Metastatic renal cell carcinoma presenting as an aural polyp

Renal cell carcinoma may metastasize to the head and neck region at different stages of its evolution. We present a case of an undiagnosed renal cell carcinoma presenting as an ear polyp, and discuss the difficulties of the diagnosis and the management of these tumours.     

Comments on “Editorial: fuzzy models-what are they andwhy?”

In the editorial by J.C. Bezdek (ibid., p.1), an example is presented to demonstrate differences between fuzzy membership and probability. The authors argue that probability can be used in a way much more closely analogous to this use of fuzzy membership, weakening the argument for the latter     

Retained fetal lung liquid in congenital lobar emphysema: a possible predictor of polyalveolar lobe

The purpose of this study was to determine whether retention of fetal lung liquid is more prevalent in polyalveolar congenital lobar emphysema than in conventional congenital lobar emphysema. Two patients with congenital lobar emphysema were prospectively identified in a 3-year period. Twenty-five such patients were identified in a retrospective study covering 39 years. Medical records were available for 22 patients who had 23 emphysematous lobes. Both babies from the prospective study and six subjects from the retrospective group had respiratory symptoms and underwent chest X-ray in the first day of life. Six of the eight babies with respiratory symptoms and chest imaging in the first day of life had retention of fetal lung liquid in an emphysematous lobe. All six of these lobes were polyalveolar. The lobe in one child was a polyalveolar lobe but without retained fetal lung liquid, and one child exhibited conventional lobar emphysema also without retained fetal lung liquid. One polyalveolar lobe caused no neonatal symptoms and was not imaged until the child was 3 months old. No baby with conventional lobar emphysema was shown to have retained fetal lung liquid. There seems to be a correlation between polyalveolar lobe and onset of respiratory symptoms in the first day of life. Retention of fetal lung liquid within the affected lobe was documented only in cases of polyalveolar lobe.     

The use of stokeslets to describe the arbitrary translation of a disk near a plane wall

A previously presented method is extended to describe the fully three-dimensional Stokes flow generated by the translation in any direction of an arbitrarily oriented disk in fluid bounded by a plane wall. The velocity field is represented solely in terms of stokeslet distributions on the disk, modified to take account of the bounding wall according to the century-old idea of Lorentz. Sets of integral equations of the second kind, not all disjoint, are obtained for the Abel transforms in each Fourier mode of the density functions. However, only a few modes need be considered in determining the flow field to order D ^-3, where D is the distance of the disk axis from the wall. Less detail is required to evaluate the drag force and torque experienced by the disk.     

A multi-agent decision support system for stock trading

A distributed problem solving system can be characterized as a group of individual cooperating agents running to solve common problems. As dynamic application domains continue to grow in scale and complexity, it becomes more difficult to control the purposeful behavior of agents, especially when unexpected events may occur. This article presents an information and knowledge exchange framework to support distributed problem solving. From the application viewpoint the article concentrates on the stock trading domain; however, many presented solutions can be extended to other dynamic domains. It addresses two important issues: how individual agents should be interconnected so that their resources are efficiently used and their goals accomplished effectively; and how information and knowledge transfer should take place among the agents to allow them to respond successfully to user requests and unexpected external situations. The article introduces an architecture, the MASST system architecture, which supports dynamic information and knowledge exchange among the cooperating agents. The architecture uses a dynamic blackboard as an interagent communication paradigm to facilitate factual data, business rule, and command exchange between cooperating MASST agents. The critical components of the MASST architecture have been implemented and tested in the stock trading domain, and have proven to be a viable solution for distributed problem solving based on cooperating agents     

Energy use in controlled temperature marine aquaculture

Temperature control offers benefits in land‐based marine aquaculture: stock growth rates may be enhanced by heating in winter; mortality rates in summer may be reduced by cooling. However, if the plant is not well designed, temperature control may create very large energy demands. This paper describes the application of temperature control in abalone aquaculture in New Zealand, with a focus on energy considerations in plant design. An abalone farm using a semi‐closed water conditioning system is used as a case study for which an energy model, based on a heat pump system, is developed. The model is used to determine the impact of plant design and tank conditions on the economics of the operation. Copyright © 2002 John Wiley & Sons, Ltd.     

Infections in patients with cystic fibrosis following lung transplantation

BACKGROUND: There is controversy over whether colonization with drug-resistant organisms is a contraindication to lung transplantation. METHODS: We undertook a retrospective review of the results of lung transplantation for patients with cystic fibrosis (CF) at Duke University Medical Center. RESULTS: As of May 1996, 21 patients with CF underwent bilateral lung transplantation. The first patient died within 24 h of transplantation from sepsis due to Stenotrophomonas maltophilia. Of the remaining 20 patients, 17 (85%) are alive and in stable condition. The three deaths were related primarily to bronchiolitis obliterans at 4 and 18 months in two patients and to cytomegalovirus pneumonitis at 5 months in the other patient. The 17 surviving patients have been followed up for a mean of 13 months (range, 0.5 to 34 months). Most of them were colonized and infected with multidrug-resistant organisms before transplantation. Following transplantation, 11 patients had complications from infections. One patient had bacteremia due to a panresistant Burkholderia cepacia and was treated successfully. Two patients had bacteremia and wound infection due to Burkholderia gladioli, previously thought to be pathogenic only in plants. Both patients were treated successfully. Of the six patients with Aspergillus fumigatus isolated from cultures before transplantation, only one had invasive disease following transplantation and responded to treatment. CONCLUSION: The organisms present before transplantation were not the primary cause of mortality in our patient population. Our findings suggest that lung transplantation should be considered in CF patients infected with multidrug-resistant organisms.