Infantile polycystic hepatorenal disease. 2 consecutive cases in a patient. Ultrasonic diagnosis and indication for elective pregnancy termination

We report a case of infantile polycystic kidney disease, during the course of two consecutive pregnancies in the same woman. Observed rates of recurrence in families at risk is higher than theoretical rates (25%). Antenatal ultrasound can show signs of bilateral involvement, which is always lethal and generally leads to elective termination of pregnancy. Diagnosis can rarely be made before 24 weeks of pregnancy.     

An error analysis for surface orientation from vanishing points

Given two parallel lines in a plane, their images formed by central projection onto the viewing plane intersect at a vanishing point, which provides a constraint on the orientation of the plane. Two such independent constraints define a vanishing line and thereby determine the orientation of the plane uniquely. In order to effectively use this information, an estimate of its accuracy must be incorporated. In the approach suggested, line directions and surface normal vectors are represented as points on a Gaussian sphere, and the error bounds are computed as regions on the sphere. Information from multiple vanishing points and surfaces is combined by intersecting the corresponding regions. In addition, constraints based on real-world knowledge can be introduced to improve the accuracy. Some experimental results on natural images re presented to illustrate this method     

Estimating frequencies of exponentials in noise using jointdiagonalization

The problem of estimating frequencies of superimposed exponentials in white noise, collected by a single sensor, is considered. We discuss a solution based on a modification of an analytic algorithm that was proposed for separation of constant modulus signals received by an antenna array by Van der Veen and Paulraj (see ibid., vol. vol.44, p.1136-55, 1996). We show that with an appropriate implementation of certain constraints, the algorithm produces excellent super-resolution results. An advantage of the algorithm is that it does not require multidimensional search, and therefore, it is free from problems associated with search algorithms like convergence to local extremum or proper initialization. Another advantage is its applicability in nonuniform sampling conditions, where methods based on linear prediction cannot be applied. We carry out a detailed performance analysis under the assumption of long data record and derive conditions for estimating all the frequencies. The performance of the proposed algorithm compares favorably with the performance of the Tufts-Kumaresan method (1982)     

Treating fluid noncompliance in the hemodialysis population using unit wide contests

Thirty-six patients with tinea unguium were treated with 200 mg of itraconazole daily for 7 days each month. We suggested that a patient who had a lesion in the thumbnail needed 5 months of treatment for mycologial cure, while in a patient without thumbnail lesion, 3 months of treatment was enough.     

Lunate and perilunate dislocation

BACKGROUND: Patellar problem is an important cause of nonseptic failure of the current condylar design of total knee arthroplasties. Patellar dislocation after total knee arthroplasty is infrequent but can cause disabling symptoms. METHODS: From March, '84 to July, '92, 1652 total knee arthroplasties were performed at this Hospital. Of these 1100 knees in 978 patients were available to be followed up regularly at the Outpatient Department. Eleven cases of patellar dislocation after total knee arthroplasty were encountered during follow-up. Among these patients, nine patients had received operation at this Hospital; the other two patients had been referred here by the other hospitals. All 11 patients had been treated with surgical methods: proximal realignment of the quadriceps alone in 6 knees, lateral retinacular release combined with revision of the malaligned components in 2 knees, combined proximal and distal realignment in 2 knees and patellar tendon transfer in 1 knee. RESULTS: After an average follow-up of 21.8 months, from April, '84 to April, '93, there was one redislocation, unfortunately caused by trauma. Using the average knee rating scale of the Hospital for Special Surgery, New York, USA, the results of 90.5 were satisfactory and encouraging. CONCLUSIONS: Patellar dislocation after total knee arthroplasty can cause disabling symptoms, including pain, weakness, limited range of motion, extension lag and difficulty when climbing up or down stairs. The cause of patellar dislocation after total knee arthroplasty was error in surgical technique in this series. Revision of the component should be performed in those with malaligned component. Proximal realignment is recommended in those with quadriceps imbalance. Distal realignment is recommended only when proximal realignment alone has failed to restore proper patellar tracking, this should be carried out with great caution due to the potential for serious complications.     

Platelet-streptococcal interactions in endocarditis

Infective endocarditis is characterized by the formation of septic masses of platelets on the surfaces of heart valves and is most commonly caused by viridans streptococci. Streptococcal virulence in endocarditis involves factors that promote infectivity and pathogenicity. Adhesins and exopolysaccharide (glycocalyx) contribute to infectivity. Although many factors may contribute to pathogenicity, the platelet aggregation-associated protein (PAAP) of Streptococcus sanguis contributes directly to the development of experimental endocarditis. PAAP is synthesized as a rhamnose-rich glycoprotein of 115 kDa and contains a collagen-like platelet-interactive domain, pro-gly-glu-gln-gly-pro-lys. Expressed on the cell wall of platelet aggregation-inducing strains (Agg+) of S. sanguis, PAAP apparently interacts with a signal-transducing receptor complex on platelets, which includes a novel 175-kDa alpha 2-integrin-associated protein and a 65-kDa collagen-binding component. From available data, the role of PAAP in the pathogenesis of experimental endocarditis may be explained by a proposed mechanistic model. On injured heart valves, PAAP first enhances platelet accumulation into a fibrin-enmeshed thrombus (vegetation), within which S. sanguis colonizes. Colonizing bacteria must resist platelet microbicidal protein (PMPR). The aggregation of platelets on the heart valve may be potentiated by an ectoATPase expressed on the surface of the S. sanguis and platelet alpha-adrenoreceptors that respond to endogenous catecholamines. The expression of PAAP may be modified during infection. Collagen is exposed on damaged heart valves; fever (heat shock) occurs during endocarditis. In response to heat shock or collagen in vitro, PAAP expression is altered. After colonization, streptococcal exotoxin(s) may cause fever. Proteases and other enzymes from streptococci and host sources may directly destroy the heart valves. When PAAP is unexpressed or neutralized with specific antibodies, experimental endocarditis runs a milder course and vegetations are smaller. The data suggest strongly, therefore, that the role of PAAP may overlap the colonization function of putative adhesins such as FimA or SsaB. Finally, PAAP also contributes to the development of the characteristic septic mural thrombus (vegetation) of infective endocarditis and the signs of valvular pathology.     

Severe algoneurodystrophy of the right foot associated with prostatic cancer

The authors report 1 case of particularly severe reflex neurovascular dystrophy whose clinical course was marked by the discovery of a carcinoma of the prostate. There was improvement in the reflex neurovascular dystrophy despite hormonal therapy of the cancer. Reflex neurovascular dystrophy cannot be considered as a form of a paraneoplastic syndrome.