Tripe palms: a cutaneous paraneoplastic syndrome

Tripe palms is a cutaneous paraneoplastic syndrome. We report a case of tripe palms in a 71-year-old man with non-small cell lung cancer. Approximately 90% of patients with tripe palms have an associated cancer, most commonly involving the lung or the stomach. Any patient with tripe palms must have a complete cancer workup, especially for lung and stomach cancer.     

Algal blooms in the spread and persistence of cholera

Cholera has been long associated with the seasonality of coastal algal blooms off Bangladesh. Using fluorescent antibody (FA) techniques, microbiologists have now identified a viable, non-cultivable form of Vibrio cholerae in a wide range of marine life, including cyanobacteria (Anabaena variabilis), diatoms (Skeletonema costatum), phaeophytes (Ascophyllum nodosum), in copepod molts, and in freshwater vascular aquatic plants (water hyacinths and duckweed). In unfavourable conditions V. cholerae assumes spore-like forms; with proper nutrients, pH and temperature, it reverts to a readily transmissible and infectious state. Nitrates and phosphates in sewage and fertilizers cause eutrophication, and scientists report an increase in intensity, duration and shifts in the biodiversity of algal blooms in many coastal, brackish and fresh waters worldwide. V. cholerae has been isolated from phyto- and zooplankton in marine and fresh waters near Lima, Peru. V. cholera 01, biotype El Tor, serotype Inaba, may have arrived in the Americas in the bilge of a Chinese freighter. There, in the abundant coastal sea life along the Latin American Pacific coast, nourished by the Humboldt current and eutrophication, it found a reservoir for surviving unfavourable conditions. It is hypothesized that the algae and Vibrio populations grew exponentially; consumed by fish, mollusks and crustacea, a heavy 'inoculum' of carriers infected with V. cholerae was generated and transported into multiple coastal communities.     

Nuclear cardiology, Part III: Scintigraphic evaluation of cardiac perfusion

OBJECTIVE: After reading Part III of this series of nuclear cardiology articles, the technologist should be able to: (a) compare and contrast radiopharmaceuticals used for myocardial perfusion imaging; (b) describe imaging protocols used for detecting coronary artery disease; and (c) describe imaging patterns seen following reconstruction of myocardial images.     

Pectoralis major tendon avulsion in association with a proximal humerus fracture

We report a very rare case of an avulsion of the pectoralis major tendon in association with a two-part proximal humerus fracture. Pectoralis major tendon avulsion was confirmed intraoperatively during open reduction and internal fixation of the humerus fracture. In retrospect, the preoperative radiographic finding of posterolateral and proximal displacement of the humeral shaft suggested an injury to the pectoralis major. Because others have reported that the best treatment of a pectoralis major tendon avulsion is surgical repair, we feel that it is important to suspect such an injury in a proximal humerus fracture when this anatomic displacement is present.     

Social support knowledge and behavior and relational intimacy: A dyadic study.

Examined the relationships among social support knowledge, supportive behavior, intimacy with one's spouse, and satisfaction with support provided by one's spouse among 41 Israeli kibbutz couples. The hypothesis that support knowledge and support behavior influence the intimacy between couples and increase satisfaction with spouse's social support efforts was tested. Alternative causal mechanisms are explored with simultaneous equation modeling. Results indicate that satisfaction with social support behavior by one's spouse is mediated entirely by intimacy with one's spouse. Results also indicate that partner's knowledge about social support behavior directly affects intimacy and indirectly generates social support satisfaction independent of actual supportive behavior. The findings do not differ by sex. The consistency of the findings with family behavior exchange theory and implications for marital therapy are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Function and sensitivity of signal processing systems based on addition followed by limiting

We show for the first time that signal processing schemes based on noncoherent signal addition will require signal transfer characteristics exhibiting high degrees of curvature. We quantify this by proposing a set of single-input, dual-output, power-conserving transfer functions and generating designs based on these characteristics. We then analyze the sensitivity of such a design scheme to nonidealities in the signal level and device behavior, and show that a sampling operation is only possible for transfer characteristics with residual "low" output of less than about 10% and low intensity reflectivity higher than 98%. For single device signal loss of up to 0.1 dB, we show that the best possible crosstalk-to-noise ratio in a packet forwarder (27 dB), is limited by the availability of the sampling operation.     

Combined-Stage Sintering Model

By focusing on the similarities between the three stages of sintering, a single equation is derived that quantifies sintering as a continuous process from beginning to end. The microstructure is characterized by two separate parameters representing geometry and scale. The dimensionless geometry parameter, denoted T, comprises five scaling factors that relate specific microstructural featuers (e.g., surface curvature) to the scale (grain diameter). Calculations of T from experimental data show (a) agreement with computer simulations of initial-stage sintering, (b) the effect of surface diffusion on T, and (c) changes in T with microstructural evolution during sintering. Application of the model to the design of firing schedules and the study of microstructural geometry effects on sintering is discussed.     

Pentoxifylline therapy in human immunodeficiency virus-seropositive persons with tuberculosis: a randomized, controlled trial

Macrophage activation and tumor necrosis factor-alpha (TNF-alpha) production are critical in tuberculosis immunity but may result in increased human immunodeficiency virus (HIV) expression and accelerated HIV disease progression in HIV-infected persons. Pentoxifylline inhibits expression of TNF-alpha and HIV. A double-blind, placebo-controlled study of adjunctive therapy with pentoxifylline (1800 mg/day) as a timed-release formulation was done in Ugandan HIV-infected patients with pulmonary tuberculosis. Subjects had early HIV disease (mean CD4 cell count, 380/microL) and did not receive other antiretroviral drugs. Pentoxifylline resulted in decreased plasma HIV RNA and serum beta 2-microglobulin and, in a subset of moderately anemic patients, improved blood hemoglobin levels. Trends were noted toward reduced TNF-alpha production in vitro and improved performance scores, but these did not reach statistical significance. No effect was noted on body mass, CD4 cell count, or survival. Additional studies of more potent TNF-alpha inhibitors in HIV-positive subjects with tuberculosis are warranted.     

Clostridium tertium bacteremia: 2 cases and review

Clostridium tertium bacteremia is unusual, seen most often with gastrointestinal disease and/or neutropenia. Two cases are described. The first was a 19-yr-old female with acute leukemia, who developed gastrointestinal symptoms and C. tertium bacteremia while neutropenic. The second was a 57-yr-old female with quiescent ulcerative colitis, who presented with fever, rigors and epigastric pain. Four organisms including C. tertium were isolated from blood cultures. This patient responded to broad spectrum antimicrobial therapy, whereas the first patient required the addition of specific agents to recover. C. tertium is aerotolerant and thus can be misidentified as a Bacillus or Corynebacterium spp. Our isolates had a distinctive Gram stain morphology, were catalase negative and failed to sporulate aerobically--this aided in the recognition of this significant Gram-positive bacillus.     

Flash photolysis of the carbon monoxide compounds of wild-type and mutant variants of cytochrome bo from Escherichia coli

The carbon monoxide compounds of the fully reduced and mixed valence forms of cytochrome bo from Escherichia coli were laser photolysed under anaerobic conditions at room temperature. The carbon monoxide recombined with characteristic rate constants of 50 s-1 or 35 s-1 in the fully reduced and mixed valence forms, respectively. Rates of CO recombination with the fully reduced enzyme were examined in a variety of mutant forms of cytochrome bo, produced by site-directed mutagenesis. A method was developed to deconvolute cytochromes bo and bd, leading to some reassessment of histidine ligands to the metals. Significant changes in the rate constant of recombination of carbon monoxide occurred in many of these mutants and these results could be rationalised generally in terms of our current working model of the folding structure of subunit I. In the mixed valence form of the enzyme the transient photolysis spectra in the visible region are consistent with a rapid electron redistribution from the binuclear centre to the low-spin haem. This electron transfer is biphasic, with rate constants of around 10(5) and 8000 s-1. The process was also examined in the His-333-Leu mutant, in which a putative histidine ligand to CuB is replaced by leucine, and which results in the loss of the CuB. It appeared that rapid haem-haem electron transfer could still occur. The observation that CuB is apparently not required for rapid haem-haem electron transfer is consistent with the recently proposed model in which the two haems are positioned on opposite sides of transmembrane helix X in subunit I of the oxidase.