in patients with autoimmune pemphigus. Materials and methods: Serum samples from 15  patients with autoimmune pemphigus were analyzed by chemoluminescent immunoassay. Results: In the serum samples of 14/15 (93.3% patients with autoimmune pemphigus we found specific IgG antibodies to nuclear and capsid EBV proteins at the levels of 30.7 to 600 U/mL (median, 147.5 [102.62; 313.25] U/mL and from 33.5 to 567 U/mL (median, 186 [85.95; 492.5] U/mL, respectively. Specific IgG antibodies to the EBV early protein were found only in 6.7% of cases. In all patients, there were no specific IgM antibodies to EBV capsule antigens. All patients (100% had specific IgG anti-CMV antibodies in the range from 64.5 to 138 U/mL (median, 103.5 [94.83; 113.75] U/mL. In 30% of cases, there were specific IgM anti-CMV antibodies at titers of 11 to 12.3 U/mL (median, 5 [5; 9.5] U/mL. Conclusion: The results of the preliminary study showed that 93.3%  of autoimmune pemphigus cases have an underlying chronic infection caused by EBV and CMV. The finding of the high titers of IgG anti-EBV and anti-CMV antibodies allows to conclude that the association of these viruses with the bullous dermatosis is not just a chance. It makes further research undoubtedly necessary. Its results would draw more accurate conclusions on the role of EBV and CMV in the pathogenesis of autoimmune pemphigus and to find new perspectives in the treatment of patients with this life-threatening disease.

  13. Purine Nucleoside Phosphorylase (PNP) Activity of Lymphocytes and T Cell Subsets in Peripheral Blood in Thyroid Tumors

    International Nuclear Information System (INIS)

    Kim, Dong Soo

    1992-01-01

    To elucidate alteration of purine nucleoside phosphorylase (PNP) activity of peripheral lymphocytes and helper/inducer and suppressor/cytototxic T cells in patients with thyroid tumors, the author examined PNP activity, and CD4 + and CD8 + cells of peripheral blood in 20 cases of simple goiter, 9 cases of thyroid adenoma and 20 cases of thyroid cancer as well as 11 cases of adult healthy subjects as control. Diagnoses were established on the basis of commonly accepted clinical and biochemical criteria in simple goiter and were confirmed histopathologically in thyroid adenoma and cancer. All blood was obtained from veins of the patients and control subjects in Pusan National University Hospital during the period of January to August, 1991. The results obtained were summarized as follows: 1) The PNP activity was significantly decreased or tended to be decreased in thyroid adenomas and cancers as compared with control subjects and simple goiters. 2) The percentage of CD8 cells was significantly decreased or tended to be decreased in thyroid cancers as compared with simple goiters, thyroid adenomas and control subjects. 3) The CD4/CD8 ratio was significantly increased or tended to be increased in thyroid cancer as compared with simple goiters, thyroid adenomas and control subjects. On the basis of the results, it can be suggested that the immunodysfunction in thyroid cancer may be due to decreased suppressor/cytotoxic T cells, and the estimation of PNP activity of peripheral lymphocyte is a helpful test in detecting the immune status in thyroid tumors.

  14. Ionizing/displacement synergistic effects induced by gamma and neutron irradiation in gate-controlled lateral PNP bipolar transistors

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Chenhui, E-mail: wangchenhui@nint.ac.cn [State Key Laboratory of Intense Pulsed Irradiation Simulation and Effect, Northwest Institute of Nuclear Technology, P.O. Box 69-10, Xi’an 710024 (China); Chen, Wei; Yao, Zhibin; Jin, Xiaoming; Liu, Yan; Yang, Shanchao [State Key Laboratory of Intense Pulsed Irradiation Simulation and Effect, Northwest Institute of Nuclear Technology, P.O. Box 69-10, Xi’an 710024 (China); Wang, Zhikuan [State Key Laboratory of Analog Integrated Circuit, Chongqing 400060 (China)

    2016-09-21

    A kind of gate-controlled lateral PNP bipolar transistor has been specially designed to do experimental validations and studies on the ionizing/displacement synergistic effects in the lateral PNP bipolar transistor. The individual and mixed irradiation experiments of gamma rays and neutrons are accomplished on the transistors. The common emitter current gain, gate sweep characteristics and sub-threshold sweep characteristics are measured after each exposure. The results indicate that under the sequential irradiation of gamma rays and neutrons, the response of the gate-controlled lateral PNP bipolar transistor does exhibit ionizing/displacement synergistic effects and base current degradation is more severe than the simple artificial sum of those under the individual gamma and neutron irradiation. Enough attention should be paid to this phenomenon in radiation damage evaluation. - Highlights: • A kind of gate-controlled lateral PNP bipolar transistor has been specially designed to facilitate the analysis of ionizing/displacement synergistic effects induced by the mixed irradiation of gamma and neutron. • The difference between ionizing/displacement synergistic effects and the simple sum of TID and displacement effects is analyzed. • The physical mechanisms of synergistic effects are explained.

  15. Investigations on accidents with massive water ingress exemplified by the pebble bed reactor PNP-500

    International Nuclear Information System (INIS)

    Moormann, R.

    1986-01-01

    A computer code is used for analyses of massive water ingress accidents in the High-Temperature Gas Cooled Reactor concept PNP-500 with pebble bed core. The analyses are mainly focussed on graphite corrosion processes. For the investigated accidents a correct reactor shut down in assumed. The mass of water ingressing into the primary circuit is varied between 1000 and 7500 kg (i.e., up to hypothetical values). The dependence of accident consequences on parameters such as intensity and starting time of the afterheat removal system or kinetic values of the chemical processes is examined. The results show that even under pessimistic assumptions the extent of the graphite corrosion is relatively low; significant damaging of fuel elements or graphite components does not occur. A primary circuit depressurization, combined with local burning of water gas, would probably not affect the fission product retention potential of the (gastight) containment. Summing up, the risk caused by these accidents remains small. (orig.) [de

  16. Final state interaction in the pd → pnp reaction at 1 GeV

    International Nuclear Information System (INIS)

    Deloff, A.

    1992-09-01

    The pd → pnp reaction at 1 GeV in both the direct and charge exchange channel has been investigated. The experimental data come from a line reversed beam-target experiment with 3.3 GeV/c deuterons incident on a proton target. In the direct channel data exhibit narrow structures in the np effective mass spectra: at threshold, at 2.02 GeV and at 2.12 GeV which have been seen before and we report on a new narrow enhancement at 1.95 GeV. In charge exchange channel the data show somewhat broader peak at 2.18 GeV. The data are explained by using a conventional approach, i.e. without sub-nucleonic degrees of freedom, but including the ΔN channel in NN scattering. 29 figs., 1 tab., 36 refs. (author)

  17. Management of recalcitrant oral pemphigus vulgaris with CO 2 laser - Report of two cases

    Directory of Open Access Journals (Sweden)

    Bhardwaj Ashu

    2010-01-01

    Full Text Available Laser has been used efficiently for treatment of oral lichen planus, leukoplakia, aphthous ulcers and oral manifestations of HIV. Two cases of recalcitrant oral pemphigus vulgaris that were successfully treated with CO 2 laser are described. The patients had been treated by a dermatologist with pulse therapy of methyl prednisolone and cyclophosphamide over a period of 6 to 8 months, but the clinical course was characterized by episodes of painful flare-ups and nonresponsiveness. The patients were extremely uncomfortable with recurrent oral lesions. CO 2 laser at low power was used to irradiate the lesions. It was shown to be effective in relieving pain and healing of lesions, with nonrecurrence. To the best of our knowledge, this is the first case report of such a treatment of oral pemphigus vulgaris. Further clinical studies are warranted to confirm efficacy and to optimize the treatment protocol.

  18. Anti-Yo Mediated Paraneoplastic Cerebellar Degeneration Associated with Pseudobulbar Affect in a Patient with Breast Cancer

    Directory of Open Access Journals (Sweden)

    Allison N. Martin

    2017-01-01

    Full Text Available Paraneoplastic cerebellar degeneration (PCD is a rare anti-Yo mediated paraneoplastic syndromes rarely that is infrequently associated with breast cancer. We present a case of a 52-year-old female presenting with diplopia, gait instability, dysarthria, dysphagia, nystagmus, and, most notably, new onset paroxysmal episodes of uncontrollable crying concerning for pseudobulbar affect (PBA. Serologic testing showed anti-Yo antibodies. The patient was found to have stage IIIA breast cancer as the inciting cause of the paraneoplastic syndrome. The patient was treated with neoadjuvant chemotherapy, modified radical mastectomy, adjuvant Herceptin, and pertuzumab. She was given IVIG for paraneoplastic syndrome, antidepressants, and dextromethorphan-quinidine (Nuedexta, the first FDA-approved therapy for PBA. With multimodality therapy, she demonstrated significant improvement in neurologic and mood symptoms associated with PCD and PBA.

  19. Analysis of immunological profile, clinical features and response to treatment in pemphigus.

    Science.gov (United States)

    Bardazzi, Federico; Balestri, Riccardo; Ismaili, Alma; LA Placa, Michelangelo; Barisani, Alessia; Patrizi, Annalisa

    2017-12-01

    Pemphigus is an autoimmune disease, characterized by the presence of serum autoantibodies against Desmoglein (Dsg) 1 and 3. It can affect the skin and/or the mucous membranes. Some authors found a correlation between the serum levels of autoantibodies, disease activity and clinical phenotype of pemphigus. Anti Dsg1 autoantibodies appear related to cutaneous phenotype, anti Dsg3 autoantibodies to mucosal involvement. From 2011 to 2014, in patients with pemphigus, the serum levels of anti-Dsg1 and 3 antibodies were determined with enzyme-linked immuno-sorbent assay at diagnosis and after 6 months of different therapies. The correlations between levels of autoantibodies, clinical phenotype, clinical activity and response to therapy, were investigated. Thirty-five patients were included. Clinical phenotypes were: mucosal in 17 patients; mucous-cutaneous in 11; and cutaneous in 7. The status of anti-Dsg1 autoantibodies was significantly related to the cutaneous and mucous-cutaneous phenotypes both at diagnosis and after 6 months. The status of anti-Dsg3 autoantibodies was significantly related to the mucosal and mucous-cutaneous phenotypes only at first evaluation. No significant correlations were found between disease activity and the status of autoantibodies. No significant variations of autoantibody levels (between first and second sample) were found with regard to different therapies, except for the variation of anti-Dsg1 autoantibodies in one patient treated with systemic steroids and methotrexate. A correlation between serum levels of autoantibodies and clinical phenotype was found. Further studies over a longer follow-up period may better characterize the correlation between autoantibody levels, clinical activity and response to different therapies of pemphigus.

  20. Prognostic factors of pemphigus vulgaris disease: a study on 119 patients

    Directory of Open Access Journals (Sweden)

    Halaji Z

    2009-03-01

    Full Text Available "nBackground: Since the systemic steroids are introduced in Pemphigus Vulgaris treatment, the prognosis of disease improved significantly. This study was designed to evaluate determining factors in the prognosis of pemphigus vulgaris in Iranian patients. "nMethods: In this study, 119 patients with documented pemphigus vulgaris who had presented to Razi Hospital from 2001 until 2003 were included. These patients had presented for the first time and treated with prednisolone and Azathioprine. Morality rate, minor and major relapses and duration of first remission had been defined as prognostic criteria and correlation between them and other demographic variables and disease characteristics were investigated. "nResults: The majority of patients (84.1% were followed for more than one year. The major recurrence and minor recurrence occurred in 28(23.5% and 65(54.6% of patients respectively, no case of mortality was observed. In patients who received treatment six months or less after onset of disease the frequency of major recurrence was less than the others. 18(17.8% vs. 12(41.4%, (p=0.009. Duration of primary remission more than one year was detected in most of the patients (64.7%. In patients with less than 10 initial cutaneous lesions, period of primary remission was longer than the other patients. (p=0.009. Shorter duration of primary remission were noted in older patients (age>50 in comparison with younger patients (age≤50, p=0.04. "nConclusions: Male gender, old age, interval more than 6 months between onsets of symptoms to initial treatment and more than 10 skin lesions on admission, are associated with poor prognosis of pemphigus vulgaris.

  1. Pemphigus. S2 Guideline for diagnosis and treatment - guided by the European Dermatology Forum (EDF) in cooperation with the European Academy of Dermatology and Venereology (EADV)

    NARCIS (Netherlands)

    Hertl, M.; Jedlickova, H.; Karpati, S.; Marinovic, B.; Uzun, S.; Yayli, S.; Mimouni, D.; Borradori, L.; Feliciani, C.; Ioannides, D.; Joly, P.; Kowalewski, C.; Zambruno, G.; Zillikens, D.; Jonkman, M. F.

    BACKGROUND: Pemphigus encompasses a group of life-threatening autoimmune bullous diseases characterized by blisters and erosions of the mucous membranes and skin. Before the era of immunosuppressive treatment, the prognosis of pemphigus was almost fatal. Due to its rarity, only few prospective

  2. A Hypothesis Concerning a Potential Involvement of Ceramide in Apoptosis and Acantholysis Induced by Pemphigus Autoantibodies

    Directory of Open Access Journals (Sweden)

    Wendy B. Bollag

    2010-01-01

    Full Text Available Autoimmune diseases affect more than 50 million Americans, resulting in significant healthcare costs. Most autoimmune diseases occur sporadically; however, endemic pemphigus foliaceus (EPF is an autoimmune skin disease localized to specific geographic loci. EPF, and the related diseases pemphigus vulgaris (PV and pemphigus foliaceus (PF, are characterized by skin lesions and autoantibodies to molecules found on epidermal keratinocytes. A variant of EPF in patients from El Bagre, Colombia, South America, has recently been reported to be distinct from previously described loci in Brazil and Tunisia epidemiologically and immunologically. As in PF and EPF, El Bagre EPF patients exhibit autoantibodies towards desmoglein-1, a cell adhesion molecule critical for maintaining epidermal integrity. An association of El Bagre EPF with sun exposure has been detected, and ultraviolet irradiation also exacerbates symptoms in PV, PF and EPF. Our hypothesis is that: (1 the autoantibodies generate pathology through an alteration in ceramide metabolism in targeted keratinocytes, resulting in apoptosis and/or cell death and acantholysis, but only when the cell's ability to metabolize ceramide is exceeded, and (2 apoptosis in response to this altered ceramide metabolism is initiated and/or exacerbated by other agents that increase ceramide levels, such as cytokines, ultraviolet irradiation, and senescence.

  3. A hypothesis concerning a potential involvement of ceramide in apoptosis and acantholysis induced by pemphigus autoantibodies.

    Science.gov (United States)

    Bollag, Wendy B

    2010-01-01

    Autoimmune diseases affect more than 50 million Americans, resulting in significant healthcare costs. Most autoimmune diseases occur sporadically; however, endemic pemphigus foliaceus (EPF) is an autoimmune skin disease localized to specific geographic loci. EPF, and the related diseases pemphigus vulgaris (PV) and pemphigus foliaceus (PF), are characterized by skin lesions and autoantibodies to molecules found on epidermal keratinocytes. A variant of EPF in patients from El Bagre, Colombia, South America, has recently been reported to be distinct from previously described loci in Brazil and Tunisia epidemiologically and immunologically. As in PF and EPF, El Bagre EPF patients exhibit autoantibodies towards desmoglein-1, a cell adhesion molecule critical for maintaining epidermal integrity. An association of El Bagre EPF with sun exposure has been detected, and ultraviolet irradiation also exacerbates symptoms in PV, PF and EPF. Our hypothesis is that: (1) the autoantibodies generate pathology through an alteration in ceramide metabolism in targeted keratinocytes, resulting in apoptosis and/or cell death and acantholysis, but only when the cell's ability to metabolize ceramide is exceeded, and (2) apoptosis in response to this altered ceramide metabolism is initiated and/or exacerbated by other agents that increase ceramide levels, such as cytokines, ultraviolet irradiation, and senescence.

  4. Catalytic mechanisms of direct pyrrole synthesis via dehydrogenative coupling mediated by PNP-Ir or PNN-Ru pincer complexes: Crucial role of proton-transfer shuttles in the PNP-Ir system

    KAUST Repository

    Qu, Shuanglin

    2014-04-02

    Kempe et al. and Milstein et al. have recently advanced the dehydrogenative coupling methodology to synthesize pyrroles from secondary alcohols (e.g., 3) and β-amino alcohols (e.g., 4), using PNP-Ir (1) and PNN-Ru (2) pincer complexes, respectively. We herein present a DFT study to characterize the catalytic mechanism of these reactions. After precatalyst activation to give active 1A/2A, the transformation proceeds via four stages: 1A/2A-catalyzed alcohol (3) dehydrogenation to give ketone (11), base-facilitated C-N coupling of 11 and 4 to form an imine-alcohol intermediate (18), base-promoted cyclization of 18, and catalyst regeneration via H2 release from 1R/2R. For alcohol dehydrogenations, the bifunctional double hydrogen-transfer pathway is more favorable than that via β-hydride elimination. Generally, proton-transfer (H-transfer) shuttles facilitate various H-transfer processes in both systems. Notwithstanding, H-transfer shuttles play a much more crucial role in the PNP-Ir system than in the PNN-Ru system. Without H-transfer shuttles, the key barriers up to 45.9 kcal/mol in PNP-Ir system are too high to be accessible, while the corresponding barriers (<32.0 kcal/mol) in PNN-Ru system are not unreachable. Another significant difference between the two systems is that the addition of alcohol to 1A giving an alkoxo complex is endergonic by 8.1 kcal/mol, whereas the addition to 2A is exergonic by 8.9 kcal/mol. The thermodynamic difference could be the main reason for PNP-Ir system requiring lower catalyst loading than the PNN-Ru system. We discuss how the differences are resulted in terms of electronic and geometric structures of the catalysts and how to use the features in catalyst development. © 2014 American Chemical Society.

  5. Polyarthritis and membranoproliferative glomerulonephritis as paraneoplastic manifestation of Hodgkin's lymphoma: A case report and literature review.

    Science.gov (United States)

    Erlij, Daniel; Calderón, Beatriz; Rivera, Angela; Mella, Cristián; Valladares, Ximena; Roessler, Emilio; Rivera, María Teresa; Méndez, Gonzalo

    2016-01-01

    Paraneoplastic syndromes can be presented in multiple ways, which include endocrinological, hematologic, rheumatologic and nephrologic manifestations. While most of the publications described solid tumors as responsible for these manifestations, hematologic neoplasms are important cause to consider as part of the differential diagnosis. We report the case of a 46 year-old man with seronegative symmetric polyarthritis of large and small joints associated with membranoproliferative glomerulonephritis with deposits of immune complexes and acute impairment of renal function, as part of a paraneoplastic syndrome secondary of a classical Hodgkin lymphoma with bone marrow invasion, which reversed completely with chemotherapy treatment. Copyright © 2015 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

  6. Retrospective study of paraneoplastic neurological syndromes in a Chinese Han population from Shandong, East China.

    Science.gov (United States)

    Miao, Shuai; Liao, Shaohua; Li, Heng; Niu, Bing; Hu, Huaiqiang; Qian, Ying; Guo, Hongwei; Cao, Bingzhen

    2018-02-05

    To analyze the clinical features, diagnostic strategies and therapeutic methods associated with paraneoplastic neurological syndromes. A retrospective study of paraneoplastic neurological syndromes was performed at a single center in Shandong, East China. The medical records and follow-up data of 28 patients were intensively reviewed between February 2011 and December 2014. Twenty-four (85.7%) patients experienced subacute or chronic onset of disease, and the most common symptoms reported were mild myasthenia and paresthesias. Twenty-five (89.3%) patients presented nervous system lesions prior to occult tumors, and the median time frame between paraneoplastic neurological syndromes onset and the diagnosis of a tumor was 15 weeks. Sensorimotor neuropathy, Lambert-Eaton myasthenic syndrome and limbic encephalitis were the three most common neurological syndromes reported. Elevated serum tumor markers were observed in 44.0% of patients, while 40.7% of patients were positive for onconeural antibodies. Tumors were detected in 21 (75.0%) patients after repeated whole-body screening, and lung carcinomas were the most common primary tumor detected. Seventeen patients received anti-tumor or immunological therapy, and clinical symptoms were relieved in 13 (76.5%) of these patients. In the majority of paraneoplastic neurological syndromes patients, the onset of disease is subacute or chronic with mild clinical symptoms. Nervous system lesions usually occur prior to occult tumors with complicated and various clinical manifestations. Neither tumor markers nor onconeural antibodies exhibit a high rate of occurrence, while repeated whole-body screening is helpful in identifying occult tumors. Early diagnosis and treatment are crucial to these patients.

  7. Anti Ma2-associated myeloradiculopathy: expanding the phenotype of anti-Ma2 associated paraneoplastic syndromes

    OpenAIRE

    Murphy, Sinead M; Khan, Usman; Alifrangis, Constantine; Hazell, Steven; Hrouda, David; Blake, Julian; Ball, Joanna; Gabriel, Carolyn; Markarian, Pierre; Rees, Jeremy; Karim, Abid; Seckl, Michael J; Lunn, Michael P; Reilly, Mary M

    2011-01-01

    Anti-Ma2 associated paraneoplastic syndrome usually presents as limbic encephalitis in association with testicular tumours.1, 2 Only four patients have been reported with involvement outside the CNS, two of whom also had limbic or brainstem encephalitis.2, 3 We report a man with anti- Ma2 associated myeloradiculopathy and previous testicular cancer whose neurological syndrome stabilised and anti-Ma2 titres fell following orchidectomy of a microscopically normal testis.

  8. Paraneoplastic SIADH and Dermatomyositis in Cervical Cancer: A Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Guy Jones

    2009-11-01

    Full Text Available We present the first known case of a patient with cervical squamous cell carcinoma complicated by paraneoplastic syndromes of both dermatomyositis and inappropriate secretion of antidiuretic hormone (SIADH. The patient in this case presented with generalized body pain and vaginal bleeding. Her cervical cancer was diagnosed as stage IIB by physical exam, imaging, and cervical biopsy, her dermatomyositis was confirmed by muscle and skin biopsy, and her SIADH was diagnosed based on laboratory findings.

  9. Cancer and Scleroderma: A Paraneoplastic Disease with Implications for Malignancy Screening

    Science.gov (United States)

    Shah, Ami A.; Rosen, Livia Casciola

    2015-01-01

    Purpose of review Recent data suggest a paraneoplastic mechanism of scleroderma pathogenesis in unique subsets of scleroderma patients. In this article, we review these data, explore potential links between cancer and scleroderma, and propose an approach to malignancy screening in scleroderma. Recent findings Emerging data have demonstrated that patients with scleroderma and RNA polymerase III autoantibodies have a significantly increased risk of cancer within a few years of scleroderma onset. Genetic alterations in the gene encoding RNA polymerase III (POLR3A) have been identified, and patients with somatic mutations in POLR3A have evidence of mutation specific T cell immune responses with generation of cross-reactive RNA polymerase III autoantibodies. These data strongly suggest that scleroderma is a by-product of anti-tumor immune responses in some patients. Additional epidemiologic data demonstrate that patients developing scleroderma at older ages may also have a short cancer-scleroderma interval, suggestive of paraneoplastic disease. Summary Scleroderma may be a paraneoplastic disease in unique patient subsets. Aggressive malignancy screening in these patients may aid in early cancer detection. Further study is required to determine whether cancer therapy could improve scleroderma outcomes in this patient population. PMID:26352736

  10. Paraneoplastic limbic encephalitis in a patient with extragonadal choriocarcinoma--significance of onconeural antibodies.

    Science.gov (United States)

    Szkandera, Joanna; Ploner, Ferdin; Bauernhofer, Thomas; Kasparek, Anne-Katrin; Payer, Franz; Balic, Marija; Knechtel, Gudrun; Gerger, Armin; Gallè, Günter; Samonigg, Hellmut; Hofmann, Günter

    2010-01-01

    Paraneoplastic limbic or brainstem encephalitis is considered to be an autoimmune-mediated disorder of the nervous system associated with different types of cancer including germ cell tumors. We report on a 31-year-old patient presenting with eye motility dysfunction, dysarthrophonia, lethargy, depression, slow mentation, disorientation, dysgraphia, and retarded motion sequence. Neurologic tests, brain imaging, and blood chemistry tests failed to determine the cause of the symptoms. Further examinations including ultrasound of the abdomen led to the detection of a retroperitoneal mass. The biopsy of this mass showed fractions of a choriocarcinoma. The patient underwent curative chemotherapy, but although the cancer therapy was successful, the neurologic disorders did not improve. Concurrent examination for anti-Ma2 antibodies in the serum was positive and confirmed the paraneoplastic origin of these symptoms. Patients with symptoms of limbic or brainstem encephalitis, especially young men, should be tested for anti-Ma2 antibodies in the serum to elucidate their origin. The detection of these antibodies supports the diagnosis of a paraneoplastic syndrome, and may lead to the earlier identification of an otherwise hidden extragonadal germ cell tumor. Copyright © 2010 S. Karger AG, Basel.

  11. Microscopic dysgerminoma associated with anti-Ma2 paraneoplastic encephalitis in a patient with gonadal dysgenesis.

    Science.gov (United States)

    Abdulkader, Marwah M; Yousef, Mohammad M; Abdelhadi, Mohamad K; Amr, Samir S; Alabsi, Eyad S; Al-Abbadi, Mousa A

    2013-05-01

    We present a 27-yr-old female with gonadal dysgenesis (46, XY), who presented to our hospital with poor consciousness, aphasia, restlessness, and visual hallucination. Physical examination revealed normal breast development and normal external female genetalia. Computed tomography scan of the head and neck revealed the presence of brain edema, hydrocephalous, and a localized hypodense lesion in the hypothalamus. Her serum was positive for the anti-Ma2, which is associated with paraneoplastic encephalitis syndrome. Computed tomography of the abdomen revealed the presence of a 7.5×5.3×3.0 cm solid pelvic mass. Interestingly, a single microscopic focus of dysgerminoma was identified in a background of stromal fibrosis and focal dystrophic calcifications. No ovarian stroma or testicular tissue was identified. To our knowledge, this is the first case of gonadal dysgenesis presenting with anti-Ma2 paraneoplastic encephalitis with dysgerminoma. A discussion about paraneoplastic encephalitis with a microscopic dysgerminoma associated with anti-Ma2 antibody is presented.

  12. 4pnp J=0e-2e autoionizing series of calcium: experimental and theoretical analysis

    International Nuclear Information System (INIS)

    Bolovinos, A.; Luc-Koenig, E.; Assimopoulos, S.; Lyras, A.; Karapanagioti, N.E.; Crete Univ., Iraklion; Charalambidis, D.; Crete Univ., Iraklion; Aymar, M.

    1996-01-01

    The even parity 4pnp J=0, 1, 2 doubly excited autoionizing states of neutral calcium in an atomic beam are investigated by a two-step isolated core excitation (ICE) method using two different combinations of polarization of the laser beams. The different excited energy levels are assigned to nine autoionizing Rydberg series 4p 1/2,3/2 np J=0, 1, 2 for 8≤n≤22. The theoretical interpretation is achieved by a combination of the eigenchannel R-matrix theory and the multichannel quantum defect (MQDT) method. Two, five and six closed interacting channels are introduced for the J=0, J=1 and J=2 series respectively. Theoretical energy level positions, autoionization widths and excitation profiles are compared with the experimental data, confirming the identification of the observed structures and providing evidence of extended mixing between the 4p 1/2 np and 4p 3/2 np series. (orig.). With 9 figs., 3 tabs

  13. The Management of Pemphigus Vulgaris in a Burn Intensive Care Unit: A Case Report and Treatment Review

    Science.gov (United States)

    2014-10-01

    achieving com- plete remission. J Am Acad Dermatol 2011;64:490–4. 10. Martin LK, Werth VP, Villaneuva EV, Murrell DF. A system- atic review of randomized...Cavacini LA, Posner MR. Treatment of pemphigus vulgaris with rituximab and intra- venous immune globulin. N Engl J Med 2006;355:1772–9. 29. Joly P

  14. [Inflammatory myofibroblastic tumor of the lymph node with paraneoplastic thrombosis and eosinophilia].

    Science.gov (United States)

    Behzad, Ali; Müller, Andrea; Rösler, Wolf; Amann, Kerstin; Linke, Rainer; Mackensen, Andreas

    2010-04-01

    A 52-year-old female patient was admitted to hospital because of progressive thrombosis despite therapeutic anticoagulation as well as leukocytosis with eosinophilia and thrombocytopenia. On examination, the patient presented with dyspnea and swelling oft her left leg and arm. The laboratory findings revealed leukocytosis (31,000/microl) with eosinophilia (54%), thrombocytopenia (58,000/microl), together with an increased C-reactive protein of 247 mg/dl (reference range < 5 mg/dl). Initial computed tomography scans showed pulmonary embolism and a slightly enlarged left inguinal lymph node. Histological examination of the lymph node biopsy revealed in part an epitheloid and spindle cell-like tumorous lesion with slightly increased tissue eosinophilia consistent with an inflammatory myofibroblastic tumor (IMT). Resection of the left inguinal lymph node resulted in an immediate regression of the paraneoplastic eosinophilia and thrombocytopenia. Anti-inflammatory medication with ibuprofen was subsequently initiated. Imaging and clinical examination at 3 months after discharge revealed no relapse and no signs of a paraneoplastic syndrome. The IMT is a rare soft-tissue tumor of intermediate dignity with a low tendency to metastasize. It is consistently accompanied by paraneoplastic syndromes. Therapy of choice is complete resection of the tumor. In nonresectable cases, corticosteroids and nonsteroidal antirheumatics have been shown to be effective. Because of the variable clinical course ranging from spontaneous regression to metastasis, IMTs might be separated into different entities (autoimmune, inflammatory, neoplastic subtype) which thus far cannot be classified on a histopathologic basis. A clinical assessment of the dignity is therefore important until further subclassifications of this rare disease become available.

  15. Managing Renal Cell Carcinoma Associated Paraneoplastic Syndrome with Nephron-sparing Surgery in a Patient with von Hippel-Lindau

    Directory of Open Access Journals (Sweden)

    John M. DiBianco

    2017-07-01

    Full Text Available A patient with germline von Hippel-Lindau (VHL gene alteration and history of multiple tumors present with classical paraneoplastic syndrome (PNS associated with renal cell carcinoma (RCC. She underwent open nephron sparing surgery with resolution of symptoms. She remained without recurrence of RCC for the initial 2 years of her follow-up. To the best of our knowledge, this case represents the first in which PNS was specifically resolved using a partial nephrectomy in a patient with VHL. This case report provides initial evidence for the potential role of nephron sparing surgery in the management of paraneoplastic symptoms associated with hereditary RCC.

  16. Paraneoplastic Encephalitis Associated with Anti-Ma2 Antibodies and Mesothelioma-Like Poorly Differentiated Lung Cancer

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    Can Ebru Bekircan

    2009-06-01

    Full Text Available We report a case of paraneoplastic encephalitis associated with anti-Ma2 antibodies. Medical history and thorax computed tomog- raphy findings suggested malignant mesothelioma. Pleural biopsy results were compatible with high-grade neoplastic infiltration. Alt- hough the biopsy could not differentiate the type of neoplasm, mesothelioma was considered a strong possibility in this poorly dif- ferentiated lung carcinoma. To the best of our knowledge this is the first case report of paraneoplastic encephalitis associated with anti-Ma2 antibodies and mesothelioma

  17. Pemphigus vulgaris in a patient with arthritis and uveitis: successful treatment with immunosuppressive therapy and acyclovir.

    Science.gov (United States)

    Pranteda, G; Carlesimo, M; Bottoni, U; Di Napoli, A; Muscianese, M; Pimpinelli, F; Cordiali, P; Laganà, B; Pranteda, G; Di Carlo, A

    2014-01-01

    A case of pemphigus vulgaris in a 41-year-old man with undifferentiated arthritis and uveitis is described. Histology of labial mucosa showed acantholytic, necrotic, and multinucleated giant keratinocytes having some nuclear inclusions suggestive of a virus infection. Specific serological tests revealed IgG positivity for HSV-1, CMV, and EBV, while real-time polymerase chain reaction assay from a biopsy of the mucosal lesion showed the presence of HSV-1/2 DNA. Treatment with prednisone, methotrexate, and acyclovir induced the complete remission of mucosal and joint symptoms, which then relapsed after interruption of antiviral therapy or immunosuppressive therapy. Therefore, a combined treatment with low doses of prednisone, methotrexate, and acyclovir was restarted and during 18 months of follow-up no recurrence was registered. Correlations between pemphigus and the herpes virus infection and also between autoimmune arthritis and herpetic agents have been well documented, but the exact role of the herpes virus in these disorders still needs further discussion. Our case strongly suggests that when autoimmune disorders do not respond to immunosuppressive agents, a viral infection should be suspected, researched, and treated. © 2014 Wiley Periodicals, Inc.

  18. Preliminary data on Pemphigus vulgaris treatment by a proteomics-defined peptide: a case report

    Directory of Open Access Journals (Sweden)

    Mittelman Abraham

    2006-10-01

    Full Text Available Abstract Background Although described by Hippocrates in 400 B.C., pemphigus disease still needs a safe therapeutical approach, given that the currently used therapies (i.e. corticosteroids and immunosuppressive drugs often provoke collateral effects. Here we present preliminary data on the possible use of a proteomics derived desmoglein peptide which appears promising in halting disease progression without adverse effects. Methods The low-similarity Dsg349–60REWVKFAKPCRE peptide was topically applied for 1 wk onto a lesion in a patient with a late-stage Pemphigus vulgaris (PV complicated by diabetes and cataract disease. The peptide was applied as an adjuvant in combination with the standard corticosteroid-based immunosuppressive treatment. Results After 1 wk, the treated PV eroded lesion appeared dimensionally reduced and with an increased rate of re-epithelization when compared to adjacent non-treated lesions. Short-term benefits were: decrease of anti-Dsg antibody titer and reduction of the corticosteroid dosage. Long-term benefits: after two years following the unique 1-wk topical treatment, the decrease of anti-Dsg antibody titer persists. The patient is still at the low cortisone dosage. Adverse effects: no adverse effect could be monitored. Conclusion With the limits inherent to any preliminary study, this case report indicates that topical treatment with Dsg349–60REWVKFAKPCRE peptide may represent a feasible first step in the search for a simple, effective and safe treatment of PV.

  19. Management of Suspected Pemphigus Vulgaris in Elderly Patient with Chronic Diseases

    Directory of Open Access Journals (Sweden)

    Ayu M. Prihanti

    2013-07-01

    Full Text Available 72 1024x768 Pemphigus vulgaris (PV is a group of vesicobullous disease affecting skin and mucous membranes. PV is associated with autoimmune diseases, characterized by binding of IgG autoantibodies to desmoglein 3. PV lesion is a thin-walled bulla arising on the skin or mucosa. Oral mucous bulla are fragile and easily breakdown, forming irreguler ulcers. There are several factors that trigger PV, including genetic factors, age, drugs and food. This paper aimed to report treatment of suspected pemphigus vulgaris in elderly patient with history of chronic diseases. A 75-year-old woman with 2 months history of bulla formation on skin and history of persistent oral ulceration. Ulcers were covered with fibrin and erosive erythematous on labial, buccal and gingival mucosa. History of hypertension, diabetes mellitus and hepatitis was revealed. Routine complete blood count showed thrombocytopenia. Diagnosis was confirmed by anamnesis, clinical examination and complete blood investigation. PV should be distinguished from other vesicobullous disease. Systemic corticosteroid was given concurrently with hepato-protector, mouthwash, supportive therapy and topical lip cream. Bulla on skin and persistent erosive ulcers of the oral mucosa are the manifestations of PV. Elderly patient with history of chronic diseases showed a complex care of PV requiring more intensive and comprehensive treatment.DOI: 10.14693/jdi.v20i1.129

  20. Host-associated populations in the lettuce root aphid, Pemphigus bursarius (L.).

    Science.gov (United States)

    Miller, N J; Kift, N B; Tatchell, G M

    2005-05-01

    Pemphigus bursarius is a host-alternating aphid in which annual rounds of sexual reproduction on its primary host, Populus nigra, are interspersed with parthenogenesis on a range of secondary hosts. Evidence was sought for the existence of genetically distinct populations, associated with different secondary hosts, in P. bursarius. Microsatellite markers revealed that genetically distinct populations were present on three different secondary host species. Microsatellites were also used, in conjunction with mitochondrial DNA sequence variation, to investigate the relationships between aphids on Populus, following sexual reproduction, and those on the secondary hosts. Evidence was found for a distinct, cyclically parthenogenetic population that exploited Lactuca sativa as its secondary host. In contrast, populations associated with Matricaria inodora appeared to be largely composed of obligate parthenogens or may even have been another species of Pemphigus. Populations on Lapsana communis appeared to be a mixture of cyclical and obligate parthenogens and were more genetically heterogeneous than those on other secondary hosts, possibly due to founder effects. Experiments to measure the performance of P. bursarius clones on different secondary hosts were inconclusive, failing to demonstrate either the presence or absence of adaptations to secondary hosts.

  1. Endemic pemphigus in the Peruvian Amazon: epidemiology and risk factors for the development of complications during treatment*

    Science.gov (United States)

    Ramos, Willy; Chacon, Gina Rocio; Galarza, Carlos; Gutierrez, Ericson Leonardo; Smith, Maria Eugenia; Ortega-Loayza, Alex Gerardo

    2012-01-01

    BACKGROUND Pemphigus is an autoimmune blistering disease. According to a report, in areas of endemic pemphigus foliaceus (EPF) in Peru there are cases of pemphigus vulgaris with epidemiologic, clinical and histopathologic characteristics similar to those of "endemic pemphigus vulgaris" (EPV) in Brazil. OBJECTIVES To determine the clinical and epidemiologic characteristics of endemic pemphigus and the risk factors of patients for developing complications during treatment. METHODS A study was carried out from July 2003 to March 2008. The study population was 60 patients with EPF and 7 patients with EPV evaluated in hospitals and clinics in the Peruvian Amazon and Lima. A multivariate analysis was carried out using binary logistic regression. RESULTS The average age of EPF patients was 31.4 years; 55% were men; 60% presented the generalized clinical variant. Non-compliance with the treatment was seen in 57.1% of the patients. Thirty-five percent presented complications (e.g. pyodermitis and pyelonephritis) during treatment. The risk factors for developing complications during treatment were non-compliance with the treatment and having the generalized clinical form. In the EPV group, the average age was 21.7 years; 71.4% were men. All patients presented with the mucocutaneous clinical variant and the initial presentation consisted of oral mucosa lesions; 71.4% presented complications during treatment, pyodermitis being the most frequent. CONCLUSIONS Non-compliance with the treatment and the generalized clinical form are risk factors for the development of complications during treatment of patients with EPF. Peru indeed has EPV cases with epidemiologic characteristics similar to EPF. Living in a rural area may represent a risk factor for the development of complications during treatment of patients with EPV. PMID:23197201

  2. Paraneoplastic limbic encephalitis and possible narcolepsy in a patient with testicular cancer: case study.

    Science.gov (United States)

    Landolfi, Joseph C.; Nadkarni, Mangala

    2003-01-01

    We describe a patient who presented with a clinical syndrome of limbic encephalitis, narcolepsy, and cataplexy. The anti-Ma2 antibody was positive. Although there was no mass on imaging, orchiectomy was performed in this patient, and testicular carcinoma was found. This is the first known case of limbic encephalitis and anti-Ma2 antibody to be associated with cataplexy and possible narcolepsy. Neurological symptoms precede the diagnosis of cancer in 50% of patients with paraneoplastic syndromes, and clinicians are therefore strongly advised to evaluate patients with neurological symptoms for this condition. PMID:12816728

  3. Rapid Eye Movement Sleep Behavior Disorder in Paraneoplastic Cerebellar Degeneration: Improvement with Immunotherapy.

    Science.gov (United States)

    Vale, Thiago Cardoso; Fernandes do Prado, Lucila Bizari; do Prado, Gilmar Fernandes; Povoas Barsottini, Orlando Graziani; Pedroso, José Luiz

    2016-01-01

    To report two female patients with paraneoplastic cerebellar degeneration (PCD) related to breast cancer that presented with rapid eye movement-sleep behavior disorder (RBD) and improved sleep symptoms with immunotherapy. The two patients were evaluated through clinical scale and polysomnography before and after therapy with intravenous immunoglobulin. RBD was successfully treated with immunotherapy in both patients. Score on the RBD screening questionnaire dropped from 10 to 1 or 0, allied with the normalization of polysomnographic findings. A marked improvement in RBD after immunotherapy in PCD raises the hypothesis that secondary RBD may be an immune-mediated sleep disorder. © 2016 Associated Professional Sleep Societies, LLC.

  4. Reversible paraneoplastic encephalomyelitis as the presenting feature of ovarian teratoma: A clinicopathological correlate

    Directory of Open Access Journals (Sweden)

    Rajappa Senthil

    2007-01-01

    Full Text Available Paraneoplastic encephalomyelitis (PEM is a well-characterized neurological syndrome. Its association with ovarian teratoma is rare. A young lady presented with features suggestive of encephalomyelitis with predominant cerebellar syndrome. Magnetic resonance imaging brain was normal. Cerebrospinal fluid showed lymphocytic pleocytosis. Computerized tomography scan of the pelvis revealed a complex left ovarian cyst. With a clinical diagnosis of PEM she underwent a left salpingo-oopherectomy. This was followed by total recovery of the PEM in two weeks. The histopathology revealed immature teratoma. The interesting feature was the clinicopathological correlation between the finding of fetal cerebellar tissue in the tumor and the PEM with predominant cerebellar features.

  5. Papilledema secondary to a superior sagittal sinus thrombosis. Mantle cell lymphoma paraneoplastic syndrome.

    Science.gov (United States)

    Platas-Moreno, I; Antón-Benito, A; Pérez-Cid-Rebolleda, M T; Rosado Sierra, M B

    2016-01-01

    A 46 year old patient presented with visual loss in the left eye during the previous months. Ophthalmoscopic examination and magnetic resonance angiography found the presence of papilledema due to thrombosis in superior sagittal sinus. The examination findings revealed a mantle cell lymphoma. Cerebral venous thrombosis is an unusual cause of papilledema. This type of thrombosis may be secondary to hyper-viscosity within a context of a paraneoplastic syndrome. Copyright © 2015 Sociedad Española de Oftalmología. Published by Elsevier España, S.L.U. All rights reserved.

  6. Relationships between acute toxicities of para nitrophenol (p-NP) and nitrobenzene (NB) to Daphnia magna and Photobacterium phosphoreum: Physicochemical properties and metabolites under anaerobic/aerobic sequentials

    Energy Technology Data Exchange (ETDEWEB)

    Sponza, Delia Teresa, E-mail: delya.sponza@deu.edu.tr [Dokuz Eyluel University, Engineering Faculty, Environmental Engineering Department, Buca Kaynaklar Campus, Buca, Izmir (Turkey); Kuscu, Ozlem Selcuk [Department of Environmental Engineering, Engineering and Architecture Faculty, Sueleyman Demirel University, Cuenuer Campus, 32260 Isparta (Turkey)

    2011-01-30

    In this study, the acute toxicities of nitrobenzene (NB) and para nitrophenol (p-NP) were investigated in a high rate sequential anaerobic migrating blanket (AMBR)/aerobic completely stirred tank reactor (CSTR) using Microtox and Daphnia magna tests. After sequential anaerobic and aerobic treatments, the inhibitions in the Microtox bacteria decreased from an initial 78.10-48.20% and 4.00%, respectively, in wastewater containing 40.00 mg/L p-NP. The inhibitions of the influent wastewater containing 60.00 mg/L NB decreased from 72.10% to 45.30% and to 4.00% after anaerobic and aerobic treatment, respectively. The acute toxicity removals were 94% and 93% in the effluent of the whole sequential system, for p-NP and NB, respectively. The acute toxicity in the influent was dependent on the parent NB and p-NP concentrations and ons their physicochemical properties such as hydrophobicity, octanol/water partition coefficient and vapour density for both Microtox bacteria and Daphnia magna while the toxicity in the effluent of the anaerobic reactor was strongly dependent on the metabolites of p-NP (p-amino phenol, phenol, NH{sub 4}-N) and NB (aniline) for Microtox test. This effluent was not toxic to Daphnia magna.

  7. Relationships between acute toxicities of para nitrophenol (p-NP) and nitrobenzene (NB) to Daphnia magna and Photobacterium phosphoreum: Physicochemical properties and metabolites under anaerobic/aerobic sequentials

    International Nuclear Information System (INIS)

    Sponza, Delia Teresa; Kuscu, Ozlem Selcuk

    2011-01-01

    In this study, the acute toxicities of nitrobenzene (NB) and para nitrophenol (p-NP) were investigated in a high rate sequential anaerobic migrating blanket (AMBR)/aerobic completely stirred tank reactor (CSTR) using Microtox and Daphnia magna tests. After sequential anaerobic and aerobic treatments, the inhibitions in the Microtox bacteria decreased from an initial 78.10-48.20% and 4.00%, respectively, in wastewater containing 40.00 mg/L p-NP. The inhibitions of the influent wastewater containing 60.00 mg/L NB decreased from 72.10% to 45.30% and to 4.00% after anaerobic and aerobic treatment, respectively. The acute toxicity removals were 94% and 93% in the effluent of the whole sequential system, for p-NP and NB, respectively. The acute toxicity in the influent was dependent on the parent NB and p-NP concentrations and ons their physicochemical properties such as hydrophobicity, octanol/water partition coefficient and vapour density for both Microtox bacteria and Daphnia magna while the toxicity in the effluent of the anaerobic reactor was strongly dependent on the metabolites of p-NP (p-amino phenol, phenol, NH 4 -N) and NB (aniline) for Microtox test. This effluent was not toxic to Daphnia magna.

  8. Considerations about the physical rehabilitation and physiotherapy on kinesiologic and functional alterations in a case of Endemic Pemphigus foliaceus - doi:10.5020/18061230.2007.p124

    Directory of Open Access Journals (Sweden)

    Carlos Hermano da Justa Pinheiro

    2012-01-01

    Full Text Available The pemphigus foliaceus is a very common skin disease in the Center-West region of Brazil and is named endemic due to its incidence in some regions of the country, South America and Latin America. In Northeast Brazil, the pemphigus foliaceus is considered a rare disease. The bearers of endemic pemphigus foliaceus show an intense healing process associated with metabolic alterations that affect the skeletal muscle and can compromise in different ways the kinesiology of the locomotor apparatus. The aim of this study was to describe a pemphigus foliaceus case in Ceara state, focusing on the postural and functional aspects of the locomotor apparatus in the clinical evolution of the disease. Case report: A pediatric patient bearer of endemic pemphigus foliaceus, resident at a mountain region of Ceará, with clinical data consisting of erythematous lesions, crusts, few visible vesicle-blister lesions, intense itch, cutaneous adhesions, postural deformities and alterations in the flexor tonus of the limbs, compromising movement extent. The physiotherapeutic protocol prescribed consisted of active exercises, inhibition of flexor tonus, passive elongation and walk training. After 3 weeks, the patient was already strolling and showed improvement in muscular and joint function. The physiotherapy when precociously done can prevent the formation of cutaneous adhesions and muscular weakness, preserving the range of motion present in diseases with an intense healing process such as endemic pemphigus foliaceus.

  9. A Case of Paraneoplastic Remitting Seronegative Symmetrical Synovitis with Pitting Edema Syndrome Improved by Chemotherapy

    Directory of Open Access Journals (Sweden)

    Takahiko Sakamoto

    2017-12-01

    Full Text Available The patient was a 69-year-old male who had started experiencing acute-onset pain in both shoulder joints and edema of both hands and feet. His symptoms progressively worsened within 1 month. Laboratory data indicated elevated CRP and erythrocyte sedimentation rate despite the normal range of antinuclear antibodies and rheumatoid factor and normal organ function. Furthermore, imaging data of the hand indicated synovitis without bone erosions. Meanwhile, chest CT revealed a lung tumor, leading to a diagnosis of primary lung adenocarcinoma with EGFR mutation (cT2aN3M0, stage IIIB. Based on these findings, he was diagnosed as suffering from paraneoplastic remitting seronegative symmetrical synovitis with pitting edema (RS3PE syndrome. Thereafter, his symptoms disappeared as the tumor size was rapidly decreased by gefitinib therapy for lung adenocarcinoma. Currently, RS3PE syndrome can be classified as a vascular endothelial growth factor (VEGF-associated disorder. Given that his symptoms improved by chemotherapy, the present case further supported the possible hypothesis that paraneoplastic RS3PE syndrome might be caused by tumor-induced VEGF. Therefore, the present case suggested that the symptoms of acute-onset joint pain accompanied by pitting edema in elderly patients should be considered suspicious for a malignant tumor, thereby warranting a detailed full-body examination.

  10. Superior Vena Cava Syndrome due to Thrombosis: A Rare Paraneoplastic Presentation of Bronchogenic Carcinoma

    Directory of Open Access Journals (Sweden)

    Avradip Santra

    2016-07-01

    Full Text Available Superior vena cava (SVC syndrome is not an uncommon occurrence in patients with malignancy and it is often described as a medical emergency. In majority of the cases, SVC syndrome occurs due to mechanical obstruction of the SVC by extraluminal compression with primary intrathoracic malignancies. However, intraluminal obstruction due to thrombosis can also produce symptoms and signs of SVC syndrome. Clot-related SVC obstruction is mostly associated with indwelling central venous catheter and pacemaker leads, although such thrombosis can occur spontaneously in a background of a hypercoagulable state, e.g., malignancy. Here, an unusual case of sudden onset SVC syndrome has been reported, which on initial radiologic evaluation was found to have a lung nodule without any significant mediastinal mass or adenopathy compressing SVC. Subsequent investigation with Doppler ultrasonography of the neck showed thrombosis in the right internal jugular, right subclavian and right brachiocephalic vein, which was responsible for SVC syndrome. Histopathological evaluation of lung nodule confirmed presence of an adenocarcinoma. Therefore, venous thromboembolism as a paraneoplastic syndrome should be kept in mind while evaluating a case of SVC obstruction in a cancer patient. Management of the underlying disease is of prime importance in such cases and anticoagulation is the mainstay of therapy. Ability to identify paraneoplastic syndrome may have a significant effect on clinical outcome, ranging from early diagnosis to improved quality of life of the patient.

  11. Voltage-Gated Potassium Channel Antibody Paraneoplastic Limbic Encephalitis Associated with Acute Myeloid Leukemia

    Directory of Open Access Journals (Sweden)

    Marion Alcantara

    2013-05-01

    Full Text Available Among paraneoplastic syndromes (PNS associated with malignant hemopathies, there are few reports of PNS of the central nervous system and most of them are associated with lymphomas. Limbic encephalitis is a rare neurological syndrome classically diagnosed in the context of PNS. We report the case of a 81-year-old man who presented with a relapsed acute myeloid leukemia (AML with minimal maturation. He was admitted for confusion with unfavorable evolution as he presented a rapidly progressive dementia resulting in death. A brain magnetic resonance imaging, performed 2 months after the onset, was considered normal. An electroencephalogram showed non-specific bilateral slow waves. We received the results of the blood screening of neuronal autoantibodies after the patient's death and detected the presence of anti-voltage-gated potassium channel (VGKC antibodies at 102 pmol/l (normal at <30 pmol/l. Other etiologic studies, including the screening for another cause of rapidly progressive dementia, were negative. To our knowledge, this is the first case of anti-VGKC paraneoplastic limbic encephalitis related to AML.

  12. Second primary tumor in anti-Ma1/2-positive paraneoplastic limbic encephalitis.

    Science.gov (United States)

    Leyhe, T; Schüle, R; Schwärzler, F; Gasser, T; Haarmeier, T

    2006-05-01

    Memory loss can be a symptom of paraneoplastic limbic encephalitis (PLE) a neuropsychiatric disorder associated mostly with small-cell lung cancer and anti-Hu antibodies or with testicular tumors and anti-Ma2 antibodies. We present the case of a patient with temporal coincidence of beginning cognitive decline and diagnosis of a carcinoma of the prostate in whom we diagnosed anti-Ma1/Ma2-positive PLE. The tumor had been completely resected but memory impairment further deteriorated. As the effective treatment of the cancer is considered as the most efficient treatment of a paraneoplastic neurological syndrome (PNS) a second neoplasia was suspected in the patient. By the aid of whole body positron emission tomography with 18-fluorine fluoro-2-deoxy-glucose (FDG-PET) an adenocarcinoma of the cecum could be detected. Two months after surgery anti-Ma antibodies were negative. We conclude that a second neoplasia should be considered, if effective cancer treatment does not lead to improvement or stabilisation of a PNS. Tumor search should be exhaustive and include PET when conventional imaging fails to show a malignancy.

  13. Performance assessment of the (Th,U)O2 HTI-Biso coated particle under PNP/HHT irradiation conditions

    International Nuclear Information System (INIS)

    Kania, M.J.; Nickel, H.

    1980-11-01

    The HTI Biso Particle, Variant-I: consisting of a dense 400 μm-diameter (Th,U)O 2 -kernel with a Biso coating using a methane derived pyrocarbon layer (HTI), is a candidate fuel for the advanced PNP/HHT High Temperature Reactor systems. This report presents the results of a comprehensive performance assessment of Variant-I represented by six relevant particle batches irradiated in 12 accelerated irradiation experiments. Fuel performance was judged based upon PNP/HHT qualification requirements with regard to in-reactor operating conditions and end-of-life (EOL) coated particle failure fraction. Fuel operating conditions in each irradiation experiment were obtained from two sources: 1) a thorough review of all available irradiation data on each experiment; and 2) a two-dimensional (R,theta) thermal modeling computer code, R2KTMP, was developed to calculate fuel operating temperature distributions within spherical elements. End-of-life particle failure fractions were determined from: gaseous fission product release, based on in-reactor R/B measurements and postirradiation annealing and room temperature investigations; solid fission product release, from single particle 137 Cs release into fuel element matrix and hot-gaseous chlorine leaching; and visual and ceramographic examinations. Failure fractions determined by solid fission product release yielded values 2-35 times higher than those determined by gaseous fission product release. (orig.) [de

  14. Enhanced low dose rate sensitivity (ELDRS) in a voltage comparator which only utilizes complementary vertical NPN and PNP transistors

    International Nuclear Information System (INIS)

    Krieg, J.F.; Titus, J.L.; Emily, D.; Gehlhausen, M.; Swonger, J.; Platteter, D.

    1999-01-01

    For the first time, enhanced low dose rate sensitivity (ELDRS) is reported in a vertical bipolar process. A radiation hardness assurance (RHA) test method was successfully demonstrated on a linear circuit, the HS139RH quad comparator, and its discrete transistor elements. This circuit only uses vertical NPN and PNP transistors. Radiation tests on the HS139RH were performed at 25 C using dose rates of 50 rd(Si)/s, 100 mrd(Si)/s and 10 mrd(Si)/s, and at 100 C using a dose rate of 10 rd(Si)/s. Tests at dose rates of 50 rd(Si)/s at 25 C and 10 rd(Si)/s at 100 C were performed on discrete vertical NPN and PNP transistor elements which comprise the HS139RH. Transistor and circuit responses were evaluated. The die's passivation overcoat layers were varied to examine the effect of removing a nitride layer and thinning a deposited SiO 2 (silox) layer

  15. A case of limbic encephalitis presenting as a paraneoplastic manifestation of limited stage small cell lung cancer: a case report

    Directory of Open Access Journals (Sweden)

    Butt Mohammad

    2010-12-01

    Full Text Available Abstract Introduction The differential diagnosis of altered mental status and behavioral change is very extensive. Paraneoplastic limbic encephalitis is a rare cause of cognitive impairment, which should be considered in the differential diagnosis. Case presentation A 64-year-old British Caucasian woman presented to our hospital with a 12-week history of confusion and short-term memory loss. She was hyponatremic with a serum sodium level of 128mmol/L. Moreover, there was evidence of left hilar prominence on the chest radiograph. A thoracic computed tomography scan showed left hilar opacity with confluent lymphadenopathy. A percutaneous biopsy confirmed a diagnosis of small cell lung cancer. There was no radiological evidence of brain metastasis on the computed tomography scan. In view of continued cognitive impairment, which was felt to be disproportionate to hyponatremia, a magnetic resonance imaging scan of the brain was undertaken. It showed hyperintense signals from both hippocampi, highly suggestive of limbic encephalitis presenting as a paraneoplastic manifestation of small cell lung cancer. She had a significant radiological and clinical response following chemotherapy and radiotherapy. Conclusion This case highlights the importance of considering paraneoplastic syndromes in patients with neurological symptoms in the context of lung malignancy. If initial investigations fail to reveal the cause of cognitive impairment in a patient with malignancy, magnetic resonance imaging may be invaluable in the diagnosis of limbic encephalitis. The clinical presentation, diagnostic techniques and management of paraneoplastic limbic encephalitis are discussed in this case report.

  16. A STUDY OF PREVALENCE OF DEPRESSION AND ANXIETY IN PATIENTS WITH PEMPHIGUS VULGARIS- A CROSS SECTIONAL STUDY

    Directory of Open Access Journals (Sweden)

    Periyar Rani Selvaraj

    2018-02-01

    Full Text Available BACKGROUND Psychiatric disorders in pemphigus vulgaris may occur due to long term course, impact of body image, unlikelihood of complete recovery and frequent recurrences. These are the major predisposing factors towards depression and anxiety. Although, investigators have evaluated psychiatric aspects of the patients suffering from skin diseases, there are rare studies in India concerning mental health in pemphigus patients. Aim- The aim and objectives of the study is to estimate the prevalence of depression and anxiety in patients with pemphigus vulgaris, to assess the socio demographic profile and quality of life. MATERIALS AND METHODS Between august 2017 and September 2017, a cross sectional study of 105 patients diagnosed as pemphigus vulgaris attending pemphigus clinic of dermatology department, Rajiv Gandhi Government General Hospital, Chennai were assessed using semi structured proforma and following questionnaires GHQ-12, HAMA, HAMD, DLQI. RESULTS 105 patients were evaluated; 55% presented depression (58/120; 46 women and 12 men; 45 patients (43% with mild depression, 13 patients (12% with moderate depression. Duration of illness and social support presented statistical significance (P = 0.039 and (P <0.001 respectively. 32% presented anxiety (34/105; 25 women and 9 men; 32 patients (30% with mild anxiety, 2 patients (2% with moderate anxiety. Social support showed statistical significance (P<0.001. In DLQI, 32 patients had no effect, 24 patients (23% had small effect, 33 patients (31% had moderate effect, 16 patients (15% had very large effect. QOL was significantly impaired, particularly with poor social support (P<0.001, low education (P=0.010, duration of illness (P = 0.003 and number of episodes (P = 0.017. CONCLUSIONS Prevalence of depression and anxiety were higher in patients with pemphigus vulgaris and depression was found to be higher among females and anxiety was higher among male patients. Also increased duration of illness

  17. An Investigation on Micro-Raman Spectra and Wavelet Data Analysis for Pemphigus Vulgaris Follow-up Monitoring.

    Science.gov (United States)

    Camerlingo, Carlo; Zenone, Flora; Perna, Giuseppe; Capozzi, Vito; Cirillo, Nicola; Gaeta, Giovanni Maria; Lepore, Maria

    2008-06-01

    A wavelet multi-component decomposition algorithm has been used for data analysis of micro-Raman spectra of blood serum samples from patients affected by pemphigus vulgaris at different stages. Pemphigus is a chronic, autoimmune, blistering disease of the skin and mucous membranes with a potentially fatal outcome. Spectra were measured by means of a Raman confocal microspectrometer apparatus using the 632.8 nm line of a He-Ne laser source. A discrete wavelet transform decomposition method has been applied to the recorded Raman spectra in order to overcome problems related to low-level signals and the presence of noise and background components due to light scattering and fluorescence. This numerical data treatment can automatically extract quantitative information from the Raman spectra and makes more reliable the data comparison. Even if an exhaustive investigation has not been done in this work, the feasibility of the follow-up monitoring of pemphigus vulgaris pathology has been clearly proved with useful implications for the clinical applications.

  18. An Investigation on Micro-Raman Spectra and Wavelet Data Analysis for Pemphigus Vulgaris Follow-up Monitoring.

    Directory of Open Access Journals (Sweden)

    Maria Lepore

    2008-06-01

    Full Text Available A wavelet multi-component decomposition algorithm has been used for data analysis of micro-Raman spectra of blood serum samples from patients affected by pemphigus vulgaris at different stages. Pemphigus is a chronic, autoimmune, blistering disease of the skin and mucous membranes with a potentially fatal outcome. Spectra were measured by means of a Raman confocal microspectrometer apparatus using the 632.8 nm line of a He-Ne laser source. A discrete wavelet transform decomposition method has been applied to the recorded Raman spectra in order to overcome problems related to low-level signals and the presence of noise and background components due to light scattering and fluorescence. This numerical data treatment can automatically extract quantitative information from the Raman spectra and makes more reliable the data comparison. Even if an exhaustive investigation has not been done in this work, the feasibility of the follow-up monitoring of pemphigus vulgaris pathology has been clearly proved with useful implications for the clinical applications.

  19. Status of the R+D programme in the field of the heat carrying and heat transfer components of the PNP project

    International Nuclear Information System (INIS)

    Mausbeck, H.; Jansing, W.

    1984-01-01

    The PNP Project (Project Nuclear Process Heat) is described. It covers the status of research and development in the field of heat exchange and heat exchanger components; concept of plant for coal gasification; description of large scale test facilities and its components; and the time schedule for the project development

  20. A Novel Bis(phosphido)pyridine [PNP] 2− Pincer Ligand and Its Potassium and Bis(dimethylamido)zirconium(IV) Complexes

    KAUST Repository

    Winston, Matthew S.

    2010-12-13

    A novel PNP bis(secondary phosphine)pyridine pincer ligand, 2,6-bis(2-(phenylphosphino)phenyl)pyridine, has been prepared in high yield, and the properties of the doubly deprotonated form as a ligand in K 4(PNP)2(THF)6 and (PNP)Zr(NMe2) 2 have been investigated. The neutral PNP ligand has been isolated as a mixture of noninterconverting diastereomers, due to the presence of two chirogenic phosphorus atoms of the secondary phopshines, but coordination of the dianionic form to potassium and zirconium allows for isolation of a single diastereomer in near-quantitative yield. The structure of a bis(dimethylamido) zirconium(IV) derivative of the bis(phosphido)pyridine ligand and DFT calculations suggest that the phosphides do not π-bond to early transition metals, likely due to geometric strain and possibly orbital size mismatch between phosphorus and zirconium. As a result, the soft phosphides are prone to formation of insoluble oligomers with substantial bridging of the phosphido lone pairs to other zirconium centers. © 2010 American Chemical Society.

  1. The Arabidopsis thaliana natriuretic peptide AtPNP-A is a systemic regulator of leaf dark respiration and signals via the phloem

    KAUST Repository

    Ruzvidzo, Oziniel

    2011-09-01

    Plant natriuretic peptides (PNPs) belong to a novel class of peptidic signaling molecules that share some structural similarity to the N-terminal domain of expansins and affect physiological processes such as water and ion homeostasis at nano-molar concentrations. Here we show that a recombinant Arabidopsis thaliana PNP (AtPNP-A) rapidly increased the rate of dark respiration in treated leaves after 5 min. In addition, we observed increases in lower leaves, and with a lag time of 10 min, the effect spread to the upper leaves and subsequently (after 15 min) to the opposite leaves. This response signature is indicative of phloem mobility of the signal, a hypothesis that was further strengthened by the fact that cold girdling, which affects phloem but not xylem or apoplastic processes, delayed the long distance AtPNP-A effect. We conclude that locally applied AtPNP-A can induce a phloem-mobile signal that rapidly modifies plant homeostasis in distal parts. © 2011 Elsevier GmbH.

  2. Preparation and biological study of 99Tcm(N) (PNP6) (Cyc-RGD) for integrin αvβ3-positive tumor imaging

    International Nuclear Information System (INIS)

    Chen Baojun; Hu Ji; Liang Jixin; Li Hongyu; Luo Lianzhe; Shen Langtao; Luo Zhifu; Chen Yang

    2007-01-01

    The Cys-RGD peptide is labelled with 99 Tc m -nitrido core combined with PNP6 lig- and (PNP6=bis (diethoxypropylphosphino ethyl) ethoxy ethylamine) to investigate the possibility of radiolabelled RGD peptides for tumor α v β 3 integrin receptor scintigraphy. The radiochemical purity is measured with HPLC, the in vitro stability is investigated at room temperature and at 37 degree C incubated in the cystein and serum solution. Biodistribution studies and gamma camera imaging are performed in normal mice and nude mice bearing FWK-1 pancreatic tumor xenografts. More than 92% radiolabelling yield is achieved under optimized condition. The high in vitro stability is found for 99 Tc m (N) (PNP6) (Cys-RGD). In vivo biodistribution studies indicate the radiolabelled peptide is cleared rapidly from blood and mainly excreted via urinary system. Tumor uptake is 2.92 ± 0.71%/g at 1 h after injection. The uptake ratios of tumor to blood and tumor to muscle (T/NT) are 11.0 and 3. 1 at 4 h after injection, respectively. Scintigraphic imaging allows contrasting visualisation of α v β 3 -expressed tumors at 1 h after injection. The results suggest 99 Tc m (N) (PNP6) (Cys- RGD) may be the potential agent for α v β 3 -positive tumor imaging. (authors)

  3. A Novel Bis(phosphido)pyridine [PNP] 2− Pincer Ligand and Its Potassium and Bis(dimethylamido)zirconium(IV) Complexes

    KAUST Repository

    Winston, Matthew S.; Bercaw, John E.

    2010-01-01

    A novel PNP bis(secondary phosphine)pyridine pincer ligand, 2,6-bis(2-(phenylphosphino)phenyl)pyridine, has been prepared in high yield, and the properties of the doubly deprotonated form as a ligand in K 4(PNP)2(THF)6 and (PNP)Zr(NMe2) 2 have been investigated. The neutral PNP ligand has been isolated as a mixture of noninterconverting diastereomers, due to the presence of two chirogenic phosphorus atoms of the secondary phopshines, but coordination of the dianionic form to potassium and zirconium allows for isolation of a single diastereomer in near-quantitative yield. The structure of a bis(dimethylamido) zirconium(IV) derivative of the bis(phosphido)pyridine ligand and DFT calculations suggest that the phosphides do not π-bond to early transition metals, likely due to geometric strain and possibly orbital size mismatch between phosphorus and zirconium. As a result, the soft phosphides are prone to formation of insoluble oligomers with substantial bridging of the phosphido lone pairs to other zirconium centers. © 2010 American Chemical Society.

  4. Paraneoplastic limbic encephalitis associated with mixed olfactory neuroblastoma and craniopharyngioma: A case report and literature review.

    Science.gov (United States)

    Nagafuji, Hiroshi; Yokoi, Hidenori; Fujiwara, Masachika; Sato, Dai; Saito, Koichiro

    2018-06-01

    Paraneoplastic limbic encephalitis (PLE) is a rare disorder of the nervous system associated with malignant disease. It has a subacute onset with the following symptoms: cognitive dysfunction, seizures, irritability, hallucinations, and short-term memory loss. Herein, we report the case of a 35-year-old man with PLE, an olfactory neuroblastoma (ONB) admixed with craniopharyngioma, and serum anti-Hu antibodies. The patient presented with generalized seizures, short-term memory loss, and a polypoid mass located high in the nasal cavity. He underwent surgical resection of the tumor and postoperative chemoradiotherapy with concurrent intra-arterial cisplatin administration. Pathological examination indicated an ONB admixed with craniopharyngioma. The patient's neurological symptoms gradually diminished after surgery. No evidence of recurrence was observed during a 4-year follow-up. We reported a histologically unusual heterogeneous tumor that comprised ONB and craniopharyngioma. This is the first reported case of PLE with anti-Hu antibodies possibly associated with ONB admixed with craniopharyngioma.

  5. Basic lay-out, arrangement and design criteria of heat components of the ''nuclear coal gasification prototype plant (PNP)''

    International Nuclear Information System (INIS)

    Pruschek, R.

    1980-01-01

    Since 1975, the companies Bergbau-Forschung GmbH, GHT Gesellschaft fuer Hochtemperaturreaktor-Technik mbH, Hochtemperatur-Reaktorbau GmbH, Kernforschungsanlage Juelich GmbH und Rheinische Braunkohlenwerke AG are working jointly on the Project ''Prototype Plant Nuclear Process Heat (PNP)'', with promotion of the ''Bundesminister fuer Forschung und Technologie'' and of the ''Minister fuer Wirtschaft, Mittelstand und Verkehr des Landes Nordrhein-Westfalen''. The objectives of the project are the development of a high-temperature reactor, with a core outlet temperature of 950 0 C, suitable for various process heat applications, and the development and testing of the appropriate coal gasification technology. The applied gasifications methods comprise endothermal and exothermal reactions. Therefore, various heat transfer components are to be developed. In the context of this Specialists Meeting, only those components will be discussed by which heat is transferred from primary helium to secondary helium or from helium to the working or process fluid

  6. Paraneoplastic limbic encephalitis with associated hypothalamitis mimicking a hyperdense hypothalamic tumor: a case report

    International Nuclear Information System (INIS)

    Bataduwaarachchi, Vipula R.; Tissera, Nirmali

    2016-01-01

    Paraneoplastic limbic encephalitis is an uncommon association of common malignancies such as small cell lung carcinoma, testicular teratoma, and breast carcinoma. The nonspecific nature of the clinical presentation, lack of freely available diagnostic markers, and requirement for advanced imaging techniques pose a great challenge in the diagnosis of this disease in resource-poor settings. A 64-year-old previously healthy Sri Lankan man was admitted to the general medical unit with subacute memory impairment regarding recent events that had occurred during the previous 3 weeks. Initial noncontrast computed tomography of the brain revealed a hyperdensity in the hypothalamic region surrounded by hypodensities extending toward the bilateral temporal lobes; these findings were consistent with a possible hypothalamic tumor with perilesional edema. The patient later developed cranial diabetes insipidus, which was further suggestive of hypothalamic disease. Interestingly, gadolinium-enhanced magnetic resonance imaging of the brain showed no such lesions; instead, it showed prominent T2-weighted signals in the inner mesial region, characteristic of encephalitis. The possibility of tuberculosis and viral encephalitis was excluded based on cerebrospinal fluid analysis results. Limbic encephalitis with predominant hypothalamitis was suspected based on the radiological pattern. Subsequent screening for underlying malignancy revealed a mass lesion in the right hilum on chest radiographs. Histological examination of the lesion showed small cell lung cancer of the “oat cell” variety. We suggest that the initial appearance of a hyperdensity in the hypothalamus region on noncontrast computed tomography is probably due to hyperemia caused by hypothalamitis. If hypothalamitis is predominant in a patient with paraneoplastic limbic encephalitis, magnetic resonance imaging will help to differentiate it from a hypothalamic secondary deposit. Limbic encephalitis should be considered in

  7. Anti-Ma and anti-Ma2-associated paraneoplastic neurological syndromes.

    Science.gov (United States)

    Ortega Suero, G; Sola-Valls, N; Escudero, D; Saiz, A; Graus, F

    Analyse the clinical profile, associated tumour types, and response to treatment of paraneoplastic neurological syndromes associated with antibodies against Ma proteins. A retrospective study of patients with antibodies against Ma proteins identified in a neuroimmunology laboratory of reference. Of the 32 patients identified, 20 showed reactivity against Ma2 only (anti-Ma2 antibodies), 11 against Ma1 and Ma2 (anti-Ma antibodies), and 1 with reactivity against Ma1 only (anti-Ma1 antibodies). The most common clinical presentations were limbic encephalopathy, diencephalic dysfunction, or brainstem encephalopathy, frequently appearing as a combination of these features. Three patients had isolated cerebellar dysfunction with anti-Ma antibodies, and 2 exhibited peripheral nervous system syndrome with anti-Ma2 antibodies. Testicular tumours were the most common neoplasms (40%) in the anti-Ma2 cases. In the group associated with anti-Ma1 antibodies, the most common were lung tumours (36%), followed by testicular tumours. All idiopathic cases were reactive to Ma2. The clinical outcome was significantly better in the anti-Ma2 group. The patient with anti-Ma1 presented with limbic encephalitis and brainstem dysfunction associated with lymphoepithelioma of the bladder. Specifically determining the different reactivities of anti-Ma protein antibodies in order to differentiate between Ma1 and Ma2 antibodies is important because anti-Ma2-associated paraneoplastic syndromes have a better outcome. Lastly, this study is the first to confirm that there may be cases that react exclusively to antibodies against Ma1. Copyright © 2016 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

  8. Avidin-biotin system: a small library of cysteine biotinylated derivatives designed for the [99mTc(N)(PNP)]2+ metal fragment

    International Nuclear Information System (INIS)

    Bolzati, Cristina; Caporale, Andrea; Agostini, Stefania; Carta, Davide; Cavazza-Ceccato, Mario; Refosco, Fiorenzo; Tisato, Francesco; Schievano, Elisabetta; Bandoli, Giuliano

    2007-01-01

    Using the avidin-biotin system as model, we investigate here the effective application of [Tc(N)L(PNP)] +/0 technology (L=N-functionalized cysteine [O - ,S - ]; PNP=aminodiphosphine) to the preparation of target-specific radiopharmaceuticals. A series of 99m Tc-nitrido complexes containing functionalized biotin ligands was prepared and their biological profile was determined. To minimize the steric and the electronic influences of the Tc-carrying complex on the biotin-avidin receptor interaction, the following N-functionalized cysteine-biotin derivatives were synthesized: (1) Biot-CysOSH; (2) Biot-Abu-CysOSH; (3) Biot-Abz-CysOSH; (4) Biot-L-(Ac)Lys-CysOSH; (5) Biot-D-(Ac)Lys-CysOSH; (6) Biot-Glu-CysOSH. The asymmetrical nitrido-Tc(V) 99g/99m Tc(N)(Biot-X-CysOS)(PNP3) (X=spacer) complexes, where PNP3 was N,N-bis-[(dimethoxypropyl)phosphinoethyl] methoxy-ethylamine, were obtained by simultaneous addition of PNP3 and the relevant biotinylated ligand to a solution containing a 99m Tc-nitrido precursor (yields >95%). In all cases, a mixture of syn- and anti isomers was observed. In vitro challenge experiments with glutathione and cysteine indicated that no transchelation reactions occurred. Assessment of the in vitro binding to avidin of the complexes revealed that only the complexes containing Biot-Abu-CysOS and Biot-Glu-CysOS ligand maintained a good affinity for the concentrator. Stability studies carried out in human and mouse plasma as well as in rat and mouse liver homogenate evidenced a rapid enzymatic degradation for the 99m Tc(N)(Biot-Abu-CysOS)(PNP3) complex, whereas the 99m Tc(N)(Biot-Glu-CysOS)(PNP3) one was stable in all conditions. Tissue biodistribution in normal Balb/C mice of the most stable candidate showed a rapid clearance both from the blood and the other tissues. The activity was eliminated both through the hepatobiliary system and the urinary tract

  9. Melanoma targeting with [99mTc(N)(PNP3)]-labeled α-melanocyte stimulating hormone peptide analogs: Effects of cyclization on the radiopharmaceutical properties

    International Nuclear Information System (INIS)

    Carta, Davide; Salvarese, Nicola; Morellato, Nicolò; Gao, Feng; Sihver, Wiebke; Pietzsch, Hans Jurgen; Biondi, Barbara; Ruzza, Paolo; Refosco, Fiorenzo; Carpanese, Debora; Rosato, Antonio; Bolzati, Cristina

    2016-01-01

    The purpose of this study was to evaluate the effect of cyclization on the biological profile of a [ 99m Tc(N)(PNP3)]-labeled α-melanocyte stimulating hormone peptide analog. A lactam bridge-cyclized H-Cys-Ahx-βAla 3 -c[Lys 4 -Glu-His-D-Phe-Arg-Trp-Glu 10 ]-Arg 11 -Pro-Val-NH 2 (NAP―NS2) and the corresponding linear H-Cys-Ahx-βAla-Nle-Asp-His-D-Phe-Arg-Trp-Gly-NH 2 (NAP―NS1) peptide were synthetized, characterized by ESI-MS spectroscopy and their melanocortin-1 receptor (MC1R) binding affinity was determined in B16/F10 melanoma cells. The consistent [ 99m Tc(N)(PNP3)]-labeled compounds were readily obtained in high specific activity and their stability and biological properties were assessed. As an example, the chemical identity of [ 99m Tc(N)(NAP–NS1)(PNP3)] + was confirmed by carrier added experiments supported by radio/UV HPLC analysis combined with ESI(+)-MS. Compared with the linear peptide, cyclization negatively affected the biological properties of NAP–NS2 peptide by reducing its binding affinity for MC1R and by decreasing the overall excretion rate of the corresponding [ 99m Tc(N)(PNP3)]-labeled peptide from the body as well as its in vivo stability. [ 99m Tc(N)(NAP–NS1)(PNP3)] + was evaluated for its potential as melanoma imaging probe in murine melanoma model. Data from in vitro and in vivo studies on B16/F10 melanoma model of [ 99m Tc(N)(NAP–NS1)(PNP3)] + clearly evidenced that the radiolabeled linear peptide keeps its biological properties up on the conjugation to the [ 99m Tc(N)(PNP3)]-building block. The progressive increase of the tumor-to-nontarget ratios over the time indicates a quite stable interaction between the radio-complex and the MC1R.

  10. Paraneoplastic Syndromes

    Science.gov (United States)

    ... tone, loss of fine motor coordination, slurred speech, memory loss, vision problems, sleep disturbances, dementia, seizures, sensory loss in ... tone, loss of fine motor coordination, slurred speech, memory loss, vision problems, sleep disturbances, dementia, seizures, sensory loss in ...

  11. Assessment of IgG Antibodies Against HSV1, HSV2, CMV and EBV in Patients with Pemphigus Vulgaris versus Healthy People

    Directory of Open Access Journals (Sweden)

    Parichehr Ghalayani

    2016-08-01

    Full Text Available Objectives: Regarding the implication of viruses particularly herpes in pemphigus vulgaris, we sought to assess and compare the level of immunoglobulin G (IgG antibodies against herpes simplex virus types 1 and 2 (HSV1 and HSV2, cytomegalovirus (CMV and Epstein-Barr virus (EBV in patients with pemphigus vulgaris and healthy people.    Materials and Methods: In this cross-sectional study, 25 patients with pemphigus vulgaris and 27 healthy individuals comprised the experimental and control groups, respectively. Serum samples were taken from both groups; the levels of IgG antibodies against HSV1, HSV2, CMV and EBV were measured using ELISA.  Results: Immunoglobulin G titer was higher for all four viruses in the patient group in comparison to the control group. This difference was significant for anti-EBV (P= 0.005, anti-CMV (P=0.0001 and anti-HSV2 (P=0.001 but not significant for anti-HSV1 (P= 0.36.Conclusion: Viruses including EBV, CMV, and HSV2 probably play a role in the pathogenesis of pemphigus in addition to the effects of genetics, toxins and other predisposing factors. In this study, no statistically significant relationship was observed between HSV1 and pemphigus vulgaris, which was probably due to the high titer of anti-HSV1 IgG in healthy individuals in the community. More studies must be done in this regard.

  12. Subacute Cerebellar Degeneration due to a Paraneoplastic Phenomenon Associated with Metastatic Merkel Cell Carcinoma: A Case Report

    Directory of Open Access Journals (Sweden)

    Angelos Sharobeam

    2017-08-01

    Full Text Available Purpose: The aim of this article is to illustrate the diagnostic challenges and management of paraneoplastic neurological syndromes in Merkel cell carcinoma. Materials and Methods: We describe a previously functionally independent 85-year-old woman who presented with subacute onset of dizziness and gait ataxia in the setting of metastatic Merkel cell carcinoma. Results: Diagnosis was made on biopsy after positron emission tomography imaging revealed increased metabolic activity in 2 left inguinofemoral lymph nodes. Cerebrospinal fluid analysis was positive for anti-Hu on subsequent admission. Her functional status improved with methylprednisolone treatment and radiotherapy. Conclusion: The case highlights the challenge of the evaluation of patients who present with progressive cerebellar signs and the need to consider a paraneoplastic syndrome, especially in the setting of previous malignancy.

  13. Neuropatia paraneoplásica associada ao mastocitoma canino Paraneoplastic neuropathy associated with canine mast cell tumor

    Directory of Open Access Journals (Sweden)

    Sabrina Marin Rodigheri

    2008-06-01

    Full Text Available As síndromes paraneoplásicas compreendem um grupo diverso de alterações clínicas associadas a neoplasias e ocorrem em sítios distantes do tumor primário ou de suas metástases. As neuropatias paraneoplásicas são distúrbios raros em cães, mas representam morbidade significativa e servem como importantes indicadores diagnósticos e prognósticos. O presente trabalho relata a ocorrência de dois casos de neuropatia paraneoplásica em cães com mastocitoma, considerando a apresentação clínica, o diagnóstico e as formas de tratamento utilizadas.Paraneoplastic syndromes comprise a diverse group of clinical anomalies associated with neoplasias and occur in a location distant from the primary tumor or of your metastasis. Paraneoplastic neuropathy are rare disturbs in dogs, but represent significant morbidity and are useful as diagnostic and prognostic indicators. This work report the occurrence of two cases of paraneoplastic neuropathy in dogs with mast cell tumor, considering the clinical signs, diagnosis and treatment used.

  14. An adult passive transfer mouse model to study desmoglein 3 signaling in pemphigus vulgaris.

    Science.gov (United States)

    Schulze, Katja; Galichet, Arnaud; Sayar, Beyza S; Scothern, Anthea; Howald, Denise; Zymann, Hillard; Siffert, Myriam; Zenhäusern, Denise; Bolli, Reinhard; Koch, Peter J; Garrod, David; Suter, Maja M; Müller, Eliane J

    2012-02-01

    Evidence has accumulated that changes in intracellular signaling downstream of desmoglein 3 (Dsg3) may have a significant role in epithelial blistering in the autoimmune disease pemphigus vulgaris (PV). Currently, most studies on PV involve passive transfer of pathogenic antibodies into neonatal mice that have not finalized epidermal morphogenesis, and do not permit analysis of mature hair follicles (HFs) and stem cell niches. To investigate Dsg3 antibody-induced signaling in the adult epidermis at defined stages of the HF cycle, we developed a model with passive transfer of AK23 (a mouse monoclonal pathogenic anti-Dsg3 antibody) into adult 8-week-old C57Bl/6J mice. Validated using histopathological and molecular methods, we found that this model faithfully recapitulates major features described in PV patients and PV models. Two hours after AK23 transfer, we observed widening of intercellular spaces between desmosomes and EGFR activation, followed by increased Myc expression and epidermal hyperproliferation, desmosomal Dsg3 depletion, and predominant blistering in HFs and oral mucosa. These data confirm that the adult passive transfer mouse model is ideally suited for detailed studies of Dsg3 antibody-mediated signaling in adult skin, providing the basis for investigations on novel keratinocyte-specific therapeutic strategies.

  15. A NOSOCOMIAL INFECTION MANIFESTED AS ERYSIPELAS IN PEMPHIGUS FOLIACEUS PATIENT UNDER INTRAVENOUS DEXAMETHASONE TREATMENT

    Directory of Open Access Journals (Sweden)

    Achmad Yudha Pranata

    2016-05-01

    Full Text Available Introduction: Puncture wound in diagnostic interventions permits the entry of bacteria into the skin or soft tissue, thus precipitating nosocomial infection, such as erysipelas. There are other risk factors of nosocomial infections including old age, immunosuppressive drugs, and underlying diseases. Pemphigus foliaceus (PF is an autoimmune disease with corticosteroid treatment as the mainstay therapy, which could cause immunosuppression and predispose patients to infection. The objective of this paper was to report erysipelas as one of the manifestations of nosocomial infection in patients under immunosuppressive therapy. Case: A case of erysipelas acquired on the 9th day of hospitalization in a PF patient underwent intravenous dexamethasone injection, with history of puncture wounds on the previous day on the site of erysipelas was reported. The clinical findings of erysipelas were well defined, painful erythema and edema that felt firm and warm on palpation, with blisters and pustules on top. Gram staining from the pustules and blisters fluid revealed Gram (+ cocci. Patient was given 2 grams intravenous ceftriaxone for 7 days and saline wet compress. Improvement on the erysipelas was seen the day after ceftriaxone injection. The patient was discharged after 12 days of hospitalization with improvement both on the PF and the erysipelas. On the next visit 7 days later, the erysipelas lesion disappeared. Conclusion: Puncture wound and immunosuppresive treatment are the factors that could cause erysipelas as a nosocomial infection, and an appropriate treatment of the infection would decrease the functional disability of the patient.

  16. Feasibility study for clinical application of caspase-3 inhibitors in Pemphigus vulgaris.

    Science.gov (United States)

    Hariton, William V J; Galichet, Arnaud; Vanden Berghe, Tom; Overmiller, Andrew M; Mahoney, My G; Declercq, Wim; Müller, Eliane J

    2017-12-01

    The potentially severe side effects of systemic corticosteroids and immunosuppressants used in Pemphigus vulgaris (PV) call for novel therapeutic approaches. In this context, pharmacological inhibition of major pathogenic signalling effectors represents a promising alternative. However, we have also shown that overinhibition of effectors required for epidermal homeostasis can exacerbate PV pathophysiology implicating transepidermal keratinocyte fragility. A feedforward target validation therefore preferentially includes studies on knockout mouse models. We previously reported on successful amelioration of PV blisters following inhibition of non-apoptotic, low-level caspase-3. Here, we use conditional, keratinocyte-specific caspase-3-deficient mice (casp3 EKO ) to demonstrate (i) absence of keratinocyte fragility upon injection of the potent Dsg3-specific antibody AK23 and (ii) amelioration of blistering on the background of known signalling effectors. Our results provide the experimental proof of concept justifying translation of the caspase-3 inhibitor approach into PV clinical trials. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  17. Superficial Dsg2 Expression Limits Epidermal Blister Formation Mediated by Pemphigus Foliaceus Antibodies and Exfoliative Toxins

    Directory of Open Access Journals (Sweden)

    Donna Brennan

    2010-01-01

    Full Text Available Cell-cell adhesion mediated by desmosomes is crucial for maintaining proper epidermal structure and function, as evidenced by several severe and potentially fatal skin disorders involving impairment of desmosomal proteins. Pemphigus foliaceus (PF and staphylococcal scalded skin syndrome (SSSS are subcorneal blistering diseases resulting from loss of function of the desmosomal cadherin, desmoglein 1 (Dsg1. To further study the pathomechanism of these diseases and to assess the adhesive properties of Dsg2, we employed a recently established transgenic (Tg mouse model expressing Dsg2 in the superficial epidermis. Neonatal Tg and wild type (WT mice were injected with purified ETA or PF Ig. We showed that ectopic expression of Dsg2 reduced the extent of blister formation in response to both ETA and PF Ig. In response to PF Ig, we observed either a dramatic loss or a reorganization of Dsg1-α, Dsg1-β, and, to a lesser extent, Dsg1-γ, in WT mice. The Inv-Dsg2 Tg mice showed enhanced retention of Dsg1 at the cell-cell border. Collectively, our data support the role for Dsg2 in cell adhesion and suggest that ectopic superficial expression of Dsg2 can increase membrane preservation of Dsg1 and limit epidermal blister formation mediated by PF antibodies and exfoliative toxins.

  18. Actinide-pnictide (An-Pn) bonds spanning non-metal, metalloid, and metal combinations (An=U, Th; Pn=P, As, Sb, Bi)

    Energy Technology Data Exchange (ETDEWEB)

    Rookes, Thomas M.; Wildman, Elizabeth P.; Gardner, Benedict M.; Wooles, Ashley J.; Gregson, Matthew; Tuna, Floriana; Liddle, Stephen T. [School of Chemistry, The University of Manchester (United Kingdom); Balazs, Gabor; Scheer, Manfred [Institute of Inorganic Chemistry, University of Regensburg (Germany)

    2018-01-26

    The synthesis and characterisation is presented of the compounds [An(Tren{sup DMBS}){Pn(SiMe_3)_2}] and [An(Tren{sup TIPS}){Pn(SiMe_3)_2}] [Tren{sup DMBS}=N(CH{sub 2}CH{sub 2}NSiMe{sub 2}Bu{sup t}){sub 3}, An=U, Pn=P, As, Sb, Bi; An=Th, Pn=P, As; Tren{sup TIPS}=N(CH{sub 2}CH{sub 2}NSiPr{sup i}{sub 3}){sub 3}, An=U, Pn=P, As, Sb; An=Th, Pn=P, As, Sb]. The U-Sb and Th-Sb moieties are unprecedented examples of any kind of An-Sb molecular bond, and the U-Bi bond is the first two-centre-two-electron (2c-2e) one. The Th-Bi combination was too unstable to isolate, underscoring the fragility of these linkages. However, the U-Bi complex is the heaviest 2c-2e pairing of two elements involving an actinide on a macroscopic scale under ambient conditions, and this is exceeded only by An-An pairings prepared under cryogenic matrix isolation conditions. Thermolysis and photolysis experiments suggest that the U-Pn bonds degrade by homolytic bond cleavage, whereas the more redox-robust thorium compounds engage in an acid-base/dehydrocoupling route. (copyright 2018 The Authors. Published by Wiley-VCH Verlag GmbH and Co. KGaA.)

  19. Activating KIR and HLA Bw4 ligands are associated to decreased susceptibility to pemphigus foliaceus, an autoimmune blistering skin disease.

    Directory of Open Access Journals (Sweden)

    Danillo G Augusto

    Full Text Available The KIR genes and their HLA class I ligands have thus far not been investigated in pemphigus foliaceus (PF and related autoimmune diseases, such as pemphigus vulgaris. We genotyped 233 patients and 204 controls for KIR by PCR-SSP. HLA typing was performed by LABType SSO reagent kits. We estimated the odds ratio, 95% confidence interval and performed logistic regression analyses to test the hypothesis that KIR genes and their known ligands influence susceptibility to PF. We found significant negative association between activating genes and PF. The activating KIR genes may have an overlapping effect in the PF susceptibility and the presence of more than three activating genes was protective (OR=0.49, p=0.003. A strong protective association was found for higher ratios activating/inhibitory KIR (OR=0.44, p=0.001. KIR3DS1 and HLA-Bw4 were negatively associated to PF either isolated or combined, but higher significance was found for the presence of both together (OR=0.34, p<10(-3 suggesting that the activating function is the major factor to interfere in the PF pathogenesis. HLA-Bw4 (80I and 80T was decreased in patients. There is evidence that HLA-Bw4(80T may also be important as KIR3DS1 ligand, being the association of this pair (OR=0.07, p=0.001 stronger than KIR3DS1-Bw4(80I (OR=0.31, p=0.002. Higher levels of activating KIR signals appeared protective to PF. The activating KIR genes have been commonly reported to increase the risk for autoimmunity, but particularities of endemic PF, like the well documented influence the environmental exposure in the pathogenesis of this disease, may be the reason why activated NK cells probably protect against pemphigus foliaceus.

  20. 18F-FDG-PET/CT in the diagnosis of paraneoplastic neurological syndromes: a retrospective analysis

    International Nuclear Information System (INIS)

    Bannas, Peter; Weber, Christoph; Adam, Gerhard; Derlin, Thorsten; Lambert, Joerg; Mester, Janos; Klutmann, Susanne; Leypoldt, Frank

    2010-01-01

    Paraneoplastic neurological syndromes (PNS) constitute a challenging diagnostic problem, as the underlying tumour often remains unidentified for a long time, even with frequent conventional diagnostic procedures. For appropriate patient management timely identification of the tumour is critical. We evaluated the value of 18 F-FDG-PET/CT in the investigation of PNS. The case notes of 46 consecutive patients with clinically suspected PNS who underwent 18 F-FDG-PET/CT were reviewed retrospectively and the performance of PET/CT for detecting underlying tumours was assessed. PET/CT detected foci of increased 18 F-FDG uptake in 10 out of 46 patients. In six of these 10 patients combined PET/CT identified the underlying disease: four patients suffered from PNS; vasculitic and local metastatic disease was detected in two other patients. Based on our results, we believe that the role of positron emission tomography in the detection of occult neoplasms in patients with PNS has been overestimated in the past. In clinical practice, PNS is far more often suspected than proven. In our study combined PET/CT identified malignancy as the underlying cause of suspected PNS in only 8.7% (4/46). We believe that combined PET/CT should be reserved for stringently selected patients with a high clinical index of suspicion for PNS and after conventional imaging techniques fail to detect a tumour. (orig.)

  1. ACUTE EXUDATIVE PARANEOPLASTIC POLYMORPHOUS VITELLIFORM MACULOPATHY DURING VEMURAFENIB AND PEMBROLIZUMAB TREATMENT FOR METASTATIC MELANOMA.

    Science.gov (United States)

    Sandhu, Harpal S; Kolomeyer, Anton M; Lau, Marisa K; Shields, Carol L; Schuchter, Lynn M; Nichols, Charles W; Aleman, Tomas S

    2017-06-13

    To describe a patient with BRAF mutation-positive cutaneous melanoma who developed acute exudative polymorphous vitelliform maculopathy during vemurafenib and pembrolizumab treatment for metastatic melanoma. Retrospective case report documented with wide-field fundus imaging, spectral domain optical coherence tomography, and fundus autofluorescence imaging. A 55-year-old woman with bilateral ductal breast carcinoma and BRAF mutation-positive metastatic cutaneous melanoma complained of bilateral blurred vision within 5 days of starting vemurafenib (BRAF inhibitor). She had been on pembrolizumab (program death receptor antibody) and intermittently on dabrafenib (BRAF inhibitor) and trametinib (MEK inhibitor), and had a normal ophthalmologic examination. On presentation three weeks after the introduction of vemurafenib, her visual acuity had declined to 20/40 in both eyes. Her examination showed diffuse elevation of the fovea with multifocal yellow-white, crescent-shaped subretinal deposits within the macula of both eyes and bilateral neurosensory retinal detachments by spectral domain optical coherence tomography. Discontinuation of vemurafenib and introduction of difluprednate and dorzolamide led to a gradual resolution (over four months) of the neurosensory detachments with recovery of vision. This case report suggests that acute exudative polymorphous vitelliform maculopathy may be directly associated with the use of BRAF inhibitors as treatment for metastatic cutaneous melanoma, or indirectly by triggering autoimmune-paraneoplastic processes. Future identification of similar associations is required to unequivocally link vemurafenib and/or pembrolizumab to acute exudative polymorphous vitelliform maculopathy in metastatic melanoma.

  2. Is mesenteric panniculitis truely a paraneoplastic phenomenon? A matched pair analysis

    Energy Technology Data Exchange (ETDEWEB)

    Gögebakan, Ö., E-mail: Oezlem.Goegebakan@vivantes.de [Vivantes Klinikum Neukölln, Department for Radiology and Interventional Therapy, Berlin (Germany); Albrecht, T., E-mail: Thomas.Albrecht@vivantes.de [Vivantes Klinikum Neukölln, Department for Radiology and Interventional Therapy, Berlin (Germany); Osterhoff, M.A., E-mail: martino@dife.de [Charité – University Medicine Berlin, CBF, Department for Endocrinology, Diabetes and Nutrition, Berlin (Germany); German Institute of Human Nutrition, Potsdam-Rehbruecke, Department of Clinical Nutrition, Nuthetal (Germany); Reimann, A., E-mail: Anja.Reimann@vivantes.de [Vivantes Klinikum Neukölln, Department for Radiology and Interventional Therapy, Berlin (Germany)

    2013-11-01

    Purpose: Mesenteric panniculitis (MP) is an underdiagnosed inflammatory condition of mesenteric adipose tissue. Prior studies suggested an association of MP with malignancy. To reassess this hypothesis, we performed the first matched case–control study comparing prevalence of malignancy and other disease in patients with and without MP. Material and methods: With a keyword search we identified CT examinations of MP patients between 2010 and 2012. Each MP patient was matched with two control patients for age, gender, abdominal diameter and CT protocol. Manifestation and extent of mesenteric panniculitis was classified independently by two investigators according to established criteria. Concomitant disease, laboratory parameters and follow up CTs were recorded and analyzed for all patients. Results: 77 of 13485 CT patients were diagnosed with MP (prevalence 0.58%). 50.6% of MP patients suffered from malignancy vs. 60.2% in the control group (p = 0.157). Over up to 4 years of follow up in 35 of these 77 MP patients no association between development of MP and the course of tumor diseases could be identified. There was also no significant difference in the rate of frequent concomitant diseases such as hypertension, diabetes or previous surgery between the two groups. Conclusion: In this first case–control-study we could show that, contrary to previous reports, mesenteric panniculitis is neither paraneoplastic nor is it associated with other diseases.

  3. Is mesenteric panniculitis truely a paraneoplastic phenomenon? A matched pair analysis

    International Nuclear Information System (INIS)

    Gögebakan, Ö.; Albrecht, T.; Osterhoff, M.A.; Reimann, A.

    2013-01-01

    Purpose: Mesenteric panniculitis (MP) is an underdiagnosed inflammatory condition of mesenteric adipose tissue. Prior studies suggested an association of MP with malignancy. To reassess this hypothesis, we performed the first matched case–control study comparing prevalence of malignancy and other disease in patients with and without MP. Material and methods: With a keyword search we identified CT examinations of MP patients between 2010 and 2012. Each MP patient was matched with two control patients for age, gender, abdominal diameter and CT protocol. Manifestation and extent of mesenteric panniculitis was classified independently by two investigators according to established criteria. Concomitant disease, laboratory parameters and follow up CTs were recorded and analyzed for all patients. Results: 77 of 13485 CT patients were diagnosed with MP (prevalence 0.58%). 50.6% of MP patients suffered from malignancy vs. 60.2% in the control group (p = 0.157). Over up to 4 years of follow up in 35 of these 77 MP patients no association between development of MP and the course of tumor diseases could be identified. There was also no significant difference in the rate of frequent concomitant diseases such as hypertension, diabetes or previous surgery between the two groups. Conclusion: In this first case–control-study we could show that, contrary to previous reports, mesenteric panniculitis is neither paraneoplastic nor is it associated with other diseases

  4. Anti-ma2 paraneoplastic encephalitis in association with recurrent cervical cancer.

    Science.gov (United States)

    Ney, Douglas E; Messersmith, Wells; Behbakht, Kian

    2014-07-01

    Paraneoplastic neurological syndromes are rare, and although they are frequently associated with gynecological malignancies, cervical cancer is a rare cause. The symptoms of anti-Ma2 encephalitis are diverse and often present prior to the diagnosis of malignancy. We report a case of a 37-year-old woman with a history of cervical cancer presenting with unexplained weight gain and vertical supranuclear gaze palsy. Magnetic resonance imaging of the brain revealed lesions within the bilateral hypothalami and midbrain. Anti-Ma2 antibodies were eventually found in the serum, prompting a search for malignancy. Recurrent metastatic cervical cancer was found in the retroperitoneal lymph nodes. This is the first report of cervical cancer in association with anti-Ma2 encephalitis, and highlights the need for a high degree of suspicion in patients with a cancer history presenting with neurological symptoms. The symptoms associated with anti-Ma2 encephalitis are diverse and typically precede the diagnosis of cancer in patients, and should trigger a search for an underlying malignancy.

  5. Paraneoplastic brain stem encephalitis in a woman with anti-Ma2 antibody.

    Science.gov (United States)

    Barnett, M; Prosser, J; Sutton, I; Halmagyi, G M; Davies, L; Harper, C; Dalmau, J

    2001-02-01

    A woman developed brain stem encephalopathy in association with serum anti-Ma2 antibodies and left upper lobe lung mass. T2 weighted MRI of the brain showed abnormalities involving the pons, left middle and superior cerebellar peduncles, and bilateral basal ganglia. Immunohistochemical analysis for serum antineuronal antibodies was confounded by the presence of a non-neuronal specific antinuclear antibody. Immunoblot studies showed the presence of anti-Ma2 antibodies. A premortem tissue diagnosis of the lung mass could not be established despite two CT guided needle biopsies, and the patient died as a result of rapid neurological deterioration. The necropsy showed that the lung lesion was an adenocarcinoma which expressed Ma2 immunoreactive protein. Neuropathological findings included prominent perivascular inflammatory infiltrates, glial nodules, and neuronophagia involving the brain stem, basal ganglia, hippocampus and the dentate nucleus of the cerebellum. Ma2 is an autoantigen previously identified in patients with germ cell tumours of the testis and paraneoplastic brain stem and limbic encephalitis. Our patient's clinical and immunopathological findings indicate that this disorder can affect women with lung adenocarcinoma, and that the encephalitic changes predominate in those regions of the brain known to express high concentrations of Ma proteins.

  6. Scleroderma of geriatric age and scleroderma-like paraneoplastic syndrome – description of two cases

    Directory of Open Access Journals (Sweden)

    Magdalena Marek

    2016-06-01

    Full Text Available Systemic sclerosis (Ssc is an autoimmune connective tissue disease of unknown origin, characterized by progressive fibrosis of the skin and internal organs. Immune reactions taking part in Ssc pathogenesis may contribute to cancer development; therefore patients with risk factors for this disease require observation for a neoplastic process. On the other hand, symptoms of Ssc may be a mask of various cancers. Differentiating between the idiopathic form of Ssc and scleroderma-like paraneoplastic syndrome often causes a lot of difficulties. The article presents two cases of Ssc at the beginning of the disease after 60 years of age. The first case was diagnosed as Ssc, whereas in the second case the defined diagnosis was scleroderma-like syndrome in the course of colorectal cancer. This paper presents an analysis of differential diagnostic procedures which were performed and led to the final diagnosis, mentions types of cancers co-occurring with Ssc and suggests a screening scheme for cancer development in patients with a diagnosis of Ssc.

  7. Cerebellar atrophy is frequently associated with non-paraneoplastic sensory neuronopathy

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    Alfredo Damasceno

    2011-08-01

    Full Text Available Sensory neuronopathies (SN are peripheral nervous system disorders associated with degeneration of dorsal root ganglion neurons. Despite the evidence of a defective proprioceptive sensory input in SN,the prominent gait and truncal ataxia raises the question of a concomitant involvement of the cerebellum. OBJECTIVE: To evaluate cerebellar atrophy in SN. METHOD: We analyzed MRI-based volumetry of anterior lobe (paleocerebellum and total cerebellum in patients with non-paraneoplastic chronic SN and compared to age- and gender-matched controls. RESULTS: Cerebellum and anterior lobe MRI volumetry were performed in 20 patients and nine controls. Mean anterior lobe and cerebellar volume were not statistically different. Three patients (15%, however, had an abnormal anterior lobe and cerebellar volume index (values outside 2.5 standard deviations. One of them also had a specific atrophy of the anterior lobe. All these patients had infectious or dysimmune associated SN. CONCLUSION: Cerebellar atrophy is infrequently associated with SN, but can be found in some patients with SN related to infectious or immune mediated conditions. It can be more prominent in the anterior lobe and may contribute to the ataxia seen in these patients.

  8. Paraneoplastic limbic encephalitis in a teenage girl with an immature ovarian teratoma

    International Nuclear Information System (INIS)

    Stein-Wexler, Rebecca; Wootton-Gorges, Sandra L.; Brunberg, James A.; Greco, Claudia M.

    2005-01-01

    Paraneoplastic limbic encephalitis (PLE) is an unusual disorder that is characterized by the association of clinical limbic system abnormalities with neoplasia, usually malignancy. It has rarely been reported in children and then manifests during the teenage years. Diagnosis is often delayed, especially when the tumor has not been recognized. In adults, the diagnosis can be revealed by the presence of antineuronal antibodies. We describe an unusual case of behavioral disturbance leading rapidly to coma in a 14-year-old girl with CSF pleocytosis who was found 10 weeks later to have an immature ovarian teratoma. Although her symptoms eventually improved slightly after tumor excision, she died while in rehabilitation. PLE is an important diagnosis to consider in the teenage girl with symptoms of a progressive limbic disorder and CSF pleocytosis, and whose brain MR imaging demonstrates no abnormality or mild T2-weighted temporal lobe signal abnormality. When this constellation of findings presents in a teenage girl, the possibility of an underlying ovarian teratoma should be considered. (orig.)

  9. Paraneoplastic hematological, biochemical, and hemostatic abnormalities in female dogs with mammary neoplasms

    Directory of Open Access Journals (Sweden)

    Naila C.B. Duda

    Full Text Available ABSTRACT: Paraneoplastic laboratory abnormalities are identified in several types of cancers in dogs and cats. In veterinary medicine, particularly in mammary cancer, there are few studies that correlate abnormal laboratory findings with tumor type and staging. The aim of this study was to evaluate hematological, biochemical, and hemostatic abnormalities and correlate them with mammary tumor staging in female dogs with mammary cancer. Blood samples from 24 female dogs were evaluated, and the hematological, biochemical, and hemostatic parameters were correlated with tumor staging obtained by physical examination, imaging exams, and histopathological surgical biopsies. The groups were organized according to tumor staging: group 1 (stages I and II, group 2 (stage III, and group 3 (stages IV and V. Anemia, neutrophilic leukocytosis, monocytosis, eosinophilia, thrombocytosis, hypoalbuminemia, hypocalcemia, hypoglycemia, and low blood urea were observed. The variables MCHC, TPP, and RDW were correlated with tumor staging with no clinical relevance. Thrombin time and fibrinogen were significant between the groups in the coagulation test, being associated with tumor staging. The findings suggest influence of the proinflammatory cytokines released during tumor growth.

  10. The value of 18-FDG PET in the diagnosis of tumours associated with paraneoplastic neurological syndromes

    International Nuclear Information System (INIS)

    Lyngkaran, Guru; Chatterton, Barry; Schultz, Chris

    2009-01-01

    Full text: Introduction: Several studies have shown the value of PET in diagnosing occult tumours in patients with paraneoplastic neurological syndromes (PNS). Objective: To audit our experience with PET in the diagnosis of occult tumours in PNS. Methods: A retrospective analysis of all PET and PET/CT scans done for PNS in South Australia from the time the PET/CT was installed (2002) till September 2008. Results of antibody tests, imaging, final diagnosis and outcome were obtained with a mean follow up of 8I9 days. Results: 24 patients (15 women), mean age 62 (range 36-80) were included. The mean interval between symptom onset and PET was 19 days (range 3-29). There were a variety of PNS including subacute sensory neuropathy, cerebellar syndrome. encephalitis, Lambert Eaton myasthenic syndrome, myopathy, transverese myelitis and subacute global neurological deterioration. Abnormal FDG uptake was seen in eight but malignancy was only confirmed in 2 patients. One patient died shortly after PET/CT likely because of lung malignancy. There were 5 false positives. At follow up 14 had no formal diagnosis, 4 had autoimmune illness and in 3 the diagnosis of PNS was revised. The sensitivity was 100%, specificity 76%, positive predictive value 37.5% and negative predictive value 100%. Conclusion: PET was positive in only 12.5% of these patients. When the 3 patients without PNS are excluded the diagnostic yield of PET is 43%. PET is a useful tool in PNS but patient selection is important.

  11. 1.45 A resolution crystal structure of recombinant PNP in complex with a pM multisubstrate analogue inhibitor bearing one feature of the postulated transition state

    International Nuclear Information System (INIS)

    Chojnowski, Grzegorz; Breer, Katarzyna; Narczyk, Marta; Wielgus-Kutrowska, Beata; Czapinska, Honorata; Hashimoto, Mariko; Hikishima, Sadao; Yokomatsu, Tsutomu; Bochtler, Matthias; Girstun, Agnieszka; Staron, Krzysztof; Bzowska, Agnieszka

    2010-01-01

    Low molecular mass purine nucleoside phosphorylases (PNPs, E.C. 2.4.2.1) are homotrimeric enzymes that are tightly inhibited by immucillins. Due to the positive charge on the ribose like part (iminoribitol moiety) and protonation of the N7 atom of the purine ring, immucillins are believed to act as transition state analogues. Over a wide range of concentrations, immucillins bind with strong negative cooperativity to PNPs, so that only every third binding site of the enzyme is occupied (third-of-the-sites binding). 9-(5',5'-difluoro-5'-phosphonopentyl)-9-deazaguanine (DFPP-DG) shares with immucillins the protonation of the N7, but not the positive charge on the ribose like part of the molecule. We have previously shown that DFPP-DG interacts with PNPs with subnanomolar inhibition constant. Here, we report additional biochemical experiments to demonstrate that the inhibitor can be bound with the same K d (∼190 pM) to all three substrate binding sites of the trimeric PNP, and a crystal structure of PNP in complex with DFPP-DG at 1.45 A resolution, the highest resolution published for PNPs so far. The crystals contain the full PNP homotrimer in the asymmetric unit. DFPP-DG molecules are bound in superimposable manner and with full occupancies to all three PNP subunits. Thus the postulated third-of-the-sites binding of immucillins should be rather attribute to the second feature of the transition state, ribooxocarbenium ion character of the ligand or to the coexistence of both features characteristic for the transition state. The DFPP-DG/PNP complex structure confirms the earlier observations, that the loop from Pro57 to Gly66 covering the phosphate-binding site cannot be stabilized by phosphonate analogues. The loop from Glu250 to Gln266 covering the base-binding site is organized by the interactions of Asn243 with the Hoogsteen edge of the purine base of analogues bearing one feature of the postulated transition state (protonated N7 position).

  12. Current regimen of pulse therapy for pemphigus: Minor modifications, improved results

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    Pasricha J

    2008-01-01

    Full Text Available Background: If administered properly, dexamethasone cyclophosphamide pulse (DCP therapy has the potential to effect lifelong recovery from pemphigus. Aims: The objective of this paper is to highlight various parameters of DCP therapy and also, to report the effects of a few modifications in the regimen. Methods: An analysis of 123 patients treated with the DCP/DP regimen over a period of five years (1998 to 2002 is presented here. Seventeen patients who did not start/continue the treatment and three patients who died during the treatment have been excluded from the analysis. Twenty patients who had not yet started families were given only dexamethasone pulses (DPs while 103 patients received DCPs. Low dose (50 mg/day cyclophosphamide was used as in the standard regimen. The three modifications introduced into the regimen were: (1 an additional daily dose of oral betamethasone sufficient to control the disease activity during phase I, which was progressively tapered off completely as the patient recovered, (2 use of systemic antibiotics if the patient had skin lesions, and oral anti-candida drugs if the patient had oral ulcers until complete healing, and (3 insistence on thorough cleaning of the skin and scalp with a normal soap and shampoo, and proper maintenance of oral hygiene in spite of skin/mucosal lesions. The regimen consisted of DCP/DP repeated in exactly 28-day cycles, along with 50 mg cyclophosphamide per day, insistence on completing the treatment and avoiding irregular pulses in all patients. The number of DCPs/DPs during phase I varied in different patients depending upon the dose of betamethasone used and the rate of recovery, but phase II (nine DCPs/DPs in exactly 28-day cycles along with 50 mg cyclophosphamide per day and phase III (only 50 mg cyclophosphamide per day was fixed at nine months each. This was followed by posttreatment follow-up (phase IV. Results: At present, all the patients are in complete remission. The

  13. Immunologic prediction of relapse in patients with pemphigus vulgaris (PV) in clinical remission.

    Science.gov (United States)

    Daneshpazhooh, Maryam; Zafarmand Sedigh, Vahid; Balighi, Kamran; Hosseini, S Hamed; Ramezani, Ali; Kalantari, Mohammad-Sadegh; Ghandi, Narges; Ghiasi, Maryam; Nikoo, Azita; Chams-Davatchi, Cheyda

    2016-06-01

    Pemphigus vulgaris (PV) is characterized by multiple relapses, occurring especially in patients on minimal therapy or off therapy. To identify immunologic predictors (anti-desmoglein [Dsg] 1 and 3 antibodies; direct immunofluorescence [DIF]) for relapse in PV patients. Eighty-nine patients in complete clinical remission for at least 6 months and receiving less than or equal to 10 mg prednisolone daily and no immunosuppressive drugs were evaluated using DIF (n=89) and Dsg ELISA (n=46). They were followed until relapse or for at least 18 months. DIF was positive in 44 of 89 patients (49.5%); anti-Dsg 3 antibodies were detected in 18 of 46 patients (39.1%) and anti-Dsg 1 antibodies were detected in 4 of 46 patients (8.7%). Relapse occurred in 38 patients (42.7%). Mean relapse-free time was significantly shorter in anti-Dsg 3-positive patients compared to anti-Dsg 3- negative patients (P = .015) and in DIF-positive patients compared to DIF-negative patients (P = .047), but not in anti-Dsg 1- positive patients compared to anti-Dsg 1-negative patients (P = .501). Sensitivity and predictive values of neither of these tests were high. Small number of anti-Dsg 1-positive patients and use of conventional ELISA. Positive anti-Dsg 3 ELISA and, to a lesser degree, positive DIF are predictors of relapse in PV patients in clinical remission. Decision on discontinuing treatment should be based on the results of these tests as well as on clinical findings. Copyright © 2015 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  14. Onconeuronal and antineuronal antibodies in patients with neoplastic and non-neoplastic pulmonary pathologies and suspected for paraneoplastic neurological syndrome

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    Michalak S

    2009-12-01

    Full Text Available Abstract Objective Onconeuronal antibodies are important diagnostic tool in patients with suspicion of paraneoplastic neurological syndromes (PNS. However, their role in PNS pathophysiology and specificity for particular neurological manifestation remains unclear. The aim of this study was to evaluate onconeuronal and antineuronal antibodies in patients with pulmonary pathologies and suspected for PNS. Materials and methods Twenty one patients with pulmonary pathologies were selected from the database of 525 consecutive patients with suspicion of PNS. Patients' sera were screened for the presence of onconeuronal and antineuronal antibodies by means of indirect immunofluorescence; the presence was confirmed by Western blotting. Clinical data were obtained from medical records, hospital data base, and questionnaire-based direct telephone contact with patients. Results Among 21 patients, aged 54 ± 11, with pulmonary pathologies, the most frequent neurological manifestations were neuropathies. Typical PNS included paraneoplastic cerebellar degeneration (PCD and limbic encephalitis (LE. We found cases with multiple onconeuronal antibodies (anti-Ri and anti-Yo and coexisting PNS (PCD/LE. Well-defined onconeuronal antibodies were identified in 23.8% of patients. Among antineuronal antibodies, the most frequent were anti-MAG (23.8%. ROC curves analysis revealed high sensitivity of onconeuronal and antineuronal antibodies for typical PNS and lower for pulmonary malignancies. Conclusions Tests for antibodies are highly sensitive for the diagnosis of typical paraneoplastic neurological syndromes. Anti-myelin and anti-MAG antibodies are associated with non-neoplastic pulmonary diseases. Patients with well-defined onconeuronal antibodies require careful screening and follow-up, because the PNS diagnosis indicates a high probability of an underlying malignancy.

  15. Accuracy of molecular diagnostics in pemphigus and bullous pemphigoid: comparison of commercial and modified mosaic indirect immunofluorescence tests as well as enzyme-linked immunosorbent assays.

    Science.gov (United States)

    Gornowicz-Porowska, Justyna; Seraszek-Jaros, Agnieszka; Bowszyc-Dmochowska, Monika; Kaczmarek, Elżbieta; Pietkiewicz, Paweł; Bartkiewicz, Paweł; Dmochowski, Marian

    2017-02-01

    Pemphigus and bullous pemphigoid (BP) are identified by autoantibodies (abs) against desmoglein 1, 3 (DSG1/3) and BP180/BP230, respectively. A novel mosaic to indirect immunofluorescence (IIF) using purified BP180 recombinant proteins spotted on slide and transfected cells expressing BP230, DSG1, DSG3 is available. The commercial (IgG detection) and modified (IgG4 detection) mosaic for indirect immunofluorescence (IIFc - IIF commercial, IIFm - IIF modified) and IgG ELISAs were evaluated in pemphigus and bullous pemphigoid (BP) molecular diagnostics. To compare diagnostic accuracy of commercial (IgG detection) and modified (IgG4 detection) mosaic IIF assay and to examine the diagnostic value of ELISAs in relation to mosaic IIF in routine laboratory diagnostics of pemphigus and BP. Sera from 37 BP and 19 pemphigus patients were studied. Associations between tests were assessed using Fisher's exact test. There are associations between the positive/negative samples detected by IIFc with desmoglein1 (DSG1)/desmoglein3 (DSG3)/BP230 transfected cells and ELISAs and no association between anti-BP180 IgG detection by IIFc and ELISA. IIFm with DSG1 and DSG3 showed both 100% sensitivity and 100% and 78% specificity, respectively, and 100% and 83% positive predictive value in relation to IIFc. IIFm with BP230 had 87% specificity, 55% sensitivity, whereas IIFm with BP180 had a 100% sensitivity and 13% specificity in relation to IIFc. The IIFc with DSG1/DSG3/BP230 transfected cells, excluding BP180 spots, is an alternative method to ELISA in pemphigus/BP diagnostics. IgG4 antibodies, both pathogenically and diagnostically important, are inconsistently detectable with IIFm.

  16. Accuracy of molecular diagnostics in pemphigus and bullous pemphigoid: comparison of commercial and modified mosaic indirect immunofluorescence tests as well as enzyme-linked immunosorbent assays

    Directory of Open Access Journals (Sweden)

    Justyna Gornowicz-Porowska

    2017-02-01

    Full Text Available Introduction : Pemphigus and bullous pemphigoid (BP are identified by autoantibodies (abs against desmoglein 1, 3 (DSG1/3 and BP180/BP230, respectively. A novel mosaic to indirect immunofluorescence (IIF using purified BP180 recombinant proteins spotted on slide and transfected cells expressing BP230, DSG1, DSG3 is available. The commercial (IgG detection and modified (IgG4 detection mosaic for indirect immunofluorescence (IIFc – IIF commercial, IIFm – IIF modified and IgG ELISAs were evaluated in pemphigus and bullous pemphigoid (BP molecular diagnostics. Aim : To compare diagnostic accuracy of commercial (IgG detection and modified (IgG4 detection mosaic IIF assay and to examine the diagnostic value of ELISAs in relation to mosaic IIF in routine laboratory diagnostics of pemphigus and BP. Material and methods : Sera from 37 BP and 19 pemphigus patients were studied. Associations between tests were assessed using Fisher’s exact test. Results: There are associations between the positive/negative samples detected by IIFc with desmoglein1 (DSG1/desmoglein3 (DSG3/BP230 transfected cells and ELISAs and no association between anti-BP180 IgG detection by IIFc and ELISA. IIFm with DSG1 and DSG3 showed both 100% sensitivity and 100% and 78% specificity, respectively, and 100% and 83% positive predictive value in relation to IIFc. IIFm with BP230 had 87% specificity, 55% sensitivity, whereas IIFm with BP180 had a 100% sensitivity and 13% specificity in relation to IIFc. Conclusions : The IIFc with DSG1/DSG3/BP230 transfected cells, excluding BP180 spots, is an alternative method to ELISA in pemphigus/BP diagnostics. IgG4 antibodies, both pathogenically and diagnostically important, are inconsistently detectable with IIFm.

  17. Dexamethasone-Cyclophosphamide Pulse Therapy In Pemphigus : An Appraisal OF Its Outcome In A Tertiary Health Care Center In South India

    Directory of Open Access Journals (Sweden)

    Thappa Devinder Mohan

    2004-01-01

    Full Text Available Dexamethasone-cyclophoshamide pulse (DCP therapy, designed by Pasricha and Gupta for pemphigus was first used in 1981 with the aim of reducing the toxicity of corticosteroids and also to achieve better therapeutic results. We have been using the same pulse therapy and herewith are presenting the results of pulse therapy in pemphigus were included in the study over a period of 6 years. They consisted of 51 cases of pemphigus vulgaris and 4 cases of pemphigus foliaceous. The male to female ration was 1.2:1. The age distribution showed a bimodal pattern with peaks at 21-30 years and 51-60 years. The body surface area involved at the time of initiation of DCP was less than 25% in 25, 25-50% in 19 and more than 50% in 11 cases. Oral cavity was involved in all cases of pemphigus vulgaris and eyes were affected in 4 patients. Twentysix cases were managed with DCP pulses only and were in remission in phase II and three of our patients in remission in phase III relapsed at 6 to 9 months. Interpulse steroids were required to induce remission in 11 patients. The remaining 18 patients did not proceed to phase II as they was either defaulting or had active disease. Only four cases progressed into phase IV and were declared cured. The various complications seen in our patients were candidiasis (n=5, hiccups (2, acneiform eruption (2, iatrogenic Cushing’s syndrome (1, herpes zoster (1, striae distensae (1, umbilical abscess (1, alopecia (1, azoospermia (1 pneumonia (1 and deep vein thrombosis (1. Two Patients on pulse therapy died of septicemia.

  18. Severe hypokinesis caused by paraneoplastic anti-Ma2 encephalitis associated with bilateral intratubular germ-cell neoplasm of the testes.

    Science.gov (United States)

    Matsumoto, Lumine; Yamamoto, Tomotaka; Higashihara, Mana; Sugimoto, Izumi; Kowa, Hisatomo; Shibahara, Junji; Nakamura, Koichiro; Shimizu, Jun; Ugawa, Yoshikazu; Goto, Jun; Dalmau, Josep; Tsuji, Shoji

    2007-04-15

    We report a 40-year-old man with severe hypokinesis as paraneoplastic manifestation of a microscopic "carcinoma in situ" of the testis. The young age of the patient, along with progressive neurologic deterioration, detection of anti-Ma2 antibodies, and ultrasound findings of bilateral microcalcifications, led to bilateral orchiectomy, revealing the tumor in both testes. After orchiectomy, neurological symptoms stabilized, but the patient eventually died of systemic complications caused by his severe neurological deficits. Anti-Ma2 paraneoplastic encephalitis should be considered in patients with severe hypokinesis, and intensive investigation and aggressive approach to treatment is encouraged to prevent progression of the neurological deficits.

  19. Pancreatic Cancer-Derived Exosomes Cause Paraneoplastic β-cell Dysfunction.

    Science.gov (United States)

    Javeed, Naureen; Sagar, Gunisha; Dutta, Shamit K; Smyrk, Thomas C; Lau, Julie S; Bhattacharya, Santanu; Truty, Mark; Petersen, Gloria M; Kaufman, Randal J; Chari, Suresh T; Mukhopadhyay, Debabrata

    2015-04-01

    Pancreatic cancer frequently causes diabetes. We recently proposed adrenomedullin as a candidate mediator of pancreatic β-cell dysfunction in pancreatic cancer. How pancreatic cancer-derived adrenomedullin reaches β cells remote from the cancer to induce β-cell dysfunction is unknown. We tested a novel hypothesis that pancreatic cancer sheds adrenomedullin-containing exosomes into circulation, which are transported to β cells and impair insulin secretion. We characterized exosomes from conditioned media of pancreatic cancer cell lines (n = 5) and portal/peripheral venous blood of patients with pancreatic cancer (n = 20). Western blot analysis showed the presence of adrenomedullin in pancreatic cancer-exosomes. We determined the effect of adrenomedullin-containing pancreatic cancer exosomes on insulin secretion from INS-1 β cells and human islets, and demonstrated the mechanism of exosome internalization into β cells. We studied the interaction between β-cell adrenomedullin receptors and adrenomedullin present in pancreatic cancer-exosomes. In addition, the effect of adrenomedullin on endoplasmic reticulum (ER) stress response genes and reactive oxygen/nitrogen species generation in β cells was shown. Exosomes were found to be the predominant extracellular vesicles secreted by pancreatic cancer into culture media and patient plasma. Pancreatic cancer-exosomes contained adrenomedullin and CA19-9, readily entered β cells through caveolin-mediated endocytosis or macropinocytosis, and inhibited insulin secretion. Adrenomedullin in pancreatic cancer exosomes interacted with its receptor on β cells. Adrenomedullin receptor blockade abrogated the inhibitory effect of exosomes on insulin secretion. β cells exposed to adrenomedullin or pancreatic cancer exosomes showed upregulation of ER stress genes and increased reactive oxygen/nitrogen species. Pancreatic cancer causes paraneoplastic β-cell dysfunction by shedding adrenomedullin(+)/CA19-9(+) exosomes into

  20. [Paraneoplastic Cushing's syndrome, a real diagnostic and therapeutic challenge: A case report and literature review].

    Science.gov (United States)

    Meftah, A; Moumen, A; Massine El Hammoumi, M; Hajhouji, S; El Jadi, H; Anas Guerboub, A; Elmoussaoui, S; Mayaudon, H; Hassane Kabiri, E; Hakkou, K; Belmejdoub, G

    2015-12-01

    Paraneoplastic Cushing's syndrome is a rare cause of endogenous hypercortisolism attributable to ectopic ACTH secretion by non-pituitary tumors. Imaging and biochemical results are often inconclusive and differential diagnosis with Cushing's disease can then be challenging. Moreover, these tumors may be occult and difficult to find and thus the need of new imaging tools such as (18)FDG-PET scan and (18)DOPA-PET scan. We report a 50-year-old man who presented with very aggressive clinical features related to Cushing's syndrome. Biological work-up confirmed the hypercortisolism and was consistent with an ectopic ACTH secretion. Conventional localization techniques failed to show any tumor and bilateral adrenalectomy was performed because of life-threatening complications. Two years later, thoracic computed tomography reveals an 11 mm mass in the left lower pulmonary lobe, (18)FDG-PET scan found a non-specific mild hypermetabolism of the lung nodule, and the (18)DOPA-PET scan confirmed the high uptake of this nodule suggesting an endocrine carcinoma. Histology confirmed a typical carcinoid tumor. The tumor cells stained positive for ACTH, CD56, chromogranin and synaptophysin. This case illustrates the dilemma between the need for morphological diagnosis of the ectopic ACTH source and control of the life-threatening hypercortisolism. (18)FDG-PET scan and (18)DOPA-PET scan should be considered early as a secondary diagnostic tool when conventional imagery fails to show any tumor. Copyright © 2015 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

  1. T cells targeting a neuronal paraneoplastic antigen mediate tumor rejection and trigger CNS autoimmunity with humoral activation.

    Science.gov (United States)

    Blachère, Nathalie E; Orange, Dana E; Santomasso, Bianca D; Doerner, Jessica; Foo, Patricia K; Herre, Margaret; Fak, John; Monette, Sébastien; Gantman, Emily C; Frank, Mayu O; Darnell, Robert B

    2014-11-01

    Paraneoplastic neurologic diseases (PND) involving immune responses directed toward intracellular antigens are poorly understood. Here, we examine immunity to the PND antigen Nova2, which is expressed exclusively in central nervous system (CNS) neurons. We hypothesized that ectopic expression of neuronal antigen in the periphery could incite PND. In our C57BL/6 mouse model, CNS antigen expression limits antigen-specific CD4+ and CD8+ T-cell expansion. Chimera experiments demonstrate that this tolerance is mediated by antigen expression in nonhematopoietic cells. CNS antigen expression does not limit tumor rejection by adoptively transferred transgenic T cells but does limit the generation of a memory population that can be expanded upon secondary challenge in vivo. Despite mediating cancer rejection, adoptively transferred transgenic T cells do not lead to paraneoplastic neuronal targeting. Preliminary experiments suggest an additional requirement for humoral activation to induce CNS autoimmunity. This work provides evidence that the requirements for cancer immunity and neuronal autoimmunity are uncoupled. Since humoral immunity was not required for tumor rejection, B-cell targeting therapy, such as rituximab, may be a rational treatment option for PND that does not hamper tumor immunity. © 2014 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  2. Two Paraneoplastic Autoimmune Syndromes: Limbic Encephalitis and Palmar Fasciitis in a Patient with Small Cell Lung Cancer.

    Science.gov (United States)

    Lazarev, Irina; Shelef, Ilan; Refaely, Yael; Ariad, Samuel; Ifergane, Gal

    2015-09-07

    Small cell lung cancer (SCLC) is characterized by a relatively high rate of autoimmune phenomena. Paraneoplastic limbic encephalitis (PLE) is an autoimmune syndrome in which a non-neural tumor containing an antigen normally present in the nervous system precipitates an antibody attack on neural tissues. Patients with PLE usually present with rapidly progressive short-term memory deficits, confusion or even dementia. Palmar fasciitis and polyarthritis syndrome (PFPAS) is another autoimmune syndrome characterized by rheumatologic manifestations, especially involving the palms of the hands. We report a case of a 59-year old woman who presented with worsening neurological symptoms of two-week duration, and later coma. The combined clinical, serological, and imaging studies suggested a diagnosis of PLE. A chest computed tomographic scan showed a 1.2 cm-diameter mass in the upper lobe of the left lung that was surgically removed and showed SCLC. Following surgery, neurological symptoms rapidly improved, allowing the patient to receive adjuvant chemotherapy. While in remission for both SCLC and PLE, the patient developed pain, soft-tissue swelling, and stiffness in both palms, suggesting the diagnosis of PFPAS. Five months following the diagnosis of palmar fasciitis, SCLC relapsed with mediastinal and cervical lymphadenopathy. This case report underlines the continuous interaction of SCLC with the immune system, expressed by coexistence of two rare paraneoplastic diseases, PLE, and PFPAS, in a patient with SCLC. While symptoms related to PLE preceded the initial diagnosis of SCLC, other symptoms related to PFPAS preceded relapse.

  3. Two paraneoplastic autoimmune syndromes: limbic encephalitis and palmar fasciitis in a patient with small cell lung cancer

    Directory of Open Access Journals (Sweden)

    Irina Lazarev

    2015-09-01

    Full Text Available Small cell lung cancer (SCLC is characterized by a relatively high rate of autoimmune phenomena. Paraneoplastic limbic encephalitis (PLE is an autoimmune syndrome in which a non-neural tumor containing an antigen normally present in the nervous system precipitates an antibody attack on neural tissues. Patients with PLE usually present with rapidly progressive short-term memory deficits, confusion or even dementia. Palmar fasciitis and polyarthritis syndrome (PFPAS is another autoimmune syndrome characterized by rheumatologic manifestations, especially involving the palms of the hands. We report a case of a 59-year old woman who presented with worsening neurological symptoms of two-week duration, and later coma. The combined clinical, serological, and imaging studies suggested a diagnosis of PLE. A chest computed tomographic scan showed a 1.2 cm-diameter mass in the upper lobe of the left lung that was surgically removed and showed SCLC. Following surgery, neurological symptoms rapidly improved, allowing the patient to receive adjuvant chemotherapy. While in remission for both SCLC and PLE, the patient developed pain, soft-tissue swelling, and stiffness in both palms, suggesting the diagnosis of PFPAS. Five months following the diagnosis of palmar fasciitis, SCLC relapsed with mediastinal and cervical lymphadenopathy. This case report underlines the continuous interaction of SCLC with the immune system, expressed by coexistence of two rare paraneoplastic diseases, PLE, and PFPAS, in a patient with SCLC. While symptoms related to PLE preceded the initial diagnosis of SCLC, other symptoms related to PFPAS preceded relapse.

  4. Inclusion Body Myositis: A Case Presenting with Respiratory Failure and Autopsy Findings Leading to the Hypothesis of a Paraneoplastic Cause.

    Science.gov (United States)

    Dardis, Christopher; Antezana, Ariel; Tanji, Kurenai; Maccabee, Paul J

    2017-06-23

    BACKGROUND Sporadic inclusion body myositis (IBM) is the most common acquired myopathy seen in adults aged over 50 years, with a prevalence estimated at between 1 and 70 per million. Weakness of the diaphragm with loss of vital capacity is almost universal in IBM. This is almost always asymptomatic. When respiratory complications occur, they are most often due to aspiration. Respiratory failure due to diaphragmatic weakness is exceptionally rare, particularly as the presenting symptom of the disease. It is not currently considered to be a paraneoplastic syndrome. CASE REPORT Our patient presented with hypercarbic respiratory failure. This is the first such reported case without signs of weakness elsewhere of which we are aware. We suspected IBM based on her history of progressive weakness and findings on electromyography. There was a delay of 5 years in obtaining biopsy for confirmation, during which she presented with recurrent episodes of respiratory failure despite using non-invasive ventilation. An autopsy revealed the presence of papillary thyroid carcinoma with spread to local lymph nodes. On the basis that these co-morbidities are unlikely to have occurred by chance (we estimate 1×10-17), we hypothesize that IBM may be a paraneoplastic condition. We acknowledge that proof would require demonstrating a pathogenic antibody. CONCLUSIONS IBM should be considered in older patients (age >45) presenting with otherwise unexplained respiratory failure. A workup for possible malignancy in this setting appears reasonable.

  5. Sequential fluctuating paraneoplastic ocular flutter-opsoclonus-myoclonus syndrome and Lambert-Eaton myasthenic syndrome in small-cell lung cancer.

    LENUS (Irish Health Repository)

    Simister, Robert J

    2011-03-01

    Paraneoplastic cerebellar degeneration may occur in association with Lambert-Eaton myasthenic syndrome (LEMS), but to our knowledge, the co-occurrence of paraneoplastic opsoclonus-myoclonus syndrome and LEMS has not been previously reported. A 67-year-old woman presented with a complex partial seizure and evolving ocular flutter, opsoclonus, myoclonus and \\'cerebellar\\' signs, all of which improved spontaneously within 6 weeks. Approximately 8 weeks after symptom onset, the patient became encephalopathic, she had a further complex partial seizure, and she became areflexic with potentiation of deep tendon reflexes. Radiological, bronchoscopic and histological investigations revealed small-cell lung cancer, and neurophysiological investigations confirmed a diagnosis of LEMS. High-titre anti-P\\/Q-type voltage-gated calcium-channel antibodies were identified in the serum, which increased as the signs of opsoclonus and myoclonus resolved. The encephalopathy and clinical features of LEMS responded dramatically to chemotherapy and radiotherapy. Spontaneous improvement of paraneoplastic opsoclonus-myoclonus syndrome may occur, and this syndrome may occur in association with LEMS. Antivoltage-gated calcium-channel antibodies are not implicated in the pathogenesis of paraneoplastic opsoclonus-myoclonus syndrome.

  6. Factores que influyen en la definición del perfil profesional del egresado de la ETS-PNP y el desempeño laboral.

    OpenAIRE

    García Casas, Oswaldo German

    2015-01-01

    El presente trabajo de investigación se ha centrado en la Escuela Técnico Superior de la Policía Nacional del Perú de Puente Piedra (ETS-PNPPP), teniendo como unidad de análisis los cadetes del último año de egreso. El objetivo principal ha sido establecer los factores que influyen en la definición del perfil profesional del egresado de la ETS-PNP-Puente Piedra; considerando que Lima Metropolitana en particular viene soportando un clima de inseguridad, debido al crecimiento de la criminali...

  7. Assessment of the Prevalence and Risk Factors Associated With Glucocorticoid-Induced Diabetes Mellitus in Pemphigus Vulgaris Patients.

    Science.gov (United States)

    Darjani, Abbas; Nickhah, Nahid; Hedayati Emami, Mohammad Hassan; Alizadeh, Narges; Rafiei, Rana; Eftekhari, Hojat; Gharaei Nejad, Kaveh

    2017-06-01

    Pemphigus vulgaris is a chronic autoimmune disease and glucocorticoids are one of the main treatments. Our study investigates the prevalence and associated factors of glucocorticoid-induced diabetes mellitus in these patients under different glucocorticoid regimens. 36 patients with first diagnosed Pemphigus vulgaris based on pathological and direct immunofluorescence findings who had received different glucocorticoid regimens (1-2 mg/kg oral or 1-2 mg/kg oral with 1g methylprednisolone pulse daily for 3 consecutive days with or without azathioprine) were evaluated during 2014-2016. Our study found that 22.2% of patients had impaired fasting glucose and incidence of corticosteroid-induced diabetes mellitus was 22.2% with no difference between oral and pulse therapy of corticosteroid. The first day after pulse therapy 19 patients of 21 had post bolus hyperglycemia that 36% of them became diabetic after 8 weeks. None of the variables, including age, BMI, HbA1c, LDL, HDL, TG, cholesterol, family history and blood pressure were associated with diabetes. Pretreatment FBS was the factor that would increase the likelihood of glucocorticoid-induced diabetes mellitus, 42.2% of patients with pretreatment FBS 100-126 developed diabetes in comparison with 17.2% in normal pretreatment FBS. Although the group who received azathioprine was associated with increased incidence of diabetes, the overall corticosteroid dose in this group was significantly higher than the other group (P=0.012), and controversy with other studies could be because of difference in corticosteroid dosage and small number of patients. The incidence of diabetes was not different between the group with glucocorticoid pulses and oral prednisolone without pulse therapy. Higher pretreatment FBS can be related to increased incidence of diabetes, but results from this study due to small number of patients are preliminary and multicenter studies are needed.

  8. Pulsoterapia com ciclofosfamida nos pênfigos: relato de sete casos Cyclophosphamide pulse therapy for pemphigus: report of seven cases

    Directory of Open Access Journals (Sweden)

    Nurimar C. Fernandes

    2005-04-01

    Full Text Available A eficácia da pulsoterapia com ciclofosfamida foi avaliada no pênfigo vulgar (dois homens e quatro mulheres entre 34 e 47 anos e em um homem de 56 anos com pênfigo foliáceo. Os critérios de inclusão para pulsoterapia foram: não controle com prednisona, efeitos colaterais importantes, recorrência da doença nas tentativas de redução da prednisona e dose de manutenção > 40mg/dia. Em um caso (cinco pulsos a dose de manutenção da prednisona foi reduzida para 10mg; em um caso (nove pulsos, para 20mg; em dois casos (10 pulsos, para 20mg; em um caso (nove pulsos, para 30mg; em um caso (sete pulsos foi zerada; em um caso a ciclofosfamida foi suspensa por leucopenia.The efficacy of cyclophosphamide pulse therapy was evaluated in pemphigus vulgaris (2 males and 4 females aged 34 to 47 years and in a 56-year-old male with pemphigus foliaceus. The inclusion criteria for pulse therapy were: prednisone failure, important side effects, recurrence of disease during the withdrawal and maintenance oral prednisone > 40 mg daily. In one case (5 pulses, the maintenance dose of prednisone was reduced to 10 mg; in another case (9 pulses, to 20 mg; in 2 cases (10 pulses, to 20 mg; in 1 case (9 pulses, to 30 mg; in 1 case (7 pulses, no prednisone was required; and in 1 case, the cyclophosphamide was interrupted due to leukopenia.

  9. Polymorphism of the promoter region and exon 1 of the CTLA4 gene in endemic pemphigus foliaceus (fogo selvagem

    Directory of Open Access Journals (Sweden)

    D.P. Pavoni

    2006-09-01

    Full Text Available Endemic pemphigus foliaceus (EPF is an autoimmune bullous skin disease characterized by acantholysis and antibodies against a desmosomal protein, desmoglein 1. Genetic and environmental factors contribute to development of this multifactorial disease. HLA class II and some cytokine gene polymorphisms are the only genetic markers thus far known to be associated with susceptibility to or protection from EPF. The cytotoxic T-lymphocyte antigen-4 gene (CTLA4 encodes a key immunoreceptor molecule that regulates and inhibits T-cell proliferation. It participates in the regulatory process controlling autoreactivity and therefore has been considered a strong candidate gene in autoimmune diseases. In the search for genes that might influence EPF pathogenesis, we analyzed variants of the CTLA4 gene in a sample of 118 patients and 291 controls from a Brazilian population. This is the first study investigating the possible role of polymorphisms of the 2q33 chromosomal region in differential susceptibility to pemphigus foliaceus. Promoter region and exon 1 single nucleotide polymorphisms -318 (C,T and 49 (A,G were genotyped using sequence-specific oligonucleotide probes after amplification by the polymerase chain reaction. The allelic and genotypic frequencies did not differ significantly between the patient and the control groups (-318T: 9.8 and 10.9%, 49G: 33.0 and 35.2% were the allelic frequencies in patients and controls, respectively. In addition, no significant difference was found when the patient and control population samples were stratified by the presence of HLA-DRB1 alleles. We conclude that the CTLA4 -318 (C,T and 49 (A,G polymorphisms do not play a major role in EPF development.

  10. Combined treatment with immunoadsorption and rituximab leads to fast and prolonged clinical remission in difficult-to-treat pemphigus vulgaris.

    Science.gov (United States)

    Behzad, M; Möbs, C; Kneisel, A; Möller, M; Hoyer, J; Hertl, M; Eming, R

    2012-04-01

    Pemphigus vulgaris (PV) is a potentially life-threatening autoimmune bullous disorder which is characterized by blisters and erosions of the skin and mucous membranes. A frequently applied first-line therapy for PV consists of systemic corticosteroids (CS) combined with immunosuppressive agents. In refractory cases, novel therapeutic strategies such as immunoadsorption (IA) and the anti-CD20 antibody rituximab (Rtx) aim at directly interfering with pathogenic autoantibodies (auto-Abs). To investigate the long-term efficacy of IA in combination with Rtx in patients with difficult-to-treat PV, we assessed the clinical response to treatment by monitoring the Autoimmune Bullous Skin Disorder Intensity Score, IgG auto-Abs against desmoglein 1 and 3 (Dsg1 and Dsg3) and the dose of systemic CS. We retrospectively analysed clinical and serological parameters of 10 patients with difficult-to-treat PV who received IA at 4-week intervals, followed by Rtx either twice at 1000 mg or four times at 375mg m(-2) . During a 12-month follow-up period, CS were tapered according to the individual clinical status. Six months after the first IA treatment eight of 10 patients were in complete remission on therapy while one patient showed a partial response and one patient was unresponsive to the treatment. At 12 months, six of eight patients were in complete remission on therapy, one patient showed stable disease and one patient had relapsed. Overall, anti-Dsg3 IgG and anti-Dsg1 IgG auto-Abs correlated well with the clinical activity and systemic CS were tapered gradually. The present findings show that the combination of IA and Rtx induces rapid clinical remission and long-term control in difficult-to-treat pemphigus. © 2011 The Authors. BJD © 2011 British Association of Dermatologists.

  11. A novel paraneoplastic syndrome with acquired lipodystrophy and chronic inflammatory demyelinating polyneuropathy in an adolescent male with craniopharyngioma.

    Science.gov (United States)

    Lockemer, Hillary Elizabeth; Sumpter, Kathryn Maria; Cope-Yokoyama, Sandy; Garg, Abhimanyu

    2018-03-28

    Acquired lipodystrophy, craniopharyngioma and chronic inflammatory demyelinating polyneuropathy (CIDP) are individually rare disorders, and have never before been reported in a single patient. A 15-year-7 month old Caucasian male presented with lower extremity weakness, frequent falls and abnormal fat distribution occurring over the previous 1 year. He was diagnosed with CIDP, craniopharyngioma and acquired lipodystrophy. The patient underwent tumor debulking and cranial irradiation for the craniopharyngioma, and received monthly intravenous immunoglobulin for the CIDP. The patient initially had some resolution of the lipodystrophy phenotype, but subsequently the abnormal fat distribution recurred and the patient developed additional systemic abnormalities, including mild pancytopenia and hepatic fibrosis. Our patient represents a novel association of acquired lipodystrophy, craniopharyngioma, and CIDP, possibly due to an as yet unidentified paraneoplastic autoantibody.

  12. Recurrence of paraneoplastic membranous glomerulonephritis following chemoradiation in a man with non-small-cell lung carcinoma

    Directory of Open Access Journals (Sweden)

    Kara Leonard

    2013-04-01

    Full Text Available Membranous glomerulonephritis can occur as a rare paraneoplastic complication of human cancers. In this case report, we describe a patient who presented acutely with symptoms of the nephrotic syndrome including heavy proteinuria and anasarca. He was subsequently diagnosed with membranous glomerulonephritis, and soon afterwards was found to have stage IIIB non-small cell lung cancer. Following chemoradiation therapy, both the patient’s cancer and membranous glomerulonephritis dramatically improved. However, approximately 14 months following his initial presentation, the patient was found to have a recurrence of his nephrotic-range proteinuria which corresponded temporally with recurrence of his cancer. We present details of the case and a review of the relevant scientific literature.

  13. Anti-Ma2 paraneoplastic encephalitis associated with testicular germ cell tumor treated by carboplatin, etoposide and bleomycin.

    Science.gov (United States)

    Kimura, Masaki; Onozawa, Mizuki; Fujisaki, Akira; Arakawa, Takashi; Takeda, Katsuhiko; Dalmau, Joseph; Hattori, Kazunori

    2008-10-01

    Anti-Ma2-associated encephalitis is a paraneoplastic disorder that predominantly affects the limbic system, diencephalon and brainstem, and is usually associated with tumors of the testis. We report a 35-year-old man with a right testicular mass who presented with multiple neurological complains, and clinical, serological and radiological features compatible with anti-Ma2-associated encephalitis. After three courses of carboplatin, etoposide and bleomycin for metastatic testicular germ-cell tumor, all elevated tumor markers normalized and the retroperitoneal metastases disappeared, but the neurological disorder deteriorated. To our knowledge, this is the first case in which orchiectomy followed by carboplatin, etoposide and bleomycin for a testicular tumor with anti-Ma2 encephalitis was performed.

  14. Anti-Ma2 antibody related paraneoplastic limbic/brain stem encephalitis associated with breast cancer expressing Ma1, Ma2, and Ma3 mRNAs.

    Science.gov (United States)

    Sahashi, K; Sakai, K; Mano, K; Hirose, G

    2003-09-01

    A 69 year old woman presented with cognitive impairment and supranuclear gaze palsy caused by paraneoplastic limbic/brain stem encephalitis associated with atypical medullary breast carcinoma. The cerebrospinal fluid from the patient harboured an anti-neuronal cell antibody against Ma2 antigen, but not against Ma1 or Ma3 antigen. Despite the antibody being restricted to the Ma2 antigen, the patient's cancer tissue expressed Ma1, Ma2, and Ma3 mRNAs. These results, and the expression of Ma2 mRNA in an atypical medullar breast carcinoma in another patient without paraneoplastic encephalitis, indicate that the induction of anti-Ma2 antibody depends on host immunoreponsiveness and not on the presence of the antigen itself in the cancer.

  15. PNP2 calculus programme for interpretation of the experimental data by pulsed source neutrons methods. (Pt. 1). [Fortran IV for ICT 1900

    Energy Technology Data Exchange (ETDEWEB)

    Fratiloiu, C; Cristea, Gh

    1975-01-01

    PNP2 is a calculation programme destined to the interpretation of the experimental data by the pulsed source neutrons method on multiplyer environments into critic or subcritic state, populated with thermal neutrons. The programme is elaborate in the FORTRAN IV language of the ICT 1900 computer. The variation form in time of the thermal neutrons population for the multiplyer environments as a result of this whipping to the moments t=KT, with pockets of neutrons, appearing in the simplified theory of the pulsed source neutrons method. By this process are determinated the quantities Nsub(..cap alpha..), ..cap alpha.., Nsub(r) and B as well as empiric variants which affect these magnitudes. With these quantities is calculated the reactivity in relative units.

  16. An uncommon manifestation of paraneoplastic cerebellar degeneration in a patient with high grade urothelial, carcinoma with squamous differentiation: A case report and literature review

    International Nuclear Information System (INIS)

    Zhu, Yaofeng; Chen, Shouzhen; Chen, Songyu; Song, Jing; Chen, Fan; Guo, Hu; Shang, Zhenhua; Wang, Yong; Zhou, Changkuo; Shi, Benkang

    2016-01-01

    Paraneoplastic neurological syndromes (PNS) are rare disorders associated with malignant tumours, which are triggered by autoimmune reactions. Paraneoplastic cerebellar degeneration (PCD) is the PNS type most commonly associated with ovarian and breast cancer. Two bladder cancers manifesting in PCD were previously reported. However, the cancers in these cases had poor outcomes. Here, we present a 68-year old man with history of high-grade papillary urothelial carcinoma of the bladder. The patient suffered from persistent cerebellar ataxia accompanied by bladder cancer recurrence five months after transurethral resection of the bladder tumour (TURBt). Laboratory screening for the specific antibodies of paraneoplastic neurological syndromes revealed no positive results. Symptoms were not remitted after a 7-day-course of high-dose glucocorticoid therapy. To our surprise, the patient recovered fully after laparoscopic radical cystectomy. Postoperative pathology revealed that surgical specimens were urothelial carcinoma in situ (CIS) and squamous cell carcinoma of the bladder. The patient remained asymptomatic and there was no evidence of recurrence after the followup period of 11 months. To our knowledge, this is the third report of PCD in a patient with bladder cancer. This case showed that tumour resection cured the PCD. To assist clinical evaluation and management, literature regarding basic PNS characteristics and bladder cancers was reviewed

  17. Dual paraneoplastic syndromes: small cell lung carcinoma-related oncogenic osteomalacia, and syndrome of inappropriate antidiuretic hormone secretion: report of a case and review of the literature.

    Science.gov (United States)

    Tantisattamo, Ekamol; Ng, Roland C K

    2011-07-01

    Acquired isolated renal phosphate wasting associated with a tumor, known as oncogenic osteomalacia or tumor-induced osteomalacia, is a rare paraneoplastic syndrome caused by overproduction of fibroblast growth factor 23. Oncogenic osteomalacia is usually associated with benign mesenchymal tumors. Syndrome of inappropriate antidiuretic hormone secretion (SIADH), on the other hand, is a common paraneoplastic syndrome caused by small cell carcinoma (SCC). Concomitant oncogenic osteomalacia and SIADH associated with SCC is very rare with only 4 other cases reported in the literature. The authors report a case of small cell lung cancer (SCLC)-related renal wasting hypophosphatemia and concurrent SIADH, and review the literature reporting 9 other cases of SCC associated with oncogenic osteomalacia. Almost half of reported cases of renal phosphate wasting associated with SCC concomitantly presented with SIADH. These cases had initial serum phosphorus level lower and survival periods shorter than those without SIADH. This rare combination of a dual paraneoplastic syndrome and low serum phosphorus may be a poor prognostic sign. In addition, both renal phosphate wasting and SIADH usually occur in a short period of time before identification of SCC. Therefore, renal wasting hypophosphatemia with concomitant SIADH/hyponatremia should prompt a search for SCC rather than a benign mesenchymal tumor.

  18. The plant lectin wheat germ agglutinin inhibits the binding of pemphigus foliaceus autoantibodies to desmoglein 1 in a majority of patients and prevents pathomechanisms of pemphigus foliaceus in vitro and in vivo.

    Science.gov (United States)

    Ortiz-Urda, Susana; Elbe-Bürger, Adelheid; Smolle, Josef; Marquart, Yvonne; Chudnovsky, Yakov; Ridky, Todd W; Bernstein, Pamela; Wolff, Klaus; Rappersberger, Klemens

    2003-12-01

    Pemphigus foliaceus (PF) is a life-threatening autoimmune blistering skin disease caused by pathogenic IgG autoantibodies against desmoglein 1 (dg1), a desmosomal cadherin-type adhesion glycoprotein. Using lectins and glycosidases, we have shown that dg1 displays an N-glycosylation pattern of the complex triantennary type. We have found that lectins and glycosidases interfere with N-bound sugar residues on the amino-terminal ectodomain of dg1 and completely abolish, in vitro, the antigenicity of dg1 in most of the patients' sera. Moreover, in an ex vivo model using punch biopsies from normal human skin, we demonstrate that preincubation of the epidermis in wheat germ agglutinin (WGA) prevents PF autoantibody binding, acantholysis, and subcorneal blistering. In addition, we show that topical treatment with WGA inhibits PF autoantibody binding to keratinocytes in both newborn BALB/c mice and in organotypic human epidermis grafted onto the back of SCID mice. The epidermis of these pretreated animals displays a regular morphology, whereas control animals develop the immunopathologic phenotype of PF. These findings suggest that WGA may interfere with autoantibody binding to dg1, preventing experimental PF without affecting the adhesive function of dg1. Our observations may provide a new approach to the therapy of PF.

  19. Dual Paraneoplastic Endocrine Syndromes Heralding Onset of Extrapulmonary Small Cell Carcinoma: A Case Report and Narrative Review

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    Jill B. Feffer

    2018-04-01

    Full Text Available ObjectiveExtrapulmonary small cell carcinoma (EPSCC is rare and frequent metastases at presentation can complicate efforts to identify a site of origin. In particular, SCC comprises <1% of prostate cancers and has been implicated in castration resistance.MethodsClinical, laboratory, imaging, and pathology data are presented.ResultsA 56-year-old man with locally advanced prostate adenocarcinoma on androgen deprivation therapy presented with a clogged nephrostomy tube. Laboratory results included calcium 13.8 mg/dL (8.5–10.5 mg/dL, albumin 3.6 g/dL (3.5–5 mg/dL, and potassium 2.8 mmol/L (3.5–5.2 mmol/L. Hypercalcemia investigation revealed intact PTH 19 pg/mL (16–87 pg/mL, 25-OH vitamin D 15.7 ng/mL (>30 ng/mL, and PTH-related peptide (PTHrP 63.4 pmol/L (<2.3 pmol/L. Workup for hypokalemia yielded aldosterone 5.3 ng/dL (<31 ng/dL, renin 0.6 ng/mL/h (0.5–4 ng/mL/h, and 6:00 a.m. cortisol 82 µg/dL (6.7–22.6 µg/dL with ACTH 147 pg/mL (no ref. range. High-dose Dexamethasone suppression testing suggested ACTH-dependent ectopic hypercortisolism. Contrast-enhanced CT findings included masses in the liver and right renal pelvis, a heterogeneous enlarged mass in the region of the prostate invading the bladder, bilateral adrenal thickening, and lytic lesions in the pelvis and spine. Liver biopsy identified epithelioid malignancy with Ki proliferation index 98% and immunohistochemical staining positive for synaptophysin and neuron-specific enolase, compatible with high-grade small cell carcinoma. Staining for ACTH was negative; no stain for CRH was available. Two weeks after chemotherapy, 6:00 a.m. cortisol normalized and CT scans showed universal improvement.ConclusionExtensive literature details paraneoplastic syndromes associated with SCC, but we report the first case of EPSCC diagnosed due to onset of dual paraneoplastic syndromes.

  20. Paraneoplastic hypercalcaemia and osteolytic lesions secondary to large B-cell lymphoma: Case report and literature review

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    Dora Luisa Covarrubias-Flores

    2018-04-01

    Full Text Available Introduction: Hypercalcaemia is a relatively common clinical finding, and its aetiology should be analysed in order to guide treatment. Case report: 56-year-old male presenting with hypercalcaemia, lumbar pain and osteolytic lesions in lumbar vertebrae, with large B-cell lymphoma subsequently confirmed by histology and immunohistochemistry. Discussion: Common causes are primary hyperparathyroidism, hypercalcaemia associated with chronic kidney disease and paraneoplastic hypercalcaemia (secondary to malignancy. Less common causes are granulomatous diseases, lymphoma and vitamin D toxicity, all associated with vitamin D metabolism, and thyrotoxicosis associated with lithium or thiazide diuretic consumption. Conclusion: Our patient presents with malignant hypercalcaemia, probably secondary to extra-renal conversion of 25(OHD to 1,25-dihydroxyvitamin D, which represents <1% of cases. Resumen: Introducción: Hipercalcemia es un hallazgo clínico relativamente común, deberá analizarse la etiología de la misma para normar conducta terapéutica. Caso clínico: Se presenta a masculino de 56 años de edad que debuta con hipercalcemia, lumbalgia y lesiones osteolíticas en columna vertebral lumbar, al que posteriormente se le confirma linfoma b de células grandes mediante histología e inmunohistoquímica. Discusión: Las principales causas son Hiperparatiroidismo primario, hipercalcemia asociada a enfermedad renal crónica e hipercalcemia paraneoplásica (secundaria a malignidad. Causas menos comunes son enfermedades granulomatosas, linfoma e intoxicación por Vitamina D, todas estas asociadas con el metabolismo de la Vitamina D; tirotoxicosis, asociada al consumo de litio o diuréticos tiazídicos. Conclusión: Nuestro paciente debuta con hipercalcemia maligna, probablemente secundaria a la conversión extrarrenal de 25(OHD a 1,25-dihidroxivitamina D, que representa <1% de los casos. Keywords: Paraneoplastic hypercalcaemia, Lymphoma, Osteolytic

  1. Neural system antigens are recognized by autoantibodies from patients affected by a new variant of endemic pemphigus foliaceus in Colombia.

    Science.gov (United States)

    Abreu-Velez, Ana Maria; Howard, Michael S; Yi, Hong; Gao, Weiqing; Hashimoto, Takashi; Grossniklaus, Hans E

    2011-06-01

    Endemic pemphigus foliaceus (EPF), is also known as "fogo selvagem" or "wild fire," reflecting the intense burning sensation of the skin reported by patients with this disease. Based on this finding, we tested for neural autoreactivity in patients affected by a new variant of EPF (El Bagre-EPF). We tested 20 El Bagre-EPF patients, 20 normal controls from the endemic area, and 20 age- and sex-matched normal controls from outside the endemic area. We tested for autoreactivity to several immunoglobulins and complement. Both human skin and bovine tail were used as antigens. We detected autoreactivity to neural structures, mechanoreceptors, nerves, perineural cell layers of the arachnoid envelope around the optic nerve, brain structures, and to neuromuscular spindles; these structures colocalized with several neural markers. The patient antibodies also colocalized with desmoplakins 1 and 2, with the armadillo repeat protein deleted in velo-cardio-facial syndrome and with p0071 antibodies. Autoreactivity was also found associated with neurovascular bundles innervating the skin, and immunoelectron microscopy using protein A gold against patient antibodies was positive against the nerve axons. Paucicellularity of the intraepidermal nerve endings and defragmentation of the neural plexus were seen in 70% of the cases and not in the controls from the endemic area (pEPF patients vis-a-vis the weakness of the extensor nerves, and furthermore, the autoreactivity to nerves in EPF could explain the "burning sensation" encountered in EPF disease.

  2. Circulating levels of mannan-binding lectin (MBL) and MBL-associated serine protease 2 in endemic pemphigus foliaceus

    DEFF Research Database (Denmark)

    Messias-Reason, I; Bosco, DG; Nisihara, RM

    2008-01-01

    Endemic pemphigus foliaceus (EPF) is an autoimmune disease, which occurs in Brazil and other regions of South America. Mannose-binding lectin (MBL) and MBL-associated serine protease (MASP-2) play a key role in innate immunity, and its deficiency has been related to increased susceptibility...... to infection and autoimmune diseases. MBL and MASP-2 serum levels were measured in 114 patients with EPF and in 100 healthy individuals in Brazil. MBL and MASP-2 levels were measured by sandwich assays (time-resolved immunofluorimetic assay) using monoclonal antibodies. No difference was observed in the MBL...... level in patients with EPF compared with controls [mean +/- SEM 1230.07 +/- 132.18 ng/mL (median 789.0 ng/mL) vs. 1036.98 +/- 117.99 ng/mL (median 559.5 ng/mL), P = 0.32]. Non-significant lower MASP-2 levels were observed in EPF [274.34 +/- 15.66 ng/mL (median 239.5 ng/mL ) vs. 304.72 +/- 15.28 ng...

  3. Dew drops on spider web appearance: a newly named pattern of IgG4 deposition in pemphigus with direct immunofluorescence

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    Marian Dmochowski

    2017-08-01

    Full Text Available Novel appearances in cutaneous pathology as well as mucocutaneous clinical signs are being described which indicate that this is still an attractive area for exploration. The H + E histology terms of “decorated tomb stoning” and “undecorated tomb stoning”, advocated by some pathologists, are misleading and as such should be avoided. Here, an appearance of IgG4 pemphigus deposits examined cost-effectively with direct immunofluorescence and suggested to be called “dew drops on spider web” is depicted in depth.

  4. Paraneoplastic scleroderma-like tissue reactions in the setting of an underlying plasma cell dyscrasia: a report of 10 cases.

    Science.gov (United States)

    Magro, Cynthia M; Iwenofu, Hans; Nuovo, Gerard J

    2013-07-01

    Systemic plasma cell dyscrasias have diverse manifestations in the skin and include an inflammatory paraneoplastic process. We encountered cases of scleroderma and eosinophilic fasciitis in the setting of an underlying plasma cell dyscrasia. Ten cases of scleroderma-like tissue reactions in the setting of an underlying plasma cell dyscrasia were encountered. The biopsies were stained for Transforming growth factor (Transforming growth factor) beta, IgG4, kappa, and lambda. Patients presented with a sclerodermoid reaction represented by eosinophilic fasciitis (5 cases), morphea (3 cases), and systemic scleroderma (2 cases). The mean age of presentation was 70 years with a striking female predominance (4:1). Acral accentuation was noted in 8 cases. In 6 of the cases, the cutaneous sclerosis antedated (4 cases) by weeks to 2 years or occurred concurrently (2 cases) with the initial diagnosis of the plasma cell. The biopsies showed changes typical of eosinophilic fasciitis and/or scleroderma. In 5 cases, light chain-restricted plasma cells were present on the biopsy. There was staining of the plasma cells for Transforming growth factor beta in 3 out of 5 cases tested. In any older patient presenting with a sudden onset of eosinophilic fasciitis or scleroderma especially with acral accentuation, investigations should be conducted in regards to an underlying plasma cell dyscrasia.

  5. Zeitlicher Verlauf der avaskulären Nekrose des Hüftkopfes bei Patienten mit Pemphigus vulgaris.

    Science.gov (United States)

    Balighi, Kamran; Daneshpazhooh, Maryam; Aghazadeh, Nessa; Saeidi, Vahide; Shahpouri, Farzam; Hejazi, Pardis; Chams-Davatchi, Cheyda

    2016-10-01

    Pemphigus vulgaris (PV) wird in der Regel mit systemischen Corticosteroiden und Immunsuppressiva behandelt. Avaskuläre Nekrose (AVN) des Hüftkopfes ist eine gut bekannte schwerere Komplikation einer Corticosteroid-Therapie. Die Charakteristika dieser schweren Komplikation bei PV sind nach wie vor unbekannt. Nicht kontrollierte, retrospektive Untersuchung aller PV-bedingten AVN-Fälle, die in einer iranischen Klinik für bullöse Autoimmunerkrankungen zwischen 1985 und 2013 diagnostiziert wurden. Anhand der Krankenakten von 2321 untersuchten PV-Patienten wurden 45 Fälle (1,93 %) von femoraler AVN identifiziert. Dreißig davon waren Männer. Das mittlere Alter bei der Diagnose der AVN betrug 47,4 ± 14,2 Jahre. Der mittlere Zeitraum zwischen der Diagnose des PV und dem Einsetzen der AVN lag bei 25,3 ± 18,3 Monaten. Mit Ausnahme von acht Fällen (17,8 %) setzte die AVN bei der Mehrheit der Patienten innerhalb von drei Jahren nach Diagnose des PV ein. Die mittlere kumulative Dosis von Prednisolon bei Patienten mit AVN betrug 13.115,8 ± 7041,1 mg. Zwischen der Prednisolon-Gesamtdosis und dem Zeitraum bis zum Einsetzen der AVN bestand eine starke Korrelation (p = 0,001). Bei Patienten mit Alendronateinnahme in der Vorgeschichte war dieser Zeitraum signifikant kürzer (p = 0,01). Die AVN ist eine schwere Komplikation einer Corticosteroid-Behandlung bei Patienten mit PV. Sie wird bei 2 % der Patienten beobachtet und tritt vor allem in den ersten drei Behandlungsjahren auf. Bei Patienten, die höhere Dosen von Prednisolon erhalten, setzt die AVN tendenziell früher ein. © 2016 Deutsche Dermatologische Gesellschaft (DDG). Published by John Wiley & Sons Ltd.

  6. Preclinical studies identify non-apoptotic low-level caspase-3 as therapeutic target in pemphigus vulgaris.

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    Camille Luyet

    Full Text Available The majority of pemphigus vulgaris (PV patients suffer from a live-threatening loss of intercellular adhesion between keratinocytes (acantholysis. The disease is caused by auto-antibodies that bind to desmosomal cadherins desmoglein (Dsg 3 or Dsg3 and Dsg1 in mucous membranes and skin. A currently unresolved controversy in PV is whether apoptosis is involved in the pathogenic process. The objective of this study was to perform preclinical studies to investigate apoptotic pathway activation in PV pathogenesis with the goal to assess its potential for clinical therapy. For this purpose, we investigated mouse and human skin keratinocyte cultures treated with PV antibodies (the experimental Dsg3 monospecific antibody AK23 or PV patients IgG, PV mouse models (passive transfer of AK23 or PVIgG into adult and neonatal mice as well as PV patients' biopsies (n=6. A combination of TUNEL assay, analyses of membrane integrity, early apoptotic markers such as cleaved poly-ADP-ribose polymerase (PARP and the collapse of actin cytoskeleton failed to provide evidence for apoptosis in PV pathogenesis. However, the in vitro and in vivo PV models, allowing to monitor progression of lesion formation, revealed an early, transient and low-level caspase-3 activation. Pharmacological inhibition confirmed the functional implication of caspase-3 in major events in PV such as shedding of Dsg3, keratin retraction, proliferation including c-Myc induction, p38MAPK activation and acantholysis. Together, these data identify low-level caspase-3 activation downstream of disrupted Dsg3 trans- or cis-adhesion as a major event in PV pathogenesis that is non-synonymous with apoptosis and represents, unlike apoptotic components, a promising target for clinical therapy. At a broader level, these results posit that an impairment of adhesive functions in concert with low-level, non-lethal caspase-3 activation can evoke profound cellular changes which may be of relevance for other

  7. On-line monitoring of base current and forward emitter current gain of the voltage regulator's serial pnp transistor in a radiation environment

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    Vukić Vladimir Đ.

    2012-01-01

    Full Text Available A method of on-line monitoring of the low-dropout voltage regulator's operation in a radiation environment is developed in this paper. The method had to enable detection of the circuit's degradation during exploitation, without terminating its operation in an ionizing radiation field. Moreover, it had to enable automatic measurement and data collection, as well as the detection of any considerable degradation, well before the monitored voltage regulator's malfunction. The principal parameters of the voltage regulator's operation that were monitored were the serial pnp transistor's base current and the forward emitter current gain. These parameters were procured indirectly, from the data on the voltage regulator's load and quiescent currents. Since the internal consumption current in moderately and heavily loaded devices was used, the quiescent current of a negligibly loaded voltage regulator of the same type served as a reference. Results acquired by on-line monitoring demonstrated marked agreement with the results acquired from examinations of the voltage regulator's maximum output current and minimum dropout voltage in a radiation environment. The results were particularly consistent in tests with heavily loaded devices. Results obtained for moderately loaded voltage regulators and the risks accompanying the application of the presented method, were also analyzed.

  8. Patients affected by a new variant of endemic pemphigus foliaceus have autoantibodies colocalizing with MYZAP, p0071, desmoplakins 1-2 and ARVCF, causing renal damage.

    Science.gov (United States)

    Abreu-Velez, A M; Howard, M S; Yi, H; Florez-Vargas, A A

    2018-05-16

    We have previously reported that about 30% of patients affected by a new variant of endemic pemphigus foliaceus (EPF) in El Bagre, Colombia (termed El Bagre-EPF or pemphigus Abreu-Manu) have systemic compromise. In the current study, we focused on studying autoreactivity to the kidney and its pathological correlations. To investigate patients with El Bagre-EPF for renal compromise. We performed a case-control study, enrolling 57 patients with El Bagre-EPF and 57 controls from the endemic area, matched by age, sex, race, work activity, demographics and comorbidities. We took skin and renal biopsies; performed direct and indirect immunofluorescence, immunohistochemistry (IHC), confocal microscopy, immunoblotting, direct and indirect immune electron microscopy; and tested kidney function in all living patients. We also used IHC to study seven kidney autopsy samples. Of the 57 patients, 19 had autoantibodies to kidney, with polyclonal reactivity (P EPF have polyclonal autoantibodies to kidney. The kidneys showed a mixed histological pattern resembling lupus nephritis, with a diffuse proliferative Class IV (G) global diffuse pattern in active lesions, and additional interposition of membranoproliferative glomerulonephritis. © 2018 British Association of Dermatologists.

  9. The tryptic cleavage product of the mature form of the bovine desmoglein 1 ectodomain is one of the antigen moieties immunoprecipitated by all sera from symptomatic patients affected by a new variant of endemic pemphigus.

    Science.gov (United States)

    Abréu-Vélez, Ana María; Javier Patiño, Pablo; Montoya, Fernando; Bollag, Wendy B

    2003-01-01

    Multiple antigens are recognized by sera from patients with pemphigus foliaceus (PF). Several have been identified including keratin 59, desmocollins, envoplakin, periplakin, and desmogleins 1 and 3 (Dsg1 and Dsg3). In addition, an 80 kDa antigen was identified as the N-terminal fragment of Dsg1 using as antigen source an insoluble epidermal cell envelope preparation. However, still unsolved was the identity of the most important antigenic moiety, a 45 kDa tryptic fragment which is recognized by all sera from patients with fogo selvagem, pemphigus foliaceus, by half of pemphigus vulgaris sera and by a new variant of endemic pemphigus in E1 Bagre, Colombia that resembles Senear-Usher syndrome. Here, we report the identification of the 45 kDa conformational epitope of a soluble tryptic cleavage product from viable bovine epidermis. To elucidate the nature of this peptide, viable bovine epidermis was trypsin-digested, and glycosylated peptides were partially purified on a concanavalin A (Con-A) affinity column. This column fraction was then used as an antigen source for further immunoaffinity purification. A PF patient's serum covalently coupled to a Staphylococcus aureus protein A column was incubated with the Con-A eluted products and the immuno-isolated antigen was separated by SDS-PAGE, transferred to a membrane, and visualized with Coomassie blue, silver and amido black stains. The 45 kD band was subjected to amino acid sequence analysis revealing the sequence, EXIKFAAAXREGED, which matched the mature form of the extracellular domain of bovine Dsg1. This study confirms the biological importance of the ectodomain of Dsg1 as well as the relevance of conformational epitopes in various types of pemphigus.

  10. Paraneoplastic limbic encephalitis as a cause of new onset of seizures in a patient with non-small cell lung carcinoma: a case report

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    Voutsas Vasileios

    2008-08-01

    Full Text Available Abstract Introduction The etiology of seizure disorders in lung cancer patients is broad and includes some rather rare causes of seizures which can sometimes be overlooked by physicians. Paraneoplastic limbic encephalitis is a rather rare cause of seizures in lung cancer patients and should be considered in the differential diagnosis of seizure disorders in this population. Case presentation This case report describes the new onset of seizures in a 64-year-old male patient receiving chemotherapy for a diagnosed stage IV non-small cell lung carcinoma. After three cycles of therapy, he was re-evaluated with a chest computed tomography which showed a 50% reduction in the tumor mass and in the size of the hilar and mediastinal lymphadenopathy. Twenty days after the fourth cycle of chemotherapy, the patient was admitted to a neurological clinic because of the onset of self-limiting complex partial seizures, with motionless stare and facial twitching, but with no signs of secondary generalization. The patient had also recently developed neurological symptoms of short-term memory loss and temporary confusion, and behavioral changes. Laboratory evaluation included brain magnetic resonance imaging, magnetic resonance spectroscopy of the brain, serum examination for 'anti-Hu' antibodies and stereotactic brain biopsy. Based on the clinical picture, the patient's history of lung cancer, the brain magnetic resonance imaging findings and the results of the brain biopsy, we concluded that our patient had a 'definite' diagnosis of paraneoplastic limbic encephalitis and he was subsequently treated with a combination of chemotherapy and oral steroids, resulting in stabilization of his neurological status. Despite the neurological stabilization, a chest computed tomography which was performed after the 6th cycle showed relapse of the disease in the chest. Conclusion Paraneoplastic limbic encephalitis is a rather rare cause of new onset of seizures in patients with

  11. Paraneoplastic antigen Ma2 autoantibodies as specific blood biomarkers for detection of early recurrence of small intestine neuroendocrine tumors.

    Science.gov (United States)

    Cui, Tao; Hurtig, Monica; Elgue, Graciela; Li, Su-Chen; Veronesi, Giulia; Essaghir, Ahmed; Demoulin, Jean-Baptiste; Pelosi, Giuseppe; Alimohammadi, Mohammad; Öberg, Kjell; Giandomenico, Valeria

    2010-12-30

    Small intestine neuroendocrine tumors (SI-NETs) belong to a rare group of cancers. Most patients have developed metastatic disease at the time of diagnosis, for which there is currently no cure. The delay in diagnosis is a major issue in the clinical management of the patients and new markers are urgently needed. We have previously identified paraneoplastic antigen Ma2 (PNMA2) as a novel SI-NET tissue biomarker. Therefore, we evaluated whether Ma2 autoantibodies detection in the blood stream is useful for the clinical diagnosis and recurrence of SI-NETs. A novel indirect ELISA was set up to detect Ma2 autoantibodies in blood samples of patients with SI-NET at different stages of disease. The analysis was extended to include typical and atypical lung carcinoids (TLC and ALC), to evaluate whether Ma2 autoantibodies in the blood stream become a general biomarker for NETs. In total, 124 blood samples of SI-NET patients at different stages of disease were included in the study. The novel Ma2 autoantibody ELISA showed high sensitivity, specificity and accuracy with ROC curve analysis underlying an area between 0.734 and 0.816. Ma2 autoantibodies in the blood from SI-NET patients were verified by western blot and sequential immunoprecipitation. Serum antibodies of patients stain Ma2 in the tumor tissue and neurons. We observed that SI-NET patients expressing Ma2 autoantibody levels below the cutoff had a longer progression and recurrence-free survival compared to those with higher titer. We also detected higher levels of Ma2 autoantibodies in blood samples from TLC and ALC patients than from healthy controls, as previously shown in small cell lung carcinoma samples. Here we show that high Ma2 autoantibody titer in the blood of SI-NET patients is a sensitive and specific biomarker, superior to chromogranin A (CgA) for the risk of recurrence after radical operation of these tumors.

  12. Clinical value of FDG-PET/CT in suspected paraneoplastic syndromes: a retrospective analysis of 137 patients

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    Bjoern Kristensen, Stine; Hess, Soeren; Petersen, Henrik; Hoeilund-Carlsen, Poul Flemming [Odense University Hospital, Department of Nuclear Medicine, Odense (Denmark)

    2015-12-15

    Paraneoplastic syndromes (PNS) are relatively infrequent manifestations appearing before or after a cancer declares itself. Autoimmune mechanisms may be involved, but their cause and pathogenesis are often unknown. Due to disparity of symptoms, PNS remain a major diagnostic challenge. We examined the value of FDG-PET/CT for ruling in or out malignancy in a heterogeneous group of patients with suspected PNS. We retrospectively extracted data from all patients referred 2009-2013 with suspected PNS. Data included age, sex, follow-up period, scan report, further diagnostic procedures, and final clinical diagnosis. Conclusions of the scan reports were compared to the final follow-up outcome as determined during an average follow-up of 31 months (range 6-51.5) in patients who were not diagnosed with cancer in immediate continuation of a positive PET/CT scan. A total of 137 patients were included. Main causes for referral were neurological (n = 67), rheumatological (n = 25), dermatological (n = 18), nephrological (n = 6), haematological (n = 2), abnormal biochemistry (n = 11), and others (n = 8). The cancer prevalence was 8.8 %. The FDG-PET/CT results were as follows: nine true positives, 22 false positives, 103 true negatives, and three false negatives. Corresponding diagnostic values were: sensitivity 75 %, specificity 82 %, accuracy 82 %, and positive and negative predictive values of 29 % and 97 %, respectively. FDG-PET/CT has in patients with suspected PNS an impressively high negative predictive value and may be of value in ruling out PNS, the more so, the more the number of false positives can be minimized or used in differential diagnosis. We believe that FDG-PET/CT may become an important adjunct to the work-up and triage of patients with suspected PNS. (orig.)

  13. Paraneoplastic cerebellar degeneration and lambert-eaton myasthenia in a patient with merkel cell carcinoma and voltage-gated calcium channel antibodies.

    Science.gov (United States)

    Pavolucci, Lucia; Giannini, Giulia; Giannoccaro, Maria Pia; Foschini, Maria Pia; Lang, Bethan; Avoni, Patrizia; Tinuper, Paolo; Vincent, Angela; Liguori, Rocco

    2017-11-01

    Merkel cell carcinoma is a rare cutaneous, aggressive tumor. Although it shares many neuroendocrine features with small cell lung carcinoma, it has only occasionally been reported with paraneoplastic neurological syndromes. A healthy 67-year-old man developed acute ataxia, vertigo, and nausea. Subsequently he also developed dysarthria, diplopia, xerostomia, fatigability and progressive anorexia. He underwent a full diagnostic workup and was found to have a high titer of voltage-gated calcium channel antibodies in serum and cerebrospinal fluid, neurophysiological findings compatible with Lambert-Eaton myasthenia and neurological signs compatible with cerebellar degeneration. A positron emission tomography study revealed a hypermetabolic lesion in the axilla, subsequently biopsied and consistent with Merkel cell carcinoma. In most previous reports, neurological symptoms preceded the Merkel cell carcinoma diagnosis, and the primary localization was in lymph nodes. This tumor should be considered in patients with paraneoplastic syndrome, and particularly Lambert-Eaton myasthenia after exclusion of small cell lung carcinoma. Muscle Nerve 56: 998-1000, 2017. © 2016 Wiley Periodicals, Inc.

  14. Recurrent Thrombotic Thrombocytopenic Purpura-Like Syndrome as a Paraneoplastic Phenomenon in Malignant Peritoneal Mesothelioma: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Francisco Socola

    2012-01-01

    Full Text Available We report the case of an African American male with no significant past medical history presenting with recurrent, rapidly relapsing episodes of thrombotic thrombocytopenic purpura (TTP despite aggressive treatment with several lines of treatment. Incidentally, these episodes were associated with severe abdominal pain which eventually developed into acute abdomen and prompted exploratory laparotomy, revealing diffuse carcinomatosis with a tumor located on the left pelvis that was encasing the distal sigmoid colon. Pathology made a final diagnosis of peritoneal mesothelioma. TTP-like syndrome (TTP-LS has been described as a paraneoplastic phenomenon in several malignancies but never before in the setting of malignant mesothelioma. Paraneoplastic TTP-like syndrome has historically been associated with a dismal prognosis and particular clinical and laboratory abnormalities described in this paper. It is of utmost importance to make a prompt determination whether TTP is idiopathic or secondary to an underlying condition because of significant differences in their prognosis, treatment, and response. This paper also reviews the current literature regarding this challenging condition.

  15. Paraneoplastic antigen Ma2 autoantibodies as specific blood biomarkers for detection of early recurrence of small intestine neuroendocrine tumors.

    Directory of Open Access Journals (Sweden)

    Tao Cui

    Full Text Available BACKGROUND: Small intestine neuroendocrine tumors (SI-NETs belong to a rare group of cancers. Most patients have developed metastatic disease at the time of diagnosis, for which there is currently no cure. The delay in diagnosis is a major issue in the clinical management of the patients and new markers are urgently needed. We have previously identified paraneoplastic antigen Ma2 (PNMA2 as a novel SI-NET tissue biomarker. Therefore, we evaluated whether Ma2 autoantibodies detection in the blood stream is useful for the clinical diagnosis and recurrence of SI-NETs. METHODOLOGY/PRINCIPAL FINDINGS: A novel indirect ELISA was set up to detect Ma2 autoantibodies in blood samples of patients with SI-NET at different stages of disease. The analysis was extended to include typical and atypical lung carcinoids (TLC and ALC, to evaluate whether Ma2 autoantibodies in the blood stream become a general biomarker for NETs. In total, 124 blood samples of SI-NET patients at different stages of disease were included in the study. The novel Ma2 autoantibody ELISA showed high sensitivity, specificity and accuracy with ROC curve analysis underlying an area between 0.734 and 0.816. Ma2 autoantibodies in the blood from SI-NET patients were verified by western blot and sequential immunoprecipitation. Serum antibodies of patients stain Ma2 in the tumor tissue and neurons. We observed that SI-NET patients expressing Ma2 autoantibody levels below the cutoff had a longer progression and recurrence-free survival compared to those with higher titer. We also detected higher levels of Ma2 autoantibodies in blood samples from TLC and ALC patients than from healthy controls, as previously shown in small cell lung carcinoma samples. CONCLUSION: Here we show that high Ma2 autoantibody titer in the blood of SI-NET patients is a sensitive and specific biomarker, superior to chromogranin A (CgA for the risk of recurrence after radical operation of these tumors.

  16. Population genetic structure of the lettuce root aphid, Pemphigus bursarius (L.), in relation to geographic distance, gene flow and host plant usage.

    Science.gov (United States)

    Miller, N J; Birley, A J; Overall, A D J; Tatchell, G M

    2003-09-01

    Microsatellite markers were used to examine the population structure of Pemphigus bursarius, a cyclically parthenogenetic aphid. Substantial allele frequency differences were observed between populations on the primary host plant (collected shortly after sexual reproduction) separated by distances as low as 14 km. This suggested that migratory movements occur over relatively short distances in this species. However, the degree of allele frequency divergence between populations was not correlated with their geographical separation, indicating that isolation by distance was not the sole cause of spatial genetic structuring. Significant excesses of homozygotes were observed in several populations. Substantial allele frequency differences were also found between aphids on the primary host and those sampled from a secondary host plant after several parthenogenetic generations at the same location in two successive years. This could have been due to the existence of obligately parthenogenetic lineages living on the secondary host or genetically divergent populations confined to different secondary host plant species but sharing a common primary host.

  17. Synthesis, characterization and biological evaluation of [{sup 188}Re(N)(cys{approx})(PNP)]{sup +/0} mixed-ligand complexes as prototypes for the development of {sup 188}Re(N)-based target-specific radiopharmaceuticals

    Energy Technology Data Exchange (ETDEWEB)

    Thieme, Stefan [Institute of Radiopharmacy, Forschungszentrum Dresden Rossendorf, P.O. Box 510 119, 01314 Dresden (Germany); Agostini, Stefania [Department of Pharmaceutical Sciences, University of Padua, Via Marzolo 5, 35131 Padova (Italy); Bergmann, Ralf; Pietzsch, Jens; Pietzsch, Hans-Juergen [Institute of Radiopharmacy, Forschungszentrum Dresden Rossendorf, P.O. Box 510 119, 01314 Dresden (Germany); Carta, Davide; Salvarese, Nicola [Department of Pharmaceutical Sciences, University of Padua, Via Marzolo 5, 35131 Padova (Italy); Refosco, Fiorenzo [ICIS-CNR, Corso Stati Uniti 4, 35127 Padova (Italy); Bolzati, Cristina, E-mail: bolzati@icis.cnr.i [Department of Pharmaceutical Sciences, University of Padua, Via Marzolo 5, 35131 Padova (Italy); ICIS-CNR, Corso Stati Uniti 4, 35127 Padova (Italy)

    2011-04-15

    We report on an efficient procedure for the preparation of [{sup 188}Re(N)(PNP)]-based complexes (where PNP is diphosphinoamine) useful in the development of target-specific radiopharmaceuticals. The radiochemical yield of the compounds was optimized considering such reaction parameters as nature of the nitrido nitrogen donor, reaction times and pH level. The chemical identity of the {sup 188}Re agents was determined by high-performance liquid chromatography comparison with the corresponding well-characterized cold Re compounds. {sup 188}Re(N) mixed compounds have been evaluated with regard to stability toward transchelation with GSH and degradation by serum enzymes. The clearance of selected radiocompounds from normal tissues and their in vivo stability were evaluated in rats by biodistribution and imaging studies. [{sup 188}Re(N)(cys{approx})(PNP)]{sup +/0} mixed-ligand compounds were efficiently prepared in aqueous solution from perrhenate using a multistep procedure based on the preliminary formation of the labile {sup 188}Re{sup III}-EDTA species, which easily undergo oxidation/ligand exchange reaction to afford the [{sup 188}Re{sup V{identical_to}}N]{sup 2+} core in the presence of dithiocarbazate. The final mixed-ligand compounds were obtained, at 100{sup o}C, by adding the two bidentate ligands to the buffered [{sup 188}Re{sup V{identical_to}}N]{sup 2+} solution (pH 3.2-3.6). However, a relatively high amount of cys{approx} ligand was required to obtain a quantitative radiochemical yield. The complexes were stable toward reoxidation to perrhenate and ligand exchange reactions. In vivo studies showed rapid distribution and elimination of the complexes from the body. No specific uptakes in sensitive tissues/organs were detected. A positive correlation of the distribution of the complexes estimated with biodistribution studies (%ID) and with micro-SPECT semiquantification imaging analysis (standard uptake values) was observed. These results support the

  18. Detection of Autoantibodies against Recombinant Desmoglein 1 and 3 Molecules in Patients with Pemphigus vulgaris: Correlation with Disease Extent at the Time of Diagnosis and during Follow-Up

    Directory of Open Access Journals (Sweden)

    Anna Belloni-Fortina

    2009-01-01

    Full Text Available The recent availability of cDNA clones for pemphigus antigens has allowed the production of recombinant desmoglein 1 and desmoglein 3 molecules and the development of an ELISA approach in order to determine levels of antibodies to them. The aim of the study was to determine the relationship between autoantibodies levels and the extent of both mucosal and skin lesions in 20 patients with pemphigus vulgaris at the time of diagnosis and during follow-up. For the detection of autoantibodies by ELISA we used the recombinant proteins expressing overlapping sequences with the entire extracellular desmoglein 1 and desmoglein 3 domains. We showed that in presence of mucosal lesions there was a correlation between extension of mucosal involvement and autoantiboidies titres against both desmoglein 1 and desmoglein 3, whereas in presence of skin lesions there was a statistically significant correlation between extension of skin lesions and autoantibodies titres against desmoglein 3, but not against desmoglein 1. A not negligible number of patients showed variations of the desmoglein 3 autoantibodies titre which did not correlate with the severity of both cutaneous and mucosal involvement. Similar results were obtained analyzing autoantibodies titres against desmoglein 1. In conclusion, we believe that the utilization of recombinant desmoglein 1 and desmoglein 3 proteins by ELISA should be used with caution to monitor disease severity and response to therapy, although it remains a high specific test for the initial diagnosis of pemphigus and the identification of a change in the clinical phenotype of this condition.

  19. The Case of a Zebra That Was Misdiagnosed as a Horse: Pulmonary Tumor Thrombotic Microangiopathy, a New Paraneoplastic Syndrome, Mimicking PD-1-Induced Pneumonitis

    Directory of Open Access Journals (Sweden)

    Corey A. Carter

    2016-01-01

    Full Text Available A case report of a 47-year-old woman with triple-negative breast cancer on a clinical trial called PRIMETIME (NCT02518958 who received the anti-PD-1 inhibitor nivolumab and the experimental anticancer agent RRx-001 is presented. Although initially diagnosed and treated for anti-PD-1-induced pneumonitis, clinical and radiological abnormalities triggered further investigation, leading to the diagnosis of pulmonary tumor thrombotic microangiopathy (PTTM. This example highlights the importance of exercising due diligence in determining immune-related adverse events and suggests that PD-1-induced pneumonitis should be a diagnosis of exclusion rather than a diagnosis by default. A case history and review of the literature are presented for PTTM, which we propose to define as a paraneoplastic syndrome.

  20. The Case of a Zebra That Was Misdiagnosed as a Horse: Pulmonary Tumor Thrombotic Microangiopathy, a New Paraneoplastic Syndrome, Mimicking PD-1-Induced Pneumonitis.

    Science.gov (United States)

    Carter, Corey A; Browning, Robert; Oronsky, Bryan T; Scicinski, Jan J; Brzezniak, Christina

    2016-01-01

    A case report of a 47-year-old woman with triple-negative breast cancer on a clinical trial called PRIMETIME (NCT02518958) who received the anti-PD-1 inhibitor nivolumab and the experimental anticancer agent RRx-001 is presented. Although initially diagnosed and treated for anti-PD-1-induced pneumonitis, clinical and radiological abnormalities triggered further investigation, leading to the diagnosis of pulmonary tumor thrombotic microangiopathy (PTTM). This example highlights the importance of exercising due diligence in determining immune-related adverse events and suggests that PD-1-induced pneumonitis should be a diagnosis of exclusion rather than a diagnosis by default. A case history and review of the literature are presented for PTTM, which we propose to define as a paraneoplastic syndrome.

  1. Polimiositis como manifestación paraneoplásica de un cáncer gástrico Polymiositis as a paraneoplastic manifestation of stomach cancer

    Directory of Open Access Journals (Sweden)

    María N Viamonte Tapia

    2011-11-01

    Full Text Available Se presenta el caso clínico de un hombre de 55 años de edad, en quien se diagnosticó en vida una polimiositis como manifestación paraneoplásica; sin embargo, como no mejoró con el tratamiento esteroideo, se complicó y falleció. El resultado de la necropsia confirmó la presencia de una neoplasia gástrica.The clinical case of a man aged 55 undergoing polymiositis diagnosis as a paraneoplastic manifestation when he was alive is presented. Nonetheless, his health condition got worse and he died even after receiving the steroid therapy. The necropsy result confirmed the presence of gastric neoplasm.

  2. Blocking RhoA/ROCK inhibits the pathogenesis of pemphigus vulgaris by suppressing oxidative stress and apoptosis through TAK1/NOD2-mediated NF-κB pathway.

    Science.gov (United States)

    Liang, Junqin; Zeng, Xuewen; Halifu, Yilinuer; Chen, Wenjing; Hu, Fengxia; Wang, Peng; Zhang, Huan; Kang, Xiaojing

    2017-12-01

    Oxidative stress and apoptosis play critical roles in pemphigus vulgaris (PV). The main aim of the present study was to investigate the effects of RhoA/ROCK signaling on UVB-induced oxidative damage, and to delineate the molecular mechanisms involved in the UVB-mediated inflammatory and apoptotic response. In HaCaT cells, we observed that blockage of RhoA/ROCK signaling with the inhibitor CT04 or Y27632 greatly inhibited the UVB-mediated increase in intracellular reactive oxygen species (ROS). Additionally, inhibition of RhoA/ROCK signaling reduced UVB-induced apoptosis, as exemplified by a reduction in DNA fragmentation, and also elevated anti-apoptotic Bcl-2 protein, concomitant with reduced levels of pro-apoptotic protein Bax, caspase-3 cleavage and decreased PARP-1 protein. The release of inflammatory mediators TNF-α, IL-1β, and IL-6 was also attenuated. Mechanically, we observed that blockage of RhoA/ROCK repressed the TAK1/NOD2-mediated NF-κB pathway in HaCaT cells exposed to UVB. Taken together, these data reveal that RhoA/ROCK signaling is one of the regulators contributing to oxidative damage and apoptosis in human keratinocytes, suggesting that RhoA/ROCK signaling has strong potential to be used as a useful therapeutic target in skin diseases including PV.

  3. Is photodynamic therapy a relevant therapeutic option in refractory benign familial pemphigus (Hailey-Hailey disease)? A series of eight patients.

    Science.gov (United States)

    Alsahli, Maha; Debu, Anca; Girard, Celine; Bessis, Didier; Du Thanh, Aurélie; Guillot, Bernard; Dereure, Olivier

    2017-11-01

    Treatment of benign familial pemphigus or Hailey-Hailey disease (HHD), a rare inherited condition associated with a significant impairment of quality of life, is often challenging and disappointing with frequent relapses and infectious complications. Topical photodynamic therapy (PDT) may offer new perspectives in this difficult setting. Eight patients with long-lasting HHD lesions refractory to multiple treatments were treated on at least one involved site with PDT using methyl-amino levulinate with a standardized protocol of three sessions of irradiation separated by 3-week intervals. A complete or partial clearing was achieved in all treated areas, and the result was satisfactorily maintained in all cases after a follow-up period ranging from 3 to 36 months. Results were of higher quality in non-inguinal areas. Tolerance was overall acceptable with local pain during and shortly after irradiation being the main limiting factor. Our series, although limited in size, emphasizes the interest of PDT in this difficult condition even though results may be incomplete. Treatment-related pain can be adequately managed by prior analgesics, cooling with sprayed water and local tumescent anesthesia. Overall, PDT appears as a relevant option in refractory HHD management with a favorable benefit/risk ratio.

  4. Patients with a new variant of endemic pemphigus foliaceus have autoantibodies against arrector pili muscle, colocalizing with MYZAP, p0071, desmoplakins 1 and 2 and ARVCF.

    Science.gov (United States)

    Abreu-Velez, A M; Valencia-Yepes, C A; Upegui-Zapata, Y A; Upegui-Quiceno, E; Mesa-Herrera, N R; Velazquez-Velez, J E; Howard, M S

    2017-12-01

    We identified a new variant of endemic pemphigus foliaceus in El Bagre, Colombia, South America, which we term El Bagre-EPF, and observed reactivity to arrector pili muscle (APM), thus we tested for autoimmunity to APM. We took skin biopsies from 30 patients with El Bagre-EPF and 30 healthy controls (HCs) matched by age, sex and occupation, who were all from the endemic area, and tested these using direct immunofluorescence (DIF), confocal microscopy, immunohistochemistry and immunoblotting (IB). Of the 30 patients with El Bagre-EPF, 27 had autoantibodies to APM that colocalized with commercial antibodies to myocardium-enriched zonula occludens-1-associated protein (MYZAP), desmoplakin (DP)1 and DP2, plakophilin 4, and Armadillo repeat gene deleted in velo-cardio-facial syndrome (ARVCF) (P EPF have autoantibodies to APM, colocalizing with the antibodies MYZAP, ARVCF, p0071, DP1 and DP2, suggesting that these molecules are El Bagre-EPF antigens. Further, all of these antigens represent components of cell junctions, indicating that the immune response is directed, at least partially, against cell junctions. The immune response in patients affected by El Bagre-EPF is polyclonal, and it includes B and T lymphocytes, mast cells, IgG, IgA, IgM, IgD, IgE, fibrinogen, albumin, complement/C1q, C3c and C4. © 2017 British Association of Dermatologists.

  5. Energy, fine structure, and hyperfine structure of the core-excited states 1s2s2pnp 5P (n = 2-5) and 1s2p2mp 5S (m = 2-5) for Li- ion

    International Nuclear Information System (INIS)

    Wang, Z.B.; Gou, B.C.; Chen, F.

    2006-01-01

    The relativistic energies, the oscillator strength, and the lifetimes of high-lying core-excited states 1s2s2pnp 5 P (n=2-5) and 1s2p 2 mp 5 S 0 (m=2-5) of Li - ion are calculated with the saddle-point variational method and restricted variation method. The fine structure and the hyperfine structure of the core-excited states for this system are also explored. The results are compared with other theoretical and experimental data in the literature. The energy obtained in this work are much lower than the others previously published whereas the wavelengths and radiative life-times are in agreement

  6. Coexistência de pênfigo vulgar e infecção pelo vírus herpes simples na mucosa oral Coexistence of pemphigus vulgaris and herpes simplex virus infection in oral mucosa

    Directory of Open Access Journals (Sweden)

    Adrianna Milagres

    2007-12-01

    Full Text Available O pênfigo vulgar é uma doença mucocutânea, imunomediada, caracterizada por lesões vesiculobolhosas, enquanto a infecção pelo vírus herpes simples (HSV é comum na cavidade oral. A coexistência das duas doenças tem sido relatada por alguns autores. Este artigo relata o caso de um paciente com múltiplas lesões em várias áreas da mucosa oral, cujo procedimento foi raspagem e biópsia incisional, que resultou no diagnóstico de pênfigo vulgar associado à infecção pelo HSV. Destaca-se a inusitada associação das doenças e a identificação citopatológica de duas populações celulares com aspectos morfológicos distintos e característicos, capazes de determinar o correto diagnóstico, sendo fundamental para a conduta e terapêutica adequada.Pemphigus vulgaris is an autoimmune mucocutaneous disease, characterized by vesiculobullous lesions. Herpes simplex virus (HSV infection is common in the oral cavity and the coexistence of pemphigus vulgaris and HSV infection has been reported by some authors. In this work, we report a case of a patient with multiple lesions involving several areas of the oral mucous membrane. Based on scraping cytology and incisional biopsy findings, the diagnosis was pemphigus vulgaris associated with HSV infection. We call attention to the uncommon association of both diseases and the cytological identification of two cell populations with different and characteristic morphological aspects, able enough to establish the correct diagnosis and define an appropriate therapeutic approach.

  7. EFFECT OF PLASMAPHERESIS AND PASSAGE OF ANTI-RETINAL ANTIBODIES THROUGH THE PLACENTA IN A CASE OF NON-PARANEOPLASTIC AUTOIMMUNE RETINOPATHY.

    Science.gov (United States)

    Sierpina, David I; Skale, David M; Fan, Joseph T

    2017-01-01

    To present a case of nonparaneoplastic autoimmune retinopathy in association with myasthenia gravis in a young woman, and to report the effect of plasmapheresis as well as passage of antiretinal antibodies through the placenta. Case report. A 31-year-old woman presented with a history of myasthenia gravis and rapidly progressive vision loss at the age of 23. Funduscopic appearance and fluorescein angiographic findings on presentation were consistent with an autoimmune retinopathy. Paraneoplastic etiology was ruled out, and antiretinal antibody testing revealed positivity for autoantibodies against GAPDH, aldolase, enolase, arrestin, as well as unnamed 48-kDa and 60-kDa proteins. ARA Western Blot and immunohistochemistry profiles were unchanged by either plasmapheresis therapy or passage of serum through the maternal placenta. However, the patient's 6-month and 8-year-old daughters appeared unaffected. This is the first report of nonparaneoplastic autoimmune retinopathy associated with myasthenia gravis, although a strong history of autoimmune disorders is a known risk factor. Our patient's antiretinal antibody panel was unaffected immediately after plasmapheresis treatment. Antibodies to GAPDH and unnamed 38-kDa and 86-kDa proteins were able to pass through the placenta into the fetal circulation, although their effect on the growing fetus is not clear.

  8. MAST CELLS, MAST/STEM CELL GROWTH FACTOR RECEPTOR (C-KIT/CD117 AND IGE MAY BE INTEGRAL TO THE PATHOGENESIS OF ENDEMIC PEMPHIGUS FOLIACEUS

    Directory of Open Access Journals (Sweden)

    Ana Maria Roselino

    2013-11-01

    Full Text Available Introduction: Pemphigus foliaceus (PF is endemic in some South American countries, especially in Colombia and Brazil; in Brazil, it is also known as fogo selvagem (FS. We aimed to study the presence of mast cells and the expression of the mast/stem cell growth factor receptor (c-kit/CD117 in PF skin biopsies, as well as the role of IgE in the disease pathogenesis. Methods: Forty-four skin biopsies from patients affected by endemic PF (EPF (30 patients from El Bagre, Colombia, and 14 from the northeastern region of São Paulo State, Brazil, 48 control biopsies from Colombian and Brazilian endemic areas, and additional control biopsies from none endemic areas in Colombia and the USA non were studied. Immunohistochemistry (IHC was performed to evaluate skin biopsies with anti-mast cell tryptase (MCT, anti-c-kit and anti-IgE antibodies. We also searched for serum IgE in 30 EPF and 30 non-atopic controls from the El Bagre region via ELISA. In our El Bagre patients and controls, we also searched for IgE in skin samples by direct immunofluorescence. Results: In 100% of the EPF biopsies, MCT, c-kit and IgE were identified with stronger expression relative to control biopsies, especially in the inflammatory infiltrates around upper dermal blood vessels and dermal eccrine glands. IgE staining was positive along the BMZ in some EPF skin samples. The DIF results confirmed a linear deposition of IgE at the BMZ. Increased IgE serum levels were also noted in PF patients relative to controls.. Conclusions: In patients with EPF, the observed increased expression of MCT, c-kit and IgE in lesional skin, associated with higher serum IgE levels may indicate possible IgE participation in the antigenic response.

  9. Synthesis and structural characterization of the ternary Zintl phases AE3Al2Pn4 and AE3Ga2Pn4 (AE=Ca, Sr, Ba, Eu; Pn=P, As)

    International Nuclear Information System (INIS)

    He, Hua; Tyson, Chauntae; Saito, Maia; Bobev, Svilen

    2012-01-01

    Ten new ternary phosphides and arsenides with empirical formulae AE 3 Al 2 Pn 4 and AE 3 Ga 2 Pn 4 (AE=Ca, Sr, Ba, Eu; Pn=P, As) have been synthesized using molten Ga, Al, and Pb fluxes. They have been structurally characterized by single-crystal and powder X-ray diffraction to form with two different structures—Ca 3 Al 2 P 4 , Sr 3 Al 2 As 4 , Eu 3 Al 2 P 4 , Eu 3 Al 2 As 4 , Ca 3 Ga 2 P 4 , Sr 3 Ga 2 P 4 , Sr 3 Ga 2 As 4 , and Eu 3 Ga 2 As 4 crystallize with the Ca 3 Al 2 As 4 structure type (space group C2/c, Z=4); Ba 3 Al 2 P 4 and Ba 3 Al 2 As 4 adopt the Na 3 Fe 2 S 4 structure type (space group Pnma, Z=4). The polyanions in both structures are made up of TrPn 4 tetrahedra, which share common corners and edges to form 2 ∞ [TrPn 2 ] 3– layers in the phases with the Ca 3 Al 2 As 4 structure, and 1 ∞ [TrPn 2 ] 3– chains in Ba 3 Al 2 P 4 and Ba 3 Al 2 As 4 with the Na 3 Fe 2 S 4 structure type. The valence electron count for all of these compounds follows the Zintl–Klemm rules. Electronic band structure calculations confirm them to be semiconductors. - Graphical abstract: AE 3 Al 2 Pn 4 and AE 3 Ga 2 Pn 4 (AE=Ca, Sr, Ba, Eu; Pn=P, As) crystallize in two different structures—Ca 3 Al 2 P 4 , Sr 3 Al 2 As 4 , Eu 3 Al 2 P 4 , Eu 3 Al 2 As 4 , Ca 3 Ga 2 P 4 , Sr 3 Ga 2 P 4 , Sr 3 Ga 2 As 4 , and Eu 3 Ga 2 As 4 , are isotypic with the previously reported Ca 3 Al 2 As 4 (space group C2/c (No. 15)), while Ba 3 Al 2 P 4 and Ba 3 Al 2 As 4 adopt a different structure known for Na 3 Fe 2 S 4 (space group Pnma (No. 62). The polyanions in both structures are made up of TrPn 4 tetrahedra, which by sharing common corners and edges, form 2 ∞ [TrPn 2 ] 3– layers in the former and 1 ∞ [TrPn 2 ] 3– chains in Ba 3 Al 2 P 4 and Ba 3 Al 2 As 4 . Highlights: ► AE 3 Ga 2 Pn 4 (AE=Ca, Sr, Ba, Eu; Pn=P, As) are new ternary pnictides. ► Ba 3 Al 2 P 4 and Ba 3 Al 2 As 4 adopt the Na 3 Fe 2 S 4 structure type. ► The Sr- and Ca-compounds crystallize with the Ca 3

  10. {sup 18}F-fluorodeoxyglucose positron emission tomography in the diagnosis of malignancy in patients with paraneoplastic neurological syndrome: a systematic review and meta-analysis

    Energy Technology Data Exchange (ETDEWEB)

    Garcia Vicente, Ana Maria [University General Hospital, Nuclear Medicine Department, Ciudad Real (Spain); Delgado-Bolton, Roberto C. [University of La Rioja, Department of Diagnostic Imaging (Radiology) and Nuclear Medicine, San Pedro Hospital and Centre for Biomedical Research of La Rioja (CIBIR), Logrono (Spain); Amo-Salas, Mariano [University of Castilla-La Mancha, Department of Mathematics, Ciudad Real (Spain); Lopez-Fidalgo, Jesus [Universidad de Navarra, ICS, Unidad de Estadistica, Campus Universitario, Pamplona (Spain); Caresia Aroztegui, Ana Paula [Parc Tauli Hospital Universitari, Nuclear Medicine Department, Sabadell, Barcelona (Spain); Garcia Garzon, Jose Ramon [Unitat PET/TC CETIR-ERESA, Barcelona (Spain); Orcajo Rincon, Javier [Hospital General Universitario Gregorio Maranon, Nuclear Medicine Department, Madrid (Spain); Garcia Velloso, Maria Jose [Clinica Universidad de Navarra, Nuclear Medicine Department, Pamplona (Spain); Arcocha Torres, Maria de [Hospital Universitario Marques de Valdecilla, Nuclear Medicine Department, Santander (Spain); Alvarez Ruiz, Soledad [Hospital Universitario Miguel Servet, Nuclear Medicine Department, Zaragoza (Spain); Collaboration: On behalf of the Oncology Task Force of Spanish Society of Nuclear Medicine and Molecular Imaging

    2017-08-15

    The detection of occult cancer in patients suspected of having a paraneoplastic neurological syndrome (PNS) poses a diagnostic challenge. The aim of our study was to perform a systematic review and meta-analysis to assess the diagnostic performance of FDG PET for the detection of occult malignant disease responsible for PNS. A systematic review of the literature (MEDLINE, EMBASE, Cochrane, and DARE) was undertaken to identify studies published in any language. The search strategy was structured after addressing clinical questions regarding the validity or usefulness of the test, following the PICO framework. Inclusion criteria were studies involving patients with PNS in whom FDG PET was performed to detect malignancy, and which reported sufficient primary data to allow calculation of diagnostic accuracy parameters. When possible, a meta-analysis was performed to calculate the joint sensitivity, specificity, and detection rate for malignancy (with 95% confidence intervals [CIs]), as well as a subgroup analysis based on patient characteristics (antibodies, syndrome). The comprehensive literature search revealed 700 references. Sixteen studies met the inclusion criteria and were ultimately selected. Most of the studies were retrospective (12/16). For the quality assessment, the QUADAS-2 tool was applied to assess the risk of bias. Across 16 studies (793 patients), the joint sensitivity, specificity, and detection rate for malignancy with FDG PET were 0.87 (95% CI: 0.80-0.93), 0.86 (95% CI: 0.83-0.89), and 14.9% (95% CI: 11.5-18.7), respectively. The area under the curve (AUC) of the summary ROC curve was 0.917. Homogeneity of results was observed for sensitivity but not for specificity. Some of the individual studies showed large 95% CIs as a result of small sample size. The results of our meta-analysis reveal high diagnostic performance of FDG PET in the detection of malignancy responsible for PNS, not affected by the presence of onconeural antibodies or clinical

  11. "1"8F-fluorodeoxyglucose positron emission tomography in the diagnosis of malignancy in patients with paraneoplastic neurological syndrome: a systematic review and meta-analysis

    International Nuclear Information System (INIS)

    Garcia Vicente, Ana Maria; Delgado-Bolton, Roberto C.; Amo-Salas, Mariano; Lopez-Fidalgo, Jesus; Caresia Aroztegui, Ana Paula; Garcia Garzon, Jose Ramon; Orcajo Rincon, Javier; Garcia Velloso, Maria Jose; Arcocha Torres, Maria de; Alvarez Ruiz, Soledad

    2017-01-01

    The detection of occult cancer in patients suspected of having a paraneoplastic neurological syndrome (PNS) poses a diagnostic challenge. The aim of our study was to perform a systematic review and meta-analysis to assess the diagnostic performance of FDG PET for the detection of occult malignant disease responsible for PNS. A systematic review of the literature (MEDLINE, EMBASE, Cochrane, and DARE) was undertaken to identify studies published in any language. The search strategy was structured after addressing clinical questions regarding the validity or usefulness of the test, following the PICO framework. Inclusion criteria were studies involving patients with PNS in whom FDG PET was performed to detect malignancy, and which reported sufficient primary data to allow calculation of diagnostic accuracy parameters. When possible, a meta-analysis was performed to calculate the joint sensitivity, specificity, and detection rate for malignancy (with 95% confidence intervals [CIs]), as well as a subgroup analysis based on patient characteristics (antibodies, syndrome). The comprehensive literature search revealed 700 references. Sixteen studies met the inclusion criteria and were ultimately selected. Most of the studies were retrospective (12/16). For the quality assessment, the QUADAS-2 tool was applied to assess the risk of bias. Across 16 studies (793 patients), the joint sensitivity, specificity, and detection rate for malignancy with FDG PET were 0.87 (95% CI: 0.80-0.93), 0.86 (95% CI: 0.83-0.89), and 14.9% (95% CI: 11.5-18.7), respectively. The area under the curve (AUC) of the summary ROC curve was 0.917. Homogeneity of results was observed for sensitivity but not for specificity. Some of the individual studies showed large 95% CIs as a result of small sample size. The results of our meta-analysis reveal high diagnostic performance of FDG PET in the detection of malignancy responsible for PNS, not affected by the presence of onconeural antibodies or clinical

  12. Human eyelid meibomian glands and tarsal muscle are recognized by autoantibodies from patients affected by a new variant of endemic pemphigus foliaceus in El-Bagre, Colombia, South America.

    Science.gov (United States)

    Abreu-Velez, Ana Maria; Howard, Michael S; Hashimoto, Takashi; Grossniklaus, Hans E

    2010-03-01

    Previously, we described a new variant of endemic pemphigus foliaceus (EPF) in Colombia, South America (El Bagre-EPF). Continuing our characterization of this variant of EPF, we now focus on one of our previously reported clinical findings: the presence of ocular lesions. These ocular lesions are seen in patients having extensive skin involvement, as measured by the Lund and Browder scale, which is generally used for patients with skin burns. We specifically searched for evidence of autoreactivity to various eyelid structures in these patients and correlated our immunologic data with the clinical findings. We performed indirect immunofluorescence studies using normal-appearing human eyelid skin from routine blepharoplasties as substrate tissue. We tested sera from 12 patients with El Bagre-EPF and ocular lesions, 5 patients with sporadic (nonendemic) pemphigus foliaceus, and 20 healthy control subjects (10 from the El Bagre-EPF endemic area and 10 from nonendemic areas). We used fluorescein isothiocyanate conjugated goat antiserum to human total IgG/IgA/IgM as a secondary antibody. In addition, we used fluorescein isothiocyanate conjugated antibodies to human fibrinogen, albumin, IgG, IgE, C1q, and C3, Texas Red (Rockland Immunochemicals, Inc, Gilbertsville, PA), Alexa Fluor 555, or Alexa Fluor 594 (Invitrogen, Carlsbad, CA). Ki-67 (a cell proliferation marker) was used to determine the cell proliferation rate, and nuclear counterstaining was performed with either 4', 6-diamidino-2-phenylindole or Topro III (Invitrogen, Carlsbad, CA). We observed autoreactivity to multiple eyelid structures, including meibomian glands and tarsal muscle bundles at different levels, and some areas of the epidermis and the dermis close to the isthmus of the eyelids. Tarsal plate autoreactivity was seen in 10 of 12 of the El Bagre-EPF sera and in one control with pemphigus erythematosus. Furthermore, immunoprecipitation using an eyelid sample as a substrate with 1 mmol/L of sodium

  13. Anti-Thyroid Peroxidase Reactivity Is Heightened in Pemphigus Vulgaris and Is Driven by Human Leukocyte Antigen Status and the Absence of Desmoglein Reactivity

    Directory of Open Access Journals (Sweden)

    Kristina Seiffert-Sinha

    2018-04-01

    Full Text Available Pemphigus vulgaris (PV belongs to an autoimmune disease cluster that includes autoimmune thyroid disease (AITD, suggesting common mechanisms driving autoimmune susceptibility. Our group has shown that PV patients exhibit significant reactivity to AITD-related anti-thyroid peroxidase (anti-TPO, and anti-TPO antibodies affect signaling pathways in keratinocytes similar to anti-desmoglein (Dsg 3 antibodies. To further assess the relevance of anti-TPO reactivity in PV, we analyzed anti-TPO levels in 280 PV and 167 healthy control serum samples across a comprehensive set of variable and static parameters of disease activity and etiopathogenesis. PV patients have significantly higher activity rates (A.R.s for anti-TPO than healthy controls, but levels do not differ between phases of clinical activity and remission. Patients that carry both the PV-associated human leukocyte antigen (HLA alleles DRB1*0402 and DQB1*0503, or DQB1*0503 alone show a low prevalence of anti-TPO (A.R. 9.5 and 4.8%, respectively, while patients that lack expression of these alleles or carry DRB1*0402 alone have a much higher prevalence of anti-TPO (A.R. 23.1 and 15.8%, respectively, suggesting that the absence of DQB1*0503 may predispose patients to the development of anti-TPO antibodies. Similarly, anti-Dsg1−/3− patients have a higher anti-TPO A.R. (26.9% than anti-Dsg1−/3+ (18.8%, anti-Dsg1+/3− (14.3%, and anti-Dsg1+/3+ (3.9% patients. Our data suggest that anti-TPO reactivity in PV is driven by genetic markers that may be in linkage disequilibrium with the established PV-susceptibility alleles and that this association drives the selection of a combination of anti-Dsg and anti-TPO antibodies, with anti-TPO filling the gap in active patients that do not carry the established PV-associated autoantibodies and/or are lacking the established PV-HLA-susceptibility alleles.

  14. Anti-Thyroid Peroxidase Reactivity Is Heightened in Pemphigus Vulgaris and Is Driven by Human Leukocyte Antigen Status and the Absence of Desmoglein Reactivity

    Science.gov (United States)

    Seiffert-Sinha, Kristina; Khan, Shahzaib; Attwood, Kristopher; Gerlach, John A.; Sinha, Animesh A.

    2018-01-01

    Pemphigus vulgaris (PV) belongs to an autoimmune disease cluster that includes autoimmune thyroid disease (AITD), suggesting common mechanisms driving autoimmune susceptibility. Our group has shown that PV patients exhibit significant reactivity to AITD-related anti-thyroid peroxidase (anti-TPO), and anti-TPO antibodies affect signaling pathways in keratinocytes similar to anti-desmoglein (Dsg) 3 antibodies. To further assess the relevance of anti-TPO reactivity in PV, we analyzed anti-TPO levels in 280 PV and 167 healthy control serum samples across a comprehensive set of variable and static parameters of disease activity and etiopathogenesis. PV patients have significantly higher activity rates (A.R.s) for anti-TPO than healthy controls, but levels do not differ between phases of clinical activity and remission. Patients that carry both the PV-associated human leukocyte antigen (HLA) alleles DRB1*0402 and DQB1*0503, or DQB1*0503 alone show a low prevalence of anti-TPO (A.R. 9.5 and 4.8%, respectively), while patients that lack expression of these alleles or carry DRB1*0402 alone have a much higher prevalence of anti-TPO (A.R. 23.1 and 15.8%, respectively), suggesting that the absence of DQB1*0503 may predispose patients to the development of anti-TPO antibodies. Similarly, anti-Dsg1−/3− patients have a higher anti-TPO A.R. (26.9%) than anti-Dsg1−/3+ (18.8%), anti-Dsg1+/3− (14.3%), and anti-Dsg1+/3+ (3.9%) patients. Our data suggest that anti-TPO reactivity in PV is driven by genetic markers that may be in linkage disequilibrium with the established PV-susceptibility alleles and that this association drives the selection of a combination of anti-Dsg and anti-TPO antibodies, with anti-TPO filling the gap in active patients that do not carry the established PV-associated autoantibodies and/or are lacking the established PV-HLA-susceptibility alleles. PMID:29675021

  15. Detection of underlying malignancy in patients with paraneoplastic neurological syndromes: comparison of {sup 18}F-FDG PET/CT and contrast-enhanced CT

    Energy Technology Data Exchange (ETDEWEB)

    Schramm, N.; Schmid-Tannwald, C.; Meinel, F.G.; Reiser, M.F.; Rist, C. [Ludwig-Maximilians-University Hospital Munich, Institute for Clinical Radiology, Munich (Germany); Rominger, A. [Ludwig-Maximilians-University Hospital Munich, Department of Nuclear Medicine, Munich (Germany); Schmidt, C. [Ludwig-Maximilians-University Hospital Munich, Department of Neurology, Munich (Germany); Morelli, J.N. [Texas A and M Health Sciences Center, Department of Radiology, Temple, TX (United States)

    2013-07-15

    To determine the value of combined {sup 18}F-FDG PET/CT with diagnostic contrast-enhanced CT (CECT) in detecting primary malignancies and metastases in patients with paraneoplastic neurological syndromes (PNS) and to compare this with CECT alone. PET/CT scans from 66 patients with PNS were retrospectively evaluated. Two blinded readers initially reviewed the CECT portion of each PET/CT scan. In a second session 3 months later, the readers analysed the combined PET/CT scans. Findings on each study were assessed using a four-point-scale (1 normal/benign; 2 inconclusive, further diagnostic work-up may be necessary; 3 malignant; 4 inflammatory). Sensitivity and specificity for malignant findings were calculated for PET/CT and CECT. Interreader agreement was determined by calculating Cohen's kappa. Pooled data from clinical follow-up (including histopathology and follow-up imaging, median follow-up 20.0 months) served as the reference gold standard. Both readers classified 12 findings in ten patients (15 %) as malignant on the PET/CT scans (two patients had two primary tumours). One such imaging finding (suspected thymic cancer) was false-positive (i.e. benign histology). The most common tumours were bronchial carcinoma (n = 3), lymph node metastases of gynaecological tumours (n = 3) and tonsillar carcinoma (n = 2). Three of 12 findings (25 %) were not detected by CECT alone (cervical carcinoma, lymph node metastasis and tonsillar carcinoma). In a per-patient analysis, sensitivity and specificity for malignant findings were 100 % and 90 % for PET/CT and 78 % and 88 % for CECT. In 24 % (reader 1) and 21 % (reader 2) of the patients, the PET/CT findings were inconclusive. Of these findings, 57 % (reader 1) and 56 % (reader 2) were only diagnosed with PET (e.g. focal FDG uptake of the thyroid, gastrointestinal tract and ovaries). On follow-up, none of these findings corresponded to malignancy. Overall agreement between the two readers was excellent with a Cohen

  16. Cell junction protein armadillo repeat gene deleted in velo-cardio-facial syndrome is expressed in the skin and colocalizes with autoantibodies of patients affected by a new variant of endemic pemphigus foliaceus in Colombia.

    Science.gov (United States)

    Abreu-Velez, Ana Maria; Yi, Hong; Howard, Michael S

    2017-10-01

    We previously described a new variant of endemic pemphigus foliaceus in El Bagre, Colombia, South America (El Bagre-EPF, or pemphigus Abreu-Manu). El Bagre-EPF differs from other types of EPF clinically, epidemiologically, immunologically and in its target antigens. We reported the presence of patient autoantibodies colocalizing with armadillo repeat gene deleted in velo-cardio-facial syndrome (ARVCF), a catenin cell junction protein colocalizing with El Bagre-EPF autoantibodies in the heart and within pilosebaceous units along their neurovascular supply routes. Here we investigate the presence of ARVCF in skin and its possibility as a cutaneous El Bagre-EPF antigen. We used a case-control study, testing sera of 45 patients and 45 controls via direct and indirect immunofluorescence (DIF/IIF), confocal microscopy, immunoelectron microscopy and immunoblotting for the presence of ARVCF and its relationship with El Bagre-EPF autoantibodies in the skin. We also immunoadsorbed samples with desmoglein 1 (Dsg1) ectodomain (El Bagre-EPF antigen) by incubating with the positive ARVCF samples from DIF and IIF. ARVCF was expressed in all the samples from the cases and controls. Immunoadsorption with Dsg1 on positive ARVCF immunofluorescence DIF/IIF cases showed that the immune response was present against non-desmoglein 1 antigen(s). Overall, 40/45 patients showed colocalization of their autoantibodies with ARVCF in the epidermis; no controls from the endemic area displayed colocalization. We demonstrate that ARVCF is expressed in many areas of human skin, and colocalizes with the majority of El Bagre-EPF autoantibodies as a putative antigen.

  17. Cell and humoral immunity in endemic pemphigus foliaceus Imunidade humoral e celular no pênfigo foliáceo endêmico

    Directory of Open Access Journals (Sweden)

    Silvia Regina C. Sartori Barravieira

    1995-02-01

    Full Text Available A study was conducted on 16 patients with pemphigus foliaceus, ten of them with the localized form (group G1 and six with the disseminated form (group G2. These patients were submitted to full blood counts, quantitation of mononuclear cell subpopulations by monoclonal antibodies, study of blastic lymphocyte transformation, and quantitation of circulating antibodies by the indirect immunofluorescence test, in order to correlate their clinical signs and symptoms and laboratory data with their immunological profile, and to determine the relationship between circulating autoantibody titers and lesion intensity and course of lesions under treatment. Leucocytosis was observed especially in group G2. All patients showed decreased relative CD3+ and CD4+ values and a tendency to decreased relative values of the CD8+ subpopulation. Blastic lymphocyte transformation indices in the presence of phytohemagglutinin were higher in patients (group G1+G2 than in controls. The indirect immunofluorescence test was positive in 100% of G2 patients and in 80% of G1 patients. The median value for the titers was higher in group G2 than in group G1. Analysis of the results as a whole permits us to conclude that cell immunity was preserved and that there was a relationship between antibody titers detected by the direct immunofluorescence test and extent of skin lesions.Foram avaliados dezesseis doentes portadores de pênfigo foliáceo endêmico, dez com a forma localizada da doença (Grupo G1 e seis com a forma disseminada (Grupo G2, com os objetivos de correlacionar o quadro clínico e laboratorial desses pacientes com o perfil imunológico dos mesmos, e verificar a relação dos títulos dos anticorpos antiepiderme circulantes, identificados pela imunofluorescência indireta, com intensidade da lesão e com a evolução das lesões em tratamento. Foram realizados: hemograma completo, quantificação de subpopulação de células mononucleares por anticorpos monoclonais

  18. Prevalence of thyroid autoimmunity in patients with pemphigus vulgaris Prevalencia de autoinmunidad tiroidea en pacientes con pénfigo vulgar

    Directory of Open Access Journals (Sweden)

    Fabián Pitoia

    2005-08-01

    Full Text Available Among bullous diseases, pemphigus vulgaris (PV is a classical variety of this type of skin disorders. To establish the real prevalence of thyroid abnormalities in such a disease, a prospective study was developed. For this reason, thyroid evaluation was performed in 15 consecutive patients who attended the Dermatology Clinic for PV and in a group of 15 healthy volunteers (Control Group matched by age and gender. Thyroid function was evaluated by measuring T3, T4 and TSH. The presence or absence of goiter was searched by palpation, while thyroid autoimmunity was investigated through the assay of thyroperoxidase antibodies (TPO-Ab. In each group there were 9 women and 6 men, aging 25-65 years (mean = 48.3 y in the PV Group, and 25-69 years (mean = 45.4 y in the Control Group. It was found that 7 patients (46.6% of the PV Group and 1 subject (6.7% of the Control Group (p El pénfigo vulgar (PV es una enfermedad ampollar clásica de etiología autoinmune que se caracteriza por la presencia de lesiones intraepiteliales. Para establecer la prevalencia de anormalidades tiroideas en el PV, realizamos un estudio prospectivo en 15 pacientes consecutivos que consultaron a la División Dermatología debido a PV y en un grupo de 15 voluntarios sanos (Grupo Control. La función tiroidea se evaluó a través de la medición de T3, T4 y TSH y la presencia de bocio se determinó por medio de la palpación tiroidea. La autoinmunidad se investigó usando un ensayo IRMA para la medición de anticuerpos antitiroperoxidasa (ATPO. En cada grupo había 9 mujeres y 6 hombres que fueron apareados por edad y sexo, con edades comprendidas entre 25 y 65 años (promedio 48.2 años en el grupo PV, y entre 25 y 69 años (promedio 45.4 años en el grupo control. Se encontró que 7 pacientes (46.6% del grupo PV y uno (6.6% del grupo control presentaron alteraciones tiroideas, (p<0.015. La presencia de ATPO positivos se observó en 6 pacientes con PV y en un voluntario del grupo

  19. Case report of severe Cushing's syndrome in medullary thyroid cancer complicated by functional diabetes insipidus, aortic dissection, jejunal intussusception, and paraneoplastic dysautonomia: remission with sorafenib without reduction in cortisol concentration.

    Science.gov (United States)

    Hammami, Muhammad M; Duaiji, Najla; Mutairi, Ghazi; Aklabi, Sabah; Qattan, Nasser; Abouzied, Mohei El-Din M; Sous, Mohamed W

    2015-09-09

    Normalization of cortisol concentration by multikinase inhibitors have been reported in three patients with medullary thyroid cancer-related Cushing's syndrome. Aortic dissection has been reported in three patients with Cushing's syndrome. Diabetes insipidus without intrasellar metastasis, intestinal intussusception, and paraneoplastic dysautonomia have not been reported in medullary thyroid cancer. An adult male with metastatic medullary thyroid cancer presented with hyperglycemia, hypernatremia, hypokalemia, hypertension, acne-like rash, and diabetes insipidus (urine volume >8 L/d, osmolality 190 mOsm/kg). Serum cortisol, adrenocorticoitropic hormone, dehydroepiandrostenedione sulfate, and urinary free cortisol were elevated 8, 20, 4.4, and 340 folds, respectively. Pituitary imaging was normal. Computed tomography scan revealed jejunal intussusception and incidental abdominal aortic dissection. Sorafenib treatment was associated with Cushing's syndrome remission, elevated progesterone (>10 fold), normalization of dehydroepiandrostenedione sulfate, but persistently elevated cortisol concentration. Newly-developed proximal lower limb weakness and decreased salivation were associated with elevated ganglionic neuronal acetylcholine receptor (alpha-3) and borderline P/Q type calcium channel antibodies. Extreme cortisol concentration may have contributed to aortic dissection and suppressed antidiuretic hormone secretion; which combined with hypokalemia due cortisol activation of mineralocorticoid receptors, manifested as diabetes insipidus. This is the first report of paraneoplastic dysautonomia and jejunal intussusception in medullary thyroid cancer, they may be related to medullary thyroid cancer's neuroendocrine origin and metastasis, respectively. Remission of Cushing's syndrome without measurable reduction in cortisol concentration suggests a novel cortisol-independent mechanism of action or assay cross-reactivity. Normalization of dehydroepiandrostenedione

  20. Paraneoplastic thrombocytosis in gastrointestinal cancer

    DEFF Research Database (Denmark)

    Baranyai, Zsolt; Josa, Valéria; Toth, Ambrus

    2016-01-01

    It has been demonstrated recently in several solid tumors that thrombocytosis at diagnosis may correlate with tumor invasion, metastatic progression and worse outcome. Several details of the pathomechanism of the relationship of thrombocytosis and cancer have been elucidated; however, the complet...

  1. Evaluation excitation functions for "2"8Si(n,p)"2"8Al, "3"1P(n,p)"3"1Si, and "1"1"3In(n,γ)"1"1"4"mIn reactions

    International Nuclear Information System (INIS)

    Zolotarev, K.I.

    2014-10-01

    Cross section data for "2"8Si(n,p)"2"8Al, "3"1P(n,p)"3"1Si and "1"1"3In(n,γ)"1"1"4"mIn reactions are needed for solving a wide spectrum of scientific and technical tasks. The excitation function of "2"8Si(n,p)"2"8Al reaction refers to the nuclear data involved in fusion reactor design calculations. The "2"8Si(n,p)"2"8Al reaction is interesting also as the monitor reaction for measurements at fusion facilities. Activation detectors on the basis of the 31P(n,p)31Si reaction are commonly used in the reactor dosimetry. The "1"1"3In(n,γ)"1"1"4"mIn reaction is promising regarding reactor dosimetry application for two reasons. First, due to the "1"1"4"mIn decay parameters which are rather suitable for activation measurements. Half-life of "1"1"4"mIn is equal to T_1/_2 = (49.51 ± 0.01) days and gamma spectrum accompanying decay has only one line with energy 190.27 keV and intensity (15.56 ± 0.15)%. Second, the "1"1"3In(n,γ)"1"1"4"mIn reaction rate may be measured by using one activation detector simultaneously with the "1"1"5In(n,γ)"1"1"6"mIn reaction. Preliminary analysis of existing evaluated excitation functions for "2"8Si(n,p)"2"8Al, "3"1P(n,p)"3"1Si and "1"1"3In(n,γ)"1"1"4"mIn reactions show that new evaluations are needed for all above mentioned reactions. This report is devoted to the preparation of the new evaluations of cross sections data and related covariance matrixes of uncertainties for the "2"8Si(n,p)"2"8Al, "3"1P(n,p)"3"1Si and "1"1"3In(n,γ)"1"1"4"mIn reactions.

  2. Physics Nobel Prize (PNP in 2008

    Directory of Open Access Journals (Sweden)

    José Maria Filardo Bassalo

    2009-08-01

    Full Text Available In this article we will talk about the Nobel Prize in Physics 2008, granted  to  the Japanese  physicists  Yoichiro  Nambu,  Makoto Kobayashi and Toshihide Maskawa,  for  their  discovery  of  the mechanisms involving strong interactions symmetries (quiral, by Nambu, and in weak interactions (charge-parity, by Kobayashi and Maskawa.

  3. Browse Title Index

    African Journals Online (AJOL)

    Items 51 - 88 of 88 ... Vol 4, No 3 (2012), Paraneoplastic Pemphigus: A Case Report and ... Vol 4, No 1 (2011), Periodontal Status and Oral Health Related ... Vol 7, No 1 (2015), Severe hyperglycaemia due to neonatal sepsis - A case report ...

  4. Intervenção fisioterapêutica promove melhora na qualidade de vida de indivíduos com pênfigo Physiotherapy intervention promotes better quality of life for individuals with pemphigus

    Directory of Open Access Journals (Sweden)

    Rodolfo Pessato Timóteo

    2010-10-01

    Full Text Available INTRODUÇÃO: O pênfigo é uma doença autoimune, caracterizada por vésico-bolhas cuja manifestações clínicas crônicas geram alterações na qualidade de vida. Existem relatos de pênfigo em vários continentes; porém ocorre predominantemente na região centro-norte da América do Sul. No Brasil, a doença predomina nos estados do Centro-Oeste e Sudeste. Objetivou-se avaliar o perfil e a qualidade de vida de pacientes com pênfigo em uma cidade brasileira, para intervenção fisioterapêutica. MÉTODOS: Foram analisados 15 prontuários de pacientes institucionalizados; contudo, 7 voluntários passaram por entrevista inicial e final por meio do questionário de qualidade de vida SF-36. Entremeio a coleta de dados, foram aplicados exercícios fisioterapêuticos durante o período de 4 meses. Após o período pré-determinado os dados foram comparados e analisados de forma quantitativa por meio do Med Calc E e teste T the student. RESULTADOS: Os 15 pacientes em tratamento tinham idade média de 40 anos; 53,3% eram melanoderma; o gênero masculino correspondia a 80%; 60% apresentam contato com zona rural e 80% são de origem da região sudeste. Os 7 pacientes que participaram da intervenção tenderam melhorar os domínios avaliados pelo SF-36 com exceção da vitalidade e aspectos sociais. CONCLUSÕES: O perfil da população deste hospital tem correlação com a literatura pesquisada. De acordo com o SF-36, houve melhora geral da qualidade de vida dos pacientes que aderiram às atividades propostas. Essa pesquisa sugere que a intervenção fisioterapêutica promove diferentes benefícios para os pacientes com pênfigo.INTRODUCTION: Pemphigus is an autoimmune disease characterized by bullae, in which its chronicity and clinical manifestations generate alterations in the quality of life. In Brazil, the disease prevails in the states of the Midwest and Southeast. The study aimed to evaluate the profile and quality of life of patients with

  5. Significado do epitope spreading na patogênese dos pênfigos vulgar e foliáceo Significance of epitope spreading in the pathogenesis of pemphigus vulgaris and foliaceus

    Directory of Open Access Journals (Sweden)

    Valéria Aoki

    2008-04-01

    Full Text Available Os pênfigos são dermatoses bolhosas auto-imunes, em que há a produção de auto-anticorpos direcionados contra moléculas de adesão dos epitélios, levando à perda da coesão celular. A produção de auto-anticorpos ocorre quando os pacientes desenvolvem um desequilíbrio da resposta imune (quebra da tolerância imunológica, passando a reconhecer antígenos próprios. A resposta é geralmente direcionada contra um único epítopo alvo; entretanto, como conseqüência da resposta inflamatória do processo primário e do extenso dano tecidual ocasionado, pode haver exposição de componentes protéicos ocultos, levando à produção de diferentes auto-anticorpos. Assim, é possível que surja uma nova doença cutânea auto-imune, em decorrência do fenômeno intra ou intermolecular de epitope spreading. São revistos os principais conceitos desse fenômeno e sua ocorrência nas dermatoses bolhosas auto-imunes, com ênfase nos pênfigos, grupo de dermatoses bolhosas autoimunes mais prevalente no Brasil.Pemphigus comprises autoimmune blistering skin diseases in which autoantibodies directed against antigens (epithelial adhesion molecules are found, leading to loss of cell cohesion. The production of autoantibodies occurs due to an immune imbalance (break of immune tolerance driving to recognition of self- antigens. The response is usually directed against an exclusive target epitope; however, due to the inflammatory response and to the extensive tissue damage, it is possible that the exposure of hidden protein components leads to distinct autoantibody production. Hence, a new autoimmune disease may occur in consequence of an intra- or intermolecular epitope spreading phenomenon. The authors review the main concepts of this phenomenon, and its occurrence in autoimmune blistering diseases, with emphasis on pemphigus, the most prevalent disease of this group in our country.

  6. Evaluation of the cross-sections for the reactions 19F(n,2n)18F, 31P(n,p)31Si, 93Nb(n,n')sup(93m)Nb and 103Rh(n,n')sup(103m)Rh

    International Nuclear Information System (INIS)

    Strohmaier, B.; Tagesen, S.; Vonach, H.

    1980-01-01

    The cross-sections for the four important neutron dosimetry reactions 19 F(n,2n) 18 F, 31 P(n,p) 31 Si, 93 Nb(n,n')sup(93m)Nb and 103 Rh(n,n')sup(103m)Rh were evaluated in the neutron energy range from threshold to 20 MeV. For the 19 F(n,2n) reaction the evaluation could be based entirely on experimental data; for the reactions 31 P(n,p) 31 Si and 103 Rh(n,n')sup(103m)Rh large gaps in the experimental excitation functions and large discrepancies between the existing data made it necessary to supplement the experimental data by cross-section calculations and to give about equal weight to the experimental and calculated cross-sections. For the 93 Nb(n,n')sup(93m)Nb reaction the evaluation had to be based entirely on the theoretically calculated cross-sections. All data sets were critically reviewed and obviously erroneous data sets were disregarded. If necessary, the data were renormalized in order to take into account adjustments in corresponding standard cross-sections and decay schemes. For each evaluated cross-sections also an uncertainty (on a 1sigma confidence level) was derived taking into account the errors given by the experimentalists, the general consistency of the experimental data and the estimated errors of the theoretically calculated cross-sections. (orig.) [de

  7. Effectiveness and side effects of anti-CD20 therapy for autoantibody-mediated blistering skin diseases: A comprehensive survey of 71 consecutive patients from the Initial use to 2007

    Directory of Open Access Journals (Sweden)

    Jennifer D Peterson

    2008-11-01

    Full Text Available Jennifer D Peterson1, Lawrence S Chan2,3,41Department of Dermatology, Texas Tech University Health Sciences Center at Lubbock, Lubbock, TX, USA; 2Department of Dermatology; 3Department of Microbiology/Immunology, University of Illinois at Chicago, Chicago, IL, USA; 4Medicine Service, Jesse Brown VA Medical Center, Chicago, IL, USAAbstract: In order to examine the efficacy and side effects of the monoclonal antibody anti-CD20 (rituximab on autoimmune blistering skin diseases, we performed a comprehensive survey of 71 consecutive patients from initial use up to 2007, using the PubMed database. A heterogeneous group of patients, including 51 patients with pemphigus vulgaris, one with pemphigus vegetans, nine with pemphigus foliaceus, five with paraneoplastic pemphigus, four with epidermolysis bullosa acquisita, and one with both bullous pemphigoid and graft vs host disease was included in this survey. Overall the monoclonal antibody seems to be effective in that 69% of patients showed complete response, 25% of patients showed partial response, whereas 6% of patients showed progressive disease. Six deaths occurred in association with the treatment, with four of these deaths in patients with paraneoplastic pemphigus, a disease characteristically resistant to conventional medication and with a high mortality rate. Of note, 11 patients who received combined rituximab and intravenous immune globulin treatments had the best outcome: complete response without any serious side effects. Therefore further investigation on rituximab with controlled clinical trial is a worthy pursuit.Keywords: blistering diseases, skin, anti-CD20, pemphigus, epidermolysis bullosa acquisita

  8. Pênfigo foliáceo canino: estudo retrospectivo de 43 casos clínicos e terapia (2000-2005 Canine Pemphigus foliaceus: a retrospective study of 43 clinical cases and therapy (2000-2005

    Directory of Open Access Journals (Sweden)

    Ana C. Balda

    2008-08-01

    Full Text Available No período de agosto de 2000 a julho de 2005 foram atendidos 43 casos de Pênfigo Foliáceo (PF canino no Serviço de Dermatologia do Hospital Veterinária, Universidade de São Paulo. Com este estudo retrospectivo visou-se atualizar dados referentes à caracterização sexual, definição racial e raça, idade, tipo e topografia lesional, quadro sintomático e resposta aos tratamentos isolados com prednisona e com a associação desta à azatioprina, além de demonstrar o aumento na ocorrência do PF relativamente à série histórica pretérita (1986-2000 do mesmo Serviço.From August 2000 to July 2005 were attended 43 cases of canine Pemphigus foliaceous (PF by the Dermatology Service of the Veterinary Teaching Hospital, University of São Paulo. The aim of the present study was to update the records referred to sex, breed, age, type and location of the lesions, clinical signs, and response to treatments with prednisone or combination with prednisone and azathioprine, and also to demonstrate the increase of occurrence of PF compared with the former series (1986-2000 observed in the same Service.

  9. Synthesis and structural characterization of the Zintl phases Na{sub 3}Ca{sub 3}TrPn{sub 4}, Na{sub 3}Sr{sub 3}TrPn{sub 4}, and Na{sub 3}Eu{sub 3}TrPn{sub 4} (Tr=Al, Ga, In; Pn=P, As, Sb)

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Yi [Department of Chemistry & Biochemistry, University of Delaware, 304A Drake Hall, Newark, DE 19716 (United States); Suen, Nian-Tzu [Department of Chemistry & Biochemistry, University of Delaware, 304A Drake Hall, Newark, DE 19716 (United States); College of Chemistry and Chemical Engineering, Yangzhou University, Yangzhou 225002 (China); Kunene, Thabiso; Stoyko, Stanislav [Department of Chemistry & Biochemistry, University of Delaware, 304A Drake Hall, Newark, DE 19716 (United States); Bobev, Svilen, E-mail: bobev@udel.edu [Department of Chemistry & Biochemistry, University of Delaware, 304A Drake Hall, Newark, DE 19716 (United States)

    2017-05-15

    15 new quaternary Zintl phases have been synthesized by solid-state reactions from the respective elements, and their structures have been determined by single-crystal X-ray diffraction. Na{sub 3}E{sub 3}TrPn{sub 4} (E=Ca, Sr, Eu; Tr=Al, Ga, In; Pn=P, As, Sb) crystallize in the hexagonal crystal system with the non-centrosymmetric space group P6{sub 3}mc (No. 186). The structure represents a variant of the K{sub 6}HgS{sub 4} structure type (Pearson index hP22) and features [TrPn{sub 4}]{sup 9–} tetrahedral units, surrounded by Na{sup +} and Ca{sup 2+}, Sr{sup 2+}, Eu{sup 2+} cations. The nominal formula rationalization [Na{sup +}]{sub 3}[E{sup 2+}]{sub 3}[TrPn{sub 4}]{sup 9–} follows the octet rule, suggesting closed-shell configurations for all atoms and intrinsic semiconducting behavior. However, structure refinements for several members hint at disorder and mixing of cations that potentially counteract the optimal valence electron count. - Graphical abstract: The hexagonal, non-centrosymmetric structure of Na{sub 3}E{sub 3}TrPn{sub 4} (E=Ca, Sr, Eu; Tr=Al, Ga, In; Pn=P, As, Sb) features [TrPn{sub 4}]{sup 9–} tetrahedral units, surrounded by Na{sup +} and Ca{sup 2+}, Sr{sup 2+}, Eu{sup 2+} cations. - Highlights: • 15 quaternary phosphides, arsenides, and antimonides are synthesized and structurally characterized. • The structure is a variant of the hexagonal K{sub 6}HgS{sub 4}-type, with distinctive pattern for the cations. • Occupational and/or positional disorder of yet unknown origin exists for some members of the series.

  10. Pênfigo foliáceo endêmico (fogo-selvagem no grupo indígena Xavánte, Mato Grosso, Brasil Endemic pemphigus foliaceus among the Xavánte indians, state of Mato Grosso, Brazil

    Directory of Open Access Journals (Sweden)

    Horacio Friedman

    1992-09-01

    Full Text Available Foi realizado inquérito soro-epidemiológico através de testes de imunofluorescência indireta e imunoprecipitação visando determinar a prevalência do pênfígo foliáceo endêmico (PFE na população indígena Xavánte do Brasil Central. Do total de 163 amostras de soro testadas, 5 (3,1% foram positivas à imunofluorescência. Todos os soros positivos procediam de indivíduos com sintomas clínicos da doença. Não foram observadas diferenças do PFE entre os Xavánte e a população em geral sob o ponto de vista imunológico, já que se verificou uma predominância da IgG4 entre os anticorpos nos pacientes indígenas.A sero-epidemiological survey was carried out by means of indirect immunofluorescence and immunoprecipitation tests in order to determine the prevalence of endemic pemphigus foliaceus (EPF among the Xavánte Indians from Central Brazil. Out of 163 serum samples, 5 (3.1% tested positive for immunofluorescence. All positive sera were from patients showing clinical signs of the disease. The immunological features of EPF among the Xavánte do not differ from those of non-Indian populations, as was observed a predominance of IgG4 among the antibodies of the Indian subjects.

  11. Anatomopatologia e imunofluorescência direta e indireta das lesões de pênfigo foliáceo endêmico resistentes à corticoterapia Pathology, direct and indirect immunofluorescent test of lesions of pemphigus foliaceous resistent to corticotherapy

    Directory of Open Access Journals (Sweden)

    Vitor Manoel Silva dos Reis

    1991-04-01

    Full Text Available São estudados 16 doentes de pênfigo foliáceo endêmico (PFE, sob tratamento com corticosteróides, que ainda apresentavam lesões eritemato-pápulo-verrucosas, geralmente hiperpigmentadas, que foram caracterizadas como lesões resistentes à corticoterapia (LRC. O estudo destas lesões foi feito através de anatomopatologia e de imunofluorescência direta (IFD. Anatomopatologicamente essas lesões mostraram tendência à hiperplasia epitelial e clivagem em níveis variáveis na epiderme o que difere dos achados nas lesões recentes do PFE e coincide com os achados nas lesões crônicas do PFE da era pré-corticóide. A IFD da pele lesada foi positiva para IgG em 93,75% dos casos, como ocorre nas fases iniciais do PFE, tendo sido negativa no único caso em que não houve clivagem. Adicionalmente, em oito desses doentes, foram estudados a IFD da pele sã e a imunofluorescência indireta (IFI. A IFD foi positiva em três destes casos e a IFI foi negativa nos oito.A group of 16 patients with endemic pemphigus foliaceus under corticotherapy and still showing erythematous, papulous, verrucous, in general hyperpigmented lesions, which were characterized as cortico therapy resistant lesions, were studied. Such study was made through anatomopathology and direct immunofluorescence (DIF. Anatomopathologically, such lesions showed tendencies to epitelial hyperplasia and cleavage in variable levels at the epidermis what differs from the early lesions of EPF and coincides with the chronic injuries of the EPF of the pre-corticoid era. The DIF of the injured skin was positive for IgG in 93.75% of cases, as it happens in the early stages of EPF, being negative in a simple case in which there was not cleavage. In addition, in eight of those patients, the DIF of the healthy skin and the indirect immunofluorescence (IIF were studied. The DIF was positive in three of these cases and in all eight the IIF was negative.

  12. Nutritonal evaluation of pemphigus foliaceus patients on long term glucocorticoid therapy Avaliação do estado nutricional de pacientes com pênfigo foliáceo sob corticoterapia prolongada

    Directory of Open Access Journals (Sweden)

    Daniel Ferreira da CUNHA

    2000-02-01

    Full Text Available Our objective was to compare food intake and nutritional status of Pemphigus Foliaceus patients (PG on long term glucocorticoid therapy to a Control Group (CG. Fourteen PG female inpatients receiving prednisone (0.33 ± 0.22mg/kg for at least 12 months and twelve CG subjects were submitted to nutritional evaluation, including anthropometry, urinary creatinine determination and serum biochemical measurements, besides 48-h-based food intake records. Groups were compared by Chi-square, Mann-Whitney and "t" tests. PG patients and CG were paired, respectively, in relation to age (24.7 ± 14.1 vs. 22.0 ± 12.0 years, body mass index (25.8 ± 6.4 vs. 24.0 ± 5.6kg/m2, daily protein intake (132.9 ± 49.8 vs. 95.2 ± 58.9g, and serum albumin (median; range (3.8; 3.5-4.1 vs. 3.8; 3.6-5.0g/dl. However, PG patients had lower height-creatinine index (64.8 ± 17.6 vs. 90.1 ± 33.4%, and higher daily energy (3080 ± 1099 vs. 2187 ± 702kcal and carbohydrate (376.8 ± 135.8 vs. 242.0 ± 80.7g intakes. Despite high food, protein and energy consumption, PG patients on long term glucocorticoid therapy had lower body muscle mass than controls, while showing high body fat stores. These findings are possibly related to combined metabolic effects of long term corticotherapy and inflammatory disease plus corticosteroid-induced increased appetite.O objetivo deste trabalho foi comparar o estado nutricional e dados de ingestão alimentar de pacientes com Pênfigo Foliáceo (PF, n=14 sob corticoterapia prolongada (prednisona, 0,33 ± 0,22mg/kg/dia há mais de 12 meses com um Grupo Controle (GC, n=12. A avaliação constou de inquérito alimentar de 48 horas, antropometria e determinação de creatinina urinária de 24h e albumina sérica. Os grupos PF e GC foram pareados, respectivamente, quanto à idade (24,7 ± 14,1 vs 22,0 ± 12,0 anos, índice de massa corporal (25,8 ± 6,4 vs 24,0 ± 5,6kg/m2, ingestão diária de proteína (132,9 ± 49,8 vs 95,2 ± 58,9g e albumina s

  13. Paraneoplastic retinopathy associated with occult bladder cancer

    DEFF Research Database (Denmark)

    Nivean, M; Muttuvelu, Danson V; Afzelius, Pia Maria Tullia

    2016-01-01

    (ERG), serology including serum antibodies for CAR, and positron emission tomography-computed tomography (PET-CT) scan. The patient was diagnosed with bladder carcinoma revealed by PET-CT. Timely recognition of this entity may be crucial for an increased patient survival thus adult onset progressive...... photoreceptor dysfunction, confirmed by ERG, should alert to a possible remote effect of known or occult malignancy. In the latter, PET-CT may be exploited as a powerful diagnostic tool....

  14. Endemic pemphigus in the peruvian Amazon: epidemiology and risk factors for the development of complications during treatment Pênfigo endêmico na Amazônia peruana: epidemiologia e fatores de risco para o desenvolvimento de complicações durante o tratamento

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    Willy Ramos

    2012-12-01

    Full Text Available BACKGROUND: Pemphigus is an autoimmune blistering disease. According to a report, in areas of endemic pemphigus foliaceus (EPF in Peru there are cases of pemphigus vulgaris with epidemiologic, clinical and histopathologic characteristics similar to those of "endemic pemphigus vulgaris" (EPV in Brazil. OBJECTIVES: To determine the clinical and epidemiologic characteristics of endemic pemphigus and the risk factors of patients for developing complications during treatment. METHODS: A study was carried out from July 2003 to March 2008. The study population was 60 patients with EPF and 7 patients with EPV evaluated in hospitals and clinics in the Peruvian Amazon and Lima. A multivariate analysis was carried out using binary logistic regression. RESULTS: The average age of EPF patients was 31.4 years; 55% were men; 60% presented the generalized clinical variant. Non-compliance with the treatment was seen in 57.1% of the patients. Thirty-five percent presented complications (e.g. pyodermitis and pyelonephritis during treatment. The risk factors for developing complications during treatment were non-compliance with the treatment and having the generalized clinical form. In the EPV group, the average age was 21.7 years; 71.4% were men. All patients presented with the mucocutaneous clinical variant and the initial presentation consisted of oral mucosa lesions; 71.4% presented complications during treatment, pyodermitis being the most frequent. CONCLUSIONS: Non-compliance with the treatment and the generalized clinical form are risk factors for the development of complications during treatment of patients with EPF. Peru indeed has EPV cases with epidemiologic characteristics similar to EPF. Living in a rural area may represent a risk factor for the development of complications during treatment of patients with EPV.FUNDAMENTOS: O pênfigo é uma doença auto-imune bolhosa. Segundo um relatório, em áreas de pênfigo foliáceo endêmico no Peru há casos

  15. Domestic minor sex trafficking: what the PNP needs to know.

    Science.gov (United States)

    Hornor, Gail

    2015-01-01

    Human trafficking is a major global public health problem and represents a substantial human rights violation. Human trafficking has been receiving attention in both the lay media and professional literature. Human trafficking can include commercial sex, forced labor, child soldiers, and stealing of human organs. One form of human trafficking represents a significant American pediatric health problem: domestic minor sex trafficking (DMST). DMST is the commercial sexual abuse of children by selling, buying, or trading their sexual service. This continuing education article will define DMST and discuss it in terms of prevalence, risk factors, and practice implications for the pediatric nurse practitioner. Copyright © 2015 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.

  16. Helium impurities in a PNP-primary coolant circuit

    International Nuclear Information System (INIS)

    Reif, M.

    1981-01-01

    The concentration of impurities to be expected have been defined in consideration of recent findings concerning the rates of infiltration and formation and the reaction mechanisms of the impurity components in the circuit. The data obtained correspond with the requirements on the metallic high-temperature components as well as with the requirements of limited graphite corrosion. (DG) [de

  17. AUTOIMMUNE CYTOPENIAS IN CHRONIC LYMPHOCYTIC LEUKEMIA, FACTS AND MYTHS

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    Pavankumar Tandra

    2013-11-01

    Full Text Available CLL has been defined as presence of more than 5000 small mature appearing monoclonal B lymphocytes with a specific immunophenotype in peripheral blood. It is a well-known fact that CLL is associated with autoimmune cytopenias. CLL cells are CD5+ B lymphocytes, and usually are not the “guilty” cells which produce autoantibodies. T cell defect is another characteristic of CLL and the total number of T cells is increased, and there is inversion of the CD4/CD8 ratio. Autoimmune hemolytic anemia (AIHA is the most common autoimmune complication of CLL and has been reported in 10-25% of CLL patients. However, the stage-adjusted estimated rate of AIHA in CLL is about 5%. Conversely, CLL is three times more common in patients who present with AIHA. Direct agglutinin test (DAT is positive in 7-14% of CLL patients but AIHA may also occur in DAT negative patients. Autoimmune thrombocytopenia (AIT is the second most common complication of CLL and has been reported in 2-3% of patients. DAT is positive in AIT but presence of antiplatelet antibodies is neither diagnostic nor reliable. Autoimmune neutropenia (AIN and pure red cell aplasia (PRCA are very rare complications of CLL and like other autoimmune complications of CLL may occur at any clinical stage. It is believed that most case reports of AIN and PRCA in CLL actually belong to large granular lymphocytic leukemia (LGL. Non-hematologic autoimmune complications of CLL including cold agglutinin disease (CAD, paraneoplastic pemphigus (PNP, acquired angioedema, and anti-myelin associated globulin are rare. Before starting any treatment, clinicians should distinguish between autoimmune cytopenias and massive bone marrow infiltration since autoimmune complications of CLL are not necessarily equal to advanced disease with poor prognosis. According to IWCLL guideline, steroids are the mainstay of treatment of simple autoimmunity. Intravenous immunoglobulin (IVIg, cyclosporine, and rituximab are used in

  18. Mini outbreak of Kaposi′s varicelliform eruption in skin ward: A study of five cases

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    Rao GRR

    2007-01-01

    Full Text Available Background: Kaposi`s varicelliform eruption (KVE represents widespread cutaneous herpes simplex virus (HSV infection in patients with preexisting dermatoses. Occasionally, this infection can present as a nosocomial infection in skin wards, if adequate bed-spacing and barrier nursing methods are not followed. We are reporting five cases of KVE; four cases acquired the infection in a makeshift ward after admission of the first case in May 2005, due to the renovation work of the regular skin ward. Aim: The purpose of this study is to create clinical awareness about this uncommon dermatologic entity and to stress upon the importance of bed-spacing and barrier nursing in skin wards. Methods: Five cases of KVE, three females and two males with different primary dermatoses (pemphigus foliaceus - one, pemphigus vulgaris - two, paraneoplastic pemphigus - one and toxic epidemal necrolysis - one were included in this study. Diagnosis was made clinically and supported with Tzanck smear and HSV serology. All the cases were treated with oral acyclovir. Results: Four out of five cases of KVE recovered with treatment, one case of extensive pemphigus vulgaris with KVE succumbed to death. Conclusion: Mini outbreaks of KVE can occur in skin wards with inadequate bed-spacing and overcrowding of patients. Therefore adequate bed-spacing, barrier nursing and isolation of suspected cases are mandatory to prevent such life-threatening infections.

  19. Detecting underlying malignancy with 18F-FDG PET/CT in patients with suspected paraneoplastic neurological syndrome%18F-FDG PET/CT在可疑神经系统副肿瘤综合征中的应用价值

    Institute of Scientific and Technical Information of China (English)

    耿园园; 高硕; 谢炳玓; 陈秋松; 蔡莉; 刘艳青

    2010-01-01

    Objective To evaluate 18F-fluorodeoxyglucose (FDG) PET/CT in detecting occult malignancy in patients with suspected paraneoplastic neurological syndrome (PNS).Methods Twenty consecutive patients who underwent PET/CT scanning with the indication of suspected PNS were retrospectively reviewed.The gold standard of PNS was either cytology or clinical follow-up, and the final diagnosis was compared with PET/CT findings.Results Of the 20 patients, six were PNS.PET/CT detected nine cases.Six were true positive and three were false positive.The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of PET/CT were 100% (6/6), 78.57% (11/14), 85.00% (17/20),66.7% (6/9) and 100.00% ( 11/11 ) respectively.The treatment plan was modified based on the PET/CT results in 4 patients.Conclusions 18F-FDG PET/CT may play a role in detecting the underlying malignancy of PNS.It is also valuable in staging of the malignancy thus providing information for therapy decision making.%目的 探讨18F-脱氧葡萄糖(FDG)PET/CT显像探测临床可疑神经系统副肿瘤综合征(PNS)患者潜在肿瘤病灶的应用价值.方法 回顾性分析20例可疑PNS患者18F-FDG PET/CT显像资料,对所有患者行随访病理检查或临床最终诊断,并将结果与PET/CT显像和随访结果进行比较.结果 20例中PET/CT显像发现可疑恶性病变或既往肿瘤复发和(或)转移者9例,阴性11例.9例阳性者中3例为假阳性.PET/CT显像对PNS恶性肿瘤检出的灵敏度、特异性、准确性、阳性预测值和阴性预测值分别为6/6,78.57%(11/14),85.00%(17/20),6/9和100.00%(11/11).6例真阳性中4例治疗方案得以修正,经抗肿瘤和免疫疗法后神经异常症状得到改善.结论 18F-FDG PET/CT显像在可疑PNS中的应用有积极意义,有助于发现恶性肿瘤,也能对肿瘤分期提供帮助.

  20. Metabolic topography of autoimmune non-paraneoplastic encephalitis

    Energy Technology Data Exchange (ETDEWEB)

    Tripathi, Madhavi; Roy, Shambo Guha; Parida, Girish Kumar; Damle, Nishikant; Shamim, Shamim Ahmed; Bal, Chandrasekhar [All India Institute of Medical Sciences, Department of Nuclear Medicine, New Delhi (India); Tripathi, Manjari; Ihtisham, Kavish; Dash, Deepa [All India Institute of Medical Sciences, Department of Neurology, Cardiothoracic and Neurosciences Centre, New Delhi (India)

    2018-02-15

    F-18 fluorodeoxyglucose (FDG) positron emission tomography (PET) is emerging to be a useful tool in supporting the diagnosis of AIE. In this study, we describe the metabolic patterns on F-18 FDG PET imaging in AIE. Twenty-four antibody-positive patients (anti-NMDA-15, anti-VGKC/LGI1-6, and anti-GAD-3), 14 females and 10 males, with an age range of 2-83 years were included in this study. Each PET study was evaluated visually for the presence of hypometabolism or hypermetabolism and semiquantitatively using Cortex ID (GE) and Scenium (Siemens) by measuring regional Z-scores. These patterns were correlated with corresponding antibody positivity once available. Visually, a pattern of hypometabolism, hypermetabolism, or both in various spatial distributions was appreciated in all 24 patients. On quantitative analysis using scenium parietal and occipital lobes showed significant hypometabolism with median Z-score of -3.8 (R) and -3.7 (L) and -2.2 (R) and -2.5 (L) respectively. Two-thirds (16/24) showed significant hypermetabolism involving the basal ganglia with median Z-score of 2.4 (R) and 3.0 (L). Similarly on Cortex ID, the median Z-score for hypometabolism in parietal and occipital lobes was -2.2 (R) and -2.4 (L) and -2.6 (R) and -2.4 (L) respectively, while subcortical regions were not evaluated. MRI showed signal alterations in only 11 of these patients. There is heterogeneity in metabolic topography of AIE which is characterized by hypometabolism most commonly involving the parietal and occipital cortices and hypermetabolism most commonly involving the basal ganglia. Scenium analysis using regional Z-scores can complement visual evaluation for demonstration of these metabolic patterns on FDG PET. (orig.)

  1. Muscular visualisation on a bone scan in paraneoplastic ...

    African Journals Online (AJOL)

    Immunosuppressive therapy based on oral prednisone and endoxan followed by molecular targeted therapy (Herceptin and taxotere) improved the myositis and cutaneous eruption. Tree months later, creatine kinase level and muscular uptake of 99mTc-MDP dramatically decreased (B). Pan African Medical Journal 2016; ...

  2. Brainstem and limbic encephalitis with paraneoplastic neuromyelitis optica.

    Science.gov (United States)

    Moussawi, Khaled; Lin, David J; Matiello, Marcelo; Chew, Sheena; Morganstern, Daniel; Vaitkevicius, Henrikas

    2016-01-01

    The spectrum of disorders associated with anti-neuromyelitis optica (NMO) antibody is being extended to include infrequent instances associated with cancer. We describe a patient with brainstem and limbic encephalitis from NMO-immunoglobulin G in serum and cerebrospinal fluid in the context of newly diagnosed breast cancer. The neurological features markedly improved with excision of her breast cancer and immune suppressive therapy. This case further broadens the NMO spectrum disorders (NMOSD) by an association between NMOSD and cancer and raises the question of coincidental occurrence and the appropriate circumstances to search for a tumor in certain instances of NMO. Copyright © 2015 Elsevier Ltd. All rights reserved.

  3. Clinical and radiological manifestations of paraneoplastic syndrome of bronchogenic carcinoma

    Directory of Open Access Journals (Sweden)

    Goldner Branislav

    2005-01-01

    Full Text Available The objective of this study was to present some clinical and radiological manifestations of PNS in relation to bronchogenic carcinoma (BC and to evaluate the usefulness of imaging findings in the diagnosis of asymptomatic BC. In the study group of 204 patients (146 male and 58 female with proven bronchogenic carcinoma, PNS was present in 18 (8.62% patients. The patients with PNS were divided into two groups. The first one consisted of 13 (72.2% patients with symptoms related to primary tumours while the second one consisted of 5 (27.7% patients with symptoms, at initial appearance, indicative of disorders of other organs and systems. The predominant disorder was Lambert-Eaton Syndrome, associated with small-cell carcinoma. Endocrine manifestations included: inappropriate antidiuretic hormone production syndrome (small-cell carcinoma, a gonadotropin effect with gynaecomastia and testicular atrophy (planocellular carcinoma, small-cell carcinoma, a case of Cushing Syndrome (small-cell carcinoma, and hyper-calcaemia, due to the production of the parathyroid hormone-related peptide, which was associated with planocellular carcinoma. A rare case of bilateral exophthalmos was found as PNS at adenocarcinoma. Digital clubbing and hypertrophic osteoarthropathy (HO were associated with planocellular and adenocarcinoma, while clubbing was much more common than HO, especially among women. The differences between the two groups were related to the time of PNS appearance. In the first group, PNS occurred late on in the illness, while in the second group, PNS preceded the diagnosis of BC. Alternatively, the disappearance of a clinical or a radiological manifestation of PNS after surgery or chemotherapy may be an indicator of an improvement in health or PNS may be the first sign of illness recurrence. Radiological manifestations of PNS in asymptomatic patients may serve as a useful screen for identifying primary BC. In symptomatic patients, it may be an indicator of a higher likelihood of metastatic disease.

  4. Metabolic topography of autoimmune non-paraneoplastic encephalitis.

    Science.gov (United States)

    Tripathi, Madhavi; Tripathi, Manjari; Roy, Shambo Guha; Parida, Girish Kumar; Ihtisham, Kavish; Dash, Deepa; Damle, Nishikant; Shamim, Shamim Ahmed; Bal, Chandrasekhar

    2018-02-01

    F-18 fluorodeoxyglucose (FDG) positron emission tomography (PET) is emerging to be a useful tool in supporting the diagnosis of AIE. In this study, we describe the metabolic patterns on F-18 FDG PET imaging in AIE. Twenty-four antibody-positive patients (anti-NMDA-15, anti-VGKC/LGI1-6, and anti-GAD-3), 14 females and 10 males, with an age range of 2-83 years were included in this study. Each PET study was evaluated visually for the presence of hypometabolism or hypermetabolism and semiquantitatively using Cortex ID (GE) and Scenium (Siemens) by measuring regional Z-scores. These patterns were correlated with corresponding antibody positivity once available. Visually, a pattern of hypometabolism, hypermetabolism, or both in various spatial distributions was appreciated in all 24 patients. On quantitative analysis using scenium parietal and occipital lobes showed significant hypometabolism with median Z-score of -3.8 (R) and -3.7 (L) and -2.2 (R) and -2.5 (L) respectively. Two-thirds (16/24) showed significant hypermetabolism involving the basal ganglia with median Z-score of 2.4 (R) and 3.0 (L). Similarly on Cortex ID, the median Z-score for hypometabolism in parietal and occipital lobes was -2.2 (R) and -2.4 (L) and -2.6 (R) and -2.4 (L) respectively, while subcortical regions were not evaluated. MRI showed signal alterations in only 11 of these patients. There is heterogeneity in metabolic topography of AIE which is characterized by hypometabolism most commonly involving the parietal and occipital cortices and hypermetabolism most commonly involving the basal ganglia. Scenium analysis using regional Z-scores can complement visual evaluation for demonstration of these metabolic patterns on FDG PET.

  5. Metabolic topography of autoimmune non-paraneoplastic encephalitis

    International Nuclear Information System (INIS)

    Tripathi, Madhavi; Roy, Shambo Guha; Parida, Girish Kumar; Damle, Nishikant; Shamim, Shamim Ahmed; Bal, Chandrasekhar; Tripathi, Manjari; Ihtisham, Kavish; Dash, Deepa

    2018-01-01

    F-18 fluorodeoxyglucose (FDG) positron emission tomography (PET) is emerging to be a useful tool in supporting the diagnosis of AIE. In this study, we describe the metabolic patterns on F-18 FDG PET imaging in AIE. Twenty-four antibody-positive patients (anti-NMDA-15, anti-VGKC/LGI1-6, and anti-GAD-3), 14 females and 10 males, with an age range of 2-83 years were included in this study. Each PET study was evaluated visually for the presence of hypometabolism or hypermetabolism and semiquantitatively using Cortex ID (GE) and Scenium (Siemens) by measuring regional Z-scores. These patterns were correlated with corresponding antibody positivity once available. Visually, a pattern of hypometabolism, hypermetabolism, or both in various spatial distributions was appreciated in all 24 patients. On quantitative analysis using scenium parietal and occipital lobes showed significant hypometabolism with median Z-score of -3.8 (R) and -3.7 (L) and -2.2 (R) and -2.5 (L) respectively. Two-thirds (16/24) showed significant hypermetabolism involving the basal ganglia with median Z-score of 2.4 (R) and 3.0 (L). Similarly on Cortex ID, the median Z-score for hypometabolism in parietal and occipital lobes was -2.2 (R) and -2.4 (L) and -2.6 (R) and -2.4 (L) respectively, while subcortical regions were not evaluated. MRI showed signal alterations in only 11 of these patients. There is heterogeneity in metabolic topography of AIE which is characterized by hypometabolism most commonly involving the parietal and occipital cortices and hypermetabolism most commonly involving the basal ganglia. Scenium analysis using regional Z-scores can complement visual evaluation for demonstration of these metabolic patterns on FDG PET. (orig.)

  6. [Severe metabolic alkalosis following hypokalemia from a paraneoplastic Cushing syndrome].

    Science.gov (United States)

    Dubé, L; Daenen, S; Kouatchet, A; Soltner, C; Alquier, P

    2001-12-01

    Metabolic alkalosis is frequently observed in critically ill patients. Etiologies are numerous but endocrinal causes are rare. We report a case of a patient with severe respiratory insufficiency, metabolic alkalosis and hypokalemia. The evolution was fatal. Further explorations revealed an ectopic Adrenocorticotropine Hormone syndrome. The initial tumor was probably a small cell lung carcinoma.

  7. Endemic Pemphigus foliaceus ("Fogo selvagem": a series from the Northeastern region of the State of São Paulo, Brazil, 1973-1998 Pênfigo foliáceo endêmico (Fogo selvagem: casuística da região nordeste do Estado de São Paulo, Brasil, 1973-1998

    Directory of Open Access Journals (Sweden)

    Maria Paula do Valle CHIOSSI

    2001-04-01

    Full Text Available Endemic Pemphigus Foliaceus (EPF is a bullous autoimmune skin disease whose incidence used to be high in the State of São Paulo (SP, Brazil, during the forties, but has declined thereafter. OBJECTIVES: to report a series of EPF patients from the northeastern region of SP. METHODS: a retrospective study concerning demographic and epidemiological data of patients seen from 1973 to 1998 was conducted at the University Hospital, Faculty of Medicine of Ribeirão Preto, SP. RESULTS: bullous disease was diagnosed in 340 patients, 245 with EPF (72.1%, 9.4 cases per year, 60.4% females, and 70.2% white, 7 to 82 year-old (29.4% in their teens; 46.9% lived in the rural zone. Concerning profession, housewives predominated among women (67.6% and agricultural workers among men (40.2%. The time of disease was less than 1 year in 62.0% of cases, followed by 1 and 5 years (27%, and more than 5 years for the remaining patients (11%. 36.7% of patients were referred by the Direção Regional de Saúde (DIR XVIII of Ribeirão Preto, with the largest number of cases being from Ribeirão Preto and Batatais: 33.3% and 23.3%, respectively; 22% from DIR XIII (Franca; 13.5% from DIR VII (Araraquara; 2.9% from DIR IX (Barretos; 4.1% from other DIRs of SP, and 20.8% from other States (16.7% from Minas Gerais. Thirteen (5.3% patients reported occurrence of the disease in some relative, and 4 (1.6% in neighbors. CONCLUSIONS: the present data characterize the northeastern region of the state of São Paulo as a remaining endemic focus of EPF.FUNDAMENTOS: O pênfigo foliáceo endêmico (PFE é doença bolhosa auto-imune, em que o Estado de São Paulo (SP destacou-se por sua alta incidência na década de 1940, a partir da qual é descrito seu declínio. OBJETIVOS: relatar casuística do PFE na região nordeste de SP. MÉTODO: levantamento de prontuários de pacientes com doenças bolhosas, Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto, Universidade de S

  8. The effect of magnetic field on chiral transmission in p-n-p graphene junctions

    Science.gov (United States)

    Li, Yuan; Wan, Qi; Peng, Yingzi; Wang, Guanqing; Qian, Zhenghong; Zhou, Guanghui; Jalil, Mansoor B. A.

    2015-12-01

    We investigate Klein tunneling in graphene heterojunctions under the influence of a perpendicular magnetic field via the non-equilibrium Green’s function method. We find that the angular dependence of electron transmission is deflected sideways, resulting in the suppression of normally incident electrons and overall decrease in conductance. The off-normal symmetry axis of the transmission profile was analytically derived. Overall tunneling conductance decreases to almost zero regardless of the potential barrier height when the magnetic field (B-field) exceeds a critical value, thus achieving effective confinement of Dirac fermions. The critical field occurs when the width of the magnetic field region matches the diameter of the cyclotron orbit. The potential barrier also induces distinct Fabry-Pérot fringe patterns, with a “constriction region” of low transmission when is close to the Fermi energy. Application of B-field deflects the Fabry-Pérot interference pattern to an off-normal angle. Thus, the conductance of the graphene heterojunctions can be sharply modulated by adjusting the B-field strength and the potential barrier height relative to the Fermi energy.

  9. The effect of magnetic field on chiral transmission in p-n-p graphene junctions.

    Science.gov (United States)

    Li, Yuan; Wan, Qi; Peng, Yingzi; Wang, Guanqing; Qian, Zhenghong; Zhou, Guanghui; Jalil, Mansoor B A

    2015-12-18

    We investigate Klein tunneling in graphene heterojunctions under the influence of a perpendicular magnetic field via the non-equilibrium Green's function method. We find that the angular dependence of electron transmission is deflected sideways, resulting in the suppression of normally incident electrons and overall decrease in conductance. The off-normal symmetry axis of the transmission profile was analytically derived. Overall tunneling conductance decreases to almost zero regardless of the potential barrier height V0 when the magnetic field (B-field) exceeds a critical value, thus achieving effective confinement of Dirac fermions. The critical field occurs when the width of the magnetic field region matches the diameter of the cyclotron orbit. The potential barrier also induces distinct Fabry-Pérot fringe patterns, with a "constriction region" of low transmission when V0 is close to the Fermi energy. Application of B-field deflects the Fabry-Pérot interference pattern to an off-normal angle. Thus, the conductance of the graphene heterojunctions can be sharply modulated by adjusting the B-field strength and the potential barrier height relative to the Fermi energy.

  10. Adsorption of p-Nitrophenol (PNP) on new adsorbents prepared from diatomite and charcoal

    International Nuclear Information System (INIS)

    Hamdi, B.; Khelifa, N.; Chernai-Hamdi, S.; Hadjari, H.

    2009-01-01

    Increasing attention has been paid to mesoporous materials with high surface area and narrow pore size distribution because of their diverse applications (e. g., adsorbents, catalysts, and host materials). Inorganic composite materials (ICM) prepared by a mixture of natural diatomite (macroporous materials) and charcoal (microporous material) in particular operative conditions. (Author)

  11. Childhood trauma exposure and toxic stress: what the PNP needs to know.

    Science.gov (United States)

    Hornor, Gail

    2015-01-01

    Trauma exposure in childhood is a major public health problem that can result in lifelong mental and physical health consequences. Pediatric nurse practitioners must improve their skills in the identification of trauma exposure in children and their interventions with these children. This continuing education article will describe childhood trauma exposure (adverse childhood experiences) and toxic stress and their effects on the developing brain and body. Adverse childhood experiences include a unique set of trauma exposures. The adverse childhood experiences or trauma discussed in this continuing education offering will include childhood exposure to emotional abuse, physical abuse, sexual abuse, emotional neglect, physical neglect, domestic violence, household substance abuse, household mental illness, parental separation or divorce, and a criminal household member. Thorough and efficient methods of screening for trauma exposure will be discussed. Appropriate intervention after identification of trauma exposure will be explored. Copyright © 2015 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.

  12. Prototype plant for nuclear process heat (PNP) - operation of the pilot plant for hydrogasification of coal

    International Nuclear Information System (INIS)

    Bruengel, N.; Dehms, G.; Fiedler, P.; Gerigk, H.P.; Ruddeck, W.; Schrader, L.; Schumacher, H.J.

    1988-04-01

    The Rheinische Braunkohlenwerke AG developed the process of hydrogasification of coal in a fluidized bed for generation of SNG. On basis of test results obtained in a semi-technical pilot plant of a through-put of 250 kg/h dried coal a large pilot plant was erected processing 10 t/h dried brown coal. This plant was on stream for about 14700 h, of which about 7800 h were with gasifier operation; during this time about 38000 t of dried brown coal of the Rhenish district were processed containing 4 to 25% of ash. At pressures of 60 to 120 bar and temperatures of 800 to 935 0 C carbon conversion rates up to 81 percent and methane amounts of 5000 m 3 (STP)/h were reached. The decisive parameter for methane generation was the hydrogen/coal-ratio. Even at high moisture contents, usually diminishing the methane yield from the coal essentially, by high hydrogen/coal-ratios high methane yields could be obtained. The gasifier itself caused no troubles during the total time operation. Difficulties with the original design of the residual char cooler could be overcome by change-over from water injection to liquid carbon dioxide. The design of the heat recovery system proved well. Alltogether so the size increasement of the gasifier from the semi-technical to the large pilot plant as well as the harmonization of gas generation and gas refining was proved. (orig.) With 20 refs., 20 tabs., 81 figs [de

  13. Single-Event Transient Testing of Low Dropout PNP Series Linear Voltage Regulators

    Science.gov (United States)

    Adell, Philippe; Allen, Gregory

    2013-01-01

    As demand for high-speed, on-board, digital-processing integrated circuits on spacecraft increases (field-programmable gate arrays and digital signal processors in particular), the need for the next generation point-of-load (POL) regulator becomes a prominent design issue. Shrinking process nodes have resulted in core rails dropping to values close to 1.0 V, drastically reducing margin to standard switching converters or regulators that power digital ICs. The goal of this task is to perform SET characterization of several commercial POL converters, and provide a discussion of the impact of these results to state-of-the-art digital processing IC through laser and heavy ion testing

  14. Review of thymic pathology in 30 cats and 36 dogs.

    Science.gov (United States)

    Day, M J

    1997-09-01

    Data are presented from 30 cats and 36 dogs in which thymic disease was recognised clinically or on postmortem examination. The diagnoses included thymic lymphoma (19 cats, 12 dogs), thymoma (five cats, 18 dogs), thymic branchial cyst formation or cystic change (one cat, four dogs), thymic hyperplasia (two cats), congenital hypoplasia (one cat, one dog), thymic haemorrhage (one cat, one dog) and thymic amyloidosis (one cat). Thymic lymphoma occurred in younger dogs and cats, and was recorded equally among domestic shorthaired and purebred (especially Siamese) cats. Eight cats with thymic lymphoma were tested for feline leukaemia virus and four were positive. Thymoma occurred more frequently in older cats and dogs, and in Labradors and German shepherd dogs. Thymic tumours were associated with paraneoplastic hypercalcaemia (six dogs), megaoesophagus (two dogs) or interface dermatitis with basement membrane immune complex deposition (one cat). Non-neoplastic thymic diseases were associated with myasthenia gravis (one cat), pemphigus foliaceus (one cat) and superficial necrolytic dermatitis (one cat).

  15. Outcome and late complications of radiotherapy in patients with unicentric Castleman disease

    International Nuclear Information System (INIS)

    Neuhof, Dirk; Debus, Juergen

    2006-01-01

    Castleman disease is a rare lymphoproliferative disorder. Surgery is considered standard therapy for the unicentric type. However, case reports have documented favorable responses to radiotherapy. The aim of this study was to analyse the clinical outcomes of five patients with unicentric Castleman disease treated with radiotherapy between 1991 and 2005. Mediastinal lymph nodes were the most common site of disease (four patients). Three patients were treated with radiotherapy alone, two patients with surgery and radiotherapy. Patients were treated with radiotherapy doses ranging from 40 Gy to 50 Gy. The median follow-up was 12 months (range, 3-175 months). During follow-up only one patient had progressive disease and died of Castleman disease. At the time of last follow-up two patients were in complete remission, one patient in partial remission, and one patient had stable disease. One patient showed serious acute and late toxicities. At the end of radiotherapy a paraneoplastic pemphigus vulgaris occurred, and eight to 11 months after radiotherapy a stenosis of the esophagus, of the left bronchus, and of the trachea due to scars. The study shows that unicentric Castleman disease is successfully treated with radiotherapy. However, for detection of possible complications as pemphigus vulgaris or stenosis of the esophagus or trachea an accurate follow-up is necessary

  16. Steven johnsons syndrome and toxic epidermal necrolysis: A review

    Directory of Open Access Journals (Sweden)

    Sri ram Anne

    2014-12-01

    Full Text Available Toxic epidermal necrolysis (TEN and Stevens Johnson Syndrome (SJS are severe adverse cutaneous drug reactions that predominantly involve the skin and mucous membranes. They are characterized by mucocutaneous tenderness and typically hemorrhagic erosions, erythema and more or less severe epidermal detachment presenting as blisters and areas of denuded skin. Drugs are assumed or identified as the main cause of SJS/TEN in most cases, but Mycoplasma pneumoniae and Herpes simplex virus infections are well documented causes alongside rare cases in which the etiology remains unknown. Several drugs are at "high" risk of inducing TEN/SJS including: Allopurinol, Trimethoprim-sulfamethoxazole and other sulfonamide-antibiotics, aminopenicillins, cephalosporins, quinolones, carbamazepine, phenytoin, phenobarbital and NSAID's of the oxicam-type. Differential diagnosis includes linear IgA dermatosis and paraneoplastic pemphigus, pemphigus vulgaris and bullous pemphigoid, acute generalized exanthematous pustulosis (AGEP, disseminated fixed bullous drug eruption and staphyloccocal scalded skin syndrome (SSSS. Due to the high risk of mortality, management of patients with SJS/TEN requires rapid diagnosis, identification and interruption of the culprit drug, specialized supportive care ideally in an intensive care unit, and consideration of immunomodulating agents such as high-dose intravenous immunoglobulin therapy.

  17. Catalytic mechanisms of direct pyrrole synthesis via dehydrogenative coupling mediated by PNP-Ir or PNN-Ru pincer complexes: Crucial role of proton-transfer shuttles in the PNP-Ir system

    KAUST Repository

    Qu, Shuanglin; Dang, Yanfeng; Song, Chunyu; Wen, Mingwei; Huang, Kuo-Wei; Wang, Zhixiang

    2014-01-01

    lower catalyst loading than the PNN-Ru system. We discuss how the differences are resulted in terms of electronic and geometric structures of the catalysts and how to use the features in catalyst development. © 2014 American Chemical Society.

  18. Quantum Cryptography II: How to re-use a one-time pad safely even if P=NP.

    Science.gov (United States)

    Bennett, Charles H; Brassard, Gilles; Breidbart, Seth

    2014-01-01

    When elementary quantum systems, such as polarized photons, are used to transmit digital information, the uncertainty principle gives rise to novel cryptographic phenomena unachievable with traditional transmission media, e.g. a communications channel on which it is impossible in principle to eavesdrop without a high probability of being detected. With such a channel, a one-time pad can safely be reused many times as long as no eavesdrop is detected, and, planning ahead, part of the capacity of these uncompromised transmissions can be used to send fresh random bits with which to replace the one-time pad when an eavesdrop finally is detected. Unlike other schemes for stretching a one-time pad, this scheme does not depend on complexity-theoretic assumptions such as the difficulty of factoring.

  19. Temperature measurement: Development work on noise thermometry and improvement of conventional thermocouples for applications in nuclear process heat (PNP)

    International Nuclear Information System (INIS)

    Brixy, H.; Hecker, R.; Oehmen, J.; Barbonus, P.; Hans, R.

    1982-06-01

    The behaviour was studied of NiCr-Ni sheathed thermocouples (sheath Inconel 600 or Incoloy 800, insulation MgO) in a helium and carbon atmosphere at temperatures of 950-1150 deg. C. All the thermocouples used retained their functional performance. The insulation resistance tended towards a limit value which is dependent on the temperature and quality of the thermocouple. Temperature measurements were loaded with great uncertainty in the temperature range of 950-1150 deg. C. Recalibrations at the temperature of 950 deg. C showed errors of up to 6%. Measuring sensors were developed which consist of a sheathed double thermocouple with a noise resistor positioned between the two hot junctions. Using the noise thermometer it is possible to recalibrate the thermocouple at any time in situ. A helium system with a high temperature experimental area was developed to test the thermocouples and the combined thermocouple-noise thermometer sensors under true experimental conditions

  20. Visible laser and UV-A radiation impact on a PNP degrading Moraxella strain and its rpoS mutant.

    Science.gov (United States)

    Nandakumar, Kanavillil; Keeler, Werden; Schraft, Heidi; Leung, Kam T

    2006-07-05

    The role of stationary phase sigma factor gene (rpoS) in the stress response of Moraxella strain when exposed to radiation was determined by comparing the stress responses of the wild-type (WT) and its rpoS knockout (KO) mutant. The rpoS was turned on by starving the WT cultures for 24 h in minimal salt medium. Under non-starved condition, both WT and KO planktonic Moraxella cells showed an increase in mortality with the increase in duration of irradiation. In the planktonic non-starved Moraxella, for the power intensity tested, UV radiation caused a substantially higher mortality rate than did by the visible laser light (the mortality rate observed for 15-min laser radiation was 53.4 +/- 10.5 and 48.7 +/- 8.9 for WT and KO, respectively, and 97.6 +/- 0 and 98.5 +/- 0 for 25 s of UV irradiation in WT and KO, respectively). However, the mortality rate decreased significantly in the starved WT when exposed to these two radiations. In comparison, rpoS protected the WT against the visible laser light more effectively than it did for the UV radiation. The WT and KO strains of Moraxella formed distinctly different types of biofilms on stainless steel coupons. The KO strain formed a denser biofilm than did the WT. Visible laser light removed biofilms from the surfaces more effectively than did the UV. This was true when comparing the mortality of bacteria in the biofilms as well. The inability of UV radiation to penetrate biofilms due to greater rates of surface absorption is considered to be the major reason for the weaker removal of biofilms in comparison to that of the visible laser light. This result suggests that high power visible laser light might be an effective tool for the removal of biofilms. (c) 2006 Wiley Periodicals, Inc.

  1. Paraneoplastic myasthenia gravis and polymyositis secondary to a thymoma in a young woman

    DEFF Research Database (Denmark)

    Ezzatian-Ahar, Shabnam; Pedersen, Emil Arnspang; Schrøder, Henrik Daa

    2016-01-01

    We present the case of a 33-year-old woman who within weeks developed severe swallowing difficulties and weakness in her limbs to an extent requiring hospitalization. Workup confirmed clinically suspected diagnoses of polymyositis and autoimmune myasthenia. A suspicion of malignant thymoma based ...

  2. Paraneoplastic hypereosinophilia in a dog with intestinal T-cell lymphoma.

    Science.gov (United States)

    Marchetti, Veronica; Benetti, Cecilia; Citi, Simona; Taccini, Valentina

    2005-09-01

    A 9-year-old, intact male Doberman Pinscher was examined because of anorexia and weakness. Results of a CBC showed severe, microcytic, hypochromic anemia with mild eosinophilia (2944 cells/microL, reference interval 100-1250/microL) and thrombocytosis. Hypoferremia, hypoferritinemia, and a positive fecal occult blood test supported a diagnosis of iron deficiency anemia secondary to chronic intestinal hemorrhage. Abdominal ultrasound evaluation showed a thickened small intestinal loop, of which representative specimens were obtained during exploratory laparotomy. Histologically, the intestinal wall was infiltrated by a neoplastic population of large, round, lymphoid cells with vesicular chromatin, 1 or more prominent nucleoli, and a high number of mitotic figures. The cells were closely admixed with mature eosinophils, but were negative for metachromatic granules with toluidine blue. Immunohistochemically, tumor cells were positive for CD3, and negative for CD21, Pan B, and CD79a. A diagnosis of intestinal T-cell lymphoma was made. Chemotherapy was begun, with 30 mg/m;2 of doxorubicin administered intravenously every 3 weeks. Eosinophil concentration was 880/microL 2 weeks after surgery (on day 15 after presentation) but increased markedly to 62,914/microL on day 30, 62,400/microL on day 37, and 39,444/microL on day 58 after presentation. An association between hypereosinophilia and T-cell lymphoma is well established in human patients, in whom production of IL-5 by neoplastic T cells has been demonstrated. Hypereosinophilia has been reported only rarely with intestinal lymphoma in cats and horses, and with T-cell lymphoma in dogs.

  3. Paraneoplastic addisonian pigmentation and acquired ichthyosis as presenting features of multiple myeloma

    International Nuclear Information System (INIS)

    Dar, N.R.; Raza, N.

    2010-01-01

    Black brown hyperpigmentation of the mucosae, sun exposed skin, palmar creases and frictional sites (Addisonian pigmentation) is characteristic of Addison disease. However, it can also occur as a para neoplastic manifestation of tumours like bronchogenic carcinoma. Acquired ichthyosis starts later in life and can also be a para neoplastic presentation.We report a unique combination of para neoplastic Addisonian pigmentation and acquired ichthyosis as presenting features in a patient with undiagnosed multiple myeloma. To the best of our knowledge this combination of para neoplastic dermatosis has not been documented before in multiple myeloma. It is concluded that the presence of more than one suspicious dermatosis may be an indicator of being para neoplastic requiring necessary work-up. (author)

  4. Lung papillary adenocarcinoma complicated with paraneoplastic autoimmune hemolytic anemia: A case report

    OpenAIRE

    Xing, Limin; Wang, Huaquan; Qu, Wen; Fang, Fang; Dong, Qi-e; Shao, Zonghong

    2014-01-01

    A middle-aged woman presented at our facility and was diagnosed after surgery with lung papillary adenocarcinoma. Seven years earlier, she had suffered from autoimmune hemolytic anemia (AIHA), which was refractory. Following lung surgery, the AIHA was cured.

  5. Aquaporin-4-Immunoglobulin G-autoimmune syndrome in a Paraneoplastic Context

    DEFF Research Database (Denmark)

    Soelberg, Kerstin; Grauslund, Jakob; Lillevang, Søren Thue

    immunofluorescence assay1. Clinical data and MRI were reviewed. Case: A 64-year old man developed sudden loss of vision and reduced visual field in both eyes. Visual acuity was 1/36 and 6/24 in the right and left eye, respectively. The optic disc was swollen, mostly in the right eye and bilateral optic neuritis (ON......) was diagnosed by an ophthalmologist. Brain MRI and cerebrospinal fluid (CSF) intracranial pressure were normal. CSF showed 4 leukocytes, oligoclonal bands and normal IgG index and protein level. At follow-up after three month atrophy and visual loss (2/36) of the right eye was apparent. Two years earlier than...

  6. Paraneoplastic Seronegative Pauci-Immune Glomerulonephritis Associated with Lung Adenocarcinoma Responds to Rituximab: A Case Report

    Directory of Open Access Journals (Sweden)

    Pragnan Kancharla

    2018-06-01

    Full Text Available Anti-neutrophil cytoplasmic antibodies (ANCA play an important role in the pathogenesis of pauci-immune renal vasculitis. However, in 10% of the cases, ANCA are absent. We present a case of a 64-year-old man with a chronic untreated hepatitis C virus infection and Middle Eastern thalassemia who was ANCA-negative when he was hospitalized due to acute kidney injury and accounts for an uncommon presentation of renal vasculitis. The patient had earlier reported to have undergone local lobectomy and adjuvant chemotherapy (carboplatin/pemetrexed for lung adenocarcinoma a month prior. IL-6 has been reported to be involved in the pathophysiological cascade causing pauci-immune glomerulonephritis amongst non-small cell lung cancer patients. Previous studies with subgroup analysis have demonstrated that ANCA negativity has been associated with more chronic glomerular lesions and less crescent formation, which tends to have a critical outcome in the renal system. However, our patient underwent kidney biopsy exhibiting active crescentic glomerulonephritis, pauci-immune type with 5 cellular crescents amongst 15 glomeruli. To our knowledge, this is the third reported case of ANCA-negative vasculitis with typical presentation on biopsy in non-small cell lung cancer patients.

  7. Prevalence of paraneoplastic hyperthyroidism in patients with metastatic non-seminomatous germ-cell tumors

    NARCIS (Netherlands)

    Oosting, S. F.; de Haas, E. C.; Links, T. P.; de Bruin, D.; Sluiter, W. J.; de Jong, I. J.; Hoekstra, H. J.; Sleijfer, D. T.; Gietema, J. A.

    Patients and methods: In all patients with metastatic NSGCT who started chemotherapy at our center from April 2001 to April 2007, thyroid function was analyzed. The association between thyroid function and HCG level was examined and the frequency of hyperthyroidism in patients with low (<5000 IU/l),

  8. A Case of Paraneoplastic Cushing Syndrome Presenting as Hyperglycemic Hyperosmolar Nonketotic Syndrome

    Directory of Open Access Journals (Sweden)

    Christina E. Brzezniak

    2017-04-01

    Full Text Available Carcinoid tumors are neuroendocrine tumors that mainly arise in the gastrointestinal tract, lungs, and bronchi. Bronchopulmonary carcinoids have been associated with Cushing syndrome, which results from ectopic adrenocorticotrophic hormone (ACTH secretion. We report the case of a 65-year-old man, a colonel in the US Air Force, with metastatic bronchopulmonary carcinoid tumors treated on a clinical trial who was hospitalized for complaints of increasing thirst, polydipsia, polyuria, weakness, and visual changes. Decompensated hyperglycemia suggested a diagnosis of hyperglycemic hyperosmolar nonketotic syndrome (HHNS. Additional findings, which included hypokalemia, hypernatremia, hypertension, metabolic alkalosis, moon facies, and striae, raised a red flag for an ectopic ACTH syndrome. Elevated ACTH levels confirmed Cushing syndrome. Treatment with a fluid replacement and insulin drip resulted in immediate symptomatic improvement. Cushing syndrome should be considered in carcinoid patients with physical stigmata such as moon facies and striae. HHNS may be the presenting clinical feature in patients with impaired glucose metabolism.

  9. Síndromes Reumáticos Paraneoplásicos = Paraneoplastic rheumatic syndromes

    Directory of Open Access Journals (Sweden)

    González Naranjo, Luis Alonso

    2011-03-01

    Full Text Available Una gran variedad de manifestaciones reumáticas han sido asociadas con neoplasias. Estas manifestaciones pueden ser por invasión tumoral directa a huesos, articulaciones y tejidos blandos, y también por efectos a distancia del tumor mediados por factores humorales (síndromes paraneoplásicos. Entre los síndromes paraneoplásicos reumáticos los más comunes son la osteoartropatía hipertrófica, la poliatritis carcinomatosa, la dermatomiositis y las vasculitis. Los síndromes paraneoplásicos pueden anteceder, por no más de 2 años, aparecer simultáneamente o luego del diagnóstico del tumor. Su curso clínico habitualmente es paralelo al del tumor. Por ende, la curación de la neoplasia usualmente, aunque no invariablemente, resulta en la resolución del síndrome paraneoplásico.

  10. Anti‐Ma2 associated paraneoplastic neurological syndrome presenting as encephalitis and progressive muscular atrophy

    Science.gov (United States)

    Waragai, M; Chiba, A; Uchibori, A; Fukushima, T; Anno, M; Tanaka, K

    2006-01-01

    A 36 year old man with a history of testicular germ cell tumour presented six months after bilateral orchidectomy with progressive amnesia, irritability, vertical gaze palsy, and generalised seizures. Eight months after initial onset of symptoms, he demonstrated a head drop with muscular atrophy of the upper limbs, shoulder girdle, and posterior neck. He reported no sensory disturbances and his sensory examination was normal. The overall clinical presentation was consistent with motor neurone disease. Cerebrospinal fluid analysis revealed mild pleocytosis and increased protein concentration. Serum and cerebrospinal fluid were positive for the anti‐Ma2 antibody by western blot analysis and immunostaining. Abnormal high signal in the grey matter was noted in the cervical spinal cord and brain by T2 weighted magnetic resonance imaging (MRI). The patient was treated with corticosteroids, intravenous immunoglobulin, and antiepileptic medication. The patient improved clinically and symptom progression ceased after initiation of treatment. There was complete resolution of the abnormal brain MRI lesions; however, the cervical spinal cord MRI lesion and muscular atrophy remained unchanged. It is suggested that the anti‐Ma2 antibody is involved not only in encephalitis, but may also play a role in the cervical spinal cord lesions resulting in a motor neurone disease‐like presentation. PMID:16361608

  11. Anti-Ma2 associated paraneoplastic neurological syndrome presenting as encephalitis and progressive muscular atrophy.

    Science.gov (United States)

    Waragai, M; Chiba, A; Uchibori, A; Fukushima, T; Anno, M; Tanaka, K

    2006-01-01

    A 36 year old man with a history of testicular germ cell tumour presented six months after bilateral orchidectomy with progressive amnesia, irritability, vertical gaze palsy, and generalised seizures. Eight months after initial onset of symptoms, he demonstrated a head drop with muscular atrophy of the upper limbs, shoulder girdle, and posterior neck. He reported no sensory disturbances and his sensory examination was normal. The overall clinical presentation was consistent with motor neurone disease. Cerebrospinal fluid analysis revealed mild pleocytosis and increased protein concentration. Serum and cerebrospinal fluid were positive for the anti-Ma2 antibody by western blot analysis and immunostaining. Abnormal high signal in the grey matter was noted in the cervical spinal cord and brain by T2 weighted magnetic resonance imaging (MRI). The patient was treated with corticosteroids, intravenous immunoglobulin, and antiepileptic medication. The patient improved clinically and symptom progression ceased after initiation of treatment. There was complete resolution of the abnormal brain MRI lesions; however, the cervical spinal cord MRI lesion and muscular atrophy remained unchanged. It is suggested that the anti-Ma2 antibody is involved not only in encephalitis, but may also play a role in the cervical spinal cord lesions resulting in a motor neurone disease-like presentation.

  12. Paraneoplastic myasthenia gravis and polymyositis secondary to a thymoma in a young woman

    DEFF Research Database (Denmark)

    Ezzatian-Ahar, Shabnam; Pedersen, Emil Arnspang; Schrøder, Henrik Daa

    2016-01-01

    We present the case of a 33-year-old woman who within weeks developed severe swallowing difficulties and weakness in her limbs to an extent requiring hospitalization. Workup confirmed clinically suspected diagnoses of polymyositis and autoimmune myasthenia. A suspicion of malignant thymoma based...

  13. Paraneoplastic precocious puberty and excessively rapid somatic growth associated with pediatric malignant hepatic tumor: 1 report of 2 cases

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Ok Hwa; Bahk, Yong Whee [Cathalic University College of Medicine, Seoul (Korea, Republic of)

    1990-04-15

    Sexual precocity in a 28-months-old boy and markedly accelerated skeletal growth with large body in a 5 years and 5 months-old-girl are reported. The former resulted from human chorionic gonadotropin-producing hepatoblastoma and the latter from cerebral gigantism associated with hepatoma. These two different disorders are discussed on the common basis of rare association of malignant hepatic tumors with precocious sexual and / or somatic growth. The clinical manifestations, chemical abnormalities, and the radiologic findings are presented with a brief review of the literature.

  14. Paraneoplastic precocious puberty and excessively rapid somatic growth associated with pediatric malignant hepatic tumor: 1 report of 2 cases

    International Nuclear Information System (INIS)

    Kim, Ok Hwa; Bahk, Yong Whee

    1990-01-01

    Sexual precocity in a 28-months-old boy and markedly accelerated skeletal growth with large body in a 5 years and 5 months-old-girl are reported. The former resulted from human chorionic gonadotropin-producing hepatoblastoma and the latter from cerebral gigantism associated with hepatoma. These two different disorders are discussed on the common basis of rare association of malignant hepatic tumors with precocious sexual and / or somatic growth. The clinical manifestations, chemical abnormalities, and the radiologic findings are presented with a brief review of the literature

  15. Severe paraneoplastic hypoglycemia in a patient with a gastrointestinal stromal tumor with an exon 9 mutation: a case report

    International Nuclear Information System (INIS)

    Escobar, Guillermo A; Robinson, William A; Nydam, Trevor L; Heiple, Drew C; Weiss, Glen J; Buckley, Linda; Gonzalez, Rene; McCarter, Martin D

    2007-01-01

    Non-islet cell tumor induced hypoglycemia (NICTH) is a very rare phenomenon, but even more so in gastrointestinal stromal tumors. It tends to present in large or metastatic tumors, and can appear at any time in the progression of the disease. We present herein a case of NICTH in a GIST tumor and report an exon 9 mutation associated to it. A thirty nine year-old man with a recurrent, metastatic gastrointestinal stromal tumor presented to the hospital with nausea, dizziness, loss of consciousness, and profound hypoglycemia (20 mg/dL). There was no evidence of factitious hypoglycemia. He was stabilized with a continuous glucose infusion and following selective vascular embolization, the patient underwent debulking of a multicentric 40 cm × 25 cm × 10 cm gastrointestinal stromal tumor. After resection, the patient became euglycemic and returned to his normal activities. Tumor analysis confirmed excessive production of insulin-like growth factor II m-RNA and the precursor protein, 'big' insulin-like growth factor II. Mutational analysis also identified a rare, 6 bp tandem repeat insert (gcctat) at position 1530 in exon 9 of KIT. Optimal management of gastrointestinal stromal tumor-induced hypoglycemia requires a multidisciplinary approach, and surgical debulking is the treatment of choice to obtain immediate symptom relief. Imatinib or combinations of glucocorticoids and growth hormone are alternative palliative strategies for symptomatic hypoglycemia. In addition, mutations in exon 9 of the tyrosine kinase receptor KIT occur in 11–20% of GIST and are often associated with poor patient outcomes. The association of this KIT mutation with non-islet cell tumor induced hypoglycemia has yet to be established

  16. Semi-annual report on the second half of the year 1986. Activities: Accompanying planning work for the PNP R and D programme 1985/1986

    International Nuclear Information System (INIS)

    1989-01-01

    As there is high materials utilization in the heat-exchanger structures in the temperature range above 950 0 C, the temperature and velocity distribution must be equalized as far as possible. Specified inlet conditions for the helical He/He heat exchanger which in this respect puts the highest requirements, allow a temperature gradient of ΔT=+15/-30 K, and a velocity range of V=±10%. The required temperature equalization is to be achieved by suitable design measures, for equalization over the pathway from core bottom to hot gas header, through the hot gas pipe and the flow conditioning device before the heat exchanger (temperature gradient at core outlet ΔT=±120 K). Experiments have to be made at the core bottom stone and the integrating structures in order to give proof of the realisation of the required equalization. The experiments will be accompanied by theoretical investigations. (orig./GL) [de

  17. Peripheral pn production and decay angular distributions in the reaction pi /sup -/p to (pn)p at 12 GeV/c incident momentum

    CERN Document Server

    Ghidini, B; Cantore, A; Di Corato, M; Donald, R A; Eades, John; Edwards, D N; Edwards, M E; French, Bernard R; Fry, J R; Houlden, M A; Mandelli, L; Moebes, J P; Müller, K; Navach, F; Palano, A; Palazzi-Cerrina, C; Paul, E; Picciarelli, V; Renneberg, W; Rühmer, W; Smith, I; Zito, G

    1978-01-01

    The reaction pi /sup -/p to (pn)p/sub s/, where p/sub s/ is a slow proton, was measured at 12 GeV/c incident momentum with the CERN-OMEGA spectrometer. Both antiproton and proton were identified uniquely by electronics information. 1844 events with four-momentum transfer squared in the range 0.13

  18. Metal-insulator transition and superconductivity induced by Rh doping in the binary pnictides RuPn (Pn=P, As, Sb)

    Science.gov (United States)

    Hirai, Daigorou; Takayama, Tomohiro; Hashizume, Daisuke; Takagi, Hidenori

    2012-04-01

    Binary ruthenium pnictides, RuP and RuAs, with an orthorhombic MnP structure, were found to show a metal to a nonmagnetic insulator transition at TMI = 270 and 200 K, respectively. In the metallic region above TMI, a structural phase transition, accompanied with a weak anomaly in the resistivity and the magnetic susceptibility, indicative of a pseudogap formation, was identified at Ts = 330 and 280 K, respectively. These two transitions were suppressed by substituting Ru with Rh. We found superconductivity with a maximum Tc = 3.7 and 1.8 K in a narrow composition range around the critical point for the pseudogap phase, Rh content xc = 0.45 and 0.25 for Ru1-xRhxP and Ru1-xRhxAs, respectively, which may provide us with a nonmagnetic route to superconductivity at a quantum critical point.

  19. "Joint Workshop on High Confidence Medical Devices, Software, and Systems (HCMDSS) and Medical Device Plug-and-Play (MD PnP) Interoperability"

    National Research Council Canada - National Science Library

    Goldman, Julian M

    2008-01-01

    Partial support was requested from TATRC, with joint funding from NSF, for a joint workshop to bring together the synergistic efforts and communities of the High Confidence Medical Devices, Software, and Systems (HCMDSS...

  20. RELACIÓN ENTRE LOS RASGOS DE PERSONALIDAD Y NIVELES DE AGRESIVIDAD EN ALUMNOS DE LA ESCUELA TÉCNICO SUPERIOR PNP CHARCANI - AREQUIPA 2015

    OpenAIRE

    RODAS MÁLAGA, MILAGROS FRANCIS

    2016-01-01

    RASGOS DE PERSONALIDAD METAS MOTIVACIONALES MODOS COGNITIVOS COMPORTAMIENTOS INTERPERSONALES AGRESIVIDAD ORIGEN DE LA AGRESIVIDAD TEORÍAS?SOBRE?LA?AGRESIVIDAD COMPONENTES DE LA AGRESIVIDAD ANTECEDENTES INVESTIGATIVOS RESULTADOS

  1. Pulsoterapia com ciclofosfamida nos pênfigos: relato de sete casos Cyclophosphamide pulse therapy for pemphigus: report of seven cases

    OpenAIRE

    Nurimar C. Fernandes; Vanessa M. Zubaty

    2005-01-01

    A eficácia da pulsoterapia com ciclofosfamida foi avaliada no pênfigo vulgar (dois homens e quatro mulheres entre 34 e 47 anos) e em um homem de 56 anos com pênfigo foliáceo. Os critérios de inclusão para pulsoterapia foram: não controle com prednisona, efeitos colaterais importantes, recorrência da doença nas tentativas de redução da prednisona e dose de manutenção > 40mg/dia. Em um caso (cinco pulsos) a dose de manutenção da prednisona foi reduzida para 10mg; em um caso (nove pulsos), para ...

  2. Biodegradation of p-nitrophenol in an aqueous waste stream by immobilized bacteria.

    OpenAIRE

    Heitkamp, M A; Camel, V; Reuter, T J; Adams, W J

    1990-01-01

    Microbiological analyses of activated sludge reactors after repeated exposure to 100 mg of p-nitrophenol (PNP) per liter resulted in the isolation of three Pseudomonas species able to utilize PNP as a sole source of carbon and energy. Cell suspensions of the three Pseudomonas sp., designated PNP1, PNP2, and PNP3, mineralized 70, 60, and 45% of a 70-mg/liter dose of PNP in 24, 48, and 96 h, respectively. Mass-balance analyses of PNP residues for all three cultures showed that undegraded PNP wa...

  3. Toxic epidermal necrolysis and Stevens-Johnson syndrome

    Directory of Open Access Journals (Sweden)

    French Lars E

    2010-12-01

    Full Text Available Abstract Toxic epidermal necrolysis (TEN and Stevens Johnson Syndrome (SJS are severe adverse cutaneous drug reactions that predominantly involve the skin and mucous membranes. Both are rare, with TEN and SJS affecting approximately 1or 2/1,000,000 annually, and are considered medical emergencies as they are potentially fatal. They are characterized by mucocutaneous tenderness and typically hemorrhagic erosions, erythema and more or less severe epidermal detachment presenting as blisters and areas of denuded skin. Currently, TEN and SJS are considered to be two ends of a spectrum of severe epidermolytic adverse cutaneous drug reactions, differing only by their extent of skin detachment. Drugs are assumed or identified as the main cause of SJS/TEN in most cases, but Mycoplasma pneumoniae and Herpes simplex virus infections are well documented causes alongside rare cases in which the aetiology remains unknown. Several drugs are at "high" risk of inducing TEN/SJS including: Allopurinol, Trimethoprim-sulfamethoxazole and other sulfonamide-antibiotics, aminopenicillins, cephalosporins, quinolones, carbamazepine, phenytoin, phenobarbital and NSAID's of the oxicam-type. Genetic susceptibility to SJS and TEN is likely as exemplified by the strong association observed in Han Chinese between a genetic marker, the human leukocyte antigen HLA-B*1502, and SJS induced by carbamazepine. Diagnosis relies mainly on clinical signs together with the histological analysis of a skin biopsy showing typical full-thickness epidermal necrolysis due to extensive keratinocyte apoptosis. Differential diagnosis includes linear IgA dermatosis and paraneoplastic pemphigus, pemphigus vulgaris and bullous pemphigoid, acute generalized exanthematous pustulosis (AGEP, disseminated fixed bullous drug eruption and staphyloccocal scalded skin syndrome (SSSS. Due to the high risk of mortality, management of patients with SJS/TEN requires rapid diagnosis, evaluation of the prognosis

  4. Suppressive effects of long-term exposure to P-nitrophenol on gonadal development, hormonal profile with disruption of tissue integrity, and activation of caspase-3 in male Japanese quail (Coturnix japonica)

    OpenAIRE

    Ahmed, Eman; Nagaoka, Kentaro; Fayez, Mostafa; Abdel-Daim, Mohamed M.; Samir, Haney; Watanabe, Gen

    2015-01-01

    P-Nitrophenol (PNP) is considered to be one of nitrophenol derivatives of diesel exhaust particles. PNP is a major metabolite of some organophosphorus compounds. PNP is a persistent organic pollutant as well as one of endocrine-disrupting compounds. Consequently, bioaccumulation of PNP potentiates toxicity. The objectives of the current study were to assess in vivo adverse effects of long-term low doses of PNP exposure on reproductive system during development stage. Twnety-eight-day-old male...

  5. Top ten most accessed AMOR articles in 2015/2016

    Directory of Open Access Journals (Sweden)

    Editorial Office

    2016-12-01

    Full Text Available In 2015/2016, Advances in Modern Oncology Research published a total of 67 articles over eight issues in two separate volumes. These published articles, consisting of editorials, reviews, case reports, and original research, have collectively accumulated 26,320 views as of December 2016. A total of 54 authors and 160 peer-reviewers from across the globe contributed to the journal in its first full year of publication. The journal’s top ten most accessed articles are:1. Indoles as anticancer agents (Vol. 1 Issue 1 2. Pharmacometrics and systems pharmacology of immune checkpoint inhibitor nivolumab in cancer translational medicine (Vol. 2 Issue 1 3. Hepatocellular carcinoma (HCC; aetiological considerations (Vol. 1 Issue 1 4. Oligoadenylate synthetase 1 (OAS1 expression in human breast and prostate cancer cases, and its regulation by sex steroid hormones (Vol. 2 Issue 2 5. Antiproliferative effects of cembranoid derivatives obtained from Red Sea soft coral Sarcophyton glaucum on human colorectal cancer cell lines (Vol. 1 Issue 1 6. Paraneoplastic pemphigus: A trait d’union between dermatology and oncology (Vol. 1 Issue 2 7. Cancer cell metastasis; perspectives from the focal adhesion (Vol. 1 Issue 1 8. Threshold-based parametric analysis of diffusion-weighted magnetic resonance imaging at 3.0 Tesla to identify men with prostate cancer (Vol. 1 Issue 2 9. Economic burden of patients with inoperable advanced breast cancer receiving early or late capecitabine or trastuzumab as second-line treatment: A population-based study (Vol. 1 Issue 2 10. Non-coding RNAs: New therapeutic targets and opportunities for hepatocellular carcinoma (Vol. 2 Issue 1

  6. The Case of a Zebra That Was Misdiagnosed as a Horse: Pulmonary Tumor Thrombotic Microangiopathy, a New Paraneoplastic Syndrome, Mimicking PD-1-Induced Pneumonitis

    OpenAIRE

    Corey A. Carter; Robert Browning; Bryan T. Oronsky; Jan J. Scicinski; Christina Brzezniak

    2016-01-01

    A case report of a 47-year-old woman with triple-negative breast cancer on a clinical trial called PRIMETIME (NCT02518958) who received the anti-PD-1 inhibitor nivolumab and the experimental anticancer agent RRx-001 is presented. Although initially diagnosed and treated for anti-PD-1-induced pneumonitis, clinical and radiological abnormalities triggered further investigation, leading to the diagnosis of pulmonary tumor thrombotic microangiopathy (PTTM). This example highlights the importance ...

  7. Resolution of hypercalcemia of malignancy following radical cystectomy in a patient with paraneoplastic syndrome associated with urothelial carcinoma of the bladder

    Directory of Open Access Journals (Sweden)

    Alfredo Harb-De La Rosa

    2015-01-01

    Full Text Available Hypercalcemia of malignancy is a common finding associated with different types of cancers; however, its association with urothelial carcinoma of the bladder is rare. We report a case of a 69-year-old male with nonmetastatic urothelial carcinoma of the bladder who developed hypercalcemia that failed to respond to medical management, but resolved completely after undergoing resection of the tumor through radical cystectomy.

  8. Paraneoplastic ophthalmoplegia and subacute motor axonal neuropathy associated with anti-GQ1b antibodies in a patient with malignant melanoma

    NARCIS (Netherlands)

    L. Kloos; C.W. Ang (Wim); W.H.J. Kruit (Wim); G. Stoter (Gerrit); P.A.E. Sillevis Smitt (Peter)

    2003-01-01

    textabstractA 68 year old woman developed oculomotor paresis shortly after metastatic progression of her melanoma was discovered. She was then immunised with the tumour antigen MAGE-3 in combination with an immunological adjuvant. During immunisation her symptoms worsened and she

  9. Apoptolysis: a novel mechanism of skin blistering in pemphigus vulgaris linking the apoptotic pathways to basal cell shrinkage and suprabasal acantholysis

    DEFF Research Database (Denmark)

    Grando, S.A.; Bystryn, J.C.; Chernyavsky, A.I.

    2009-01-01

    of EGF receptor, Src, mTOR, p38 MAPK and other signalling elements downstream of ligated antigens, elevation of intracellular calcium and launching of the cell death cascades. (3) Basal cell shrinkage due to: (i) collapse and retraction of the tonofilaments cleaved by executioner caspases; and (ii...

  10. Facial skin follllicular hyperkeratosis of patients with basal cell carcinoma

    Directory of Open Access Journals (Sweden)

    M. V. Zhuchkov

    2016-01-01

    Full Text Available This article provides a clinical observation of paraneoplastic syndrome of a patient with basal cell carcinoma of skin. Authors present clinical features of the described for the first time, paraneoplastic retentional follicular hyperkeratosis of facial area.

  11. SwissProt search result: AK100101 [KOME

    Lifescience Database Archive (English)

    Full Text Available AK100101 J023004I20 (Q14576) ELAV-like protein 3 (Hu-antigen C) (HuC) (Paraneoplastic... cerebellar degeneration-associated antigen) (Paraneoplastic limbic encephalitis antigen 21) ELAV3_HUMAN 9e-15 ...

  12. SwissProt search result: AK100904 [KOME

    Lifescience Database Archive (English)

    Full Text Available AK100904 J023132A08 (Q14576) ELAV-like protein 3 (Hu-antigen C) (HuC) (Paraneoplastic... cerebellar degeneration-associated antigen) (Paraneoplastic limbic encephalitis antigen 21) ELAV3_HUMAN 3e-16 ...

  13. SwissProt search result: AK067260 [KOME

    Lifescience Database Archive (English)

    Full Text Available AK067260 J013096N13 (Q14576) ELAV-like protein 3 (Hu-antigen C) (HuC) (Paraneoplastic... cerebellar degeneration-associated antigen) (Paraneoplastic limbic encephalitis antigen 21) ELAV3_HUMAN 3e-15 ...

  14. SwissProt search result: AK067492 [KOME

    Lifescience Database Archive (English)

    Full Text Available AK067492 J013110L09 (Q14576) ELAV-like protein 3 (Hu-antigen C) (HuC) (Paraneoplastic... cerebellar degeneration-associated antigen) (Paraneoplastic limbic encephalitis antigen 21) ELAV3_HUMAN 1e-14 ...

  15. SwissProt search result: AK098867 [KOME

    Lifescience Database Archive (English)

    Full Text Available AK098867 J013001A12 (Q14576) ELAV-like protein 3 (Hu-antigen C) (HuC) (Paraneoplastic... cerebellar degeneration-associated antigen) (Paraneoplastic limbic encephalitis antigen 21) ELAV3_HUMAN 2e-17 ...

  16. SwissProt search result: AK070743 [KOME

    Lifescience Database Archive (English)

    Full Text Available AK070743 J023062K14 (Q14576) ELAV-like protein 3 (Hu-antigen C) (HuC) (Paraneoplastic... cerebellar degeneration-associated antigen) (Paraneoplastic limbic encephalitis antigen 21) ELAV3_HUMAN 7e-18 ...

  17. SwissProt search result: AK068720 [KOME

    Lifescience Database Archive (English)

    Full Text Available AK068720 J013169L09 (Q14576) ELAV-like protein 3 (Hu-antigen C) (HuC) (Paraneoplastic... cerebellar degeneration-associated antigen) (Paraneoplastic limbic encephalitis antigen 21) ELAV3_HUMAN 7e-14 ...

  18. SwissProt search result: AK120313 [KOME

    Lifescience Database Archive (English)

    Full Text Available AK120313 J013055L11 (Q14576) ELAV-like protein 3 (Hu-antigen C) (HuC) (Paraneoplastic... cerebellar degeneration-associated antigen) (Paraneoplastic limbic encephalitis antigen 21) ELAV3_HUMAN 5e-16 ...

  19. SwissProt search result: AK065167 [KOME

    Lifescience Database Archive (English)

    Full Text Available AK065167 J013002C13 (Q14576) ELAV-like protein 3 (Hu-antigen C) (HuC) (Paraneoplastic... cerebellar degeneration-associated antigen) (Paraneoplastic limbic encephalitis antigen 21) ELAV3_HUMAN 2e-17 ...

  20. SwissProt search result: AK070850 [KOME

    Lifescience Database Archive (English)

    Full Text Available AK070850 J023066B20 (Q14576) ELAV-like protein 3 (Hu-antigen C) (HuC) (Paraneoplastic... cerebellar degeneration-associated antigen) (Paraneoplastic limbic encephalitis antigen 21) ELAV3_HUMAN 1e-17 ...

  1. SwissProt search result: AK120437 [KOME

    Lifescience Database Archive (English)

    Full Text Available AK120437 J013098D14 (Q14576) ELAV-like protein 3 (Hu-antigen C) (HuC) (Paraneoplastic... cerebellar degeneration-associated antigen) (Paraneoplastic limbic encephalitis antigen 21) ELAV3_HUMAN 2e-13 ...

  2. SwissProt search result: AK121107 [KOME

    Lifescience Database Archive (English)

    Full Text Available AK121107 J023072J20 (Q14576) ELAV-like protein 3 (Hu-antigen C) (HuC) (Paraneoplastic... cerebellar degeneration-associated antigen) (Paraneoplastic limbic encephalitis antigen 21) ELAV3_HUMAN 1e-11 ...

  3. SwissProt search result: AK072804 [KOME

    Lifescience Database Archive (English)

    Full Text Available AK072804 J023135B10 (Q14576) ELAV-like protein 3 (Hu-antigen C) (HuC) (Paraneoplastic... cerebellar degeneration-associated antigen) (Paraneoplastic limbic encephalitis antigen 21) ELAV3_HUMAN 3e-12 ...

  4. SwissProt search result: AK120962 [KOME

    Lifescience Database Archive (English)

    Full Text Available AK120962 J023039O15 (Q14576) ELAV-like protein 3 (Hu-antigen C) (HuC) (Paraneoplastic... cerebellar degeneration-associated antigen) (Paraneoplastic limbic encephalitis antigen 21) ELAV3_HUMAN 4e-12 ...

  5. SwissProt search result: AK101214 [KOME

    Lifescience Database Archive (English)

    Full Text Available AK101214 J033031B04 (Q14576) ELAV-like protein 3 (Hu-antigen C) (HuC) (Paraneoplastic... cerebellar degeneration-associated antigen) (Paraneoplastic limbic encephalitis antigen 21) ELAV3_HUMAN 5e-18 ...

  6. SwissProt search result: AK101593 [KOME

    Lifescience Database Archive (English)

    Full Text Available AK101593 J033051E20 (Q14576) ELAV-like protein 3 (Hu-antigen C) (HuC) (Paraneoplastic... cerebellar degeneration-associated antigen) (Paraneoplastic limbic encephalitis antigen 21) ELAV3_HUMAN 3e-14 ...

  7. SwissProt search result: AK069912 [KOME

    Lifescience Database Archive (English)

    Full Text Available AK069912 J023037G11 (Q14576) ELAV-like protein 3 (Hu-antigen C) (HuC) (Paraneoplastic... cerebellar degeneration-associated antigen) (Paraneoplastic limbic encephalitis antigen 21) ELAV3_HUMAN 6e-16 ...

  8. SwissProt search result: AK099501 [KOME

    Lifescience Database Archive (English)

    Full Text Available AK099501 J013028I07 (Q14576) ELAV-like protein 3 (Hu-antigen C) (HuC) (Paraneoplastic... cerebellar degeneration-associated antigen) (Paraneoplastic limbic encephalitis antigen 21) ELAV3_HUMAN 2e-15 ...

  9. SwissProt search result: AK073225 [KOME

    Lifescience Database Archive (English)

    Full Text Available AK073225 J033023C04 (Q14576) ELAV-like protein 3 (Hu-antigen C) (HuC) (Paraneoplastic... cerebellar degeneration-associated antigen) (Paraneoplastic limbic encephalitis antigen 21) ELAV3_HUMAN 2e-15 ...

  10. SwissProt search result: AK067816 [KOME

    Lifescience Database Archive (English)

    Full Text Available AK067816 J013116F07 (Q14576) ELAV-like protein 3 (Hu-antigen C) (HuC) (Paraneoplastic... cerebellar degeneration-associated antigen) (Paraneoplastic limbic encephalitis antigen 21) ELAV3_HUMAN 1e-21 ...

  11. SwissProt search result: AK103490 [KOME

    Lifescience Database Archive (English)

    Full Text Available AK103490 J033130N07 (Q14576) ELAV-like protein 3 (Hu-antigen C) (HuC) (Paraneoplastic... cerebellar degeneration-associated antigen) (Paraneoplastic limbic encephalitis antigen 21) ELAV3_HUMAN 4e-19 ...

  12. SwissProt search result: AK067210 [KOME

    Lifescience Database Archive (English)

    Full Text Available AK067210 J013096J03 (Q14576) ELAV-like protein 3 (Hu-antigen C) (HuC) (Paraneoplastic... cerebellar degeneration-associated antigen) (Paraneoplastic limbic encephalitis antigen 21) ELAV3_HUMAN 6e-21 ...

  13. SwissProt search result: AK069121 [KOME

    Lifescience Database Archive (English)

    Full Text Available AK069121 J023007A14 (Q14576) ELAV-like protein 3 (Hu-antigen C) (HuC) (Paraneoplastic... cerebellar degeneration-associated antigen) (Paraneoplastic limbic encephalitis antigen 21) ELAV3_HUMAN 8e-17 ...

  14. SwissProt search result: AK121802 [KOME

    Lifescience Database Archive (English)

    Full Text Available AK121802 J033097J11 (Q14576) ELAV-like protein 3 (Hu-antigen C) (HuC) (Paraneoplastic... cerebellar degeneration-associated antigen) (Paraneoplastic limbic encephalitis antigen 21) ELAV3_HUMAN 2e-12 ...

  15. SwissProt search result: AK241310 [KOME

    Lifescience Database Archive (English)

    Full Text Available AK241310 J065141C01 (Q14576) ELAV-like protein 3 (Hu-antigen C) (HuC) (Paraneoplastic... cerebellar degeneration-associated antigen) (Paraneoplastic limbic encephalitis antigen 21) ELAV3_HUMAN 6e-14 ...

  16. SwissProt search result: AK067252 [KOME

    Lifescience Database Archive (English)

    Full Text Available AK067252 J013098L06 (Q14576) ELAV-like protein 3 (Hu-antigen C) (HuC) (Paraneoplastic... cerebellar degeneration-associated antigen) (Paraneoplastic limbic encephalitis antigen 21) ELAV3_HUMAN 3e-14 ...

  17. SwissProt search result: AK073796 [KOME

    Lifescience Database Archive (English)

    Full Text Available AK073796 J033067B10 (Q14576) ELAV-like protein 3 (Hu-antigen C) (HuC) (Paraneoplastic... cerebellar degeneration-associated antigen) (Paraneoplastic limbic encephalitis antigen 21) ELAV3_HUMAN 5e-17 ...

  18. SwissProt search result: AK101706 [KOME

    Lifescience Database Archive (English)

    Full Text Available AK101706 J033060I24 (Q14576) ELAV-like protein 3 (Hu-antigen C) (HuC) (Paraneoplastic... cerebellar degeneration-associated antigen) (Paraneoplastic limbic encephalitis antigen 21) ELAV3_HUMAN 1e-21 ...

  19. A cationic Ag-I(PNPtBu) species acting as PNP transfer agent: Facile synthesis of Pd(PNPtBu)(alkyl) complexes and their reactivity compared to PCPtBu analogues

    NARCIS (Netherlands)

    van der Vlugt, J.I.; Siegler, M.A.; Janssen, M.; Vogt, D.; Spek, A.L.

    2009-01-01

    The straightforward Synthesis of cationic complex 1, [Ag(PNtBu)]BF4 (PNPtBu = 1,2-bis[(di-tert-butylphosphino)methyl]pyridine), and its facile transmetalating properties toward gold and palladium are described. The corresponding Au complex [Au(PNPtBu)](2)(BF4)(2) (2) exists its a dimer in the solid

  20. A cationic Agi( PNPtBu) species acting as PNP transfer agent: facile synthesis of Pd(PNPtBu)(alkyl) complexes and their reactivity compared to PCPtBu analogues

    NARCIS (Netherlands)

    Vlugt, van der J.I.; Siegler, M.A.; Janssen, M.C.C.; Vogt, D.; Spek, A.L.

    2009-01-01

    The straightforward synthesis of cationic complex 1, [Ag(PNPtBu)]BF4 (PNPtBu = 1,2-bis[(di-tert-butylphosphino)methyl]pyridine), and its facile transmetalating properties toward gold and palladium are described. The corresponding Au complex [Au(PNPtBu)]2(BF4)2 (2) exists as a dimer in the solid

  1. Purine nucleoside phosphorylase deficiency in two unrelated Saudi patients

    International Nuclear Information System (INIS)

    Alangari, Abdullah; AlHarbi, Abdullah; AlGhonaium Abdulaziz; Santisteban, Ines; Hershfield, Michael

    2009-01-01

    Purine nucleoside phosphorylase (PNP) deficiency is a rare autosomal recessive metabolic disorder that results in combined immunodeficiency, neurologic dysfunction and autoimmunity. PNP deficiency has never been reported from Saudi Arabia or in patients with an Arabic ethnic background. We report on two Saudi girls with PNP deficiency. Both showed severe lymphopenia and neurological involvement. Sequencing of the PNP gene of one girl revealed a novel missense mutation Pro146>Leu in exon 4 due to a change in the codon from CCT>CTT. Expression of PNP (146L) cDNA in E coli indicated that the mutation greatly reduced, but did not completely eliminate PNP activity. (author)

  2. 77 FR 313 - Self-Regulatory Organizations; NYSE Arca, Inc.; Notice of Filing and Immediate Effectiveness of...

    Science.gov (United States)

    2012-01-04

    ... designated as a PNP Plus Order that remains unexecuted and would otherwise lock or cross the best protected... below (above) the Lower (Upper) Price Band, as defined in the Plan, the automatic re-pricing of PNP Plus...

  3. Performance Evaluation of Bulk Liquid Membrane Technique on p-Nitrophenol Removal from Aqueous Solution

    Directory of Open Access Journals (Sweden)

    K. Pourkhanali

    2018-03-01

    Full Text Available The transport of p-nitrophenol (PNP through a bulk liquid membrane (BLM was investigated to evaluate the effect of different experimental conditions on PNP partitioning behavior. The influence of solvent type, different salts in feed phase, the feed phase pH and PNP concentration in feed phase on transport efficiency of PNP through the BLM were studied. The results indicated that the highest removal efficiency of PNP was observed for 80 % xylene + 20 % toluene as liquid membrane, Na2SO4 as salt in feed phase, in the acidic feed phase and in 150 min. The effect of initial concentration of PNP on the efficiency of the separation PNP showed that the increase in initial concentration up to 350 ppm had positive effect, and more than 350 ppm had negative effect on the PNP removal behavior. Also, pertraction in BLM systems were described by a kinetic model of two consecutive irreversible first order chemical reactions.

  4. Purification and Properties of a Novel Thermostable Galacto-Oligosaccharide-Producing (beta)-Galactosidase from Sterigmatomyces elviae CBS8119

    OpenAIRE

    Onishi, N.; Tanaka, T.

    1996-01-01

    Volume 61, no. 11, p. 4028, column 1, line 37: "p-nitrophenyl-(beta)-d-galactopyranoside" should read "p-nitrophenyl-(beta)-d-glucopyranoside." Page 4028, column 1, line 38: "p-nitrophenyl-(beta)-l-arabinopyranoside" should read "p-nitrophenyl-(alpha)-l-arabinopyranoside." Page 4028, column 2, Table 2, last line: "PNP-(beta)-l-arabinopyranoside" should read "PNP-(alpha)-l-arabinopyranoside." Page 4028, column 2, Table 2, footnote a, line 4: "PNP-(alpha)-l-arabinopyranoside" should read "PNP-(...

  5. Characterization of para-Nitrophenol-Degrading Bacterial Communities in River Water by Using Functional Markers and Stable Isotope Probing.

    Science.gov (United States)

    Kowalczyk, Agnieszka; Eyice, Özge; Schäfer, Hendrik; Price, Oliver R; Finnegan, Christopher J; van Egmond, Roger A; Shaw, Liz J; Barrett, Glyn; Bending, Gary D

    2015-10-01

    Microbial degradation is a major determinant of the fate of pollutants in the environment. para-Nitrophenol (PNP) is an EPA-listed priority pollutant with a wide environmental distribution, but little is known about the microorganisms that degrade it in the environment. We studied the diversity of active PNP-degrading bacterial populations in river water using a novel functional marker approach coupled with [(13)C6]PNP stable isotope probing (SIP). Culturing together with culture-independent terminal restriction fragment length polymorphism analysis of 16S rRNA gene amplicons identified Pseudomonas syringae to be the major driver of PNP degradation in river water microcosms. This was confirmed by SIP-pyrosequencing of amplified 16S rRNA. Similarly, functional gene analysis showed that degradation followed the Gram-negative bacterial pathway and involved pnpA from Pseudomonas spp. However, analysis of maleylacetate reductase (encoded by mar), an enzyme common to late stages of both Gram-negative and Gram-positive bacterial PNP degradation pathways, identified a diverse assemblage of bacteria associated with PNP degradation, suggesting that mar has limited use as a specific marker of PNP biodegradation. Both the pnpA and mar genes were detected in a PNP-degrading isolate, P. syringae AKHD2, which was isolated from river water. Our results suggest that PNP-degrading cultures of Pseudomonas spp. are representative of environmental PNP-degrading populations. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

  6. Effects of the pneumoperitoneum and Trendelenburg position on respiratory mechanics in the rats by the end-inflation occlusion method

    Directory of Open Access Journals (Sweden)

    Alessandro Rubini

    2012-01-01

    Conclusion: The cranial displacement of the diaphgram occurring as a consequence of Pnp and/or Tnd, for example during laparoscopic surgical procedures, causes an increment of respiratory system elastance and viscoelastic resistance. The analysis of addictive effects show that these are more likely to occur when Pnp + Tnd are compared to isolated Tnd rather than to isolated Pnp.

  7. Genes involved in degradation of para-nitrophenol are differentially arranged in form of non-contiguous gene clusters in Burkholderia sp. strain SJ98.

    Directory of Open Access Journals (Sweden)

    Surendra Vikram

    Full Text Available Biodegradation of para-Nitrophenol (PNP proceeds via two distinct pathways, having 1,2,3-benzenetriol (BT and hydroquinone (HQ as their respective terminal aromatic intermediates. Genes involved in these pathways have already been studied in different PNP degrading bacteria. Burkholderia sp. strain SJ98 degrades PNP via both the pathways. Earlier, we have sequenced and analyzed a ~41 kb fragment from the genomic library of strain SJ98. This DNA fragment was found to harbor all the lower pathway genes; however, genes responsible for the initial transformation of PNP could not be identified within this fragment. Now, we have sequenced and annotated the whole genome of strain SJ98 and found two ORFs (viz., pnpA and pnpB showing maximum identity at amino acid level with p-nitrophenol 4-monooxygenase (PnpM and p-benzoquinone reductase (BqR. Unlike the other PNP gene clusters reported earlier in different bacteria, these two ORFs in SJ98 genome are physically separated from the other genes of PNP degradation pathway. In order to ascertain the identity of ORFs pnpA and pnpB, we have performed in-vitro assays using recombinant proteins heterologously expressed and purified to homogeneity. Purified PnpA was found to be a functional PnpM and transformed PNP into benzoquinone (BQ, while PnpB was found to be a functional BqR which catalyzed the transformation of BQ into hydroquinone (HQ. Noticeably, PnpM from strain SJ98 could also transform a number of PNP analogues. Based on the above observations, we propose that the genes for PNP degradation in strain SJ98 are arranged differentially in form of non-contiguous gene clusters. This is the first report for such arrangement for gene clusters involved in PNP degradation. Therefore, we propose that PNP degradation in strain SJ98 could be an important model system for further studies on differential evolution of PNP degradation functions.

  8. Plant natriuretic peptides are apoplastic and paracrine stress response molecules

    KAUST Repository

    Wang, Yuhua

    2011-04-07

    Higher plants contain biologically active proteins that are recognized by antibodies against human atrial natriuretic peptide (ANP). We identified and isolated two Arabidopsis thaliana immunoreactive plant natriuretic peptide (PNP)-encoding genes, AtPNP-A and AtPNP-B, which are distantly related members of the expansin superfamily and have a role in the regulation of homeostasis in abiotic and biotic stresses, and have shown that AtPNP-A modulates the effects of ABA on stomata. Arabidopsis PNP (PNP-A) is mainly expressed in leaf mesophyll cells, and in protoplast assays we demonstrate that it is secreted using AtPNP-A:green fluorescent protein (GFP) reporter constructs and flow cytometry. Transient reporter assays provide evidence that AtPNP-A expression is enhanced by heat, osmotica and salt, and that AtPNP-A itself can enhance its own expression, thereby generating a response signature diagnostic for paracrine action and potentially also autocrine effects. Expression of native AtPNP-A is enhanced by osmotica and transiently by salt. Although AtPNP-A expression is induced by salt and osmotica, ABA does not significantly modulate AtPNP-A levels nor does recombinant AtPNP-A affect reporter expression of the ABA-responsive RD29A gene. Together, these results provide experimental evidence that AtPNP-A is stress responsive, secreted into the apoplastic space and can enhance its own expression. Furthermore, our findings support the idea that AtPNP-A, together with ABA, is an important component in complex plant stress responses and that, much like in animals, peptide signaling molecules can create diverse and modular signals essential for growth, development and defense under rapidly changing environmental conditions. © 2011 The Author.

  9. Cytotoxicity and cellular uptake of tri-block copolymer nanoparticles with different size and surface characteristics

    Directory of Open Access Journals (Sweden)

    Bhattacharjee Sourav

    2012-04-01

    Full Text Available Abstract Background Polymer nanoparticles (PNP are becoming increasingly important in nanomedicine and food-based applications. Size and surface characteristics are often considered to be important factors in the cellular interactions of these PNP, although systematic investigations on the role of surface properties on cellular interactions and toxicity of PNP are scarce. Results Fluorescent, monodisperse tri-block copolymer nanoparticles with different sizes (45 and 90 nm and surface charges (positive and negative were synthesized, characterized and studied for uptake and cytotoxicity in NR8383 and Caco-2 cells. All types of PNP were taken up by the cells. The positive smaller PNP45 (45 nm showed a higher cytotoxicity compared to the positive bigger PNP90 (90 nm particles including reduction in mitochondrial membrane potential (ΔΨm, induction of reactive oxygen species (ROS production, ATP depletion and TNF-α release. The negative PNP did not show any cytotoxic effect. Reduction in mitochondrial membrane potential (ΔΨm, uncoupling of the electron transfer chain in mitochondria and the resulting ATP depletion, induction of ROS and oxidative stress may all play a role in the possible mode of action for the cytotoxicity of these PNP. The role of receptor-mediated endocytosis in the intracellular uptake of different PNP was studied by confocal laser scanning microscopy (CLSM. Involvement of size and charge in the cellular uptake of PNP by clathrin (for positive PNP, caveolin (for negative PNP and mannose receptors (for hydroxylated PNP were found with smaller PNP45 showing stronger interactions with the receptors than bigger PNP90. Conclusions The size and surface characteristics of polymer nanoparticles (PNP; 45 and 90 nm with different surface charges play a crucial role in cellular uptake. Specific interactions with cell membrane-bound receptors (clathrin, caveolin and mannose leading to cellular internalization were observed to depend on

  10. Catarata subcapsular posterior em pacientes com pênfigo e penfigóide tratados com corticoterapia oral Posterior subcapsular cataract in patients with pemphigus and pemphigoid using oral corticosteroid

    Directory of Open Access Journals (Sweden)

    Viviane Reggiani

    2004-10-01

    Full Text Available FUNDAMENTO: O tratamento mais utilizado para pacientes com dermatoses bolhosas crônicas é a corticoterapia oral, muitas vezes em altas doses e por períodos prolongados. Como efeitos colaterais dessa terapêutica, freqüentemente ocorrem: hipertensão arterial, diabete, osteoporose, infecções e distúrbios hidroeletrolíticos. A catarata subcapsular posterior é raramente citada na literatura como efeito colateral da corticoterapia em pacientes com doenças bolhosas. OBJETIVO: Avaliar a prevalência de catarata subcapsular posterior como efeito colateral da corticoterapia oral. MÉTODOS: Trata-se de um estudo retrospectivo incluindo 49 pacientes com dermatoses bolhosas crônicas em uso de corticoterapia acompanhados entre janeiro de 1987 e dezembro de 1997 no ambulatório de Dermatoses Bolhosas do Departamento de Dermatologia da Unifesp/EPM e regularmente submetidos à avaliação oftalmológica em busca de catarata cortisônica. RESULTADOS: No período de 1987 a 1997, 49 pacientes foram avaliados, tendo apresentado prevalência de catarata subcapsular posterior como efeito colateral da corticoterapia oral de 28,57%. CONCLUSÕES: 1 a prevalência de catarata foi de 28,57%; 2 o tempo médio de tratamento até o surgimento de catarata foi de 45,71 meses; 3 a média da dose máxima de corticosteróide utilizada pelos pacientes foi de 78,57mg/dia.BACKGROUND: Oral corticosteroid is the treatment most used for patients with chronic bullous dermatosis, often at high dosages and over long periods of time. Arterial hypertension, diabetes, osteoporosis, infections and hydro-electrolytic disturbances frequently occur as side effects of this therapy. Posterior subcapsular cataract is rarely mentioned in the literature as a side effect of corticosteroid in patients with bullous diseases. OBJECTIVES: To evaluate the incidence of posterior subcapsular cataract as a side effect of oral corticosteroid. METHODS: A retrospective study: 49 patients with chronic bullous diseases using a corticosteroid were followed-up from 1987 to 1997 at the Bullous Dermatosis Outpatient Care Unit of the Department of Dermatology, UNIFESP - EPM. The patients were regularly submitted to ophthalmologic evaluation in search for cortisone cataract. This evaluation was carried out at the beginning of the treatment and regularly during the use of the corticosteroid. RESULTS: From 1987 to 1997, the incidence of posterior subcapsular cataract as a side effect of oral corticosteroid was 28.57% in these patients. CONCLUSIONS: 1 among 49 patients, 14 (28.57% presented with cortisone cataract. 2 the period of time of prednisone use up to the appearance of cataract varied from eight months to nine years and three months (average 45.71 months. 3 the maximum dose of oral corticosteroid required for the management of the clinical picture ranged from 60 to 120 mg daily (average of 78.57 mg daily.

  11. Evaluation of the potential of soil remediation by direct multi-channel pulsed corona discharge in soil.

    Science.gov (United States)

    Wang, Tie Cheng; Qu, Guangzhou; Li, Jie; Liang, Dongli

    2014-01-15

    A novel approach, named multi-channel pulsed corona discharge in soil, was developed for remediating organic pollutants contaminated soil, with p-nitrophenol (PNP) as the model pollutant. The feasibility of PNP degradation in soil was explored by evaluating effects of pulse discharge voltage, air flow rate and soil moisture on PNP degradation. Based on roles of chemically active species and evolution of degradation intermediates, PNP degradation processes were discussed. Experimental results showed that about 89.4% of PNP was smoothly degraded within 60min of discharge treatment at pulse discharge voltage 27kV, soil moisture 5% and air flow rate 0.8Lmin(-1), and the degradation process fitted the first-order kinetic model. Increasing pulse discharge voltage was found to be favorable for PNP degradation, but not for energy yield. There existed appropriate air flow rate and soil moisture for obtaining gratifying PNP degradation efficacy. Roles of radical scavenger and measurement of active species suggested that ozone, H2O2, and OH radicals played very important roles in PNP degradation. CN bond in PNP molecule was cleaved, and the main intermediate products such as hydroquinone, benzoquinone, catechol, phenol, acetic acid, formic acid, oxalic acid, NO2(-) and NO3(-) were identified. Possible pathway of PNP degradation in soil in such a system was proposed. Copyright © 2013 Elsevier B.V. All rights reserved.

  12. Plant natriuretic peptides: Systemic regulators of plant homeostasis and defense that can affect cardiomyoblasts

    KAUST Repository

    Gehring, Christoph A.

    2010-09-01

    Immunologic evidence has suggested the presence of biologically active natriuretic peptide (NPs) hormones in plants because antiatrial NP antibodies affinity purify biologically active plant NPs (PNP). In the model plant, an Arabidopsis thaliana PNP (AtPNP-A) has been identified and characterized. AtPNP-A belongs to a novel class of molecules that share some similarity with the cell wall loosening expansins but do not contain the carbohydrate-binding wall anchor thus suggesting that PNPs and atrial natriuretic peptides are heterologs. AtPNP-A acts systemically, and this is consistent with its localization in the apoplastic extracellular space and the conductive tissue. Furthermore, AtPNP-A signals via the second messenger cyclic guanosine 3′,5′-monophosphate and modulates ion and water transport and homeostasis. It also plays a critical role in host defense against pathogens. AtPNP-A can be classified as novel paracrine plant hormone because it is secreted into the apoplastic space in response to stress and can enhance its own expression. Interestingly, purified recombinant PNP induces apo-ptosis in a dose-dependent manner and was most effective on cardiac myoblast cell lines. Because PNP is mimicking the effect of ANP in some instances, PNP may prove to provide useful leads for development of novel therapeutic NPs. Copyright © 2013 by The American Federation for Medical Research.

  13. Supplemental dietary phytosterin protects against 4-nitrophenol-induced oxidative stress and apoptosis in rat testes

    Directory of Open Access Journals (Sweden)

    Yonghui Zhang

    2015-01-01

    Full Text Available 4-Nitrophenol (PNP, is generally regarded as an environmental endocrine disruptor (EED. Phytosterin (PS, a new feed additive, possesses highly efficient antioxidant activities. The transcription factor, nuclear factor-erythroid 2-related factor 2 (Nrf2, is an important regulator of cellular oxidative stress. Using rats, this study examined PNP-induced testicular oxidative damage and PS-mediated protection against that damage. The generation of MDA and H2O2 upon PNP and PS treatment was milder than that upon treatment with PNP alone. This mitigation was accompanied by partially reversed changes in SOD, CAT, GSH and GSH-Px. Moreover, PNP significantly reduced the caudal epididymal sperm counts and serum testosterone levels. Typical morphological changes were also observed in the testes of PNP-treated animals. PNP reduced the transcriptional level of Nrf2, as evaluated by RT-PCR, but it promoted the dissociation from the Nrf2 complex, stabilization and translocation into the nucleus, as evaluated by immunohistochemistry and Western blotting. In addition, PNP enhanced the Nrf2-dependent gene expression of heme oxygenase-1 (HO-1 and glutamate–cysteine ligase catalytic subunit (GCLC. These results suggest that the Nrf2 pathway plays an important role in PNP-induced oxidative damage and that PS possesses modulatory effects on PNP-induced oxidative damage in rat testes.

  14. Plant natriuretic peptides: Systemic regulators of plant homeostasis and defense that can affect cardiomyoblasts

    KAUST Repository

    Gehring, Christoph A; Irving, Helen R.

    2010-01-01

    Immunologic evidence has suggested the presence of biologically active natriuretic peptide (NPs) hormones in plants because antiatrial NP antibodies affinity purify biologically active plant NPs (PNP). In the model plant, an Arabidopsis thaliana PNP (AtPNP-A) has been identified and characterized. AtPNP-A belongs to a novel class of molecules that share some similarity with the cell wall loosening expansins but do not contain the carbohydrate-binding wall anchor thus suggesting that PNPs and atrial natriuretic peptides are heterologs. AtPNP-A acts systemically, and this is consistent with its localization in the apoplastic extracellular space and the conductive tissue. Furthermore, AtPNP-A signals via the second messenger cyclic guanosine 3′,5′-monophosphate and modulates ion and water transport and homeostasis. It also plays a critical role in host defense against pathogens. AtPNP-A can be classified as novel paracrine plant hormone because it is secreted into the apoplastic space in response to stress and can enhance its own expression. Interestingly, purified recombinant PNP induces apo-ptosis in a dose-dependent manner and was most effective on cardiac myoblast cell lines. Because PNP is mimicking the effect of ANP in some instances, PNP may prove to provide useful leads for development of novel therapeutic NPs. Copyright © 2013 by The American Federation for Medical Research.

  15. Autoantibodies in Senear-Usher Syndrome: Cross-Reactivity or Multiple Autoimmunity?

    Directory of Open Access Journals (Sweden)

    María Elena Pérez-Pérez

    2012-01-01

    Full Text Available Senear-Usher syndrome or pemphigus erythematosus is a pathology that overlaps clinically and serologically with pemphigus foliaceus and lupus erythematosus. Skin biopsies of patients with pemphigus erythematosus reveal acantholysis and deposits of immunoglobulins in desmosomes, and they are positive in the lupus band test. In the present paper, we determined whether the autoantibodies associated with pemphigus erythematosus targeted a single antigen or multiple antigens as a result of the stimulation of independent B cell clones. Our present paper demonstrates that patients with pemphigus erythematosus produce both antiepithelial antibodies specific for desmoglein 1 and 3 and antinuclear antibodies specific for Ro, La, Sm, and double-stranded DNA antigens. After eluting specific anti-epithelial or anti-nuclear antibodies, which were recovered and tested using double-fluorescence assays, a lack of cross-reactivity was demonstrated between desmosomes and nuclear and cytoplasmic lupus antigens. This result suggests that autoantibodies in pemphigus erythematosus are directed against different antigens and that these autoantibodies are produced by independent clones. Given these clinical and serological data, we suggest that pemphigus erythematosus behaves as a multiple autoimmune disease.

  16. The plant natriuretic peptide receptor is a guanylyl cyclase and enables cGMP-dependent signaling

    KAUST Repository

    Turek, Ilona

    2016-03-05

    The functional homologues of vertebrate natriuretic peptides (NPs), the plant natriuretic peptides (PNPs), are a novel class of peptidic hormones that signal via guanosine 3′,5′-cyclic monophosphate (cGMP) and systemically affect plant salt and water balance and responses to biotrophic plant pathogens. Although there is increasing understanding of the complex roles of PNPs in plant responses at the systems level, little is known about the underlying signaling mechanisms. Here we report isolation and identification of a novel Leucine-Rich Repeat (LRR) protein that directly interacts with A. thaliana PNP, AtPNP-A. In vitro binding studies revealed that the Arabidopsis AtPNP-A binds specifically to the LRR protein, termed AtPNP-R1, and the active region of AtPNP-A is sufficient for the interaction to occur. Importantly, the cytosolic part of the AtPNP-R1, much like in some vertebrate NP receptors, harbors a catalytic center diagnostic for guanylyl cyclases and the recombinant AtPNP-R1 is capable of catalyzing the conversion of guanosine triphosphate to cGMP. In addition, we show that AtPNP-A causes rapid increases of cGMP levels in wild type (WT) leaf tissue while this response is significantly reduced in the atpnp-r1 mutants. AtPNP-A also causes cGMP-dependent net water uptake into WT protoplasts, and hence volume increases, whereas responses of the protoplasts from the receptor mutant are impaired. Taken together, our results suggest that the identified LRR protein is an AtPNP-A receptor essential for the PNP-dependent regulation of ion and water homeostasis in plants and that PNP- and vertebrate NP-receptors and their signaling mechanisms share surprising similarities. © 2016 Springer Science+Business Media Dordrecht

  17. A Mononuclear Fe(III) Single Molecule Magnet with a 3/2↔5/2 Spin Crossover

    DEFF Research Database (Denmark)

    Mossin, Susanne L.; Tran, Ba L.; Adhikari, Debashis

    2012-01-01

    The air stable complex [(PNP)FeCl2] (1) (PNP = N[2-P(CHMe2)2-4-methylphenyl]2–), prepared from one-electron oxidation of [(PNP)FeCl] with ClCPh3, displays an unexpected S = 3/2 to S = 5/2 transition above 80 K as inferred by the dc SQUID magnetic susceptibility measurement. The ac SQUID magnetiza...

  18. The effect of phytosterol protects rats against 4-nitrophenol-induced liver damage.

    Science.gov (United States)

    Chen, Jiaqin; Song, Meiyan; Li, Yansen; Zhang, Yonghui; Taya, Kazuyoshi; Li, ChunMei

    2016-01-01

    We investigated the effect of phytosterol (PS) in regard to liver damage induced by 4-nitrophenol (PNP). Twenty rats were randomly divided into four groups (Control, PS, PNP, and PNP+PS). The PS and PNP+PS groups were pretreated with PS for one week. The PNP and PNP+PS groups were injected subcutaneously with PNP for 28 days. The control group received a basal diet and was injected with vehicle alone. Treatment with PS prevented the elevation of the total bilirubin levels, as well as an increase in serum alkaline transaminase and aspartate transaminase, which are typically caused by PNP-induced liver damage. Histopathologically showed that liver damage was significantly mitigated by PS treatment. However, there was no significant change in antioxidant enzyme activities, and the Nrf2-antioxidant system was not activated after treatment with PS. These results suggest that PS could mitigate liver damage induced by PNP, but does not enhance antioxidant capacity. Copyright © 2015 Elsevier B.V. All rights reserved.

  19. Polymeric Nanoparticles Containing Taxanes Enhance Chemoradiotherapeutic Efficacy in Non-small Cell Lung Cancer

    International Nuclear Information System (INIS)

    Jung, Joohee; Park, Sung-Jin; Chung, Hye Kyung; Kang, Hye-Won; Lee, Sa-Won; Seo, Min Hyo; Park, Heon Joo; Song, Si Yeol; Jeong, Seong-Yun; Choi, Eun Kyung

    2012-01-01

    Purpose: To reduce the side effects and improve the efficacy of chemoradiation therapy, taxanes were incorporated into polymeric nanoparticles (PNP), and their synergic effect on radiation therapy in non-small cell lung cancer was evaluated. Methods and Materials: The properties of PNP-taxanes were characterized by transmission electron microscopy and dynamic light scattering. The chemoradiotherapeutic efficacy of PNP-taxanes was determined by clonogenic assay, cellular morphology, and flow cytometry in A549 cells. In mice bearing A549-derived tumors, the tumor growth delay was examined after the treatment of PNP-taxanes and/or ionizing radiation (IR). Results: The PNP-taxanes were found to be approximately 45 nm in average diameter and to have high solubility in water. They showed the properties of active internalization into cells and preserved the anticancer effect of free taxanes. The survival fraction of A549 cells by clonogenic assay was significantly reduced in the group receiving combined treatment of PNP-taxanes and IR. In addition, in vivo radiotherapeutic efficacy was markedly enhanced by the intravenous injection of PNP-taxanes into the xenograft mice. Conclusions: We have demonstrated the feasibility of PNP-taxanes to enhance the efficacy of chemoradiation therapy. These results suggest PNP-taxanes can hold an invaluable and promising position in treating human cancers as a novel and effective chemoradiation therapy agent.

  20. Modular Open Network ARCHitecture (MONARCH): Transitioning plug-and-play to aerospace

    Science.gov (United States)

    Martin, M.; Lyke, J.

    The Air Force Research Laboratory (AFRL) developed an initial plug-and-play (PnP) capability for spacecraft, similar to USB on personal computers, which better defines hardware and software interfaces and incorporates self-discovery and auto-configuration in order to simplify spacecraft development and reduce cost and schedule. PnP technology was matured through a suborbital PnP flight experiment in September 2007 and a secondary Spacecraft Avionics Experiment (SAE) payload on the TacSat-3 satellite, which launched in May 2009. AFRL developed and submitted a complete set of PnP standards through the American Institute of Aeronautics and Astronautics (AIAA) in 2011. Space electronics to adapt existing satellite components and implement full PnP on satellites in accordance with these AFRL standards was independently developed in alternate hardware implementations by Goodrich Corp under AFRL and by Northrop Grumman under Operationally Responsive Space (ORS). In 2011, AFRL conducted a cost-benefit analysis of PnP and assembled a collaborative review board (CRB) in Sept 2011 to evaluate PnP. This CRB was comprised of representatives from Space and Missiles Center (SMC), National Reconnaissance Organization (NRO), Naval Research Laboratory (NRL), John Hopkins University (JHU) Applied Physics Laboratory (APL), The Aerospace Corporation, and several large commercial and DOD satellite developers. This CRB laid out a transition path to develop and implement PnP standards for implementation in large (> 1000 kg) DOD and commercial satellites. Transition of PnP technology into operational systems continues in PnP architecture studies for SMC, PnP products from multiple space industry vendors, commercial implementations of PnP, and the Northrop Grumman ORS-2 spacecraft currently project to fly in 2014-2015. This paper provides details related to development of PnP technology, AFRL's cost-benefit analysis of PnP, recommendations of the PnP CRB, and on-going efforts to mature - nd

  1. Estrogenic and anti-androgenic activities of 4-nitrophenol in diesel exhaust particles

    International Nuclear Information System (INIS)

    Li Chunmei; Taneda, Shinji; Suzuki, Akira K.; Furuta, Chie; Watanabe, Gen; Taya, Kazuyoshi

    2006-01-01

    A 4-nitrophenol (PNP) isolated from diesel exhaust particles (DEP) has been identified as a vasodilator. PNP is also a known degradation product of the insecticide parathion. We used uterotrophic and Hershberger assays to study the estrogenic and anti-androgenic activities of PNP in-vivo. In ovariectomized immature female rats injected subcutaneously with 1, 10, or 100 mg/kg PNP daily for 7 days, significant (P < 0.05) increases in uterine weight were seen in only those receiving 10 or 100 mg/kg PNP. Furthermore, in castrated immature male rats implanted with a silastic tube (length, 5 mm) containing crystalline testosterone and injected subcutaneously with 0.01, 0.1, or 1 mg/kg PNP daily for 5 days, those receiving the doses of 0.1 mg/kg showed significant (P < 0.05) weight decreases in seminal vesicles, ventral prostate, levator ani plus bulbocavernosus muscles, and glans penis. Plasma FSH and LH levels did not change in female rats but were significantly (P < 0.05) increased in male rats treated with 0.1 mg/kg PNP. These results clearly demonstrated that PNP has estrogenic and anti-androgenic activities in-vivo. Our results therefore suggest that diesel exhaust emissions and the degradation of parathion can lead to accumulation of PNP in air, water, and soil and thus could have serious deleterious effects on wildlife and human health

  2. Motor neuron disease associated with carcinoma | Gritzman | South ...

    African Journals Online (AJOL)

    Paraneoplastic complications are obscure and difficult to understand. The association of motor neuron disease and carcinoma may sometimes be more than coincidental, and 2 cases are described. One patient had motor neuron disease, limbic encephalitis (a recognized paraneoplastic disorder) and carcinoma of the ...

  3. SwissProt search result: AK104489 [KOME

    Lifescience Database Archive (English)

    Full Text Available AK104489 006-302-B08 (Q14576) ELAV-like protein 3 (Hu-antigen C) (HuC) (Paraneoplastic... cerebellar degeneration-associated antigen) (Paraneoplastic limbic encephalitis antigen 21) ELAV3_HUMAN 3e-14 ...

  4. SwissProt search result: AK104715 [KOME

    Lifescience Database Archive (English)

    Full Text Available AK104715 001-038-A04 (Q14576) ELAV-like protein 3 (Hu-antigen C) (HuC) (Paraneoplastic... cerebellar degeneration-associated antigen) (Paraneoplastic limbic encephalitis antigen 21) ELAV3_HUMAN 1e-14 ...

  5. SwissProt search result: AK060161 [KOME

    Lifescience Database Archive (English)

    Full Text Available AK060161 006-310-H10 (Q14576) ELAV-like protein 3 (Hu-antigen C) (HuC) (Paraneoplastic... cerebellar degeneration-associated antigen) (Paraneoplastic limbic encephalitis antigen 21) ELAV3_HUMAN 1e-13 ...

  6. UniProt search blastx result: AK287732 [KOME

    Lifescience Database Archive (English)

    Full Text Available AK287732 J065141C01 Q14576|ELAV3_HUMAN ELAV-like protein 3 (Hu-antigen C) (HuC) (Paraneoplastic... cerebellar degeneration-associated antigen) (Paraneoplastic limbic encephalitis antigen 21) - Homo sapiens (Human) 2.00E-13 ...

  7. SwissProt search result: AK061041 [KOME

    Lifescience Database Archive (English)

    Full Text Available AK061041 006-205-D04 (Q14576) ELAV-like protein 3 (Hu-antigen C) (HuC) (Paraneoplastic... cerebellar degeneration-associated antigen) (Paraneoplastic limbic encephalitis antigen 21) ELAV3_HUMAN 3e-11 ...

  8. UniProt search blastx result: AK288879 [KOME

    Lifescience Database Archive (English)

    Full Text Available AK288879 J090079C21 Q14576|ELAV3_HUMAN ELAV-like protein 3 (Hu-antigen C) (HuC) (Paraneoplastic... cerebellar degeneration-associated antigen) (Paraneoplastic limbic encephalitis antigen 21) - Homo sapiens (Human) 2.00E-15 ...

  9. SwissProt search result: AK061072 [KOME

    Lifescience Database Archive (English)

    Full Text Available AK061072 006-206-D01 (Q14576) ELAV-like protein 3 (Hu-antigen C) (HuC) (Paraneoplastic... cerebellar degeneration-associated antigen) (Paraneoplastic limbic encephalitis antigen 21) ELAV3_HUMAN 6e-15 ...

  10. SwissProt search result: AK108879 [KOME

    Lifescience Database Archive (English)

    Full Text Available AK108879 002-152-D05 (Q14576) ELAV-like protein 3 (Hu-antigen C) (HuC) (Paraneoplastic... cerebellar degeneration-associated antigen) (Paraneoplastic limbic encephalitis antigen 21) ELAV3_HUMAN 5e-21 ...

  11. SwissProt search result: AK060597 [KOME

    Lifescience Database Archive (English)

    Full Text Available AK060597 001-024-G08 (Q14576) ELAV-like protein 3 (Hu-antigen C) (HuC) (Paraneoplastic... cerebellar degeneration-associated antigen) (Paraneoplastic limbic encephalitis antigen 21) ELAV3_HUMAN 2e-15 ...

  12. SwissProt search result: AK060178 [KOME

    Lifescience Database Archive (English)

    Full Text Available AK060178 001-001-A05 (Q14576) ELAV-like protein 3 (Hu-antigen C) (HuC) (Paraneoplastic... cerebellar degeneration-associated antigen) (Paraneoplastic limbic encephalitis antigen 21) ELAV3_HUMAN 7e-15 ...

  13. CORRELACIÓN ENTRE EL USO DE REDES SOCIALES VIRTUALES Y EL DESARROLLO DE LAS HABILIDADES SOCIALES EN LOS ESTUDIANTES DEL V CICLO DEL NIVEL PRIMARIO DE LAS INSTITUCIONES EDUCATIVAS PNP NEPTALÍ VALDERRAMA AMPUERO, FAP. RAÚL LEGUÍA DRAGO Y EL EJÉRCITO. AREQUIPA, 2014

    OpenAIRE

    BARRA PINTO, PAMELA ROCÍO

    2016-01-01

    LA COMUNICACIÓN LAS REDES SOCIALES VIRTUALES CARACTERÍSTICAS DE LA COMUNICACIÓN VIRTUAL TIPOS DE REDES SOCIALES VIRTUALES USO DE LAS REDES SOCIALES: FRECUENCIA CONTROL DE UNA PERSONA ADULTA DURANTE EL USO DE LAS REDES SOCIALES EL IMPACTO DE LAS REDES SOCIALES EN LA COMUNICACIÓN E INTERACCION SOCIAL LAS HABILIDADES SOCIALES TIPOS DE HABILIDADES SOCIALES VENTAJAS Y DESVENTAJAS DEL DESARROLLO DE LAS HABILIDADES SOCIALES TEORÍAS DE LAS HABILIDADES SOCIALES IMPACTO DEL USO DE LA REDES SOCIALES VIR...

  14. What Is Alopecia Areata?

    Science.gov (United States)

    ... Bullosa Lichen Sclerosus Pachyonychia Congenita Pemphigus Psoriasis Raynaud’s Phenomenon Rosacea Vitiligo All Diseases and Conditions Kids Pages ... a role. This does not mean that your child will inherit the disease. In fact, this probably ...

  15. Pachyonychia Congenita

    Science.gov (United States)

    ... Bullosa Lichen Sclerosus Pachyonychia Congenita Pemphigus Psoriasis Raynaud’s Phenomenon Rosacea Vitiligo All Diseases and Conditions Kids Pages ... on the soles of the feet when a child begins to walk. In some cases, blisters and ...

  16. Synthesis and application of iron and zinc doped biochar for removal of p-nitrophenol in wastewater and assessment of the influence of co-existed Pb(II)

    International Nuclear Information System (INIS)

    Wang, Pei; Tang, Lin; Wei, Xue; Zeng, Guangming; Zhou, Yaoyu; Deng, Yaocheng; Wang, Jingjing; Xie, Zhihong; Fang, Wei

    2017-01-01

    Highlights: • Iron and zinc doped biochar was developed with larger specific surface area, new generated hydroxyl groups, and beneficial magnetism compared with pristine biochar. • Fe/Zn-biochar presented good performance both for PNP and Pb(II) adsorption as well as their simultaneous removal. • Mechanism of the enhanced adsorption for low concentrations of co-existing PNP and Pb(II) was proposed. - Abstract: The modification of biochar as a low-cost adsorbent is essential to improve its surface properties and shows great potential in water decontamination. The iron and zinc doped sawdust biochar (Fe/Zn-biochar) with large apparent surface area (518.54 m 2 /g) proposed in this work showed good performance for p-nitrophenol (PNP) removal compared with the pristine biochar (P-biochar), iron doped biochar (Fe-biochar) and zinc doped biochar (Zn-biochar) respectively. The batch experiments turned out that Fe/Zn-biochar exhibited larger PNP adsorption capacity under acidic pH solution, and the ionic strength had slightly negative impact on PNP adsorption. The adsorption kinetics and isotherms were discussed, and the experimental data fitted well the Pseudo-second-order equation and Langmuir model. The thermodynamic study indicated that the PNP adsorption was a spontaneous endothermic process. Furthermore, the simultaneous removal for PNP and Pb(II) by Fe/Zn-biochar was investigated. It implied that the adsorption of PNP and Pb(II) at their low concentration might be enhanced by the complexing-bridging mechanism of PNP and Pb(II) ascribing to the affinity between PNP and hydrophobic sites, in addition to the affinity between Pb(II) and oxygen-containing hydrophilic sites on Fe/Zn-biochar surface. However, the predominated competition between PNP and Pb(II) at their high concentrations with Fe/Zn-biochar suppressed their adsorption.

  17. Removal of high concentration p-nitrophenol in aqueous solution by zero valent iron with ultrasonic irradiation (US–ZVI)

    International Nuclear Information System (INIS)

    Lai, Bo; Chen, Zhaoyu; Zhou, Yuexi; Yang, Ping; Wang, Juling; Chen, Zhiqiang

    2013-01-01

    Highlights: ► High concentration PNP can be reduced into the nontoxic p-aminophenol by US–ZVI. ► High removal efficiency of PNP is resulted from the synergistic reaction of ZVI and US. ► The reaction pathway of PNP in the US–ZVI system is proposed. ► Processing parameters of the US–ZVI system were optimized seriously. -- Abstract: In this study, the US–ZVI system was used to produce the strong reductants including ·H and nascent Fe 2+ ions to eliminate the toxicity of the high concentration p-nitrophenol (PNP) wastewater. The effect of the reactor structure, initial pH, ZVI dosage, ultrasonic power and initial PNP concentration on the removal efficiency of PNP from water was investigated intensively. The results show that a higher removal rate can be obtained by using a conical structure reactor, and the lower initial pH can aid the acceleration of PNP removal rate by using US–ZVI system. Furthermore, the removal efficiencies of PNP increased obviously with the increase of initial ZVI concentration from 0 to 15 g L −1 . Also, the treatment capacity of ZVI was enhanced remarkably by the ultrasonic irradiation, and the US–ZVI system can maintain high treatment efficiency for the high concentration PNP wastewater (500–10,000 mg L −1 ). Meanwhile, the high removal efficiency of PNP was mainly resulted from the synergistic reaction of ZVI and US. At last, the main degradation product (i.e., p-aminophenol) was detected by gas chromatography–mass spectrum (GC–MS). Thus, the reaction pathway of PNP in the US–ZVI system is proposed as a reducing process by the ·H and nascent Fe 2+ ions

  18. Removal of high concentration p-nitrophenol in aqueous solution by zero valent iron with ultrasonic irradiation (US–ZVI)

    Energy Technology Data Exchange (ETDEWEB)

    Lai, Bo, E-mail: laibo1981@163.com [School of Architecture and Environment, Sichuan University, Chengdu 610065 (China); Chen, Zhaoyu [School of Architecture and Environment, Sichuan University, Chengdu 610065 (China); Zhou, Yuexi [Research Center of Water Pollution Control Technology, Chinese Research Academy of Environmental Sciences, Beijing 100012 (China); Yang, Ping [School of Architecture and Environment, Sichuan University, Chengdu 610065 (China); Wang, Juling [Research Center of Water Pollution Control Technology, Chinese Research Academy of Environmental Sciences, Beijing 100012 (China); Chen, Zhiqiang [State Key Laboratory of Urban Water Resource and Environment, Harbin Institute of Technology, Harbin 150090 (China)

    2013-04-15

    Highlights: ► High concentration PNP can be reduced into the nontoxic p-aminophenol by US–ZVI. ► High removal efficiency of PNP is resulted from the synergistic reaction of ZVI and US. ► The reaction pathway of PNP in the US–ZVI system is proposed. ► Processing parameters of the US–ZVI system were optimized seriously. -- Abstract: In this study, the US–ZVI system was used to produce the strong reductants including ·H and nascent Fe{sup 2+} ions to eliminate the toxicity of the high concentration p-nitrophenol (PNP) wastewater. The effect of the reactor structure, initial pH, ZVI dosage, ultrasonic power and initial PNP concentration on the removal efficiency of PNP from water was investigated intensively. The results show that a higher removal rate can be obtained by using a conical structure reactor, and the lower initial pH can aid the acceleration of PNP removal rate by using US–ZVI system. Furthermore, the removal efficiencies of PNP increased obviously with the increase of initial ZVI concentration from 0 to 15 g L{sup −1}. Also, the treatment capacity of ZVI was enhanced remarkably by the ultrasonic irradiation, and the US–ZVI system can maintain high treatment efficiency for the high concentration PNP wastewater (500–10,000 mg L{sup −1}). Meanwhile, the high removal efficiency of PNP was mainly resulted from the synergistic reaction of ZVI and US. At last, the main degradation product (i.e., p-aminophenol) was detected by gas chromatography–mass spectrum (GC–MS). Thus, the reaction pathway of PNP in the US–ZVI system is proposed as a reducing process by the ·H and nascent Fe{sup 2+} ions.

  19. Synthesis and application of iron and zinc doped biochar for removal of p-nitrophenol in wastewater and assessment of the influence of co-existed Pb(II)

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Pei [College of Environmental Science and Engineering, Hunan University, Changsha 410082 (China); Key Laboratory of Environmental Biology and Pollution Control, Hunan University, Ministry of Education, Changsha 410082, Hunan (China); Tang, Lin, E-mail: tanglin@hnu.edu.cn [College of Environmental Science and Engineering, Hunan University, Changsha 410082 (China); Key Laboratory of Environmental Biology and Pollution Control, Hunan University, Ministry of Education, Changsha 410082, Hunan (China); Wei, Xue [College of Environmental Science and Engineering, Hunan University, Changsha 410082 (China); Key Laboratory of Environmental Biology and Pollution Control, Hunan University, Ministry of Education, Changsha 410082, Hunan (China); Zeng, Guangming, E-mail: zgming@hnu.edu.cn [College of Environmental Science and Engineering, Hunan University, Changsha 410082 (China); Key Laboratory of Environmental Biology and Pollution Control, Hunan University, Ministry of Education, Changsha 410082, Hunan (China); Zhou, Yaoyu [College of Environmental Science and Engineering, Hunan University, Changsha 410082 (China); Key Laboratory of Environmental Biology and Pollution Control, Hunan University, Ministry of Education, Changsha 410082, Hunan (China); College of Resources and Environment, Hunan Agricultural University, Changsha 410128 (China); Deng, Yaocheng; Wang, Jingjing; Xie, Zhihong; Fang, Wei [College of Environmental Science and Engineering, Hunan University, Changsha 410082 (China); Key Laboratory of Environmental Biology and Pollution Control, Hunan University, Ministry of Education, Changsha 410082, Hunan (China)

    2017-01-15

    Highlights: • Iron and zinc doped biochar was developed with larger specific surface area, new generated hydroxyl groups, and beneficial magnetism compared with pristine biochar. • Fe/Zn-biochar presented good performance both for PNP and Pb(II) adsorption as well as their simultaneous removal. • Mechanism of the enhanced adsorption for low concentrations of co-existing PNP and Pb(II) was proposed. - Abstract: The modification of biochar as a low-cost adsorbent is essential to improve its surface properties and shows great potential in water decontamination. The iron and zinc doped sawdust biochar (Fe/Zn-biochar) with large apparent surface area (518.54 m{sup 2}/g) proposed in this work showed good performance for p-nitrophenol (PNP) removal compared with the pristine biochar (P-biochar), iron doped biochar (Fe-biochar) and zinc doped biochar (Zn-biochar) respectively. The batch experiments turned out that Fe/Zn-biochar exhibited larger PNP adsorption capacity under acidic pH solution, and the ionic strength had slightly negative impact on PNP adsorption. The adsorption kinetics and isotherms were discussed, and the experimental data fitted well the Pseudo-second-order equation and Langmuir model. The thermodynamic study indicated that the PNP adsorption was a spontaneous endothermic process. Furthermore, the simultaneous removal for PNP and Pb(II) by Fe/Zn-biochar was investigated. It implied that the adsorption of PNP and Pb(II) at their low concentration might be enhanced by the complexing-bridging mechanism of PNP and Pb(II) ascribing to the affinity between PNP and hydrophobic sites, in addition to the affinity between Pb(II) and oxygen-containing hydrophilic sites on Fe/Zn-biochar surface. However, the predominated competition between PNP and Pb(II) at their high concentrations with Fe/Zn-biochar suppressed their adsorption.

  20. Treatment of Intraepidermal Autoimmune Bullous Diseases Sürekli Eğitim

    Directory of Open Access Journals (Sweden)

    Tamer İrfan Kaya

    2011-06-01

    Full Text Available Pemfigus is an autoimmune bullous skin disease, characterized by intraepidermal blisters. It is a severe and potentially life-threatening chronic disease with blisters and erosions on the mucosae and the skin. Treatment options do not differ for two most common types of pemphigus, pemphigus vulgaris and pemphigus foliaceus, except that the latter is usually less resistant to treatment and corticosteroids can often be started at lower doses. Systemic corticosteroids are still the most widely used drugs in the treatment of pemphigus and continue to be the mainstay of therapy for this disease. Adjuvant drugs are commonly used in combination with the aims of increasing efficacy and of having a steroid-sparing action, thereby allowing reduced corticosteroid side-effects. Mortality and complete remission rates have improved since the introduction of adjuvant drugs to pemphigus. Adjuvant drugs include immunoadsorbtion, corticosteroid pulse therapy, intravenous immunoglobulin (IVIG, immunosuppressive agents such as azathioprine, cyclophosphamide, mycophenolate mofetil and and anti-CD20 monoclonal antibody (rituximab. The lack of consensus in the published literature about the treatment of this disorder is responsible for different treatment strategies. Treatments need to be chosen after careful consideration of the potential benefits and side effects according to the patients’ medical condition. Here, both conventional therapies and novel treatment regimens for pemphigus are discussed. (Turkderm 2011; 45 Suppl 1: 44-53

  1. A Numerical Comparison of Ionic Multi-Species Diffusion with and without Sorption Hysteresis for Cement-Based Materials

    DEFF Research Database (Denmark)

    Jensen, Mads Mønster; Johannesson, Björn; Geiker, Mette Rica

    2015-01-01

    . The model is an extended version of the Poisson–Nernst–Planck (PNP) system of equations. The PNP extension includes a two-phase vapor and liquid model coupled by a sorption hysteresis function and a chemical equilibrium term. The strong and weak solutions for the equation system are shown, and a finite...

  2. Steady state solution of the Poisson-Nernst-Planck equations

    International Nuclear Information System (INIS)

    Golovnev, A.; Trimper, S.

    2010-01-01

    The exact steady state solution of the Poisson-Nernst-Planck equations (PNP) is given in terms of Jacobi elliptic functions. A more tractable approximate solution is derived which can be used to compare the results with experimental observations in binary electrolytes. The breakdown of the PNP for high concentration and high applied voltage is discussed.

  3. A new assessment model and tool for pediatric nurse practitioners.

    Science.gov (United States)

    Burns, C

    1992-01-01

    This article presents a comprehensive assessment model for pediatric nurse practitioner (PNP) practice that integrates familiar elements of the classical medical history, Gordon's Functional Health Patterns, and developmental fields into one system. This model drives the diagnostic reasoning process toward consideration of a broad range of disease, daily living (nursing diagnosis), and developmental diagnoses, which represents PNP practice better than the medical model does.

  4. Shedding light on the role of photosynthesis in pathogen colonization and host defense

    KAUST Repository

    Garavaglia, Betiana S.; Thomas, Ludivine; Gottig, Natalia; Zimaro, Tamara; Garofalo, Cecilia G.; Gehring, Christoph A; Ottado, Jorgelina

    2010-01-01

    The role of photosynthesis in plant defense is a fundamental question awaiting further molecular and physiological elucidation. To this end we investigated host responses to infection with the bacterial pathogen Xanthomonas axonopodis pv. citri, the pathogen responsible for citrus canker. This pathogen encodes a plant-like natriuretic peptide (XacPNP) that is expressed specifically during the infection process and prevents deterioration of the physiological condition of the infected tissue. Proteomic assays of citrus leaves infected with a XacPNP deletion mutant (DeltaXacPNP) resulted in a major reduction in photosynthetic proteins such as Rubisco, Rubisco activase and ATP synthase as a compared with infection with wild type bacteria. In contrast, infiltration of citrus leaves with recombinant XacPNP caused an increase in these host proteins and a concomitant increase in photosynthetic efficiency as measured by chlorophyll fluorescence assays. Reversion of the reduction in photosynthetic efficiency in citrus leaves infected with DeltaXacPNP was achieved by the application of XacPNP or Citrus sinensis PNP lending support to a case of molecular mimicry. Finally, given that DeltaXacPNP infection is less successful than infection with the wild type, it appears that reducing photosynthesis is an effective plant defense mechanism against biotrophic pathogens.

  5. ORF Alignment: NC_002607 [GENIUS II[Archive

    Lifescience Database Archive (English)

    Full Text Available NC_002607 gi|15790649 >1b22A 10 70 5 63 2e-10 ... pdb|1XU4|A Chain A, Atpase In Compl...ex With Amp-Pnp, Magnesium And Potassium ... Co-F pdb|1T4G|A Chain A, Atpase In Complex With Amp-Pnp ...

  6. ORF Alignment: NC_003551 [GENIUS II[Archive

    Lifescience Database Archive (English)

    Full Text Available NC_003551 gi|20094872 >1b22A 10 70 5 63 2e-10 ... pdb|1XU4|A Chain A, Atpase In Compl...ex With Amp-Pnp, Magnesium And Potassium ... Co-F pdb|1T4G|A Chain A, Atpase In Complex With Amp-Pnp

  7. Shedding light on the role of photosynthesis in pathogen colonization and host defense

    KAUST Repository

    Garavaglia, Betiana S.

    2010-09-01

    The role of photosynthesis in plant defense is a fundamental question awaiting further molecular and physiological elucidation. To this end we investigated host responses to infection with the bacterial pathogen Xanthomonas axonopodis pv. citri, the pathogen responsible for citrus canker. This pathogen encodes a plant-like natriuretic peptide (XacPNP) that is expressed specifically during the infection process and prevents deterioration of the physiological condition of the infected tissue. Proteomic assays of citrus leaves infected with a XacPNP deletion mutant (DeltaXacPNP) resulted in a major reduction in photosynthetic proteins such as Rubisco, Rubisco activase and ATP synthase as a compared with infection with wild type bacteria. In contrast, infiltration of citrus leaves with recombinant XacPNP caused an increase in these host proteins and a concomitant increase in photosynthetic efficiency as measured by chlorophyll fluorescence assays. Reversion of the reduction in photosynthetic efficiency in citrus leaves infected with DeltaXacPNP was achieved by the application of XacPNP or Citrus sinensis PNP lending support to a case of molecular mimicry. Finally, given that DeltaXacPNP infection is less successful than infection with the wild type, it appears that reducing photosynthesis is an effective plant defense mechanism against biotrophic pathogens.

  8. Characterization of p-nitrophenol degrading actinomycetes from ...

    African Journals Online (AJOL)

    Of several Microbial Biotechnology Research Laboratory (MBRL) strains isolated from limestone deposits in Ukhrul, Manipur, India, two strains, (HS4-2 and HS6-1) were found to be promising PNP biodegraders, degrading up to 30 mg/L PNP in neutral basal salts medium (BSM, pH 7.0). Higher strength alkaline BSM (5X ...

  9. Biodegradation of p-nitrophenol using Arthrobacter chlorophenolicus A6 in a novel upflow packed bed reactor.

    Science.gov (United States)

    Sahoo, Naresh Kumar; Pakshirajan, Kannan; Ghosh, Pranab Kumar

    2011-06-15

    A novel packed bed reactor (PBR) was designed with cross flow aeration at multiple ports along the depth to improve the hydrodynamic conditions of the reactor, and the biodegradation efficiency of Arthrobacter chlorophenolicus A6 on p-nitrophenol (PNP) removal in PBR at different PNP loading rates were evaluated. The novel PBR was designed to improve the hydrodynamic features such as mixing time profile (t(m95)), oxygen mass transfer coefficient (k(L)a), and overall gas hold up capacity (ɛ(G)) of the reactor. PNP concentration in the influent was varied between 600 and 1400 mg l(-1) whereas the hydraulic retention time (HRT) in the reactor was varied between 18 and 7.5h. Complete removal of PNP was achieved in the reactor up to a PNP loading rate of 2787 mg l(-1)d(-1). More than 99.9% removal of PNP was achieved in the reactor for an influent concentration of 1400 mg l(-1) and at 18 h HRT. In the present study, PNP was utilized as sole source of carbon and energy by A. chlorophenolicus A6. Furthermore, the bioreactor showed good compatibility in handling shock loading of PNP. Copyright © 2011 Elsevier B.V. All rights reserved.

  10. Biodegradation of p-nitrophenol using Arthrobacter chlorophenolicus A6 in a novel upflow packed bed reactor

    International Nuclear Information System (INIS)

    Sahoo, Naresh Kumar; Pakshirajan, Kannan; Ghosh, Pranab Kumar

    2011-01-01

    A novel packed bed reactor (PBR) was designed with cross flow aeration at multiple ports along the depth to improve the hydrodynamic conditions of the reactor, and the biodegradation efficiency of Arthrobacter chlorophenolicus A6 on p-nitrophenol (PNP) removal in PBR at different PNP loading rates were evaluated. The novel PBR was designed to improve the hydrodynamic features such as mixing time profile (t m95 ), oxygen mass transfer coefficient (k L a), and overall gas hold up capacity (ε G ) of the reactor. PNP concentration in the influent was varied between 600 and 1400 mg l -1 whereas the hydraulic retention time (HRT) in the reactor was varied between 18 and 7.5 h. Complete removal of PNP was achieved in the reactor up to a PNP loading rate of 2787 mg l -1 d -1 . More than 99.9% removal of PNP was achieved in the reactor for an influent concentration of 1400 mg l -1 and at 18 h HRT. In the present study, PNP was utilized as sole source of carbon and energy by A. chlorophenolicus A6. Furthermore, the bioreactor showed good compatibility in handling shock loading of PNP.

  11. Transistor data book

    International Nuclear Information System (INIS)

    1988-03-01

    It introduces how to use this book. It lists transistor data and index, which are Type No, Cross index, Germanium PNP low power transistors, silicon NPN low power transistors, Germanium PNP high power transistors, Switching transistors, transistor arrays, Miscellaneous transistors, types with U.S military specifications, direct replacement transistors, suggested replacement transistors, schematic drawings, outline drawings, device number keys and manufacturer's logos.

  12. A novel biosensor for p-nitrophenol based on an aerobic anode microbial fuel cell.

    Science.gov (United States)

    Chen, Zhengjun; Niu, Yongyan; Zhao, Shuai; Khan, Aman; Ling, Zhenmin; Chen, Yong; Liu, Pu; Li, Xiangkai

    2016-11-15

    P-nitrophenol is one of the most common contaminants in chemical industrial wastewater, and in situ real-time monitoring of PNP cannot be achieved by conventional analytical techniques. Here, a two-chamber microbial fuel cell with an aerobic anode chamber was tested as a biosensor for in situ real-time monitoring of PNP. Pseudomonas monteilii LZU-3, which was used as the biological recognition element, can form a biofilm on the anode electrode using PNP as a sole substrate. The optimal operation parameters of the biosensor were as follows: external resistance 1000Ω, pH 7.8, temperature 30°C, and maximum PNP concentration 50mgL(-1). Under these conditions, the maximum voltages showed a linear relationship with PNP concentrations ranging from 15±5 to 44±4.5mgL(-1). Furthermore, we developed a novel portable device for in situ real-time monitoring of PNP. When the device was applied to measure PNP in wastewater containing various additional aromatic compounds and metal ions, the performance of the biosensor was not affected and the correlation between the maximum voltages and the PNP concentrations ranging from 9±4mgL(-1) to 36 ± 5mgL(-1) was conserved. The results demonstrated that the MFC biosensor provides a rapid and cost-efficient analytical method for real-time monitoring of toxic and recalcitrant pollutants in environmental samples. Copyright © 2016 Elsevier B.V. All rights reserved.

  13. Isolation and Identification of a Brevibacterium linens strain ...

    African Journals Online (AJOL)

    nitrophenol (PNP). Subsequent subcultures in agar, nutrient agar plates and agar slants by streaking led to isolation of pure colonies. The pure culture could degrade up to 300 mg/L PNP in presence of yeast extract. It was Gram positive rods, ...

  14. The health care team. The role of pediatric nurse practitioners as viewed by California pediatricians.

    Science.gov (United States)

    Schoen, E J; Erickson, R J; Barr, G; Allen, H

    1973-01-01

    A single-mailing questionnaire surveyed attitudes of members of District IX, American Academy of Pediatrics (California) toward the role of the pediatric nurse practitioner (pnp). Responses from 568 members (53%) represented a broad range of age, practice type (58% group, 25% solo, 17% "other"), geographic location, and opinion. The most favorable attitudes toward pnp use were expressed by young pediatricians in large-group and "other" categories; least favorable were solo practitioners older than 60 years. Practice type was more important than age. Most respondents expressed the opinion that a pediatrician-pnp team approach would enrich both professions, and that parental acceptance of the pnp was likely; but that pnp use would not reduce costs. Majorities favored the concept of the pnp as part of the practice team but under constant pediatrician surveillance: seeing the patient for part of the visit and participating under supervision in care for minor illness, but not replacing the pediatrician even in well-child care. Some pnps hope for a more independent role on the pediatrician-pnp team. Modification of both pediatrician and pnp ideas appears requisite to a team approach that will satisfy both professional groups and the public.

  15. Anopheles gambiae Purine Nucleoside Phosphorylase: Catalysis, Structure, and Inhibition

    Energy Technology Data Exchange (ETDEWEB)

    Taylor,E.; Rinaldo-Matthis, A.; Li, L.; Ghanem, M.; Hazleton, K.; Cassera, M.; Almo, S.; Schramm, V.

    2007-01-01

    The purine salvage pathway of Anopheles gambiae, a mosquito that transmits malaria, has been identified in genome searches on the basis of sequence homology with characterized enzymes. Purine nucleoside phosphorylase (PNP) is a target for the development of therapeutic agents in humans and purine auxotrophs, including malarial parasites. The PNP from Anopheles gambiae (AgPNP) was expressed in Escherichia coli and compared to the PNPs from Homo sapiens (HsPNP) and Plasmodium falciparum (PfPNP). AgPNP has kcat values of 54 and 41 s-1 for 2'-deoxyinosine and inosine, its preferred substrates, and 1.0 s-1 for guanosine. However, the chemical step is fast for AgPNP at 226 s-1 for guanosine in pre-steady-state studies. 5'-Deaza-1'-aza-2'-deoxy-1'-(9-methylene)-Immucillin-H (DADMe-ImmH) is a transition-state mimic for a 2'-deoxyinosine ribocation with a fully dissociated N-ribosidic bond and is a slow-onset, tight-binding inhibitor with a dissociation constant of 3.5 pM. This is the tightest-binding inhibitor known for any PNP, with a remarkable Km/Ki* of 5.4 x 107, and is consistent with enzymatic transition state predictions of enhanced transition-state analogue binding in enzymes with enhanced catalytic efficiency. Deoxyguanosine is a weaker substrate than deoxyinosine, and DADMe-Immucillin-G is less tightly bound than DADMe-ImmH, with a dissociation constant of 23 pM for AgPNP as compared to 7 pM for HsPNP. The crystal structure of AgPNP was determined in complex with DADMe-ImmH and phosphate to a resolution of 2.2 Angstroms to reveal the differences in substrate and inhibitor specificity. The distance from the N1' cation to the phosphate O4 anion is shorter in the AgPNP{center_dot}DADMe-ImmH{center_dot}PO4 complex than in HsPNP{center_dot}DADMe-ImmH{center_dot}SO4, offering one explanation for the stronger inhibitory effect of DADMe-ImmH for AgPNP.

  16. Identification of the para-nitrophenol catabolic pathway, and characterization of three enzymes involved in the hydroquinone pathway, in pseudomonas sp. 1-7

    Directory of Open Access Journals (Sweden)

    Zhang Shuangyu

    2012-03-01

    Full Text Available Abstract Background para-Nitrophenol (PNP, a priority environmental pollutant, is hazardous to humans and animals. However, the information relating to the PNP degradation pathways and their enzymes remain limited. Results Pseudomonas sp.1-7 was isolated from methyl parathion (MP-polluted activated sludge and was shown to degrade PNP. Two different intermediates, hydroquinone (HQ and 4-nitrocatechol (4-NC were detected in the catabolism of PNP. This indicated that Pseudomonas sp.1-7 degraded PNP by two different pathways, namely the HQ pathway, and the hydroxyquinol (BT pathway (also referred to as the 4-NC pathway. A gene cluster (pdcEDGFCBA was identified in a 10.6 kb DNA fragment of a fosmid library, which cluster encoded the following enzymes involved in PNP degradation: PNP 4-monooxygenase (PdcA, p-benzoquinone (BQ reductase (PdcB, hydroxyquinol (BT 1,2-dioxygenase (PdcC, maleylacetate (MA reductase (PdcF, 4-hydroxymuconic semialdehyde (4-HS dehydrogenase (PdcG, and hydroquinone (HQ 1,2-dioxygenase (PdcDE. Four genes (pdcDEFG were expressed in E. coli and the purified pdcDE, pdcG and pdcF gene products were shown to convert HQ to 4-HS, 4-HS to MA and MA to β-ketoadipate respectively by in vitro activity assays. Conclusions The cloning, sequencing, and characterization of these genes along with the functional PNP degradation studies identified 4-NC, HQ, 4-HS, and MA as intermediates in the degradation pathway of PNP by Pseudomonas sp.1-7. This is the first conclusive report for both 4-NC and HQ- mediated degradation of PNP by one microorganism.

  17. Polyneuropathy in levodopa-treated Parkinson's patients.

    Science.gov (United States)

    Szadejko, Karol; Dziewiatowski, Krzysztof; Szabat, Krzysztof; Robowski, Piotr; Schinwelski, Michał; Sitek, Emilia; Sławek, Jarosław

    2016-12-15

    Recently published studies show that the prevalence of polyneuropathy (PNP) is higher in patients with Parkinson's disease (PD) than in age-matched controls. Its pathogenesis, however is a matter of controversy. The major hypothesis is the toxicity of high concentrations of homocysteine (Hcy) possibly related to levodopa (LD) therapy. The aim of the present study was to determine the prevalence of PNP, independent of other etiologies, and to determine the relationship to demographic and clinical factors in LD-treated Parkinson's patients. A total of 102 patients (51 patients with PD and 51 sex- and age-matched healthy controls) were enrolled in the study. The presence of any risk factors for PNP, ascertained from the history and laboratory tests, was an exclusion criterion. The Toronto Clinical Scoring System (TCSS) was used for clinical assessment of PNP. The objective assessment was based on electroneurography (ENG) studies in which motor nerves (peroneal and tibial nerves) as well as sensory nerves (sural and superficial peroneal nerves) were bilaterally examined. The severity of the disease was determined using the UPDRS scale (Unified Parkinson's Disease Rating Scale) and the Hoehn-Yahr (H-Y) scale. In the PD group, the clinical and neurophysiological indicators of PNP, manifested as a symmetrical and predominantly sensory axonal neuropathy, were more frequent then in the control group and observed in 43.1% vs. 13.7% and 15.7% vs. 2% of subjects respectively. The presence of PNP correlated with age and the severity of PD. Patients with PD and PNP had a higher level of Hcy as compared to PD patients without PNP, however the difference was not statistically significant. The frequency of PNP in PD patients is higher than in controls. The characteristics and discrepancy between the number of patients with clinical and ENG detected PNP may suggest the small fiber neuropathy (SFN) as the dominant form of neuropathy in PD patients. Copyright © 2016 Elsevier B.V. All

  18. Fluoroscopy of spontaneous breathing is more sensitive than phrenic nerve stimulation for detection of right phrenic nerve injury during cryoballoon ablation of atrial fibrillation.

    Science.gov (United States)

    Linhart, Markus; Nielson, Annika; Andrié, René P; Mittmann-Braun, Erica L; Stöckigt, Florian; Kreuz, Jens; Nickenig, Georg; Schrickel, Jan W; Lickfett, Lars M

    2014-08-01

    Right phrenic nerve palsy (PNP) is a typical complication of cryoballoon ablation of the right-sided pulmonary veins (PVs). Phrenic nerve function can be monitored by palpating the abdomen during phrenic nerve pacing from the superior vena cava (SVC pacing) or by fluoroscopy of spontaneous breathing. We sought to compare the sensitivity of these 2 techniques during cryoballoon ablation for detection of PNP. A total of 133 patients undergoing cryoballoon ablation were monitored with both SVC pacing and fluoroscopy of spontaneous breathing during ablation of the right superior PV. PNP occurred in 27/133 patients (20.0%). Most patients (89%) had spontaneous recovery of phrenic nerve function at the end of the procedure or on the following day. Three patients were discharged with persistent PNP. All PNP were detected first by fluoroscopic observation of diaphragm movement during spontaneous breathing, while diaphragm could still be stimulated by SVC pacing. In patients with no recovery until discharge, PNP occurred at a significantly earlier time (86 ± 34 seconds vs. 296 ± 159 seconds, P < 0.001). No recovery occurred in 2/4 patients who were ablated with a 23 mm cryoballoon as opposed to 1/23 patients with a 28 mm cryoballoon (P = 0.049). Fluoroscopic assessment of diaphragm movement during spontaneous breathing is more sensitive for detection PNP as compared to SVC pacing. PNP as assessed by fluoroscopy is frequent (20.0%) and carries a high rate of recovery (89%) until discharge. Early onset of PNP and use of 23 mm cryoballoon are associated with PNP persisting beyond hospital discharge. © 2014 Wiley Periodicals, Inc.

  19. Neurological manifestation of colonic adenocarcinoma

    Directory of Open Access Journals (Sweden)

    Uzair Chaudhary

    2012-04-01

    Full Text Available Paraneoplastic neurologic disorders are extremely rare in cancer patients and are most commonly associated with certain tumors, such as ovarian cancer, small cell lung cancer, and breast cancer. We report here a paraneoplastic neurological syndrome in a 53-year-old man with colonic adenocarcinoma with a solitary liver metastasis. His paraneoplastic syndrome was successfully treated by methylprednisolone and primary oncologic therapies including neoadjuvant chemotherapy and definitive surgery. This is also the first documented case of simultaneous manifestation of a sensory neuropathy and limbic encephalitis with colon cancer.

  20. Parents' Perception of Satisfaction With Pediatric Nurse Practitioners' Care And Parental Intent to Adhere To Recommended Health Care Regimen.

    Science.gov (United States)

    Kinder, Frances DiAnna

    2016-01-01

    The purposes of this study were to explore parents' perceptions of satisfaction with care from primary care pediatric nurse practitioners (PNPs) and to explore the relationships of the four components of parental satisfaction with parents' intent to adhere to recommended health care regimen. The study used a descriptive correlational research design. A convenience sample of 91 participants was recruited from practices in southeastern Pennsylvania. The 28-item, Parents' Perceptions of Satisfaction with Care from Pediatric Nurse Practitioners (PPSC-PNP) tool was developed to measure four components of satisfaction and overall satisfaction of parents with PNP care after the health visit. A 100 mm visual analog (VAS) scale measured parental intent to adhere to the care regimen recommended by the PNP. Parents' perceptions of overall satisfaction with care from PNPs and satisfaction with each of the four components (communication, clinical competence, caring behavior, and decisional control) were high as measured by the PPSC-PNP. Multiple regression analysis revealed that clinical competence had the strongest positive relationship with parental intent to adhere to PNP recommended health regimen and was the only variable to enter the regression equation. The findings of this study have implications for nursing practice. The PPSC-PNP instrument may be used with a variety of pediatric populations and settings as a benchmark for quality care. Clinical competence is important for the role of the PNP. Other variables of parental intent to adhere to the health regimen should be explored in future studies.

  1. Photooxidative Removal of p -Nitrophenol by UV/H 2 O 2 Process in a Spinning Disk Photoreactor: Influence of Operating Parameters

    Directory of Open Access Journals (Sweden)

    H. Dadkhah

    2017-10-01

    Full Text Available In this paper, spinning disk photoreactor (SDP has been used for the removal of a refractory pollutant, namely p-nitrophenol (PNP, in UV/H2O2 process. The effect of various parameters such as the plate type in the SDP, concentration of oxidant (H2O2, fluid volume, initial concentration of PNP, distance of the lamps from the spinning disk, distance of the lamps from each other, pH, and rotation speed of the spinning disk in the removal efficiency has been investigated. The results indicated that the use of scrobiculate disc instead of flat disc significantly increased the removal percentage of PNP from 46 to 100 % for the irradiation time of 20 min; it also increased with increasing H2O2 concentration, but the increase in fluid volume and the initial concentration of PNP reduced the removal percentage of PNP in the SDP. The increase in the distance of UV lamps from each other and from disc surface in the SDP reduced the removal percentage of PNP. However, the increase in pH to 5.5 increased removal efficiency while increasing pH above 5.5 reduced PNP removal efficiency. The disk rotation speed from 0 to 90 rpm increased the removal percentage from 49 to 70 % for the irradiation time of 5 min, but increasing the rotation speed to more than 90 rpm reduced the removal efficiency.

  2. Interaction Of Calcium Phosphate Nanoparticles With Human Chorionic Gonadotropin Modifies Secondary And Tertiary Protein Structure

    Directory of Open Access Journals (Sweden)

    Al-Hakeim Hussein K

    2015-12-01

    Full Text Available Calcium phosphate nanoparticles (CaPNP have good biocompatibility and bioactivity inside human body. In this study, the interaction between CaPNP and human chorionic gonadotropin (hCG was analyzed to determine the changes in the protein structure in the presence of CaPNP and the quantity of protein adsorbed on the CaPNP surface. The results showed a significant adsorption of hCG on the CaPNP nanoparticle surface. The optimal fit was achieved using the Sips isotherm equation with a maximum adsorption capacity of 68.23 µg/mg. The thermodynamic parameters, including ∆H° and ∆G°, of the adsorption process are positive, whereas ∆S° is negative. The circular dichroism results of the adsorption of hCG on CaPNP showed the changes in its secondary structure; such changes include the decomposition of α-helix strand and the increase in β-pleated sheet and random coil percentages. Fluorescence study indicated minimal changes in the tertiary structure near the microenvironment of the aromatic amino acids such as tyrosine and phenyl alanine caused by the interaction forces between the CaPNP and hCG protein. The desorption process showed that the quantity of the hCG desorbed significantly increases as temperature increases, which indicates the weak forces between hCG and the surface.

  3. Antineuronal Autoantibodies : Molecular Characterization and Clinical Implication

    NARCIS (Netherlands)

    Hameete, M.H.|info:eu-repo/dai/nl/371750539

    2017-01-01

    Neurological autoimmune disorders associated with antineuronal autoantibodies result from an immune reaction directed at neuronal self-antigens. When affecting the central nervous system these can be divided into two subgroups: ‘classical’ paraneoplastic neurological syndromes (PNS) and autoimmune

  4. Browse Title Index

    African Journals Online (AJOL)

    Vol 23, No 1 (2016), Multiple cystic lung disease in an adolescent boy, Abstract PDF ... Vol 14, No 1 (2013), Multisegmental tubercular spinal epidural abscess ... in paraneoplastic dermatomyositis associated with breast cancer, Abstract PDF.

  5. Narcolepsy, REM sleep behavior disorder, and supranuclear gaze palsy associated with Ma1 and Ma2 antibodies and tonsillar carcinoma.

    Science.gov (United States)

    Adams, Chris; McKeon, Andrew; Silber, Michael H; Kumar, Rajeev

    2011-04-01

    To describe a patient with diencephalic and mesencephalic presentation of a Ma1 and Ma2 antibody-associated paraneoplastic neurological disorder. Case report. The Colorado Neurological Institute Movement Disorders Center in Englewood, Colorado, and the Mayo Clinic in Rochester, Minnesota. A 55-year-old man with a paraneoplastic neurological disorder characterized by rapid eye movement sleep behavior disorder, narcolepsy, and a progressive supranuclear palsy-like syndrome in the setting of tonsillar carcinoma. Immunotherapy for paraneoplastic neurological disorder, surgery and radiotherapy for cancer, and symptomatic treatment for parkinsonism and sleep disorders. Polysomnography, multiple sleep latency test, and neurological examination. The cancer was detected at a limited stage and treatable. After oncological therapy and immunotherapy, symptoms stabilized. Treatment with modafinil improved daytime somnolence. Rapid onset and progression of multifocal deficits may be a clue to paraneoplastic etiology. Early treatment of a limited stage cancer (with or without immunotherapy) may possibly slow progression of neurological symptoms. Symptomatic treatment may be beneficial.

  6. Cerebellar leukoencephalopathy: most likely histiocytosis-related

    NARCIS (Netherlands)

    van der Knaap, M.S.; Arts, W.F.M.; Garbern, J.Y.; Hedlund, G.; Winkler, F.; Barbosa, C.; King, M.D.; Bjornstad, A.; Hussain, N.; Beyer, M.K.; Gomez, C.; Patterson, M.C.; Grattan-Smith, P.; Timmons, M.; van der Valk, P.

    2008-01-01

    Background: Histiocytosis, both Langerhans and non-Langerhans cell type, can be associated with cerebellar white matter abnormalities, thought to be paraneoplastic. The associated clinical picture consists of ataxia, spasticity, and cognitive decline. Hormonal dysfunction is frequent. MRI shows

  7. Plant natriuretic peptides induce proteins diagnostic for an adaptive response to stress

    KAUST Repository

    Turek, Ilona; Marondedze, Claudius; Wheeler, Janet I.; Gehring, Christoph A; Irving, Helen R.

    2014-01-01

    In plants, structural and physiological evidence has suggested the presence of biologically active natriuretic peptides (PNPs). PNPs are secreted into the apoplast, are systemically mobile and elicit a range of responses signaling via cGMP. The PNP-dependent responses include tissue specific modifications of cation transport and changes in stomatal conductance and the photosynthetic rate. PNP also has a critical role in host defense responses. Surprisingly, PNP-homologs are produced by several plant pathogens during host colonization suppressing host defense responses. Here we show that a synthetic peptide representing the biologically active fragment of the Arabidopsis thaliana PNP (AtPNP-A) induces the production of reactive oxygen species in suspension-cultured A. thaliana (Col-0) cells. To identify proteins whose expression changes in an AtPNP-A dependent manner, we undertook a quantitative proteomic approach, employing tandem mass tag (TMT) labeling, to reveal temporal responses of suspension-cultured cells to 1 nM and 10 pM PNP at two different time-points post-treatment. Both concentrations yield a distinct differential proteome signature. Since only the higher (1 nM) concentration induces a ROS response, we conclude that the proteome response at the lower concentration reflects a ROS independent response. Furthermore, treatment with 1 nM PNP results in an over-representation of the gene ontology (GO) terms “oxidation-reduction process,” “translation” and “response to salt stress” and this is consistent with a role of AtPNP-A in the adaptation to environmental stress conditions.

  8. The Regulation of para-Nitrophenol Degradation in Pseudomonas putida DLL-E4.

    Directory of Open Access Journals (Sweden)

    Qiongzhen Chen

    Full Text Available Pseudomonas putida DLL-E4 can efficiently degrade para-nitrophenol and its intermediate metabolite hydroquinone. The regulation of para-nitrophenol degradation was studied, and PNP induced a global change in the transcriptome of P. putida DLL-E4. When grown on PNP, the wild-type strain exhibited significant downregulation of 2912 genes and upregulation of 845 genes, whereas 2927 genes were downregulated and 891 genes upregulated in a pnpR-deleted strain. Genes related to two non-coding RNAs (ins1 and ins2, para-nitrophenol metabolism, the tricarboxylic acid cycle, the outer membrane porin OprB, glucose dehydrogenase Gcd, and carbon catabolite repression were significantly upregulated when cells were grown on para-nitrophenol plus glucose. pnpA, pnpR, pnpC1C2DECX1X2, and pnpR1 are key genes in para-nitrophenol degradation, whereas pnpAb and pnpC1bC2bDbEbCbX1bX2b have lost the ability to degrade para-nitrophenol. Multiple components including transcriptional regulators and other unknown factors regulate para-nitrophenol degradation, and the transcriptional regulation of para-nitrophenol degradation is complex. Glucose utilization was enhanced at early stages of para-nitrophenol supplementation. However, it was inhibited after the total consumption of para-nitrophenol. The addition of glucose led to a significant enhancement in para-nitrophenol degradation and up-regulation in the expression of genes involved in para-nitrophenol degradation and carbon catabolite repression (CCR. It seemed that para-nitrophenol degradation can be regulated by CCR, and relief of CCR might contribute to enhanced para-nitrophenol degradation. In brief, the regulation of para-nitrophenol degradation seems to be controlled by multiple factors and requires further study.

  9. Plant natriuretic peptides induce proteins diagnostic for an adaptive response to stress

    KAUST Repository

    Turek, Ilona

    2014-11-26

    In plants, structural and physiological evidence has suggested the presence of biologically active natriuretic peptides (PNPs). PNPs are secreted into the apoplast, are systemically mobile and elicit a range of responses signaling via cGMP. The PNP-dependent responses include tissue specific modifications of cation transport and changes in stomatal conductance and the photosynthetic rate. PNP also has a critical role in host defense responses. Surprisingly, PNP-homologs are produced by several plant pathogens during host colonization suppressing host defense responses. Here we show that a synthetic peptide representing the biologically active fragment of the Arabidopsis thaliana PNP (AtPNP-A) induces the production of reactive oxygen species in suspension-cultured A. thaliana (Col-0) cells. To identify proteins whose expression changes in an AtPNP-A dependent manner, we undertook a quantitative proteomic approach, employing tandem mass tag (TMT) labeling, to reveal temporal responses of suspension-cultured cells to 1 nM and 10 pM PNP at two different time-points post-treatment. Both concentrations yield a distinct differential proteome signature. Since only the higher (1 nM) concentration induces a ROS response, we conclude that the proteome response at the lower concentration reflects a ROS independent response. Furthermore, treatment with 1 nM PNP results in an over-representation of the gene ontology (GO) terms “oxidation-reduction process,” “translation” and “response to salt stress” and this is consistent with a role of AtPNP-A in the adaptation to environmental stress conditions.

  10. [VGKC antibodies associated with limbic encephalitis].

    Science.gov (United States)

    Soeder, B M; Urbach, H; Elger, C E; Bien, C G; Beyenburg, S

    2005-06-01

    Since the initial description of limbic encephalitis (LE) in 1960/1968, several subforms of this clinico-neuropathological syndrome have been identified. The best known is paraneoplastic LE. However, non-paraneoplastic forms have been reported, too. Very recently, autoantibodies against voltage-gated potassium channels have been described in association with LE. The diagnostic workup of such a case and the apparently typical good response to long-term immunotherapy of this LE subform are described.

  11. Application of the Poisson-Nernst-Planck equations to the migration test

    DEFF Research Database (Denmark)

    Krabbenhøft, Kristian; Krabbenhøft, Jørgen

    2008-01-01

    The Poisson-Nernst-Planck (PNP) equations are applied to model the migration test. A detailed analysis of the equations is presented and the effects of a number of common, simplifying assumptions are quantified. In addition, closed-form solutions for the effective chloride diffusivity based...... on the full PNP equations are derived, a number of experiments are analyzed in detail, and a new, truly accelerated migration test is proposed. Finally, we present a finite element procedure for numerical solution of the PNP equations....

  12. Escherichia coli Purine Nucleoside Phosphorylase II, the Product of the xapA Gene

    DEFF Research Database (Denmark)

    Dandanell, Gert; Szczepanowski, R.H.; Kierdaszuk, B.

    2005-01-01

    the monoanionic form of xanthine. A single amino acid exchange, tyrosine 191 to leucine, is sufficient to convert E. coli PNP-II into an enzyme with the specificity of conventional trimeric PNPs, but the reciprocal mutation in human PNP, valine 195 to tyrosine, does not elicit xanthosine phosphorylase activity...... forms, PNP-II trimers dimerize, leading to a subunit arrangement that is qualitatively different from the "trimer of dimers" arrangement of conventional high molecular mass PNPs. Crystal structures are compatible with similar binding modes for guanine and xanthine, with a preference for the neutral over...

  13. ORF Alignment: NC_000962 [GENIUS II[Archive

    Lifescience Database Archive (English)

    Full Text Available ulosis CDC1551] pdb|1N3I|C Chain C, ... Crystal Structure Of Mycobacterium Tuberculosis...Structure Of Mycobacterium Tuberculosis Pnp With ... Transition State Analog Dadme-Immh pdb|1N3I|A Ch...ain A, ... Crystal Structure Of Mycobacterium Tuberculosis Pnp With ... Transition State Analo...g Dadme-Immh pdb|1I80|C Chain C, ... Crystal Structure Of M. Tuberculosis ...in B, Crystal Structure Of M. Tuberculosis ... Pnp In Complex With Iminoribitol, 9-Deazahypoxanthine

  14. ORF Alignment: NC_002755 [GENIUS II[Archive

    Lifescience Database Archive (English)

    Full Text Available ulosis CDC1551] pdb|1N3I|C Chain C, ... Crystal Structure Of Mycobacterium Tuberculosis...Structure Of Mycobacterium Tuberculosis Pnp With ... Transition State Analog Dadme-Immh pdb|1N3I|A Ch...ain A, ... Crystal Structure Of Mycobacterium Tuberculosis Pnp With ... Transition State Analo...g Dadme-Immh pdb|1I80|C Chain C, ... Crystal Structure Of M. Tuberculosis ...in B, Crystal Structure Of M. Tuberculosis ... Pnp In Complex With Iminoribitol, 9-Deazahypoxanthine

  15. ORF Alignment: NC_002945 [GENIUS II[Archive

    Lifescience Database Archive (English)

    Full Text Available ulosis CDC1551] pdb|1N3I|C Chain C, ... Crystal Structure Of Mycobacterium Tuberculosis...Structure Of Mycobacterium Tuberculosis Pnp With ... Transition State Analog Dadme-Immh pdb|1N3I|A Ch...ain A, ... Crystal Structure Of Mycobacterium Tuberculosis Pnp With ... Transition State Analo...g Dadme-Immh pdb|1I80|C Chain C, ... Crystal Structure Of M. Tuberculosis ...in B, Crystal Structure Of M. Tuberculosis ... Pnp In Complex With Iminoribitol, 9-Deazahypoxanthine

  16. Synthesis, solid-state structure, and bonding analysis of a homoleptic beryllium azide

    International Nuclear Information System (INIS)

    Naglav, Dominik; Tobey, Briac; Lyhs, Benjamin; Roemer, Beate; Blaeser, Dieter; Woelper, Christoph; Jansen, Georg; Schulz, Stephan

    2017-01-01

    [Ph 4 P] 2 [Be(N 3 ) 4 ] (1) and [PNP] 2 [Be(N 3 ) 4 ] (2; PNP=Ph 3 PNPPh 3 ) were synthesized by reacting Be(N 3 ) 2 with [Ph 4 P]N 3 and [PNP]N 3 . Compound 1 represents the first structurally characterized homoleptic beryllium azide. The electronic structure and bonding situation in the tetraazidoberyllate dianion [Be(N 3 ) 4 ] 2- were investigated by quantum-chemical calculations (NPA, ELF, LOL). (copyright 2017 Wiley-VCH Verlag GmbH and Co. KGaA, Weinheim)

  17. High temperature alloys for the primary circuit of a prototype nuclear process heat plant

    International Nuclear Information System (INIS)

    Ennis, P.J.; Schuster, H.

    1979-01-01

    As part of a comprehensive materials test programme for the High Temperature Reactor Project 'Prototype Plant for Nuclear Process Heat' (PNP), high temperature alloys are being investigated for primary circuit components operating at temperatures above 750 0 C. On the basis of important material parameters, in particular corrosion behaviour and mechanical properties in primary coolant helium, the potential of candidate alloys is discussed. By comparing specific PNP materials data with the requirements of PNP and those of conventional plant, the implications for the materials programme and component design are given. (orig.)

  18. Synthesis, Solid-State Structure, and Bonding Analysis of a Homoleptic Beryllium Azide.

    Science.gov (United States)

    Naglav, Dominik; Tobey, Briac; Lyhs, Benjamin; Römer, Beate; Bläser, Dieter; Wölper, Christoph; Jansen, Georg; Schulz, Stephan

    2017-07-10

    [Ph 4 P] 2 [Be(N 3 ) 4 ] (1) and [PNP] 2 [Be(N 3 ) 4 ] (2; PNP=Ph 3 PNPPh 3 ) were synthesized by reacting Be(N 3 ) 2 with [Ph 4 P]N 3 and [PNP]N 3 . Compound 1 represents the first structurally characterized homoleptic beryllium azide. The electronic structure and bonding situation in the tetraazidoberyllate dianion [Be(N 3 ) 4 ] 2- were investigated by quantum-chemical calculations (NPA, ELF, LOL). © 2017 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

  19. Acromegaly in a patient with a pulmonary neuroendocrine tumor: case report and review of current literature.

    Science.gov (United States)

    Krug, Sebastian; Boch, Michael; Rexin, Peter; Pfestroff, Andreas; Gress, Thomas; Michl, Patrick; Rinke, Anja

    2016-06-27

    Pulmonary neuroendocrine tumors (NET) form a heterogeneous group of rare diseases. In these tumors, paraneoplastic syndromes have been described to drive the course of the disease, among them acromegaly induced by paraneoplastic secretion of growth hormone-releasing hormone (GHRH). We report the case of a 43 years old patient initially diagnosed with acromegaly accompanied by weight gain and acral enlargement. Subsequently, further diagnostic work-up identified a solitary pulmonary neuroendocrine tumor (NET). Laboratory tests revealed markedly increased growth hormone (GH) and insulin-like growth factor 1 (IGF-1) without GHRH elevation in the absence of pituitary pathologies confirming the paraneoplastic origin of clinical presentation with acromegaly. Curative surgery was performed leading to normalization of the elevated hormone levels and improvement of the clinical symptoms. Immunohistochemically, a typical carcinoid (TC) was seen with low proliferation index and abundant IGF-1 expression. The association of acromegaly and pulmonary NET has only rarely been reported. We present an individual case of paraneoplastic GH- and IGF-1 secretion in a patient with pulmonary NET. Based on their rarity, the knowledge of paraneoplastic syndromes occurring in patients with pulmonary NET such as acromegaly due to paraneoplastic GH- and IGF-1 secretion is mandatory to adequately diagnose and treat these patients.

  20. Dermatomiosite vesiculobolhosa como manifestação paraneoplásica de tumores sincrônicos de próstata e língua: relato de caso Paraneoplastic vesiculobullous dermatomyositis with synchronic prostate and tongue tumors: case report

    Directory of Open Access Journals (Sweden)

    Paula Renaux Caratta

    2011-08-01

    Full Text Available A dermatomiosite é uma miopatia inflamatória que cursa com manifestações cutâneas. No adulto acima de 50 anos, pode estar associada a neoplasias malignas, comportando-se como um grande sinalizador de malignidade. OBJETIVO: Demonstrar essa associação com aspectos peculiares: dermatomiosite de apresentação atípica paralela a dois tumores sincrônicos, em geral, não relacionados àquela. RELATO DO CASO: Descrevemos o caso de um paciente do gênero masculino de 72 anos, que desenvolveu dermatomiosite, inicialmente apenas com quadro cutâneo clássico, evoluindo com lesões vesiculobolhosas, e, meses após, com miopatia. Após extensa investigação, foi localizado um adenocarcinoma de próstata. Houve remissão da doença após tratamento do câncer e administração de glicocorticoide. Durante a retirada gradual do glicocorticoide, ocorreu reativação da dermatomiosite, sendo reiniciadas investigações, que revelaram a presença de carcinoma escamoso de língua. Tratada esta neoplasia, houve remissão completa, mesmo após a retirada total do corticoide. CONCLUSÃO: Trata-se de um caso raro por envolver as formas menos usuais de apresentação da dermatomiosite, tanto com relação ao quadro cutaneomuscular, quanto à sua associação a tumores de próstata e língua (tumores nunca antes relatados juntos. Este caso demonstra a importância da investigação minuciosa em busca de neoplasias na abordagem desses pacientes.Dermatomyositis is an inflammatory myopathy with skin manifestations. In the adult over the age of 50 years, it can be associated with malignant neoplasias, being, thus, a signal of malignancy. OBJECTIVE: To show the association of dermatomyositis of atypical presentation with two synchronous tumors, usually not related to that. CASE REPORT: We report the case of a 72-year-old male, who developed dermatomyositis, initially with only classic skin findings, which progressed to vesiculobullous lesions, and, months later, to myopathy. After extensive investigation, prostate adenocarcinoma was diagnosed. After treatment of the cancer and administration of glucocorticoid, the disease went into remission. During gradual glucocorticoid withdrawal, dermatomyositis recurred, and the new investigation revealed the presence of squamous cell carcinoma of the tongue. After treating this neoplasia, complete remission occurred, even after total corticoid withdrawal. CONCLUSION: This is a rare case involving less usual dermatomyositis presentation forms, relating to the cutaneous-muscle findings and the association with prostate and tongue tumors (tumors never reported together. This case demonstrates the importance of a careful investigation, searching for neoplasias, when approaching such patients.