Postoperatives Pyoderma gangraenosum Cullen

The clinical picture in pyoderma gangrenosum varies but a typical medical history with resistance to antimicrobial treatment and worsening or first manifestation of disease because of surgical procedures are indications of this diagnosis. We describe the course of a woman patient who had a pyoderma gangrenosum for more than 1.5 years. After confirming the diagnosis an immunomodulating therapy was initiated until complete remission of the ulcers. Differential diagnosis and different clinicopathologic forms of pyoderma gangrenosum are discussed and an overview of the association with internal diseases is provided.

Kutane Botryomykose

Botryomycosis is a rare chronic bacterial infection, which can involve the skin as well as internal organs. Clinically and histologically it resembles actinomycosis and deep fungal infections. The most common causative organisms described are Staphylococcus aureus, Escherichia coli and Pseudomonas aeruginosa, but the pathogenesis of botryomycosis is still poorly understood. A 16-year-old girl presented with multiple erythematous solid and partly purulent nodules which were extremely resistant to therapy. In this case we could diagnose a botryomycosis caused by Staphylococcus aureus.

Obliquely propagating dust-density plasma waves in the presence of an ion beam

Self-excited dust-density waves are experimentally studied in a dusty plasma under microgravity. Two types of waves are observed: a mode inside the dust volume propagating in the direction of the ion flow and a new mode propagating obliquely at the boundary between the dusty plasma and the space-charge sheath. A model for dust-density waves propagating at an arbitrary angle with respect to the ion-flow direction is presented, which explains the preference for oblique or parallel modes as a function of ion velocity.

Ondansetron oral spray (Zensana) versus ondansetron oral tablets in a randomized, bioavailability study in adult subjects

8622

Background: Zensana ondansetron oral spray (ZSN) is the first oral spray 5-HT3 antagonist to deliver ondansetron, the most commonly prescribed anti-emetic for chemotherapy induced nausea and vomiting (CINV) through the oral cavity. ZSN achieves therapeutic drug levels by delivering small droplets of concentrated drug solution over the oral mucosa, which has a rich blood supply and has been shown to be an alternative drug delivery route. ZSN may offer certain advantages to patients experiencing CINV who have difficulty swallowing and holding down pills. Methods: This was a randomized, crossover, pharmacokinetic (PK) study where ZSN, administered as 4mg, 8mg, 12mg, and 8mg with a 30-sec hold before swallowing was evaluated in healthy subjects against an 8mg ondasetron (Zofran [ZFR]) tablet (reference). Treatments were separated by 48 hrs. PK samples were measured during the 24 hrs after dosing and were assayed using LC/MS/MS techniques. PK parameters were analyzed using a cross-over ANOVA model. Two treatments were concluded bioequivalent if the 90% CI of the geometric mean ratios for ln-transformed Cmax, AUC0-t, and AUC0-inf fell between the FDA guideline of 80% to 125%. Results: Thirty-two subjects (17 women, 15 men) received each of the 5 treatments, except for one man who did not receive the 12mg dose. The geometric mean ratios and the 90% CI for Cmax, AUC0-t, and AUC0-inf respectively, for each pair of treatments were as follows: ZSN 4mg vs 8mg tablet (TAB): 41%(39–43%); 45%(43–47%), and 47%(45–49%); ZSN 8mg vs 8mg TAB: 87%(83–91%), 98%(94–102%), and 99%(94–103%); ZSN 12mg vs 8mg TAB: 145%(138–152%), 157%(150–164%), and 157%(150–164%); and ZSN 8mg with a 30 sec hold vs 8mg TAB: 86%(82–90%), 99%(94–103%), and 99%(95–104%). There were no serious or unexpected adverse events (AE) and the safety profile was similar across all treatments. The most commonly reported AEs were constipation (11/32[34%]), headache (10/32[31%]), and dizziness (5/32[16%]) which were mild to moderate in severity. Conclusions: ZSN 8mg falls within the FDA criteria for bioequivalence, and is bioequivalent to an 8mg ZFR tablet. ZSN 4, 8, or 12mg has a similar safety profile as a ZFR 8 mg tablet.

[Table: see text]

Measurement of bottom-quark hadron masses in exclusive J/psi decays with the CDF detector

We measure the masses of b hadrons in exclusively reconstructed final states containing a J/psi --> mu-mu+ decay using 220 pb(-1) of data collected by the CDF II experiment. We find: m(B+) = 5279.10 +/- 0.41(stat.) +/- 0.36(sys.) MeV/c2, m(B0) = 5279.63 +/- 0.53(stat.) +/- 0.33(sys.) MeV/c2, m(B(s)0) = 5366.01 +/- 0.73(stat.) +/- 0.33(sys.) MeV/c2, m(lambda(b)0) = 5619.7 +/- 1.2(stat.) +/- 1.2(sys.) MeV/c2. m(B+) - m(B0) = -0.53 +/- 0.67(stat.) +/- 0.14(sys.) MeV/c2, m(B(s)0) - m(B0) = 86.38 +/- 0.90(stat.) +/- 0.06(sys.) MeV/c2, m(lambda(b)0) - m(B0) = 339.2 +/- 1.4(stat.) +/- 0.1(sys.) MeV/c2. The measurements of the B(s)0, lambda(b)0 mass, m(B(s)0) - m(B0) and m(lambda(b)0) - m(B0) mass difference are of better precision than the current world averages.

Sodium Thiosulphate as a Promising Therapeutic Option to Treat Calciphylaxis

A 35-year-old haemodialysis-dependent woman with chronic renal failure developed large, very painful necrotic ulcers and necrosis on the thighs, buttocks and the abdomen with signs of fast progression. The skin biopsy specimens showed a broad necrosis of the epidermis and thrombosed dermal vessels with focal calcium deposits within the wall. In addition, laboratory findings presented an increased product of serum calcium and phosphate concentrations. Thus, we diagnosed calciphylaxis on the basis of clinical, biochemical and histopathological criteria. We initiated a therapy in which our patient was treated with intravenous sodium thiosulphate 3 times weekly. Already after 2 weeks of treatment, no new lesions were detectable and there was a dramatic pain relief. In the following 4 weeks, a successive decline of the ulcers and the healing of individual tissue defects could be seen. Four months after the start of the therapy, the patient underwent successful renal transplantation. Thus, the intravenous therapy of calciphylaxis with sodium thiosulphate might be a new effective alternative in the treatment of this life-threatening disease.

Chordoid glioma of the third ventricle: immunohistochemical and molecular genetic characterization of a novel tumor entity

Chordoid glioma of the third ventricle was recently reported as a novel tumor entity of the central nervous system with characteristic clinical and histopathological features (Brat et al., J Neuropathol Exp Neurol 57: 283-290, 1998). Here, we report on a histopathological, immunohistochemical and molecular genetic analysis of five cases of this rare neoplasm. All tumors were immunohistochemically investigated for the expression of various differentiation antigens, the proliferation marker Ki-67, and a panel of selected proto-oncogene and tumor suppressor gene products. These studies revealed a strong expression of GFAP, vimentin, and CD34. In addition, most tumors contained small fractions of neoplastic cells immunoreactive for epithelial membrane antigen, S-100 protein, or cytokeratins. The percentage of Ki-67 positive cells was generally low (<5%). All tumors showed immunoreactivity for the epidermal growth factor receptor and schwannomin/merlin. There was no nuclear accumulation of the p53, p21 (Waf-1) and Mdm2 proteins. To examine genomic alterations associated with the development of chordoid gliomas, we screened 4 tumors by comparative genomic hybridization (CGH) analysis. No chromosomal imbalances were detected. More focussed molecular genetic analyses revealed neither aberrations of the TP53 and CDKN2A tumor suppressor genes nor amplification of the EGFR, CDK4, and MDM2 proto-oncogenes. Our data strongly support the hypothesis that chordoid glioma of the third ventricle constitutes a novel tumor entity characterized by distinct morphological and immunohistochemical features, as well as a lack of chromosomal and genetic alterations commonly found in other types of gliomas or in meningiomas.

Chronic venous insufficiency - a potential trigger for localized scleroderma

Localized scleroderma is a cutaneous disease that is characterized by an initial inflammatory response, followed by sclerosis of the skin. The cause of localized scleroderma has not yet been determined. Seifarth et al. reported two cases of localized scleroderma at sites of chronic venous insufficiency. We document here three more patients in whom localized scleroderma was located at insufficient veins. Treatment of underlying chronic venous insufficiency (CVI) leads to a substantial clinical improvement of scleroderma at the site of insufficient veins, but not elsewhere. Experimental data support the concept of chronic venous insufficiency creating a microenvironment, which may lead to localized scleroderma. Local hypoxaemia, which is present in CVI, induces the release of endothelium-derived cytokines, such as IL-1. Subsequently, expression of endothelial adhesion molecules and consequently leucocyte extravasation are induced. Infiltrating leucocytes secrete a number of inflammatory mediators, including transforming growth factor beta, which is a potent stimulus for collagen synthesis. Therefore, it may well be that CVI is a potential trigger factor for localized scleroderma. In addition, localized scleroderma may only develop if a certain amount of trigger factors are present - and resolves if one or more of the contributing factors (i.e. CVI) can be treated.

Comprehensive genomic analysis of desmoplastic medulloblastomas: identification of novel amplified genes and separate evaluation of the different histological components

Desmoplastic medulloblastoma (DMB) is a malignant cerebellar tumour composed of two distinct tissue components, pale islands and desmoplastic areas. Previous studies revealed mutations in genes encoding members of the sonic hedgehog pathway, including PTCH, SMOH and SUFUH in DMBs. However, little is known about other genomic aberrations. We performed comparative genomic hybridization (CGH) analysis of 22 sporadic DMBs and identified chromosomal imbalances in 20 tumours (91%; mean, 4.9 imbalances/tumour). Recurrent chromosomal gains were found on chromosomes 3, 9 (six tumours each), 20, 22 (five tumours each), 2, 6, 7, 17 (four tumours each) and 1 (three tumours). Recurrent losses involved chromosomes X (eight tumours), Y (six of eleven tumours from male patients), 9, 12 (four tumours each), as well as 10, 13 and 17 (three tumours each). Four tumours demonstrated high-level amplifications involving sequences from 1p22, 5p15, 9p, 12p13, 13q33-q34 and 17q22-q24, respectively. Further analysis of the 9p and 17q22-q24 amplicons by array-based CGH (matrix-CGH) and candidate gene analyses revealed amplification of JMJD2C at 9p24 in one DMB and amplification of RPS6KB1, APPBP2, PPM1D and BCAS3 from 17q23 in three DMBs. Among the 17q23 genes, RPS6KB1 showed markedly elevated transcript levels as compared to normal cerebellum in five of six DMBs and four of five classic medulloblastomas investigated. Finally, CGH analysis of microdissected pale islands and desmoplastic areas showed common chromosomal imbalances in five of six informative tumours. In summary, we have identified several novel genetic alterations in DMBs and provide genetic evidence for a monoclonal origin of their different tissue components.

Search for new physics using high-mass tau pairs from 1.96 TeV pp collisions

We present the results of a search for anomalous resonant production of tau lepton pairs with large invariant mass, the first such search using the CDF II Detector in Run II of the Tevatron pp collider. Such anomalous production could arise from various new physics processes. In a data sample corresponding to 195 pb(-1) of integrated luminosity we predict 2.8+/-0.5 events from standard model background processes and observe 4. We use this result to set limits on the production of heavy scalar and vector particles decaying to tau lepton pairs.

Measurement of B(t --> Wb)/B(t--> Wq) at the collider detector at fermilab

We present a measurement of the ratio of top-quark branching fractions R = B(t --> Wb)/B(t --> Wq), where q can be a b, s, or a d quark, using lepton-plus-jets and dilepton data sets with an integrated luminosity of approximately 162 pb(-1) collected with the Collider Detector at Fermilab during Run II of the Tevatron. The measurement is derived from the relative numbers of tt events with different multiplicity of identified secondary vertices. We set a lower limit of R > 0.61 at 95% confidence level.

Search for long-lived doubly charged Higgs bosons in pp collisions at sqrt[s] = 1.96 TeV

We present a search for long-lived doubly charged Higgs bosons (H(+/- +/-)), with signatures of high ionization energy loss and muonlike penetration. We use 292 pb(-1) of data collected in pp collisions at sqrt[s] = 1.96 TeV by the CDF II detector at the Fermilab Tevatron. Observing no evidence of long-lived doubly charged particle production, we exclude H(+/- +/-)(L) and H(+/- +/-)(R) bosons with masses below 133 GeV/c(2) and 109 GeV/c(2), respectively. In the degenerate case we exclude H(+/- +/-) mass below 146 GeV/c(2). All limits are quoted at the 95% confidence level.

Search for Higgs bosons decaying into bb and produced in association with a vector boson in pp collisions at square root of s = 1.8 TeV

We present a new search for H0V production, where H0 is a scalar Higgs boson decaying into bb with branching ratio beta, and V is a Z0 boson decaying into e+e-, mu+mu-, or nunu. This search is then combined with previous searches for H0V where V is a W+/- boson or a hadronically decaying Z0. The data sample consists of 106 +/- 4 pb(-1) of pp collisions at square root of s = 1.8 TeV accumulated by the Collider Detector at Fermilab. Observing no evidence of a signal, we set 95% Bayesian credibility level upper limits on sigma(pp --> H0V) x beta. For H0 masses of 90, 110, and 130 GeV/c2, the limits are 7.8, 7.2, and 6.6 pb, respectively.

[Silica-containing urinary stones--clinical issues to keep in mind]

Formation of calculi in efferent urinary passages is always due to supersaturation of urinary calculi substances and associated increased crystallization. Apart from the typical calculi, consisting of calcium oxalate, inorganic phosphates, uric acid or cystine, there are occasional signs of rare substance classes. Although more than 50 silicate stones have already been reported internationally, this stone entity remains relatively unknown. In particular, the occurrence of silicate stones in the absence of magnesium trisilicate abuse is extremely rare. A medium-sized left-sided ureterolith was removed from a 54-year-old male patient using a ureteroscope. X-ray diffraction showed it to be a compound stone consisting of 40% silicate. The patient, who in 1986 was living close to the nuclear reactor accident in Chernobyl, showed no signs of a constant uptake of magnesium trisilicate. However, he had undergone partial (2/3) gastrectomy 4 months before for a drug-refractory gastric ulcer, which had been diagnosed at the end of the 1980s and treated with excessive dosages of a magnesium trisilicate antacid preparation until the time of the operation. The patient had also been suffering from unstable angina pectoris since 1986 and treated with Pentalong (pentaerythrityltetranitrate) for 17 years. We were also able to detect silicium dioxide in components of this drug using X-ray diffraction. Silicate uroliths are extremely rare but they can be clearly identified by X-ray diffraction or infrared spectroscopy and distinguished from artifacts or quartz pebbles. Formation of calculi can be prevented by increasing diuresis as well as switching to a different drug and reducing the dosage.

Evidence for B0 s-->phiphi decay and measurements of branching ratio and A(CP) for B+ -->phiK+

We present the first evidence of charmless decays of the B(0)(s) meson, the decay B(0)(s)--> phiphi, and a measurement of the branching ratio BR(B(0)(s)--> phiphi) using 180 pb(-1) of data collected by the CDF II experiment at the Fermilab Tevatron collider. In addition, the BR and direct CP asymmetry for the B+-->phiK+ decay are measured. We obtain BR(B(0)(s)--> phiphi)=[14(+6)(-5)(stat)+/-6(syst)] x 10(-6), BR(B+-->phiK+)=[7.6+/-1.3(stat)+/-0.6(syst)] x 10(-6), and A(CP)(B+-->phiK+)= -0.07+/-0.17(stat)+0.03 / -0.02(syst). Both decays are governed in the standard model by second order (penguin) b-->s(-)ss amplitudes.

Search for anomalous kinematics in tt dilepton events at CDF II

We report on a search for anomalous kinematics of tt dilepton events in pp collisions at square root of s=1.96 TeV using 193 pb(-1) of data collected with the CDF II detector. We developed a new a priori technique designed to isolate the subset in a data sample revealing the largest deviation from standard model (SM) expectations and to quantify the significance of this departure. In the four-variable space considered, no particular subset shows a significant discrepancy, and we find that the probability of obtaining a data sample less consistent with the SM than what is observed is 1.0%-4.5%.

Measurement of the cross section for prompt diphoton production in pp collisions at square root of s=1.96 TeV

We report a measurement of the rate of prompt diphoton production in pp collisions at square root of s=1.96 TeV using a data sample of 207 pb(-1) collected with the upgraded Collider Detector at Fermilab. The background from nonprompt sources is determined using a statistical method based on differences in the electromagnetic showers. The cross section is measured as a function of the diphoton mass, the transverse momentum of the diphoton system, and the azimuthal angle between the two photons and is found to be consistent with perturbative QCD predictions.

Measurement of the W(+)W(-) production cross section in pp collisions at square root[s]=1.96 TeV using dilepton events

We present a measurement of the W(+)W(-) production cross section using 184 pb(-1) of p(p) collisions at a center-of-mass energy of 1.96 TeV collected with the Collider Detector at Fermilab. Using the dilepton decay channel W(+)W(-)-->l(+)nul(-), where the charged leptons can be either electrons or muons, we find 17 candidate events compared to an expected background of 5.0(+2.2)(-0.8) events. The resulting W(+)W(-) production cross-section measurement of sigma(pp-->W(+)W(-))=14.6(+5.8)(-5.1)(stat)(+1.8)(-3.0)(syst) +/- 0.9(lum) pb agrees well with the standard model expectation.