[A historic case of Wegener's granulomatosis: the physicist who discovered the electromagnetic waves: Heinrich Hertz].

PubMed

Feldmann, H

2005-06-01

A diary and an extensive correspondence of Heinrich Hertz and his family provide a meticulous documentation of his life, made available by Albrecht Folsing in 1997 through a carefully investigated biography, which permit the conclusion that H. Hertz died of Wegener's granulomatosis, 45 years before this disease had been explored. WEGENER'S GRANULOMATOSIS: The symptoms of the granulomatosis, that was first described by Friedrich Wegener in 1936 and 1939 are presented in short with literal quotations of the author: It begins with a refractory cold that will last until the end, then follow involvement of the paranasal sinuses, ears, mucous lining of mouth and pharynx, slight fever, weakness, in the final phase dissemination with nephritis, septic fever, arthritis, myalgia, paralyses leading to total immobility, exitus. The etiology is not fully understood but probably based on immunoreaction. H. HERTZ: CURRICULUM VITAE: Born in Hamburg, Germany, in 1857: after secondary school academic training in physics at Dresden, Munic and Berlin. 1885 professor of physics in Karlsruhe, then starting in 1889 at Bonn. 1887/88 exploration of the electromagnetic waves, now the basis for all radio communication, and exploration of the photoelectric effect, the basis of solar techniques. Numerous highranking distinctions. H. HERTZ: The case history is presented in detail based on numerous literal quotations from personal letters and the diary. After a few banal affections involving the teeth and toes the systemic disease became manifest in summer 1892 with a refractory cold which remained the focus of treatment until death. Granulation tissue in the nose that was excised several times: no tuberculosis, no carcinoma. Otitis with purulent mastoiditis, in October 1892 mastoidectomy, persistent purulence. Early in 1893 diagnosis of nephritis. Extraction of a superior tooth, punturing of the maxillary sinus, then twice radical opening of the maxillary sinus. Painful ankylosis and paralyses ending in complete immobility, hyperthermy, exitus on Jan. 1 1894. The case history is repeated in short and discussed. At that time a diagnosis and an effective therapy were not available. Today the disease could have been kept under control applying immunosuppressive and antibiotic treatment.

Wegener granulomatosis as an uncommon cause of panhypopituitarism in childhood.

PubMed

Kara, Ozlem; Demirel, Fatma; Acar, Banu Celikel; Cakar, Nilgün

2013-01-01

Wegener granulomatosis (WG) is a cytoplasmic antineutrophil cytoplasmic antibody (c-ANCA)-associated, multi-system, necrotizing granulomatous vasculitis. Inflammation of the nasal or oral mucosa, and lung and kidney involvements are typical in the course of the disease. In rare cases, pituitary involvement may occur and cause panhypopituitarism. Pituitary involvement is very rare, and only two pediatric case reports have been published to date out of a total of 24 cases. This is a case report of an adolescent patient who presented with panhypopituitarism symptoms and was later diagnosed with WG. A 16-year-old female patient complained of fever, headache, purulent nasal discharge and severe muscle and joint pain. Additionally, she had polyuria and polydipsia. Investigations revealed a pituitary mass and panhypopituitarism. Positivity of c-ANCA and renal biopsy result compatible with WG confirmed the diagnosis.

Wegener's granulomatosis occurring de novo during pregnancy.

PubMed

Alfhaily, F; Watts, R; Leather, A

2009-01-01

Wegener's granulomatosis (WG) is rarely diagnosed during the reproductive years and uncommonly manifests for the first time during pregnancy. We report a case of de novo WG presenting at 30 weeks gestation with classical symptoms of WG (ENT, pulmonary). The diagnosis was confirmed by radiological, laboratory, and histological investigations. With a multidisciplinary approach, she had a successful vaginal delivery of a healthy baby. She was treated successfully by a combination of steroids, azathioprine and intravenous immunoglobulin in the active phase of disease for induction of remission and by azathioprine and steroids for maintenance of remission. The significant improvement in her symptoms allowed us to continue her pregnancy to 37 weeks when delivery was electively induced. Transplacental transmission of PR3-ANCA occurred but the neonate remained well. This case of de novo WG during pregnancy highlights the seriousness of this disease and the challenge in management of such patients.

Induction of Regulatory t Cells by Low Dose il2 in Autoimmune and Inflammatory Diseases

ClinicalTrials.gov

2018-01-10

Rheumatoid Arthritis; Ankylosing Spondylitis; Systemic Lupus Erythematosus; Psoriasis; Behcet's Disease; Wegener's Granulomatosis; Takayasu's Disease; Crohn's Disease; Ulcerative Colitis; Autoimmune Hepatitis; Sclerosing Cholangitis; Gougerot-sjögren; Idiopathic Thrombocytopenic Purpura; Systemic Sclerosis

[Morphological pathology of vessels in granulomatosis with polyangiitis (Wegener's disease)].

PubMed

Zerbino, D D; Zimba, E A

2015-01-01

to investigate the incidence of injuries in different vascular beds and the morphopathological changes in vessels in granulomatosis with polyangiitis. The morphopathological features of vascular injuries were investigated in 11 dead patients aged 16--74 years with granulomatosis with polyangiitis. Proliferative and destructive angiitis with predominant involvement of microcirculatory vessels and with development of necrosis-prone granulomas in their walls and perivascularly was established to underlie the clinical manifestations of granulomatosis with polyangiitis. The most typical localization of the pathologic process is the vessels of the upper respiratory tract, lungs, and kidneys. Cardiopulmonary and renal failures are causes of death in the majority of cases. It should be noted that the vessels of the heart, liver, and gastrointestinal tract are frequently involved in the pathological process. Vascular changes in these organs determine the clinical features of granulomatosis with polyangiitis and lead to a number of fatal complications. Granulomatosis with polyangiitis is a systemic disease with polymorphism of clinical manifestations, which requires in-depth analysis based on current precision patient examination methods, including a histopathological study.

Assessment of the Item Selection and Weighting in the Birmingham Vasculitis Activity Score for Wegener's Granulomatosis

PubMed Central

MAHR, ALFRED D.; NEOGI, TUHINA; LAVALLEY, MICHAEL P.; DAVIS, JOHN C.; HOFFMAN, GARY S.; MCCUNE, W. JOSEPH; SPECKS, ULRICH; SPIERA, ROBERT F.; ST.CLAIR, E. WILLIAM; STONE, JOHN H.; MERKEL, PETER A.

2013-01-01

Objective To assess the Birmingham Vasculitis Activity Score for Wegener's Granulomatosis (BVAS/WG) with respect to its selection and weighting of items. Methods This study used the BVAS/WG data from the Wegener's Granulomatosis Etanercept Trial. The scoring frequencies of the 34 predefined items and any “other” items added by clinicians were calculated. Using linear regression with generalized estimating equations in which the physician global assessment (PGA) of disease activity was the dependent variable, we computed weights for all predefined items. We also created variables for clinical manifestations frequently added as other items, and computed weights for these as well. We searched for the model that included the items and their generated weights yielding an activity score with the highest R2 to predict the PGA. Results We analyzed 2,044 BVAS/WG assessments from 180 patients; 734 assessments were scored during active disease. The highest R2 with the PGA was obtained by scoring WG activity based on the following items: the 25 predefined items rated on ≥5 visits, the 2 newly created fatigue and weight loss variables, the remaining minor other and major other items, and a variable that signified whether new or worse items were present at a specific visit. The weights assigned to the items ranged from 1 to 21. Compared with the original BVAS/WG, this modified score correlated significantly more strongly with the PGA. Conclusion This study suggests possibilities to enhance the item selection and weighting of the BVAS/WG. These changes may increase this instrument's ability to capture the continuum of disease activity in WG. PMID:18512722

Autologous Peripheral Blood Stem Cell Transplantation in Patients With Life Threatening Autoimmune Diseases

ClinicalTrials.gov

2005-06-23

Purpura, Schoenlein-Henoch; Graft Versus Host Disease; Anemia, Hemolytic, Autoimmune; Rheumatoid Arthritis; Churg-Strauss Syndrome; Hypersensitivity Vasculitis; Wegener's Granulomatosis; Systemic Lupus Erythematosus; Giant Cell Arteritis; Pure Red Cell Aplasia; Juvenile Rheumatoid Arthritis; Polyarteritis Nodosa; Autoimmune Thrombocytopenic Purpura; Takayasu Arteritis

Rare presentation of Wegener's granulomatosis in the pituitary gland: Case report and literature review.

PubMed

Baird, Samantha M; Pratap, Upasna; McLean, Catriona; Law, Candice P; Maartens, Nicholas

2017-01-01

Wegener's granulomatosis (WG) is a systemic vasculitis that can affect a variety of organs including ear, nose and throat, lungs and kidneys. However WG is unusual in the pituitary and rare in the central nervous system. A 56-year-old male with likely WG presented with polyuria and polydipsia despite six months of conservative medical management. MRI scanning revealed an enlarging heterogeneously enhancing pituitary gland. Following endoscopic transsphenoidal pituitary biopsy and debulking, final tissue pathology was diagnostic for WG in the pituitary gland. Diagnosis remains difficult but most patients present with central diabetes insipidus (CDI) as well as varying degrees of hypopituitarism on a background of disease activity in other organs. Clinical judgment needs to balance the need for invasive surgical tissue diagnosis with increasing immunosuppressive therapy. It is important to consider this rare complication of WG to ensure timely diagnosis and management. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

Granulomatosis with polyangiitis presenting as facial nerve palsy in a teenager.

PubMed

Wang, James C; Leader, Brittany A; Crane, Ryan A; Koch, Bernadette L; Smith, Matthew M; Ishman, Stacey L

2018-04-01

Granulomatosis with polyangiitis (GPA, previously known as Wegener's granulomatosis) is an autoimmune systemic small-vessel vasculitis, associated with the presence of anti-neurophil cytoplasmic antibodies with a cytoplasmic staining pattern (c-ANCA). It is characterized by necrotizing granulomas, usually affecting the airways and kidneys. GPA should be considered when patients do not improve despite adequate treatment of otologic symptoms, when patients have unspecific symptoms suggesting systemic disease (e.g. fever, malaise), or when other organs are involved (kidney, lungs, etc.). We present an interesting case of a 14-year-old female with eight-weeks of bilateral otalgia, unilateral facial nerve palsy, decreased appetite, and fatigue refractory to steroid, anti-viral, and antibiotic treatment ultimately diagnosed with GPA. Copyright © 2018. Published by Elsevier B.V.

Assessment of Health Related Quality of Life as an Outcome Measure in Granulomatosis with Polyangiitis (Wegener's)

PubMed Central

Tomasson, Gunnar; Boers, Maarten; Walsh, Michael; LaValley, Michael; Cuthbertson, David; Carette, Simon; Davis, John C.; Hoffman, Gary S.; Khalidi, Nader A.; Langford, Carol A.; McAlear, Carol A.; McCune, W. Joseph; Monach, Paul A.; Seo, Philip; Specks, Ulrich; Spiera, Robert; St. Clair, E. William; Stone, John H.; Ytterberg, Steven R.; Merkel, Peter A.

2011-01-01

Objective Assess a generic measure of health-related quality of life (HRQOL) as an outcome measure in granulomatosis with polyangiitis (Wegener's, GPA) Methods Subjects were participants in the Wegener’s Granulomatosis Etanercept Trial (WGET) or the Vasculitis Clinical Research Consortium Longitudinal Study (VCRC-LS). HRQOL was assessed with the Short Form 36 Health Survey (SF-36) that includes physical and mental component summary scores (PCS and MCS). Disease activity was assessed with the Birmingham Vasculitis Activity Score for Wegener’s Granulomatosis (BVAS/WG). Results Data from 180 subjects in the WGET (median follow-up = 2.3 years, mean number of visits = 10) and 237 subjects in the VCRC-LS (median follow-up = 2.0 years, mean number of visits = 8) were analyzed. One unit increase in BVAS/WG corresponded to a 1.15 unit (95%CI: 1.02; 1.29) decrease in PCS and a 0.93 (95%CI: 0.78; 1.07) decrease in MCS in the WGET and by 1.16 for PCS (95%CI: 0.94; 1.39) and 0.79 for MCS (95%CI: 0.51; 1.39) in the VCRC-LS. In both arms of the WGET study, SF-36 measures improved rapidly during the first 6 weeks of treatment followed by gradual improvement among patients achieving sustained remission (0.5 improvement in PCS per three months), but worsened slightly (0.03 decrease in PCS per three months) among patients not achieving sustained remission (p = 0.005). Conclusion HRQOL, as measured by SF-36, is reduced among patients with GPA. SF-36 measures are modestly associated with other disease outcomes and discriminate between disease states of importance in GPA. PMID:21954229

Impaired granulocyte oxidative burst and decreased expression of leucocyte adhesion molecule-1 (LAM-1) in patients with Wegener's granulomatosis.

PubMed Central

Riecken, B; Gutfleisch, J; Schlesier, M; Peter, H H

1994-01-01

Neutrophils are the target of autoantibodies in Wegener's granulomatosis (WG). In this study, granulocyte function and surface marker expression were investigated in patients with WG. The oxidative burst in response to phorbol myristate acetate (PMA) was tested with granulocytes of 25 patients with histologically proven WG. A significantly diminished percentage of oxygen radical-producing cells was found in patients with active disease. Surface antigen expression of CD11b and LAM-1 was analysed on granulocytes of 20 patients with WG. Whereas the expression of CD11b was normal, surface expression of LAM-1 was decreased in nine cases with WG. The decrease of LAM-1 correlated with disease activity. Phagocytosis of Escherichia coli was tested in 10 patients with WG, and normal values were found in all cases. We conclude that down-regulation of LAM-1 may be a marker of disease activity in WG. The altered response to PMA may indicate functional changes in granulocyte reactivity due to autoantibody-induced damage of the granulocyte membrane. PMID:7512009

Comparison of disease activity measures for anti-neutrophil cytoplasmic autoantibody (ANCA)-associated vasculitis.

PubMed

Merkel, P A; Cuthbertson, D D; Hellmich, B; Hoffman, G S; Jayne, D R W; Kallenberg, C G M; Krischer, J P; Luqmani, R; Mahr, A D; Matteson, E L; Specks, U; Stone, J H

2009-01-01

Currently, several different instruments are used to measure disease activity and extent in clinical trials of anti-neutrophil cytoplasmic autoantibody (ANCA)-associated vasculitis, leading to division among investigative groups and difficulty comparing study results. An exercise comparing six different vasculitis instruments was performed. A total of 10 experienced vasculitis investigators from 5 countries scored 20 cases in the literature of Wegener granulomatosis or microscopic polyangiitis using 6 disease assessment tools: the Birmingham Vasculitis Activity Score (BVAS), The BVAS for Wegener granulomatosis (BVAS/WG), BVAS 2003, a Physician Global Assessment (PGA), the Disease Extent Index (DEI) and the Five Factor Score (FFS). Five cases were rescored by all raters. Reliability of the measures was extremely high (intraclass correlations for the six measures all = 0.98). Within each instrument, there were no significant differences or outliers among the scores from the 10 investigators. Test/retest reliability was high for each measure: range = 0.77 to 0.95. The scores of the five acute activity measures correlated extremely well with one another. Currently available tools for measuring disease extent and activity in ANCA-associated vasculitis are highly correlated and reliable. These results provide investigators with confidence to compare different clinical trial data and helps form common ground as international research groups develop new, improved and universally accepted vasculitis disease assessment instruments.

Long-term outcome of antineutrophil cytoplasmic antibody-associated small vessel vasculitis after renal transplantation.

PubMed

Marco, Helena; Mirapeix, Eduard; Arcos, Emma; Comas, Jordi; Ara, Jordi; Gil-Vernet, Salvador; Puig, Josep; Vinyas, Odette; Perello, Manel; Oppenheimer, Federico; Poveda, Rafael; Ibernón, Meritxell; Díaz, Montserrat; Ballarin, Jose

2013-01-01

The survival after renal transplantation of patients with antineutrophil cytoplasmic antibody (ANCA)-associated to systemic vasculitis is as good as in other diseases, although most of the reports are based on small numbers of patients. Furthermore, it is not known whether comorbidities (cardiovascular [CV] disease and cancer) are more frequent than in general population. We report our experience and the analysis of the published data on this topic. The outcome after transplantation in 49 patients with ANCA-associated small vessel vasculitis was compared with a control group. The relapse rate of vasculitis was 0.01 per patient per year. Comparison with the control patients revealed no difference in long-term outcome, CV mortality or incidence of malignancies. In the published literature, patients with ANCA at transplantation and with Wegener's granulomatosis are at greater risk of relapse. Taking our own results together with the review of the literature, we conclude that patient and graft survival rates compare favorably with those in control group that the recurrence rate is very low and that there is no increase in the incidence of cancer or in CV mortality. Patients with ANCA at transplantation and with Wegener's granulomatosis have a higher relapse rate. © 2013 John Wiley & Sons A/S.

Subglottic stenosis in granulomatosis with polyangiitis (Wegener's granulomatosis): Report of 4 cases.

PubMed

Horta-Baas, Gabriel; Hernández-Cabrera, María Fernanda; Catana, Rocío; Pérez-Cristóbal, Mario; Barile-Fabris, Leonor Adriana

2016-01-01

Subglottic stenosis (SGS) in granulomatosis with polyangiitis (GPA) may result from active disease or from chronic recurrent inflammation. The objective of the study was to describe the clinical features and treatment of patients with subglottic stenosis. We retrospectively reviewed the medical records of all patients with SGS due to GPA diagnosed at Rheumatology deparment between January 2000 and June 2015. We present 4 cases of SGS at our department during a period of 15 years. The interval between the presentation of the GPA and SGS varied between 2 and 144 months. The leading symptoms of SGS were dyspnoea on exertion and stridor. Three patients presented SGS without evidence of systemic activity. Two patients presented SGS grade i and received tracheal dilatation; two recurred and three needed a tracheostomy due to severe airway-limiting stenosis. SGS presents high morbidity. Even though subglottic dilatation provides symptomatic relief, recurrences may present. Severe airway-limiting stenosis often requires tracheostomy. Copyright © 2015 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

Cavitary pulmonary nodules in atypical collagen disease and lupoid drug reaction. Report of two cases.

PubMed

Muren, C; Strandberg, O

1989-01-01

The case histories of two patients with cavitary pulmonary nodules and the findings at chest radiography are reviewed. The first patient had a connective tissue disease with features common to systematic lupus erythematosus and Wegener's granulomatosis. In the second patient the lung changes developed as part of a drug reaction to carbamezapine and/or phenytoin. The common denominator of the cavitating nodules is probably the presence of granulomas, developing as a sequela of pulmonary vasculitis.

Clinical value of gallium-67 scintigraphy in assessment of disease activity in Wegener's granulomatosis

PubMed Central

Slart, R; Jager, P; Poot, L; Piers, D; Cohen, T; Stegeman, C

2003-01-01

Background: Diagnosis of active pulmonary and paranasal involvement in patients with Wegener's granulomatosis (WG) can be difficult. The diagnostic value of gallium-67 scintigraphy in WG is unclear. Objective: To evaluate the added diagnostic value of gallium-67 scintigraphy in patients with WG with suspected granulomatous inflammation in the paranasal and chest regions. Methods: Retrospectively, the diagnostic contribution of chest and head planar gallium scans in 40 episodes of suspected vasculitis disease activity in 28 patients with WG was evaluated. Scans were grouped into normal or increased uptake for each region. Histological proof or response to treatment was the "gold standard" for the presence of WG activity. Results: WG activity was confirmed in 8 (20%) episodes, with pulmonary locations in three, paranasal in four, and both in one (n=7 patients); all these gallium scans showed increased gallium uptake (sensitivity 100%). Gallium scans were negative for the pulmonary area in 23/36 scans (specificity 64%), and negative for paranasal activity in 13/16 scans (specificity 81%) in episodes without WG activity. Positive predictive value of WG activity for lungs and paranasal region was 24% and 63%, respectively, negative predictive value was 100% for both regions. False positive findings were caused by bacterial or viral infections. Conclusion: Gallium scans are clinically helpful as a negative scan virtually excludes active WG. Gallium scintigraphy of chest and nasal region has a high sensitivity for the detection of disease activity in WG. However, because of positive scans in cases of bacterial or viral infections, specificity was lower. PMID:12810430

[Usefulness of analyzing ANCA changes for diagnosis of Wegener's granulomatosis].

PubMed

Wiatr, E; Labecka, H; Płodziszewska, M; Maziarka, D; Wawrzyńska, L; Zych, J; Jarzabek-Chorzelska, M; Kuś, J; Chorzelski, T; Rowińska-Zakrzewska, E

1999-01-01

ANCA were described in 1982 as sensitive and specific markers for active Wegener's granulomatosis (WG). We analysed the results of ANCA test performed in 298 patients hospitalized in Institute of Tuberculosis and Lung Diseases in the period 1990-1998 because of different symptoms and syndromes of respiratory system which could be symptoms of WG. Presence of c-ANCA, p-ANCA and other not well defined types of ANCA in the titer greater than 1:40 in the serum was regarded as positive result of test. We found it in 60 patients. In 47 WG pts ANCA were present in 40 of 42 pts with active disease and 1 of 5 in remission. Further 19 positive results were found in a group of 251 patients with other diseases: 1 of 4 pts with Churg-Strauss syndrome, 1 of 2 with pulmonary renal syndrome, 5 of 28 with connective tissue diseases, 1 of 21 with tuberculosis, 1 of 23 with sarcoidosis, 1 of 6 with histiocytosis, 3 of 11 with hypersensitivity pneumonitis, 1 (lymphoma) of 34 with neoplasms, 1 of 20 with pulmonary fibrosis, 1 of 8 with cardiac failure, 1 of 5 with pleural fluid, 1 of 10 pneumoconiosis and toxic reactions (after furagin), 1 of 6 with BOOP. Sensitivity of ANCA test in our material is 87%, specificity = 95%, and positive prevalence accuracy is 68%. It means that 32% of the patients with positive results could be inappropriate treated as WG. ANCA test could be not used as a screening test. Results of ANCA test alone cannot be used as basis for treatment. ANCA test is a helpful tool in diagnosing of WG.

Transcription of PR3 and Related Myelopoiesis Genes in Peripheral Blood Mononuclear Cells in Active Wegener's Granulomatosis

PubMed Central

Cheadle, Chris; Berger, Alan E.; Andrade, Felipe; James, Regina; Johnson, Kristen; Watkins, Tonya; Park, Jin Kyun; Chen, Yu-Chi; Ehrlich, Eva; Mullins, Marissa; Chrest, Francis; Barnes, Kathleen C.; Levine, Stuart M.

2010-01-01

Objective Wegener's granulomatosis (WG) is a systemic inflammatory disease causing substantial morbidity. This study seeks to understand the biology underlying WG, and to discover markers of disease activity useful in prognosis and treatment guidance. Methods Gene expression profiling was performed using total RNA from PBMC and granulocyte fractions from 41 WG patients and 23 healthy controls. Gene set enrichment analysis (GSEA) was performed to search for candidate WG-associated molecular pathways and disease activity biomarkers. Principal component analysis (PCA) was used to visualize relationships between subgroups of WG patients and controls. Longitudinal changes in PR3 expression were evaluated using RT-PCR, and clinical outcomes including remission status and disease activity were determined using the BVAS-WG. Results We identified 86 genes significantly up-regulated in WG PBMCs and 40 in WG PMNs relative to controls. Genes up-regulated in WG PBMCs were involved in myeloid differentiation, and included the WG autoantigen, PR3. The coordinated regulation of myeloid differentiation genes was confirmed by gene set analysis. Median expression values of the 86 WG PBMC genes were associated with disease activity (p=1.3 × 10−4), and patients expressing these genes at a lower level were only modestly different from healthy controls (p=0.07). PR3 transcription was significantly up-regulated in the PBMCs (p=1.3 ×10−5, FDR=0.002), but not in the PMNs (p=0.03, FDR=0.28) of WG patients, and changes in BVAS-WG tracked with PBMC PR3 RNA levels in a preliminary longitudinal analysis. Conclusion Transcription of PR3 and related myeloid differentiation genes in PBMCs may represent novel markers of disease activity in WG. PMID:20155833

Differentiation between Wegener's granulomatosis and microscopic polyangiitis by an artificial neural network and by traditional methods.

PubMed

Linder, Roland; Orth, Isabelle; Hagen, E Christian; van der Woude, Fokko J; Schmitt, Wilhelm H

2011-06-01

To investigate the operating characteristics of the American College of Rheumatology (ACR) traditional format criteria for Wegener's granulomatosis (WG), the Sørensen criteria for WG and microscopic polyangiitis (MPA), and the Chapel Hill nomenclature for WG and MPA. Further, to develop and validate improved criteria for distinguishing WG from MPA by an artificial neural network (ANN) and by traditional approaches [classification tree (CT), logistic regression (LR)]. All criteria were applied to 240 patients with WG and 78 patients with MPA recruited by a multicenter study. To generate new classification criteria (ANN, CT, LR), 23 clinical measurements were assessed. Validation was performed by applying the same approaches to an independent monocenter cohort of 46 patients with WG and 21 patients with MPA. A total of 70.8% of the patients with WG and 7.7% of the patients with MPA from the multicenter cohort fulfilled the ACR criteria for WG (accuracy 76.1%). The accuracy of the Chapel Hill criteria for WG and MPA was only 35.0% and 55.3% (Sørensen criteria: 67.2% and 92.4%). In contrast, the ANN and CT achieved an accuracy of 94.3%, based on 4 measurements (involvement of nose, sinus, ear, and pulmonary nodules), all associated with WG. LR led to an accuracy of 92.8%. Inclusion of antineutrophil cytoplasmic antibodies did not improve the allocation. Validation of methods resulted in accuracy of 91.0% (ANN and CT) and 88.1% (LR). The ACR, Sørensen, and Chapel Hill criteria did not reliably separate WG from MPA. In contrast, an appropriately trained ANN and a CT differentiated between these disorders and performed better than LR.

Fruit and food eponyms in dermatology.

PubMed

Jindal, Nidhi; Jindal, Pooja; Kumar, Jeevan; Gupta, Sanjeev; Jain, V K

2015-01-01

Dermatology world is brimming with myriad of interesting clinical conditions, signs and syndromes. It is infinite, which has systemic clinical connotations too. Complicated pronunciations of diagnosis have always placed residents in an intricate state. Each one is trying his best to make this cumbersome subject comparatively more acceptable and convenient. The present paper is an attempt to further simplify the subject by correlating difficult conditions with commonly used and seen things such as fruit and food. A total of 45 dermatological conditions were found to be based on fruit and food eponyms. For example, strawberries can remind us of strawberry gums of Wegener's granulomatosis and strawberry nevus.

Mastoiditis and facial paralysis as initial manifestations of temporal bone systemic diseases - the significance of the histopathological examination.

PubMed

Maniu, Alma Aurelia; Harabagiu, Oana; Damian, Laura Otilia; Ştefănescu, Eugen HoraŢiu; FănuŢă, Bogdan Marius; Cătană, Andreea; Mogoantă, Carmen Aurelia

2016-01-01

Several systemic diseases, including granulomatous and infectious processes, tumors, bone disorders, collagen-vascular and other autoimmune diseases may involve the middle ear and temporal bone. These diseases are difficult to diagnose when symptoms mimic acute otomastoiditis. The present report describes our experience with three such cases initially misdiagnosed. Their predominating symptoms were otological with mastoiditis, hearing loss, and subsequently facial nerve palsy. The cases were considered an emergency and the patients underwent tympanomastoidectomy, under the suspicion of otitis media with cholesteatoma, in order to remove a possible abscess and to decompress the facial nerve. The common features were the presence of severe granulation tissue filling the mastoid cavity and middle ear during surgery, without cholesteatoma. The definitive diagnoses was made by means of biopsy of the granulation tissue from the middle ear, revealing granulomatosis with polyangiitis (formerly known as Wegener's granulomatosis) in one case, middle ear tuberculosis and diffuse large B-cell lymphoma respectively. After specific associated therapy facial nerve functions improved, and atypical inflammatory states of the ear resolved. As a group, systemic diseases of the middle ear and temporal bone are uncommon, but aggressive lesions. After analyzing these cases and reviewing the literature, we would like to stress upon the importance of microscopic examination of the affected tissue, required for an accurate diagnosis and effective treatment.

Idiopathic granulomatous mastitis: a medical or surgical disease of the breast?

PubMed

Skandarajah, Anita; Marley, Leah

2015-12-01

Idiopathic granulomatous mastitis (IGM) is a rare benign breast disease, which can be protracted, disfiguring and may be linked to an underlying autoimmune disorder. The clinical presentation may mimic bacterial mastitis or carcinoma. To review the mode of presentation, diagnosis, management, resolution and incidence of IGM in three tertiary breast centres and propose guidelines for management. The breast and anatomical databases of three centres were reviewed from January 2000 to December 2013 to identify patients with histological diagnosis of IGM. Clinical and demographic characteristics were retrieved and treatment modalities and time to resolution were recorded. Seventeen patients were identified with a median age of 40. The majority of patients were premenopausal, multiparous and presented with a mass. All patients had initial treatment as infectious mastitis. The diagnosis was made by core biopsy in 71%. Eleven patients required immunosuppressive treatment with steroids and four of these patients required a steroid-sparing agent because of steroidal side effects, recurrence or persistence of symptoms. The median time to resolution was 3 months (0-24 months). One patient had subsequent systemic Wegener's granulomatosis diagnosed. Idiopathic granulomatosis mastitis requires histological confirmation, close monitoring, exclusion of underlying systemic autoimmune conditions and judicious use of steroids and steroid-sparing agents such as methotrexate. It has a protracted course with some patients relapsing quickly upon cessation of steroids. © 2014 Royal Australasian College of Surgeons.

Epidemiology of granulomatosis with polyangiitis (Wegener's granulomatosis) in Northern Italy: a 15-year population-based study.

PubMed

Catanoso, Mariagrazia; Macchioni, Pierluigi; Boiardi, Luigi; Manenti, Lucio; Tumiati, Bruno; Cavazza, Alberto; Luberto, Ferdinando; Pipitone, Nicolò; Salvarani, Carlo

2014-10-01

To investigate the epidemiology of granulomatosis with polyangiitis (GPA) over a 15-year period in a defined area of northern Italy. All patients with incident GPA diagnosed from January 1, 1995 to December 31, 2009 living in the Reggio Emilia area were identified by looking at computerized hospital discharge diagnoses, by contacting Reggio Emilia Hospital physicians and community-based specialists, and by checking the databases of the pathology and the laboratory departments and the Reggio Emilia district database for rare diseases. Patients were classified according to the European Medicines Agency (EMA) algorithm. Patients were followed up from the time of diagnosis until either their death or December 31, 2011. For each case, we identified 20 control subjects from the same geographic area matched for age and gender. A total of 18 patients (7 men and 11 women) with GPA were identified. The overall age- and sex-adjusted incidence rate (IR) was 2.4 per million (95% CI: 1.2-3.5). The mean annual IR increased from 1.7/million/year during 1995-1999 to 3.4 during 2005-2009. The highest IR occurred in females aged 70-79 years (13.5 per million; 95% CI: 5.0-30.0) and in males aged ≥ 80 years (14.9 per million; 95% CI: 2.5-49.4). The prevalence of GPA on December 31, 2009 was 34.3 per million (95% CI: 20.3-54.2). The point prevalence per million increased from 17.8 (95% CI: 7.7-35.1) in 1999 to 34.3 (95% CI: 20.3-54.2) in 2009. Survival among individuals with GPA was significantly reduced compared to that observed in the matched control population (p < 0.001). In the Italian population, GPA is very uncommon and GPA patients have reduced survival. Copyright © 2014 Elsevier Inc. All rights reserved.

Rare occupational cause of nasal septum perforation: Nickel exposure.

PubMed

Bolek, Ertugrul Cagri; Erden, Abdulsamet; Kulekci, Cagri; Kalyoncu, Umut; Karadag, Omer

2017-10-06

Many etiologies are held accountable for nasal septum perforations. Topical nasal drug usage, previous surgeries, trauma, nose picking, squamous cell carcinoma, some rheumatological disorders such as granulomatosis with polyangiitis (Wegener granulomatosis), some infectious diseases such as syphilis and leprosy are among the causes of the perforations. Occupational heavy metal exposures by inhalation rarely may also cause nasal septum perforation. Here, we present a 29-year-old patient without any known diseases, who is a worker at a metallic coating and nickel-plating factory, referred for investigation of his nasal cartilage septum perforation from an otorhinolaryngology clinic. The patient questioning, physical examination and laboratory assessment about rheumatic and infectious diseases were negative. There was a metallic smell in the breath during the physical examination. The analysis showed serum nickel level at 31 μg/l and urine nickel at 18 μg/l (84.11 μg/g creatinine). Other possible serum and urine heavy metal levels were within normal ranges. Nickel exposure is usually together with other heavy metals (chromium or cadmium), it is rarely alone. Nickel ingested by inhalation usually leads to respiratory problems such as reduced olfactory acuity, ulcers, septum perforation or tumors of the nasal sinuses. This case demonstrates the importance of occupational anamnesis and awareness of diagnosis. Int J Occup Med Environ Health 2017;30(6):963-967. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

[On classification of changes in necrotizing lesions of the midface].

PubMed

Szyfter, W; Wierzbicka, M

1996-01-01

Lethal midline granuloma syndrome (LMG) describes lesions of the midface and is characterized by a progressive and often fatal ulceration and destruction of the upper air way involving the nose, the paranasal sinuses, the palate and the soft tissues of the face. Under the term LMG we distinguish four entities: idiopathic midline destructive disease (IMDD), polymorphic reticulosis (PR), non Hodkin's lymphoma and Wegener's granulomatosis (WG). Review of the literature allows to present the differential diagnosis making use of latest technological achievements in clinical immunology and immunohistochemistry. First of all the LMG must be discriminated from localized WG occurring in the midface. The clinical, serological and histopathological findings in WG are described. Literature review is carried out and recent concepts of it's etiology and pathogenesis are presented. Autoantibodies directed against cytoplasmic antigens of neutrophils (ANCA) with specificity for proteinase 3 (PR 3) are valuable marker for differential diagnosis and specificity are discussed. We make a comparison between the "limited" or "non renal" WG and "classical" or "renal" form of the disease.

[The complement system in the pathogenesis of antineutrophil cytoplasm antibodies-associated vasculitis].

PubMed

Flores-Suárez, Luis F

2011-12-01

One of the main characteristics of the vasculitis associated with antineutrophil cytoplasm autoantibodies (AASV) is the absence of immune complex deposition in biopsies of affected tissues as well as a lack of complement depletion. However, in early stages of disease induced in animal models, it has been observed that the complement system may be involved in the generation of these diseases. There are various animal models which have been developed with the aim of knowing which are the pathogenic mechanisms in granulomatosis with polyangiitis (Wegener) (GPA) and microscopic polyangiitis (MPA), the latter being explained using these approaches in a more satisfactory manner, as there is lack of a model which reproduces the changes leading to a granulomatous vasculitis associated with antibodies against proteinase-3, as in GPA. This short review presents recent evidence of the presence of complement in biopsies of patients with AASV and the most recent animal models, which show the participation of complement in their etiology. Copyright © 2011 Elsevier España, S.L. All rights reserved.

Comparing Presenting Clinical Features in 48 Children With Microscopic Polyangiitis to 183 Children Who Have Granulomatosis With Polyangiitis (Wegener's): An ARChiVe Cohort Study.

PubMed

Cabral, David A; Canter, Debra L; Muscal, Eyal; Nanda, Kabita; Wahezi, Dawn M; Spalding, Steven J; Twilt, Marinka; Benseler, Susanne M; Campillo, Sarah; Charuvanij, Sirirat; Dancey, Paul; Eberhard, Barbara A; Elder, Melissa E; Hersh, Aimee; Higgins, Gloria C; Huber, Adam M; Khubchandani, Raju; Kim, Susan; Klein-Gitelman, Marisa; Kostik, Mikhail M; Lawson, Erica F; Lee, Tzielan; Lubieniecka, Joanna M; McCurdy, Deborah; Moorthy, Lakshmi N; Morishita, Kimberly A; Nielsen, Susan M; O'Neil, Kathleen M; Reiff, Andreas; Ristic, Goran; Robinson, Angela B; Sarmiento, Angelyne; Shenoi, Susan; Toth, Mary B; Van Mater, Heather A; Wagner-Weiner, Linda; Weiss, Jennifer E; White, Andrew J; Yeung, Rae S M

2016-10-01

To uniquely classify children with microscopic polyangiitis (MPA), to describe their demographic characteristics, presenting clinical features, and initial treatments in comparison to patients with granulomatosis with polyangiitis (Wegener's) (GPA). The European Medicines Agency (EMA) classification algorithm was applied by computation to categorical data from patients recruited to the ARChiVe (A Registry for Childhood Vasculitis: e-entry) cohort, with the data censored to November 2015. The EMA algorithm was used to uniquely distinguish children with MPA from children with GPA, whose diagnoses had been classified according to both adult- and pediatric-specific criteria. Descriptive statistics were used for comparisons. In total, 231 of 440 patients (64% female) fulfilled the classification criteria for either MPA (n = 48) or GPA (n = 183). The median time to diagnosis was 1.6 months in the MPA group and 2.1 months in the GPA group (ranging to 39 and 73 months, respectively). Patients with MPA were significantly younger than those with GPA (median age 11 years versus 14 years). Constitutional features were equally common between the groups. In patients with MPA compared to those with GPA, pulmonary manifestations were less frequent (44% versus 74%) and less severe (primarily, hemorrhage, requirement for supplemental oxygen, and pulmonary failure). Renal pathologic features were frequently found in both groups (75% of patients with MPA versus 83% of patients with GPA) but tended toward greater severity in those with MPA (primarily, nephrotic-range proteinuria, requirement for dialysis, and end-stage renal disease). Airway/eye involvement was absent among patients with MPA, because these GPA-defining features preclude a diagnosis of MPA within the EMA algorithm. Similar proportions of patients with MPA and those with GPA received combination therapy with corticosteroids plus cyclophosphamide (69% and 78%, respectively) or both drugs in combination with plasmapheresis (19% and 22%, respectively). Other treatments administered, ranging in decreasing frequency from 13% to 3%, were rituximab, methotrexate, azathioprine, and mycophenolate mofetil. Younger age at disease onset and, perhaps, both gastrointestinal manifestations and more severe kidney disease seem to characterize the clinical profile in children with MPA compared to those with GPA. Delay in diagnosis suggests that recognition of these systemic vasculitides is suboptimal. Compared with adults, initial treatment regimens in children were comparable, but the complete reversal of female-to-male disease prevalence ratios is a provocative finding. © 2016, American College of Rheumatology.

Fertility counseling and preservation practices in youth with lupus and vasculitis undergoing gonadotoxic therapy.

PubMed

Nahata, Leena; Sivaraman, Vidya; Quinn, Gwendolyn P

2016-11-01

To assess fertility counseling and preservation practices among children, adolescents, and young adults with rheumatic diseases undergoing cyclophosphamide (CTX) treatment. Retrospective chart review (2006-2016). Academic pediatric center. Male and female patients with systemic lupus erythematosus, Wegener's granulomatosis/granulomatosis with polyangiitis, or other vaculitides, receiving CTX treatment. None. Documentation of fertility counseling and fertility preservation. A total of 58 subjects met the inclusion criteria; 5 were excluded due to incomplete records, thus N = 53. Of these 75% were female (N = 40). Median age was 14 years at diagnosis and 15 years at first CTX treatment. A total of 51% of subjects (69% of males and 45% of females) had no documentation about potential fertility loss before CTX treatment. Among females where fertility counseling was documented, the only fertility preservation option discussed was leuprolide acetate (LA), which was pursued in all of these cases. Of 13 males (77% postpubertal), 3 were offered sperm banking, of whom 2 declined and the other attempted after treatment began and was azoospermic. Of 53 patients, 1 was referred to a fertility specialist. Mean cumulative CTX dose was 9.2 g in males and 8 g in females. Based on these findings, increasing awareness about infertility risk, fertility preservation options, and referral to fertility specialists is needed among pediatric rheumatologists. Prospective studies are needed to assess fertility outcomes in this patient population (including effectiveness of LA with regard to pregnancy rates [PRs]), as well as barriers/facilitators to fertility counseling and fertility preservation. Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Chronic respiratory disfunction due to diffuse alveolar hemorrhage in patients with systemic lupus erythematosus and primary vasculitis.

PubMed

Pérez Aceves, Eva; Pérez Cristóbal, Mario; Espinola Reyna, Gerardo A; Ariza Andraca, Raul; Xibille Fridmann, Daniel; Barile Fabris, Leonor A

2013-01-01

Pulmonary hemorrhage (PH) occurs in 2-5% of SLE patients, and is associated with a high mortality rate (79-90%). Diagnostic criteria for this complication include: 1) Pulmonary infiltrates, with at least ¾ of lung tissue involved in a chest x ray, 2) Acute respiratory failure, 3) A decrease of 3g/dL or more in hemoglobin levels. PH might lead to organized pneumonia, collagen deposition, and pulmonary fibrosis which in time might cause changes in pulmonary function tests with either restrictive or obstructive patterns. To evaluate the existence of abnormalities in pulmonary function tests after a PH episode. We included patients with SLE and primary vasculitis that developed PH. During the acute episode, we measured SLEDAI in SLE patients, five factor score in microscopic polyangiitis (MPA) and Birmingham Vasculitis Activity Store (BVAS) in granulomatosis with polyangiitis (GPA) (Wegener). We determined the number of PH events, treatment, and ventilator assistance requirements and correlated its association with abnormal pulmonary function tests. We included 10 patients, 7 with SLE, 2 with MPA and 1 with GPA (Wegener). The mean activity measures were: SLEDAI 20.4 ± 7.5, FFS 2, and BVAS 36. Treatment consisted in methylprednisolone (MPD) in 3 patients, MPD plus cyclophosphamide (CY) in 6 patients, and MPD, CY, IV immunoglobulin, and plasmapheresis in one patient. Five patients required ventilatory support. We found abnormalities in pulmonary function tests in 8 patients, three had an obstructive pattern and five a restrictive pattern; 2 patients did not show any change. We did not find a significant association with any of the studied variables. PH might cause abnormalities in pulmonary function tests and prolonged immunosuppressive treatment could be required. Copyright © 2012 Elsevier España, S.L. All rights reserved.

Bronchoalveolar carcinoma (adenocarcinoma) mimicking recurrent bacterial community-acquired pneumonia (CAP).

PubMed

Cunha, Burke A; Syed, Uzma; Mikail, Nardeen

2012-01-01

Depending on the community-acquired pneumonia (CAP) pathogen, host factors, and immune status, CAPs resolve on chest x-rays at different rates. CAPs that resolve more slowly than expected, or not at all, are termed "slowly or non-resolving CAPs." In contrast, recurrent CAPs may be due to host defense defects (eg, multiple myelomas) or post-obstructive bronchogenic carcinomas. There are a variety of noninfectious disorders that may mimic CAPs on chest x-ray: alveolar hemorrhage, pulmonary drug reactions, radiation pneumonitis, Wegener's granulomatosis, bronchiolitis obliterans organizing pneumonia, bronchogenic carcinomas, and lymphomas. Noninfectious mimics of recurrent CAPs include congestive heart failure, pulmonary emboli, infarctions, sarcoidosis, and systemic lupus erythematosus pneumonitis. We present the case of a middle-aged man who presented with recurrent right middle lobe and right lower lobe CAPs. Diagnostic bronchoscopy showed no bronchial obstruction, but open lung biopsy showed bronchoalveolar carcinoma (well-differentiated adenocarcinoma). Bronchoalveolar carcinomas presenting as post-obstructive or recurrent CAPs are rare because the spread is along tissue planes and not endobronchially. The case described demonstrates a rare cause of bronchogenic carcinoma mimicking recurrent CAP. Copyright © 2012 Elsevier Inc. All rights reserved.

Sinonasal involvement in systemic vasculitides and cocaine-induced midline destructive lesions: Diagnostic controversies

PubMed Central

García-Lliberós, A.; Gómez, M. J.; Navarro, A.; Martorell, A.

2013-01-01

Multiple systemic diseases produce various clinical manifestations in the sinonasal area. They usually appear as difficult-to-diagnose disease processes with slow, atypical clinical courses. The aim of this study was to evaluate the sinonasal manifestations of systemic vasculitides, highlighting key points for diagnosis and differential diagnosis with other pathological entities, especially cocaine-induced midline destructive lesions (CIMDL). A retrospective study was performed of 10 patients treated in our hospital during the last 5 years with an initial diagnosis of systemic vasculitides with sinonasal involvement: eight patients with granulomatosis with polyangiitis (GPA; new nomenclature for Wegener granulomatosis) and two patients with Churg-Strauss syndrome (CSS). The study variables were clinical presentation, nasal endoscopy results, maxillofacial scan results, nasal biopsy results, erythrocyte sedimentation rate, and autoimmune antibody levels. The definitive diagnosis was GPA in six (60%) patients, CSS in two (20%) patients, and CIMDL in two (20%) patients. Nasal symptoms were similar in all patients, but nasal polyps were present in only one patient with CSS. Systemic manifestations were absent in patients with CIMDL. Likewise, peripheral eosinophilia was observed only in the two patients with CSS. Specific positive biopsy specimens were obtained in six patients (all six patients with GPA, one with CSS, and one with CIMDL). Antineutrophil cytoplasmic antibodies (ANCA) were positive in all patients with GPA (proteinase 3 antigen in five patients and myeloperoxidase in one patient), and perinuclear ANCA was positive in one patient with CIMDL; however, this patient showed an undefined pattern. Finally, the response to treatment was adequate in all patients excluding those with CIMDL. GPA and CIMDL syndromes pose a difficult differential diagnosis because they have common clinical, serological, and histological presentations. Negative histological results do not exclude the diagnosis of sinonasal vasculitides. The absence of systemic manifestations and the lack of response to treatment will lead to the confirmation of CIMDL syndrome in a cocaine user. Otolaryngologists play an important role in the early and differential diagnosis of these diseases. PMID:24124643

ANCA-associated vasculitis in Hispanic Americans: an unrecognized severity.

PubMed

Sreih, Antoine G; Mandhadi, Ranadeep; Aldaghlawi, Fadi; Khan, Asad; Irshad, Vajiha; Finn, Katherine; Block, Joel A

2015-05-01

This study aims to compare the severity and outcomes of antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) between Hispanics and Caucasians living in the same geographical area. All patients diagnosed with AAV at two academic institutions in Chicago from January 2006 to December 2012 were retrospectively and prospectively identified. Disease activity was measured with the Birmingham Vasculitis Activity Score (BVAS), and disease damage was measured with the Vasculitis Damage Index (VDI). Student's t test and chi-square tests were employed; p ≤ 0.05 was considered significant. Seventy patients with AAV were identified; 15 patients were excluded. Fifty-five patients were included in the study: 23 Hispanics and 32 Caucasians, 35 patients with granulomatosis with polyangiitis (Wegener's), 12 with microscopic polyangiitis, 7 with eosinophilic granulomatosis with polyangiitis, and 1 with renal-limited vasculitis. Compared to Caucasians, Hispanics had a higher BVAS at presentation (16.3 ± 7.6 versus 10.7 ± 7.5, p = 0.006), a higher VDI at presentation (2.90 ± 1.50 versus 2.06 ± 1.30, p = 0.030), and a cumulative VDI (3.90 ± 1.70 versus 2.50 ± 1.90, p = 0.010). Renal involvement was more common among Hispanics (85 % of Hispanics versus 48 % of Caucasians, p = 0.01). Seventy percent of Hispanics had acute renal failure (mean creatinine = 3.37 ± 4.4 mg/dl) of whom seven (50 %) required dialysis, versus 25 % of Caucasians (mean creatinine = 1.78 ± 1.57 mg/dl, p = 0.03) and only two requiring dialysis. Compared to Caucasians, Hispanics with AAV present with more severe disease and higher damage indices. Larger studies are required to confirm these findings and delineate the respective roles of environment and genetics in the pathogenesis of the disease.

Immunosuppression Related to Collagen-Vascular Disease or Its Treatment

PubMed Central

Hamilton, Carol Dukes

2005-01-01

Collagen-vascular diseases are associated with immune dysregulation and inflammation, leading to tissue destruction or compromise. Immunosuppression is more commonly associated with the drugs used to treat these disorders than with the diseases themselves. The newest agents being used to treat collagen-vascular diseases are the tumor necrosis factor (TNF)-α inhibitors. U.S. Food and Drug Administration–approved TNF-α inhibitors have differing effects on the immune system, reflecting their potency and mechanisms of action. They are particularly effective in breaking down granulomatous inflammation, which makes them effective treatment for sarcoidosis and Wegener's granulomatosis. This same property makes them likely to break down the host defense mechanism that normally contains pathogens such as mycobacteria and fungi in a dormant state, namely the physical and immunologic barrier formed by granulomas in the lung and elsewhere. The most common infection reported with the TNF-α inhibitors has been tuberculosis, which may manifest as pulmonary and/or extrapulmonary disease, with the latter being more common and severe than usual. Histoplasma capsulatum, Aspergillus, Cryptococcus neoformans, and Listeria monocytogenes have also been described in a number of cases, and their frequency is discussed. PMID:16322600

Treatment of Eosinophilic Granulomatosis with Polyangiitis: A Review.

PubMed

Raffray, Loïc; Guillevin, Loïc

2018-05-15

Eosinophilic granulomatosis with polyangiitis (formerly Churg-Strauss syndrome) is a rare type of anti-neutrophil cytoplasm antibody-associated vasculitis. Nevertheless, eosinophilic granulomatosis with polyangiitis stands apart because it has features of vasculitis and eosinophilic disorders that require targeted therapies somewhat different from those used for other anti-neutrophil cytoplasm antibody-associated vasculitides. Considerable advances have been made in understanding the underlying pathophysiology of eosinophilic granulomatosis with polyangiitis that have highlighted the key role of eosinophils and opened new therapeutic opportunities. Its conventional treatment relies mainly on agents that decrease inflammation: corticosteroids and immunosuppressant adjunction for severe manifestations. New therapeutic approaches are needed for refractory disease, relapses and issues associated with corticosteroid dependence, especially for asthma manifestations. Drugs under evaluation mostly target eosinophils and B cells. Results of low-evidence-based trials suggested possible efficacies of biologicals: B-cell-blocking rituximab and anti-immunoglobulin E omalizumab. Recently, the first large-scale randomised controlled trial on eosinophilic granulomatosis with polyangiitis proved the efficacy of anti-interleukin-5 mepolizumab. That finding opens a new era in eosinophilic granulomatosis with polyangiitis management, with mepolizumab approval but also in future drug evaluations and trial designs for eosinophilic granulomatosis with polyangiitis. Additional studies are needed to determine which patients would benefit most from targeted therapies and achieve personalised treatment for patients with eosinophilic granulomatosis with polyangiitis. Herein, we review eosinophilic granulomatosis with polyangiitis characteristics and provide an overview of established and novel pharmacological agents.

Granulomatous Lymphoproliferative Disorders: Granulomatous Slack Skin and Lymphomatoid Granulomatosis.

PubMed

Gangar, Pamela; Venkatarajan, Sangeetha

2015-07-01

Granulomatous cutaneous T-cell lymphomas (CTCL) and lymphomatoid granulomatosis are considered granulomatous lymphoproliferative disorders. The most common types of granulomatous CTCL are granulomatous mycosis fungoides and granulomatous slack skin. Lymphomatoid granulomatosis is a rare Epstein-Barr virus driven lymphoproliferative disorder. This article reviews the etiopathogenesis, clinical presentation, systemic associations, and management of both granulomatous slack skin syndrome and lymphomatoid granulomatosis. Copyright © 2015 Elsevier Inc. All rights reserved.

Eosinophilic Granulomatosis with Polyangiitis, formerly Churg-Strauss Syndrome (EGPA)

MedlinePlus

... Strauss Syndrome (EGPA) Eosinophilic Granulomatosis with Polyangiitis, formerly Churg-Strauss Syndrome (EGPA) First Description Who gets EGPA (the “ ... granulomatosis with polyangiitis (EGP), formerly known as the Churg-Strauss Syndrome , is a systemic vasculitis. This disease was ...

Hydroxyurea for Treatment of Nephrotic Syndrome Associated With Polycythemia Vera.

PubMed

Hundemer, Gregory L; Rosales, Ivy A; Chen, Yi-Bin; Colvin, Robert B; Tolkoff-Rubin, Nina E

2016-09-01

Myeloproliferative disorders are a rare cause of focal segmental glomerulosclerosis (FSGS), although the mechanism is unclear. Hydroxyurea is commonly used in these disorders for its cytoreductive properties; however, the effect of this treatment on proteinuria or kidney function remains unclear in cases of myeloproliferative disorder-associated FSGS. We describe the clinical course of a patient with polycythemia vera and nephrotic-range proteinuria, demonstrated to have FSGS on biopsy. The patient had a distant history of granulomatosis with polyangiitis (Wegener's), for which he routinely had his kidney function and proteinuria measured, allowing for early detection of nephrotic syndrome soon after being diagnosed with polycythemia vera. Treatment with hydroxyurea resulted in rapid improvement in proteinuria that correlated with a decrease in hematocrit. This response was replicated 2 additional times when the patient was taken off and then restarted on hydroxyurea therapy. He now maintains a steady dose of hydroxyurea with favorable kidney measures (proteinuria with <1g/d of protein excretion and serum creatinine of 1.27mg/dL [corresponding to estimated glomerular filtration rate of 56mL/min/1.73 m(2)]). This case suggests that early screening and treatment for myeloproliferative disorder-associated FSGS may lead to improved long-standing kidney function. Copyright © 2016 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

Early Outcomes in Children With Antineutrophil Cytoplasmic Antibody-Associated Vasculitis.

PubMed

Morishita, Kimberly A; Moorthy, Lakshmi N; Lubieniecka, Joanna M; Twilt, Marinka; Yeung, Rae S M; Toth, Mary B; Shenoi, Susan; Ristic, Goran; Nielsen, Susan M; Luqmani, Raashid A; Li, Suzanne C; Lee, Tzielan; Lawson, Erica F; Kostik, Mikhail M; Klein-Gitelman, Marisa; Huber, Adam M; Hersh, Aimee O; Foell, Dirk; Elder, Melissa E; Eberhard, Barbara A; Dancey, Paul; Charuvanij, Sirirat; Benseler, Susanne M; Cabral, David A

2017-07-01

To characterize the early disease course in childhood-onset antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) and the 12-month outcomes in children with AAV. Eligible subjects were children entered into the Pediatric Vasculitis Initiative study who were diagnosed before their eighteenth birthday as having granulomatosis with polyangiitis (Wegener's), microscopic polyangiitis, eosinophilic granulomatosis with polyangiitis (Churg-Strauss), or ANCA-positive pauci-immune glomerulonephritis. The primary outcome measure was achievement of disease remission (Pediatric Vasculitis Activity Score [PVAS] of 0) at 12 months with a corticosteroid dosage of <0.2 mg/kg/day. Secondary outcome measures included the rates of inactive disease (PVAS of 0, with any corticosteroid dosage) and rates of improvement at postinduction (4-6 months after diagnosis) and at 12 months, presence of damage at 12 months (measured by a modified Pediatric Vasculitis Damage Index [PVDI]; score 0 = no damage, score 1 = one damage item present), and relapse rates at 12 months. In total, 105 children with AAV were included in the study. The median age at diagnosis was 13.8 years (interquartile range 10.9-15.8 years). Among the study cohort, 42% of patients achieved remission at 12 months, 49% had inactive disease at postinduction (4-6 months), and 61% had inactive disease at 12 months. The majority of patients improved, even if they did not achieve inactive disease. An improvement in the PVAS score of at least 50% from time of diagnosis to postinduction was seen in 92% of patients. Minor relapses occurred in 12 (24%) of 51 patients after inactive disease had been achieved postinduction. The median PVDI damage score at 12 months was 1 (range 0-6), and 63% of patients had ≥1 PVDI damage item scored as present at 12 months. This is the largest study to date to assess disease outcomes in pediatric AAV. Although the study showed that a significant proportion of patients did not achieve remission, the majority of patients responded to treatment. Unfortunately, more than one-half of this patient cohort experienced damage to various organ systems early in their disease course. © 2017, American College of Rheumatology.

An atypical presentation of cardiac tamponade and periorbital swelling in a patient with eosinophilic granulomatosis with polyangiitis: a case report.

PubMed

Keefe, Alexandra C; Hymas, Joseph C; Emerson, Lyska L; Ryan, John J

2017-09-24

Eosinophilic granulomatosis with polyangiitis is a rare, necrotizing systemic vasculitis associated with asthma and hypereosinophilia. Its cause and pathophysiology are still being elucidated. We report a case of eosinophilic granulomatosis with polyangiitis in a 50-year-old Caucasian woman who presented with chest pain, dyspnea at rest, fever, and periorbital swelling. She was found to have significant hypereosinophilia and cardiac tamponade physiology. A biopsy confirmed extensive infiltration of both lungs and pericardium by eosinophils. She did not have any anti-neutrophil cytoplasmic antibodies. Eosinophilic granulomatosis with polyangiitis diagnosis does not require the presence of anti-neutrophil cytoplasmic antibodies. Anti-neutrophil cytoplasmic antibody-positive and anti-neutrophil cytoplasmic antibody-negative eosinophilic granulomatosis with polyangiitis may present with different clinical phenotypes, perhaps suggesting two distinct disease etiologies and distinct pathophysiology.

Validation and correction of rainfall data from the WegenerNet high density network in southeast Austria

NASA Astrophysics Data System (ADS)

O, Sungmin; Foelsche, U.; Kirchengast, G.; Fuchsberger, J.

2018-01-01

Eight years of daily rainfall data from WegenerNet were analyzed by comparison with data from Austrian national weather stations. WegenerNet includes 153 ground level weather stations in an area of about 15 km × 20 km in the Feldbach region in southeast Austria. Rainfall has been measured by tipping bucket gauges at 150 stations of the network since the beginning of 2007. Since rain gauge measurements are considered close to true rainfall, there are increasing needs for WegenerNet data for the validation of rainfall data products such as remote sensing based estimates or model outputs. Serving these needs, this paper aims at providing a clearer interpretation on WegenerNet rainfall data for users in hydro-meteorological communities. Five clusters - a cluster consists of one national weather station and its four closest WegenerNet stations - allowed us close comparison of datasets between the stations. Linear regression analysis and error estimation with statistical indices were conducted to quantitatively evaluate the WegenerNet daily rainfall data. It was found that rainfall data between the stations show good linear relationships with an average correlation coefficient (r) of 0.97 , while WegenerNet sensors tend to underestimate rainfall according to the regression slope (0.87). For the five clusters investigated, the bias and relative bias were - 0.97 mm d-1 and - 11.5 % on average (except data from new sensors). The average of bias and relative bias, however, could be reduced by about 80 % through a simple linear regression-slope correction, with the assumption that the underestimation in WegenerNet data was caused by systematic errors. The results from the study have been employed to improve WegenerNet data for user applications so that a new version of the data (v5) is now available at the WegenerNet data portal (www.wegenernet.org).

Pulmonary talc granulomatosis in a cocaine sniffer.

PubMed

Oubeid, M; Bickel, J T; Ingram, E A; Scott, G C

1990-07-01

The development of pulmonary granulomatosis following intravenous injection of medications intended for oral use has been well described previously. Talc is the most commonly implicated agent. We present a case of talc granulomatosis which developed in a patient following cocaine sniffing and suggest that this may be the cause of development of granulomata in drug addicts who deny any history of intravenous drug abuse.

Polymorphisms in genes encoding leptin, ghrelin and their receptors in German multiple sclerosis patients.

PubMed

Rey, Linda K; Wieczorek, Stefan; Akkad, Denis A; Linker, Ralf A; Chan, Andrew; Hoffjan, Sabine

2011-01-01

Multiple sclerosis (MS) is a neuro-inflammatory, autoimmune disease influenced by environmental and polygenic components. There is growing evidence that the peptide hormone leptin, known to regulate energy homeostasis, as well as its antagonist ghrelin play an important role in inflammatory processes in autoimmune diseases, including MS. Recently, single nucleotide polymorphisms (SNPs) in the genes encoding leptin, ghrelin and their receptors were evaluated, amongst others, in Wegener's granulomatosis and Churg-Strauss syndrome. The Lys656Asn SNP in the LEPR gene showed a significant but contrasting association with these vasculitides. We therefore aimed at investigating these polymorphisms in a German MS case-control cohort. Twelve SNPs in the LEP, LEPR, GHRL and GHSR genes were genotyped in 776 MS patients and 878 control subjects. We found an association of a haplotype in the GHSR gene with MS that could not be replicated in a second cohort. Otherwise, no significant differences in allele or genotype frequencies were observed between patients and controls in this particular cohort. Thus, the present results do not support the hypothesis that genetic variation in the leptin/ghrelin system contributes substantially to the pathogenesis of MS. However, a modest effect of GHSR variation cannot be ruled out and needs to be further evaluated in future studies. Copyright © 2011 Elsevier Ltd. All rights reserved.

Pneumocystis jirovecii pneumonia in mycophenolate mofetil-treated patients with connective tissue disease: analysis of 17 cases.

PubMed

Zhang, Yongfeng; Zheng, Yi

2014-12-01

The association of Pneumocystis jirovecii pneumonia (PJP) with connective tissue disease (CTD) and mycophenolate mofetil's (MMF) potent activity against PJP have been separately reported. Until now, there have been no papers describing the occurrence of PJP following MMF treatment in CTD patients. The objective of this study was to describe the clinical features, risk factors, outcomes of PJP in patients with CTD and investigates the effects of MMF on the occurrence of PJP in China. In this retrospective cohort study, we performed a chart review, analyzing clinical features, treatment, and outcomes of PJP in patients with CTD in a single hospital. A total of 17 cases met the inclusion criteria of having PJP and a CTD diagnosis: systemic lupus erythematosus; polymyositis; dermatomyositis; rheumatoid arthritis; Wegener's granulomatosis; and microscopic polyangiitis. Sixteen patients were treated with glucocorticoids (GCs) plus immunosuppressive drugs. Only one patient had GCs without immunosuppressive drugs. Ten subjects (62.5 %) received MMF (1-1.5 g/day), and all ten had lymphopenia. The mortality rates of MMF and non-MMF patients were 50 and 14 %, respectively. This study is the first report of PJP following MMF plus GC treatment in patients with CTD. CTD itself may be a risk factor for PJP. When CTD patients receiving MMF therapy have low lymphocyte counts and/or CD4 lymphocyte counts <250/µL, we should be care of occurrence of PJP.

Self-expanding stent made of polyester mesh with silicon coating (Polyflex) in the treatment of inoperable tracheal stenoses.

PubMed

Terra, Ricardo Mingarini; Minamoto, Helio; Tedde, Miguel Lia; Almeida, José Luiz Jesus de; Jatene, Fabio Biscegli

2007-01-01

To evaluate the Polyflex stent in terms of its efficacy, ease of implantation, and complications in patients with tracheobronchial affections. This was a prospective study, in which sixteen patients with inoperable tracheal stenosis secondary to orotracheal intubation (n = 12), neoplasia (n = 3), or Wegener's granulomatosis (n = 1) were monitored. Of these patients, eleven were women, and five were men. The mean age was 42.8 years (range, 21-72 years). Patients were submitted to implantation of a total of 21 Polyflex stents. All procedures were carried out in the operating room under general anesthesia, and the stents were implanted via suspension laryngoscopy using the stent applicator. Stents were implanted and symptoms were resolved in all cases. The stents remained in place for a mean period of 7.45 months, ranging from 2 to 18 months. The complications observed in the immediate postoperative period were dysphonia (in two patients, 12.5%) and odynophagia (in two patients, 12.5%). Late complications were cough (in ten patients, 62.5%), migration (in seven patients, 43.75%), granuloma formation (in two patients, 12.5%), and pneumonia (in one patient, 6.25%). The Polyflex stent is easily implanted, easily removed, well tolerated by patients and effective in resolving symptoms. However, its use is associated with a high rate of migration, especially in patients with post-orotracheal intubation stenosis.

Differential diagnosis of granulomatous lung disease: clues and pitfalls: Number 4 in the Series "Pathology for the clinician" Edited by Peter Dorfmüller and Alberto Cavazza.

PubMed

Ohshimo, Shinichiro; Guzman, Josune; Costabel, Ulrich; Bonella, Francesco

2017-09-30

Granulomatous lung diseases are a heterogeneous group of disorders that have a wide spectrum of pathologies with variable clinical manifestations and outcomes. Precise clinical evaluation, laboratory testing, pulmonary function testing, radiological imaging including high-resolution computed tomography and often histopathological assessment contribute to make a confident diagnosis of granulomatous lung diseases. Differential diagnosis is challenging, and includes both infectious (mycobacteria and fungi) and noninfectious lung diseases (sarcoidosis, necrotising sarcoid granulomatosis, hypersensitivity pneumonitis, hot tub lung, berylliosis, granulomatosis with polyangiitis, eosinophilic granulomatosis with polyangiitis, rheumatoid nodules, talc granulomatosis, Langerhans cell histiocytosis and bronchocentric granulomatosis). Bronchoalveolar lavage, endobronchial ultrasound-guided transbronchial needle aspiration, transbronchial cryobiopsy, positron emission tomography and genetic evaluation are potential candidates to improve the diagnostic accuracy for granulomatous lung diseases. As granuloma alone is a nonspecific histopathological finding, the multidisciplinary approach is important for a confident diagnosis. Copyright ©ERS 2017.

Tracing the origin of Geodynamics: The Alfred Wegener Memorial Expedition 2014

NASA Astrophysics Data System (ADS)

Stüwe, Kurt

2015-04-01

2012 marked the 100st anniversary of the seminal publications on Continental Drift Theory by Alfred Wegener. These publications (and Wegener's book "On the origin of the continents", published three years later) are widely accepted to be the fundamental breakthrough that opened the path to the Theory of Plate Tectoncis and ultimately the path to modern Geodynamics some 50 years later. In the same historic year of the 1912 publications, Alfred Wegener set off for what was to become the most dramatic of his three Greenland expeditions. On this expedition Wegener and Koch crossed the entire northern icecap of Greenland. In honour of the hundreds anniversary of Wegener's publications, the Austrian Academy of Sciences funded an expedition to trace the footsteps of the 1912 expedition in the spirit of Alfred Wegener, while also conducting modern Earth Science. This expedition that was conducted in summer 2014. For the expedition, a 1952 Cessna180 was acquired in Alaska, adapted with bush wheels, wing extensions and extra tanks and was flown by the author and one of the worlds most renown bush pilots from Alaska in a 10 day effort to Greenland. There, the entire NE Greenland Caledonides were covered and photographed. Field work for a masters projects was conducted and samples were collected from a series of some of the most remote locations in the Caledonides ever visited. Most spectacularly, the original sled of Wegeners 1912 expedition was found some 30 kilometers from its expected location in the Dove Bugt Region of northeastern Greenland.

Low Dose Naltrexone to Improve Physical Health in Patients With Vasculitis

ClinicalTrials.gov

2018-06-08

Eosinophilic Granulomatosis With Polyangiitis (EGPA); Churg-Strauss Syndrome (CSS); Giant Cell Arteritis; Granulomatosis With Polyangiitis; Microscopic Polyangiitis; Polyarteritis Nodosa; Takayasu Arteritis

Clinical Transcriptomics in Systemic Vasculitis (CUTIS)

ClinicalTrials.gov

2018-04-10

Cryoglobulinemic Vasculitis (CV); Drug-induced Vasculitis; Eosinophilic Granulomatosis With Polyangiitis (EGPA); IgA Vasculitis; Isolated Cutaneous Vasculitis; Granulomatosis With Polyangiitis (GPA); Microscopic Polyangiitis (MPA); Polyarteritis Nodosa (PAN); Urticarial Vasculitis; Vasculitis

[Granulomatosis with polyangiitis manifested as diabetes insipidus].

PubMed

Pátek, Ondřej; Horáčková, Miroslava; Vítová, Lenka; Horváth, Rudolf; Háček, Jaromír; Schück, Otto

The case report shows a surprising presentation of pulmonary granulomatosis with polyangiitis (GPA) through symptoms of diabetes insipidus (DI) with granulomatous infiltration of the pituitary gland. The pituitary hormonal dysfunction as a result of granulomatosis of the pituitary gland is rare. Several studies have demonstrated that the incidence of the pituitary dysfunction reaches approx. 1 % of the patients with GPA. However it is mostly presented in patients with the disease already diagnosed. The patient described by us had no clinical expressions of GPA in the respiratory tract. He presented with polyuria and polydipsia. It was not until a more detailed examination of these symptoms was performed that a focal lung disease was detected and diagnosed as GPA. diabetes insipidus - granulomatosis with polyangiitis - granulomatous infiltration of the pituitary gland - pituitary hormonal dysfunction.

Current and future prospects in the management of granulomatosis with polyangiitis (Wegener’s granulomatosis)

PubMed Central

Tarzi, Ruth M; Pusey, Charles D

2014-01-01

Granulomatosis with polyangiitis (GPA, formerly Wegener’s granulomatosis) is a multisystem autoimmune condition associated with anti-neutrophil cytoplasm antibodies. Management of GPA can be complex, owing to the sometimes fulminant and multisystem nature of the presentation, the age demographics of the affected population, and a significant incidence of disease relapse. In this paper, we discuss how some of the challenges in the management of GPA have been and continue to be addressed including: reducing the toxicity of induction therapy; developing biomarkers to determine who can safely stop maintenance immunosuppression; improving the efficacy of maintenance therapy for relapsing patients; managing localized disease; and management of disease and treatment-associated comorbidity. Consideration is also given to emerging therapeutics in the treatment of GPA. PMID:24790453

[Novel trends in monitoring and therapy of ANCA associated vasculitides].

PubMed

Bečvář, Radim

2018-01-01

Vasculitides with positivity of autoantibodies to neutrophil leukocytes cytoplasm (ANCA, AAV) belong to primary vasculitides involving small and less commonly medium size blood vessels. Three different clinical types of AAV can be distinguished: granulomatosis with polyangiitis, eosinophilic granulomatosis with polyangiitis and microscopic polyangiitis. Since these autoantibodies seem to be weak activity biomarkers of AAV new molecules and factors start to come up, e.g. neutrophil extracellular traps NET, several T-lymphocyte subpopulations and different immunoglobulins classes of ANCA. In modern biological therapy rituximab is widely used, for refractory cases intravenous immunoglobulins and antithymocyte globulin are recommended. The data from clinical trials with alemtuzumab are controversial, but avacopan selective inhibitor of C5a receptor and inhibitor of B-lymphocyte activation factor belimumab are promise for future.Key words: biologicals - biomarkers - eosinophilic granulomatosis with polyangiitis - granulomatosis with polyangiitis - microscopic polyangiitis.

Eosinophilic granulomatosis with polyangiitis (Churg-Strauss syndrome) presenting as diffuse myositis.

PubMed

Parent, Marc-Etienne; Larue, Sandrine; Ellezam, Benjamin

2014-11-21

Eosinophilic granulomatosis with polyangiitis is a complex multisystemic syndrome with heterogeneous presentation. Most often, there is a clinical history of asthma or other atopic conditions, and current presentation generally includes signs of cutaneous or pulmonary involvement. Very few reports described myalgia or weakness as the chief complaint. Of these, only a few included muscle biopsy evaluation and none showed convincing evidence of primary myositis. We believe this report is the first to demonstrate true myositis in the setting of early eosinophilic granulomatosis with polyangiitis. This report describes a 74 year old Caucasian man, with no known allergies, presenting severe myalgia, muscle weakness, jaw claudication, and fever. Blood work showed marked eosinophilia and high creatine kinase levels. Biceps brachialis muscle biopsy revealed eosinophilic necrotizing vasculitis and true myositis with myophagocytosis of non-necrotic fibers and strong sarcolemmal MHC-1 overexpression by immunohistochemistry. This patient was successfully treated with prednisone and azathioprine. Our finding of true myositis in a case of eosinophilic granulomatosis with polyangiitis suggests that primary auto-immunity against muscle fibers, distinct from the secondary effects of vasculitis, can occur in this entity and may represent an overlap syndrome. Early recognition of eosinophilic granulomatosis with polyangiitis in patients presenting with myositis may provide an opportunity to treat the vasculitis before onset of severe multisystemic disease. We recommend the use of muscle biopsy with immunohistochemistry for MHC-1 to confirm the diagnosis of myositis in the setting of eosinophilic granulomatosis with polyangiitis.

Proinflammatory genotype of interleukin-1 and interleukin-1 receptor antagonist is associated with ESRD in proteinase 3-ANCA vasculitis patients.

PubMed

Borgmann, Stefan; Endisch, Georg; Hacker, Ulrich T; Song, Bong-Seok; Fricke, Harald

2003-05-01

Small-vessel vasculitides are associated with antineutrophil cytoplasmic antibodies (ANCAs). Cytoplasmic ANCAs are targeted mainly against proteinase 3 (PR3), whereas myeloperoxidase (MPO) is the major antigen of perinuclear ANCAs. These relapsing vasculitides show heterogeneous clinical pictures, and disease severity may vary broadly from mild local organ manifestation to acute organ failure (eg, renal failure). We tested whether two cytokine polymorphisms in the interleukin-1beta (IL-1beta) and IL-1 receptor antagonist (IL-1ra) genes, known to determine cytokine secretion, are associated with clinical manifestations and outcome of ANCA-associated vasculitides. Polymerase chain reaction and restriction fragment length polymorphism analyses were performed to determine polymorphisms in the IL-1beta and IL-1ra genes in 79 patients with PR3-ANCA, 30 patients with MPO-ANCA vasculitis, and 196 healthy controls. The frequency of the so-called proinflammatory genotype, characterized by high secretion of IL-1beta and low secretion of its antagonist IL-1ra, was increased significantly in patients with PR3-ANCA with end-stage renal disease. Patients with a renal manifestation of PR3-ANCA vasculitis have an increased risk for developing end-stage renal disease when carrying the proinflammatory IL-1beta/IL-1ra genotype. Anti-inflammatory therapy specifically antagonizing the proinflammatory effect of IL-1beta may be a promising treatment for patients with Wegener's granulomatosis with renal manifestations.

Eosinophilic leukocytoclastic vasculitis - a spectrum ranging from Wells' syndrome to Churg-Strauss syndrome?

PubMed

Ratzinger, Gudrun; Zankl, Julia; Eisendle, Klaus; Zelger, Bernhard

2014-01-01

Wells' syndrome is defined as an inflammatory disorder with the histopathological presence of eosinophilic infiltrates and flame figures in the absence of vasculitis. Eosinophilic leukocytoclastic vasculitis shows eosinophilic infiltrates in combination with vasculitic changes. And Churg Strauss Syndrome comprises all three characteristics - eosinophilic infiltrates, vasculitis and flame figures. To determine whether these three diseases are distinct entities or different manifestations of a similar clinicopathologic process. Histopathological samples and clinical courses of 17 patients with eosinophilic infiltrates, flame figures and clinical features of Wells' syndrome were re-evaluated. Histopathologically, we focused on the presence or absence of vasculitic features. Clinically, we included only patients who were diagnosed with Wells' syndrome at least once in the course of their disease. 4 patients were finally diagnosed with Wells' syndrome, 5 with eosinophilic leukocytoclastic vasculitis and 6 with Churg Strauss syndrome. Further, we had one case of an overlap between Wells' syndrome and eosinophilic vasculitis and one case of Wegener granulomatosis. Vasculitic features were found in the samples of all patients. Histologically, we find vasculitic features in typical presentations of Wells' syndrome. Clinically, we find typical features of Wells' syndrome in patients finally diagnosed with eosinophilic leukocytoclastic vasculitis or Churg Strauss syndrome. Furthermore, we have observed and formerly reported 3 patients with progression from Wells' syndrome to Churg Strauss syndrome. Thus, we assume that eosinophilic leukocytoclastic vasculitis might form a bridge between Wells' syndrome and Churg Strauss syndrome.

Chapter 5: Allergic rhinitis.

PubMed

Uzzaman, Ashraf; Story, Rachel

2012-01-01

Rhinitis is a symptomatic inflammatory disorder of the nose with different causes such as allergic, nonallergic, infectious, hormonal, drug induced, and occupational and from conditions such as sarcoidosis and necrotizing antineutrophil cytoplasmic antibodies positive (Wegener's) granulomatosis. Allergic rhinitis affects up to 40% of the population and results in nasal (ocular, soft palate, and inner ear) itching, congestion, sneezing, and clear rhinorrhea. Allergic rhinitis causes extranasal untoward effects including decreased quality of life, decreased sleep quality, obstructive sleep apnea, absenteeism from work and school, and impaired performance at work and school termed "presenteeism." The nasal mucosa is extremely vascular and changes in blood supply can lead to obstruction. Parasympathetic stimulation promotes an increase in nasal cavity resistance and nasal gland secretion. Sympathetic stimulation leads to vasoconstriction and consequent decrease in nasal cavity resistance. The nasal mucosa also contains noradrenergic noncholinergic system, but the contribution to clinical symptoms of neuropeptides such as substance P remains unclear. Management of allergic rhinitis combines allergen avoidance measures with pharmacotherapy, allergen immunotherapy, and education. Medications used for the treatment of allergic rhinitis can be administered intranasally or orally and include oral and intranasal H(1)-receptor antagonists (antihistamines), intranasal and systemic corticosteroids, intranasal anticholinergic agents, and leukotriene receptor antagonists. For intermittent mild allergic rhinitis, an oral or intranasal antihistamine is recommended. In individuals with persistent moderate/severe allergic rhinitis, an intranasal corticosteroid is preferred. When used in combination, an intranasal H(1)-receptor antagonist and a nasal steroid provide greater symptomatic relief than monotherapy. Allergen immunotherapy is the only disease-modifying intervention available.

Neutrophil Elastase, Proteinase 3, and Cathepsin G as Therapeutic Targets in Human Diseases

PubMed Central

Horwitz, Marshall S.; Jenne, Dieter E.; Gauthier, Francis

2010-01-01

Polymorphonuclear neutrophils are the first cells recruited to inflammatory sites and form the earliest line of defense against invading microorganisms. Neutrophil elastase, proteinase 3, and cathepsin G are three hematopoietic serine proteases stored in large quantities in neutrophil cytoplasmic azurophilic granules. They act in combination with reactive oxygen species to help degrade engulfed microorganisms inside phagolysosomes. These proteases are also externalized in an active form during neutrophil activation at inflammatory sites, thus contributing to the regulation of inflammatory and immune responses. As multifunctional proteases, they also play a regulatory role in noninfectious inflammatory diseases. Mutations in the ELA2/ELANE gene, encoding neutrophil elastase, are the cause of human congenital neutropenia. Neutrophil membrane-bound proteinase 3 serves as an autoantigen in Wegener granulomatosis, a systemic autoimmune vasculitis. All three proteases are affected by mutations of the gene (CTSC) encoding dipeptidyl peptidase I, a protease required for activation of their proform before storage in cytoplasmic granules. Mutations of CTSC cause Papillon-Lefèvre syndrome. Because of their roles in host defense and disease, elastase, proteinase 3, and cathepsin G are of interest as potential therapeutic targets. In this review, we describe the physicochemical functions of these proteases, toward a goal of better delineating their role in human diseases and identifying new therapeutic strategies based on the modulation of their bioavailability and activity. We also describe how nonhuman primate experimental models could assist with testing the efficacy of proposed therapeutic strategies. PMID:21079042

Immunosuppression induced by talc granulomatosis in the rat.

PubMed Central

Radić, I; Vucak, I; Milosević, J; Marusić, A; Vukicević, S; Marusić, M

1988-01-01

Granulomatosis caused by four subcutaneous talc powder-suspension injections induced strong immunosuppression in rats. The disturbance included reduction of mononuclear white blood cell count in the peripheral blood, atrophy of the thymic cortex, spleen enlargement with predominance of red over the white pulp, increase in the number of lymph node germinal centres and a significant delay of the first-set and second-set allograft rejection. Neither phagocytic function of reticuloendothelial system nor erythrocyte count and humoral immune response were found to be altered. Indomethacin suppression of prostaglandin production did not normalize the allograft rejection dynamics. In contrast, splenectomy completely abolished the immunosuppressive effects of granulomatosis. In splenectomized, talc-treated animals WBC counts were not altered and the rejection of allografts was not delayed. Suppression of immune response to alloantigens was transferred to normal and splenectomized recipients by both serum and spleen cells of talc-injected animals. Also, in a cell mixture-transfer experiment, spleen cells from talc-granulomatosis-bearing donors suppressed the immune response induced by lymph node cells from immune donors in T cell-deficient rats. The inability of serum from splenectomized talc-injected rats to transfer the suppression suggested the crucial role of the spleen in the mechanisms leading to suppression in rats bearing talc-granulomatosis. PMID:3052948

Review article: cinnamon- and benzoate-free diet as a primary treatment for orofacial granulomatosis.

PubMed

Campbell, H E; Escudier, M P; Patel, P; Challacombe, S J; Sanderson, J D; Lomer, M C E

2011-10-01

Orofacial granulomatosis is a rare chronic granulomatous inflammatory disease of the lips, face and mouth. The aetiology remains unclear but may involve an allergic component. Improvements have been reported with cinnamon- and benzoate-free diets. To explore the prevalence of compound and food sensitivity and examine the dietary treatments used in orofacial granulomatosis. A comprehensive literature search was carried out and relevant studies from January 1933 to January 2010 were identified using the electronic database search engines; AGRIS 1991-2008, AMED 1985-2008, British Nursing and Index archive 1985-2008, EMBASE 1980-2008, evidence based medicine review databases (e.g. Cochrane DSR), International Pharmaceutical and Medline 1950-2008. Common sensitivities identified, predominantly through patch testing, were to benzoic acid (36%) food additives (33%), perfumes and flavourings (28%), cinnamaldehyde (27%), cinnamon (17%), benzoates (17%) and chocolate (11%). The cinnamon- and benzoate-free diet has been shown to provide benefit in 54-78% of patients with 23% requiring no adjunctive therapies. A negative or positive patch test result to cinnamaldehyde, and benzoates did not predict dietary outcome. The most concentrated source of benzoate exposure is from food preservatives. Use of liquid enteral formulas can offer a further dietary therapy, particularly in children with orofacial granulomatosis. Management of orofacial granulomatosis is challenging but cinnamon- and benzoate-free diets appear to have a definite role to play. © 2011 Blackwell Publishing Ltd.

Central nervous system involvement in pediatric rheumatic diseases: current concepts in treatment.

PubMed

Duzova, Ali; Bakkaloglu, Aysin

2008-01-01

Central nervous system (CNS) manifestations are not rare in pediatric rheumatic diseases. They may be a relatively common feature of the disease, as in systemic lupus erythematosus (SLE) and Behçet's disease. Direct CNS involvement of a systemic rheumatic disease, primary CNS vasculitis, indirect involvement secondary to hypertension, hypoxia and metabolic changes, and drug associated adverse events may all result in CNS involvement. We have reviewed the CNS manifestations of SLE, Behçet's disease, Henoch-Schönlein purpura, polyarteritis nodosa, juvenile idiopathic arthritis, juvenile ankylosing spondylitis, familial Mediterranean fever, scleroderma, sarcoidosis, Wegener's granulomatosis, Takayasu's arteritis, CINCA syndrome, Kawasaki disease, and primary CNS vasculitis; and adverse CNS effects of anti-rheumatic drugs in pediatric patients. The manifestations are diverse; ranging from headache, seizures, chorea, changes in personality, depression, memory and concentration problems, cognitive impairment, cerebrovascular accidents to coma, and death. The value of cerebrospinal fluid (CSF) examination (pleocytosis, high level of protein), auto-antibodies in serum and CSF, electroencephalography, neuroimaging with computerized tomography, magnetic resonance imaging, SPECT, PET, and angiography depends on the disease. Brain biopsy is gold standard for the diagnosis of CNS vasculitis, however it may be inconclusive in 25% of cases. A thorough knowledge of the rheumatic diseases and therapy-related adverse events is mandatory for the management of a patient with rheumatic disease and CNS involvement. Severe CNS involvement is associated with poor prognosis, and high mortality rate. High dose steroid and cyclophosphamide (oral or intravenous) are first choice drugs in the treatment; plasmapheresis, IVIG, thalidomide, and intratechal treatment may be valuable in treatment-resistant, and serious cases.

A systematic review of the literature of the three related disease entities cheilitis granulomatosa, orofacial granulomatosis and Melkersson - Rosenthal syndrome.

PubMed

Wehl, Goetz; Rauchenzauner, Markus

2018-05-14

Melkersson Rosenthal syndrome (MRS) is a rare disorder of unknown etiology and comprises the triad: orofacial edema, recurrent facial paralysis and lingua plicata. In the current literature confusing heterogeneity exists, mixing together the historically grown terms cheilitis granulomatosa or granulomatous cheilitis, Melkersson Rosenthal syndrome and the umbrella term orofacial granulomatosis (OFG). We provide a systematic review comprising all three disease entities of orofacial granulomatosis using the computerized database "Pubmed Medline" entering the key words "orofacial granulomatosis" (141 references), "Melkersson-Rosenthal syndrome" (207 references), "granulomatous cheilitis" or "cheilitis granulomatosa" (102 references) back to 1956. Full text journals and case studies were included, and data synthesis was performed individually. Etiology remains unclear for all three disease entities. Etiological relatedness to chronic inflammatory bowel disease is under discussion and effectiveness was found for different treatments, e.g. local triamcinolone injections, antibiotics, surgical interventions, TNF alpha blockers or exclusive enteral nutrition. No randomized controlled trial concerning the therapy of orofacial granulomatosis was found. As a consequence, therapeutic conclusions are drawn mainly from small case series, thus limiting the evidence of therapeutic interventions. OFG with the sub-entities MRS and cheilitis granulomatosa is an etiological obscure disease process with various possible therapeutic interventions potentially alleviating the disease course but to broaden treatment knowledge further study in randomized controlled trials are needed. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

First results from comparison of rainfall estimations by GPM IMERG with rainfall measurements from the WegenerNet high density network

NASA Astrophysics Data System (ADS)

Oo, Sungmin; Foelsche, Ulrich; Kirchengast, Gottfried; Fuchsberger, Jürgen

2016-04-01

The research level products of the Integrated Multi-Satellite Retrievals for Global Precipitation Measurement (IMERG "Final" run datasets) were compared with rainfall measurements from the WegenerNet high density network as part of ground validation (GV) projects of GPM missions. The WegenerNet network comprises 151 ground level weather stations in an area of 15 km × 20 km in south-eastern Austria (Feldbach region, ˜46.93° N, ˜15.90° E) designed to serve as a long-term monitoring and validation facility for weather and climate research and applications. While the IMERG provides rainfall estimations every half hour at 0.1° resolution, the WegenerNet network measures rainfall every 5 minutes at around 2 km2 resolution and produces 200 m × 200 m gridded datasets. The study was conducted on the domain of the WegenerNet network; eight IMERG grids are overlapped with the network, two of which are entirely covered by the WegenerNet (40 and 39 stations in each grid). We investigated data from April to September of the years 2014 to 2015; the date of first two years after the launch of the GPM Core Observatory. Since the network has a flexibility to work with various spatial and temporal scales, the comparison could be conducted on average-points to pixel basis at both sub-daily and daily timescales. This presentation will summarize the first results of the comparison and future plans to explore the characteristics of errors in the IMERG datasets.

Wegener Crater Dunes - False Color

NASA Image and Video Library

2016-06-23

The THEMIS camera contains 5 filters. The data from different filters can be combined in multiple ways to create a false color image. This image from NASA 2001 Mars Odyssey spacecraft shows some of the dunes on the floor of Wegener Crater.

Altered Liver Proteoglycan/Glycosaminoglycan Structure as a Manifestation of Extracellular Matrix Remodeling upon BCG-induced Granulomatosis in Mice.

PubMed

Kim, L B; Shkurupy, V A; Putyatina, A N

2017-01-01

Experimental BCG-induced granulomatosis in mice was used to study changes in the dynamics of individual liver proteoglycan components reflecting phasic extracellular matrix remodeling, determined by the host-parasite interaction and associated with granuloma development. In the early BCG-granulomatosis period, the increase in individual proteoglycan components promotes granuloma formation, providing conditions for mycobacteria adhesion to host cells, migration of phagocytic cells from circulation, and cell-cell interaction leading to granuloma development and fibrosis. Later, reduced reserve capacity of the extracellular matrix, development of interstitial fibrosis and granuloma fibrosis can lead to trophic shortage for cells within the granulomas, migration of macrophages out of them, and development of spontaneous necrosis and apoptosis typical of tuberculosis.

Development and Implementation of Joint Programs in Laser Ranging and Other Space Geodetic Techniques

NASA Technical Reports Server (NTRS)

Pearlman, Michael R.; Carter, David (Technical Monitor)

2002-01-01

On-going activities of the NASA special consultant to WEGENER (Working group of European Geoscientists for the Establishment of Networks for Earth-science Research) program are reported. Topics cover include: the WEGENER 2002 conference in Greece and the International Laser Ranging Service (ILRS).

The role of proteinase 3 (PR3) and the protease-activated receptor-2 (PAR-2) pathway in dendritic cell (DC) maturation of human-DC-like monocytes and murine DC.

PubMed

Jiang, Bo; Grage-Griebenow, Evelin; Csernok, Elena; Butherus, Kristine; Ehlers, Stefan; Gross, Wolfgang L; Holle, Julia U

2010-01-01

The aim of the study was to assess PAR-2 expression on dendritic cell (DC) subsets and other immune cells of Wegener's granulomatosis (WG) patients and healthy controls (HC) and to investigate whether Proteinase 3 (PR3, a serine protease which can activate PAR2) induces maturation of human DC-like monocytes and murine Flt-3 ligand- and GM-CSF-generated DC. Human peripheral blood cells including DC subsets and Flt-3l- and GM-CSF-generated mouse DC were analysed for expression of PAR-2 and DC maturation markers by flow cytometry before and after stimulation with PR3, trypsin, PAR-2 agonist or LPS for 24 h. There was no difference of PAR-2 expression on PMNs, monocytes, lymphocytes and DC between all WG samples and HC. However, in inactive WG, expression of PAR-2 was downregulated on the cell surface of PMNs, monocytes, lymphocytes, and CD11c+DC compared to active WG and HC. PR3 and PAR2-agonists did not induce upregulation of PAR-2 or maturation markers of human DC-like monocytes in WG and HC. Likewise, murine PR3 did not induce upregulation of PAR-2 or maturation markers in murine DC. PAR-2 expression is downregulated on human peripheral blood cells including CD11c+ DC in inactive WG compared to active WG and HC, possibly reflecting a non-activated status of these cells in inactive disease. PR3 and PAR-2- agonists did not induce maturation of human ex vivo DC-like monocytes in WG and HC and of murine DC, suggesting this pathway is not singularly involved in the maturation of these cell subsets.

Effect of intensive plasma exchange (PE) in rapidly progressive crescentic glomerulonephritis (RPCGN).

PubMed

D'Amico, G; Sinico, R; Fornasieri, A; Ferrario, F; Colasanti, G; Porri, M T; Paracchini, M L; Gibelli, A

1983-07-01

Ten adult patients with RPCGN (crescents in greater than 70% of glomeruli), primary in 6 and associated with systemic diseases in 4, were treated with PE, associated with oral steroids (P) and cyclophosphamide (C) in all cases and with intravenous methylprednisolone pulses (MP) in 7 cases. Four out of ten patients were anuric and needed dialysis treatment at the start of treatment. Therapeutic benefit, i.e. reversal of the trend to further deterioration and substantial improvement of GFR, was achieved in 8 out of 10 patients (80%), including 2 of 4 anuric patients, and in 7 of those (8) who had still active cellular crescents (87.5%). Similar therapeutic benefit had been achieved only in 10% of a comparable population of 10 patients with RPCGN treated before 1980 with P and C, without PE or MP pulses. It is difficult to establish whether the better therapeutic results in the more recently treated group were due to PE or to MP pulses of to both the new approaches, even though the clinical improvement obtained in all the 3 patients treated with PE without concomitant MP suggest a specific beneficial role for PE. RPCGN is a catastrophic illness characterized by progressive deterioration of kidney function, resulting in oliguria and uremia, usually within weeks or months. The most consistent histopathologic finding is the presence of extensive glomerular crescents resulting from proliferation of the extracapillary epithelial cell lining of Bowman's capsule. It is apparent that RPCGN is not a homogeneous entity, clinically, histologically or immunohistologically, but rather a clinicopathologic syndrome, the features of which may be seen in a variety of systemic disorders, including SLE, polyarteritis nodosa, Wegener's granulomatosis, Henoch-Schönlein purpura, cryoglobulinemia, and subacute bacterial endocarditis.(ABSTRACT TRUNCATED AT 250 WORDS)

Altered cellular and humoral immunity to varicella-zoster virus in patients with autoimmune diseases.

PubMed

Rondaan, Christien; de Haan, Aalzen; Horst, Gerda; Hempel, J Cordelia; van Leer, Coretta; Bos, Nicolaas A; van Assen, Sander; Bijl, Marc; Westra, Johanna

2014-11-01

Patients with autoimmune diseases such as systemic lupus erythematosus (SLE) and granulomatosis with polyangiitis (Wegener's) (GPA) have a 3-20-fold increased risk of herpes zoster compared to the general population. The aim of this study was to evaluate if susceptibility is due to decreased levels of cellular and/or humoral immunity to the varicella-zoster virus (VZV). A cross-sectional study of VZV-specific immunity was performed in 38 SLE patients, 33 GPA patients, and 51 healthy controls. Levels of IgG and IgM antibodies to VZV were measured using an in-house glycoprotein enzyme-linked immunosorbent assay (ELISA). Cellular responses to VZV were determined by interferon-γ (IFNγ) enzyme-linked immunospot (ELISpot) assay and carboxyfluorescein succinimidyl ester (CFSE) dye dilution proliferation assay. Levels of IgG antibodies to VZV were increased in SLE patients as compared to healthy controls, but levels of IgM antibodies to VZV were not. Antibody levels in GPA patients did not differ significantly from levels in healthy controls. In response to stimulation with VZV, decreased numbers of IFNγ spot-forming cells were found among SLE patients (although not GPA patients) as compared to healthy controls. Proliferation of CD4+ T cells in response to stimulation with VZV was decreased in SLE patients but not GPA patients. SLE patients have increased levels of IgG antibodies against VZV, while cellular immunity is decreased. In GPA patients, antibody levels as well as cellular responses to VZV were comparable to those in healthy controls. These data suggest that increased prevalence of herpes zoster in SLE patients is due to a poor cellular response. Vaccination strategies should aim to boost cellular immunity against VZV. Copyright © 2014 by the American College of Rheumatology.

Cocaine-induced midline destructive lesions - an autoimmune disease?

PubMed

Trimarchi, M; Bussi, M; Sinico, R A; Meroni, Pierluigi; Specks, U

2013-02-01

In Europe it is estimated that around 13million of adults (15-64years) have used cocaine at least once in their lifetime. The most frequently used route of administration for the drug is intranasal inhalation, or "snorting", and thus the adverse effects of cocaine on the nasal tract are very common. Habitual nasal insufflations of cocaine may cause mucosal lesions, and if cocaine use becomes chronic and compulsive, progressive damage of the mucosa and perichondrium leads to ischemic necrosis of septal cartilage and perforation of the nasal septum. Occasionally, cocaine-induced lesions cause extensive destruction of the osteocartilaginous structures of nose, sinuses and palate that can mimic other diseases such as tumors, infections, and immunological diseases. Thorough diagnostic workup, including endoscopic, radiologic, histopathologic and serologic testing is imperative to arrive at the proper diagnosis and to initiate appropriate local and systemic treatment. Positive antineutrophil cytoplasmic antibody (ANCA) test results may be found in an unexpectedly large proportion of patients with CIMDL. In several instances their lesions are clinically indistinguishable from granulomatosis with polyangiitis (Wegener's) limited to the upper respiratory tract. CIMDL seem to be the result of a necrotizing inflammatory tissue response triggered by cocaine abuse in a subset of patients predisposed to produce ANCA, particularly those reacting with HNE. The presence of these HNE-ANCA seems to promote or define the disease phenotype. CIMDL do not respond well to immunosuppressive therapy. Only the consistent removal of persistent stimuli of autoantibody production (cocaine, bacterial superinfections) can halt the disease process, prevent the progression of the lesions and promise success of surgical repair procedures. Copyright © 2012 Elsevier B.V. All rights reserved.

Development and validation of case-finding algorithms for the identification of patients with anti-neutrophil cytoplasmic antibody-associated vasculitis in large healthcare administrative databases.

PubMed

Sreih, Antoine G; Annapureddy, Narender; Springer, Jason; Casey, George; Byram, Kevin; Cruz, Andy; Estephan, Maya; Frangiosa, Vince; George, Michael D; Liu, Mei; Parker, Adam; Sangani, Sapna; Sharim, Rebecca; Merkel, Peter A

2016-12-01

The aim of this study was to develop and validate case-finding algorithms for granulomatosis with polyangiitis (Wegener's, GPA), microscopic polyangiitis (MPA), and eosinophilic GPA (Churg-Strauss, EGPA). Two hundred fifty patients per disease were randomly selected from two large healthcare systems using the International Classification of Diseases version 9 (ICD9) codes for GPA/EGPA (446.4) and MPA (446.0). Sixteen case-finding algorithms were constructed using a combination of ICD9 code, encounter type (inpatient or outpatient), physician specialty, use of immunosuppressive medications, and the anti-neutrophil cytoplasmic antibody type. Algorithms with the highest average positive predictive value (PPV) were validated in a third healthcare system. An algorithm excluding patients with eosinophilia or asthma and including the encounter type and physician specialty had the highest PPV for GPA (92.4%). An algorithm including patients with eosinophilia and asthma and the physician specialty had the highest PPV for EGPA (100%). An algorithm including patients with one of the diagnoses (alveolar hemorrhage, interstitial lung disease, glomerulonephritis, and acute or chronic kidney disease), encounter type, physician specialty, and immunosuppressive medications had the highest PPV for MPA (76.2%). When validated in a third healthcare system, these algorithms had high PPV (85.9% for GPA, 85.7% for EGPA, and 61.5% for MPA). Adding the anti-neutrophil cytoplasmic antibody type increased the PPV to 94.4%, 100%, and 81.2% for GPA, EGPA, and MPA, respectively. Case-finding algorithms accurately identify patients with GPA, EGPA, and MPA in administrative databases. These algorithms can be used to assemble population-based cohorts and facilitate future research in epidemiology, drug safety, and comparative effectiveness. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

ANCA-associated vasculitis: diagnostic and therapeutic strategy.

PubMed

Ozaki, Shoichi

2007-06-01

Among small-vessel vasculitides, microscopic polyangiitis (MPA), Wegener's granulomatosis (WG), and allergic granulomatous angiitis (AGA) are known collectively as ANCA-associated vasculitis (AAV) because of the involvement of anti-neutrophil cytoplasmic antibodies (ANCA) as the common pathogenesis. Major target antigens of ANCA associated with vasculitis are myeloperoxidase (MPO) and proteinase 3 (PR3). MPO-ANCA is related to MPA and AGA, and PR3-ANCA is the marker antibody in WG. MPO-ANCA-associated vasculitis is more frequent in Japan, whereas PR3-ANCA-associated vasculitis is more common in Europe and USA. ANCA appears to induce vasculitis by directly activating neutrophils. Therefore, no immunoglobulins or complement components are detected in the vasculitis lesions; hence, AAV is called pauci-immune vasculitis (pauci = few/little). Untreated patients with severe AAV with multi-organ involvement have a poor prognosis, which is improved by combination therapy with cyclophosphamide and high-dose corticosteroid. Randomized controlled trials (RCT) regarding induction and maintenance of remission of AAV indicated that the rate of remission induction by the standard regimen is approximately 90% in 6 months, that maintenance of remission can be achieved with oral azathioprine as well as cyclophosphamide, and that methotrexate can be used only for non-renal mild AAV. As these data were obtained mostly in patients positive for PR3-ANCA, caution must be taken in applying these findings to Japanese patients, most of whom are positive for MPO-ANCA. A prospective study is now underway to clarify the effectiveness of the standard regimen in Japanese patients with MPO-ANCA-associated vasculitis. This article describes the diagnostic criteria and the recent evidence-based therapeutic strategy of AAV.

Clinically significant borderline resistance of sequential clinical isolates of Klebsiella pneumoniae.

PubMed

Wagenlehner, F M E; Heisig, P; Irtenkauf, C; Notka, F; Decker, J; Lehn, N; Linde, H

2003-10-01

Two sequential clinical isolates of Klebsiella pneumoniae (Kpn) were isolated from bronchoalveolar lavage fluid (Kpn#1) and sputum (Kpn#2) of a patient with pneumonia, complicated by anatomical and immunosuppressive problems due to Wegener's granulomatosis. Despite 4 weeks of systemic treatment with ciprofloxacin (CIP) Kpn#2 was isolated thereafter. A fluoroquinolone-resistant mutant (Kpn#1-SEL) was derived from Kpn#1 in vitro by selecting on agar plates supplemented with ofloxacin. Kpn#1, Kpn#1-SEL and Kpn#2 had an identical pattern in PFGE. CIP MICs were 0.25, 2 and 4 mg/l for Kpn#1, Kpn#2 and Kpn#1-SEL, respectively. Kpn ATCC 10031 (CIP MIC 0.002 mg/l) served as control. We analyzed mechanisms of fluoroquinolone resistance by determining antibiotic susceptibility, organic solvent tolerance, accumulation of fluoroquinolones, dominance testing with wild-type topoisomerase genes (gyrA/B, parC/E), sequencing of the quinolone resistance determining regions of gyrA/B, parC/E and marR and Northern blotting of marR and acrAB genes. Compared with Kpn ATCC 10031, elevated MICs to fluoroquinolones and unrelated antibiotics in Kpn#1 was presumably due to a primary efflux pump other than AcrAB and increased the CIP MIC 125-fold. Although Kpn#1 tested sensitive according to NCCLS breakpoints, the elevated CIP MIC of 0.25 mg/l presumably rendered this isolate clinically resistant and lead to therapeutic failure in this case. Further increase of MIC to fluoroquinolones in vivo and in vitro was distinct. Kpn#1-SEL, selected in vitro, acquired a GyrA target mutation, whereas in Kpn#2 no known resistance mechanism could be detected.

Rare case of eosinophilic granulomatosis with polyangiitis in two patients with α-1-antitrypsin deficiency (PiSZ)

PubMed Central

Moxey, Jordan Maureen; Low, Emma Victoria; Turner, Alice Margaret

2016-01-01

We present two cases of eosinophilic granulomatosis with polyangiitis occurring with α-1-antitrypsin deficiency, both PiSZ phenotype. The simultaneous occurrence of these two conditions has seldom been described in the literature, despite evidence of an association between α-1-antitrypsin deficiency and other forms of vasculitis. Both patients had pulmonary involvement and reported intermittent exacerbations of vasculitic symptoms. Both patients were managed on low-dose oral steroids and azathioprine remaining well with occasional exacerbations. It is important to consider whether there is an association between eosinophilic granulomatosis with polyangiitis and α-1-antitrypsin deficiency, as this may lead to more severe pulmonary symptoms during exacerbations. If a genetic association between the two conditions is found, clinicians should be aware of the possible need to screen for α-1-antitrypsin deficiency in appropriate patients. PMID:27118743

The Epidemiology of Antineutrophil Cytoplasmic Autoantibody-Associated Vasculitis in Olmsted County, Minnesota: A Twenty-Year US Population-Based Study.

PubMed

Berti, Alvise; Cornec, Divi; Crowson, Cynthia S; Specks, Ulrich; Matteson, Eric L

2017-12-01

To estimate the annual incidence, prevalence, and mortality of antineutrophil cytoplasmic autoantibody (ANCA)-associated vasculitis (AAV) and its subsets, granulomatosis with polyangiitis (Wegener's) (GPA), microscopic polyangiitis (MPA), and eosinophilic granulomatosis with polyangiitis (Churg-Strauss) (EGPA), in a US-based adult population. All medical records of patients with a diagnosis of, or suspicion of having, AAV in Olmsted County, Minnesota from January 1, 1996 to December 31, 2015 were reviewed. AAV incidence rates were age- and sex-adjusted to the 2010 US white population. Age- and sex-adjusted prevalence of AAV was calculated on January 1, 2015. Survival rates observed in the study cohort were compared with expected rates in the Minnesota population. Of the 58 incident cases of AAV in Olmsted County during the study period, 23 (40%) were cases of GPA, 28 (48%) were cases of MPA, and 7 (12%) were cases of EGPA. Overall, 28 (48%) of the patients with AAV were women and 57 (98%) were white. The mean ± SD age at diagnosis was 61.1 ± 16.5 years. Thirty-four patients (61%) had myeloperoxidase (MPO)-ANCAs, and 17 (30%) were positive for proteinase 3 (PR3)-ANCAs; 5 (9%) were ANCA-negative. The annual incidence of AAV was 3.3 per 100,000 population (95% confidence interval [95% CI] 2.4-4.1). The incidence rates of GPA, MPA, and EGPA were 1.3 (95% CI 0.8-1.8), 1.6 (95% CI 1.0-2.2), and 0.4 (95% CI 0.1-0.6), respectively. The overall prevalence of AAV was 42.1 per 100,000 (95% CI 29.6-54.6). The mortality rate among AAV patients overall, and among patients with EGPA, those with MPA, and those with MPO-ANCAs, was increased in comparison to the Minnesota general population (each P < 0.05), whereas mortality rates among patients with GPA, those with PR3-ANCAs, and ANCA-negative patients did not differ from that in the general population. The annual incidence of AAV in Olmsted County, Minnesota over the 20 years of the study was 3.3 per 100,000, with a prevalence of 42.1 per 100,000, which is substantially higher than the rates reported in other areas worldwide. The incidence of GPA was similar to that of MPA. Patients with MPA and those with EGPA, but not patients with GPA, experienced higher rates of mortality than that in the Minnesota general population. MPO-ANCAs were a marker of poor survival in this population of patients with AAV. © 2017, American College of Rheumatology.

Contrast-enhanced ultrasound and computed tomography findings of granulomatosis with polyangiitis presenting with multiple intrarenal microaneurysms: A case report.

PubMed

Kim, Youe Ree; Lee, Young Hwan; Lee, Jong-Ho; Yoon, Kwon-Ha

Granulomatosis with polyangiitis (GPA) is a systemic disorder that affects small- and medium- sized vessels in many organs. Although the kidneys are the second most commonly involved organ in patients with GPA, its manifestation as multiple intrarenal aneurysms is rare. We report an unusual manifestation of GPA with multiple intrarenal microaneurysms, as demonstrated by contrast-enhanced ultrasound and computed tomography. Copyright © 2017 Elsevier Inc. All rights reserved.

[Talc-induced pulmonary granulomas in drug addicts].

PubMed

Latartseva, L N; Kryvenko, O N

2013-01-01

Among the diseases accompanied by granuloma formation in the lung, there is so-called granulomatosis developing in injection drug users who have been long injecting suspensions of oral medications containing talc and other water insoluble fillers. 102 deaths of chronic intravenous drug users were examined; 12 of whom showed pulmonary talc-induced granulomatosis. Their morphology was studied using polarized light microscopy. The main mechanisms of thanatogenesis in lethal cases within the first hours after intravenous injection of talc-containing oral medication suspensions are explained.

The new WegenerNet climate station network web portal - A gateway to over 10 years of high-resolution precipitation data

NASA Astrophysics Data System (ADS)

Fuchsberger, Jürgen; Kirchengast, Gottfried; Bichler, Christoph; Kabas, Thomas; Lenz, Gunther; Leuprecht, Armin

2017-04-01

The Feldbach region in southeast Austria, characteristic for experiencing a rich variety of weather and climate patterns, has been selected as the focus area for a pioneering weather and climate observation network at very high resolution: The WegenerNet comprises 153 meteorological stations measuring temperature, humidity, precipitation, and other parameters, in a tightly spaced grid within an area of about 20 km × 15 km centered near the city of Feldbach (46.93°N, 15.90°E). With its stations about every 2 km2, each with 5-min time sampling, the network provides regular measurements since January 2007. Detailed information is available in the recent description by Kirchengast et al. (2014) and via www.wegcenter.at/wegenernet. As a smaller "sister network" of the WegenerNet Feldbach region, the WegenerNet Johnsbachtal consists of eleven meteorological stations (complemented by one hydrographic station at the Johnsbach creek), measuring temperature, humidity, precipitation, radiation, wind, and other parameters in an alpine setting at altitudes ranging from below 700 m to over 2100 m. Data are available partly since 2007, partly since more recent dates and have a temporal resolution of 10 minutes. The networks are set to serve as a long-term monitoring and validation facility for weather and climate research and applications. Uses include validation of nonhydrostatic models operated at 1-km-scale resolution and of statistical downscaling techniques (in particular for precipitation), validation of radar and satellite data, study of orography-climate relationships, and many others. Quality-controlled station time series and gridded field data (spacing 200 m × 200 m) are available in near-real time (data latency less than 1-2 h) for visualization and download via a data portal (www.wegenernet.org). This data portal has been undergoing a complete renewal over the last year, and now serves as a modern gateway to the WegenerNet's more than 10 years of high-resolution data. The poster gives a brief introduction to the WegenerNet design and setup and shows a detailed overview of the new data portal. It also focuses on showing examples for high-resolution precipitation measurements, especially heavy-precipitation and convective events. Reference: Kirchengast, G., T. Kabas, A. Leuprecht, C. Bichler, and H. Truhetz (2014): WegenerNet: A pioneering high-resolution network for monitoring weather and climate. Bull. Amer. Meteor. Soc., 95, 227-242, doi:10.1175/BAMS-D-11-00161.1.

Disseminated talc granulomatosis. An unusual finding in a patient with acquired immunodeficiency syndrome and fatal cytomegalovirus infection.

PubMed

Lewis, J H; Sundeen, J T; Simon, G L; Schulof, R S; Wand, G S; Gelfand, R L; Miller, H; Garrett, C T; Jannotta, F S; Orenstein, J M

1985-02-01

The association of disseminated magnesium silicate talc granulomatosis and acquired immunodeficiency syndrome is reported in a male homosexual who used intravenous drugs and who died of overwhelming cytomegalovirus (CMV) infection. Autopsy findings included widespread deposition of talc crystals in the lungs, liver, lymph nodes, bone marrow, and spleen. Typical CMV inclusions were seen in the lungs, kidneys, adrenal glands, gastrointestinal tract, and right eye. There was no evidence of malignancy. Analysis of peripheral blood neutrophil function revealed impaired chemotaxis and chemokinesis, but opsonophagocytosis had remained normal. The CMV infection in the small bowel was extensive and resulted in severe destruction of the muscularis propria and neural plexi, leading to marked dilatation and persistent diarrhea. The terminal course was marked by intractable hypotension, pneumonitis, and malnutrition, which could be attributed respectively to CMV involvement of the adrenal glands, lungs, and small bowel. The etiology and possible role of systemic talc granulomatosis in the development of immunosuppressive illness is reported herein.

[Acute myocardial infarction as Eosinophilic granulomatosis with polyangiitis (formerly Churg Strauss syndrome) initial presentation].

PubMed

Sulaiman, Wahinuddin; Seung, Ong Ping; Noor, Sabariah Mohd

2014-01-01

Eosinophilic granulomatosis with polyangiitis is a rare primary vasculitic disease characterized by hypereosinophilia, late onset asthma and extravascular eosinophil granulomas. We report a case presented initially with acute myocardial infarction which later only proceed with asthma, skin manifestations and peripheral neuropathy. Laboratory parameters showed hypereosinohpilia with negative perinuclear pattern of antineutrophil cytoplasmic autoantibodies (p-ANCA). Skin biopsy showed leucocytoclastic vasculitis with eosinophilic infiltration while coronary angiography was normal. The patient's symptoms improved with IV methylprednisolone, pulse cyclophosphamide and azathioprine. Copyright © 2014 Elsevier Editora Ltda. All rights reserved.

Genetically Distinct Subsets within ANCA-Associated Vasculitis

PubMed Central

Lyons, Paul A.; Rayner, Tim F.; Trivedi, Sapna; Holle, Julia U.; Watts, Richard A.; Jayne, David R.W.; Baslund, Bo; Brenchley, Paul; Bruchfeld, Annette; Chaudhry, Afzal N.; Tervaert, Jan Willem Cohen; Deloukas, Panos; Feighery, Conleth; Gross, Wolfgang L.; Guillevin, Loic; Gunnarsson, Iva; P, Lorraine Harper M.R.C; Hrušková, Zdenka; Little, Mark A.; Martorana, Davide; Neumann, Thomas; Ohlsson, Sophie; Padmanabhan, Sandosh; Pusey, Charles D.; Salama, Alan D.; Sanders, Jan-Stephan F.; Savage, Caroline O.; Segelmark, Mårten; Stegeman, Coen A.; Tesař, Vladimir; Vaglio, Augusto; Wieczorek, Stefan; Wilde, Benjamin; Zwerina, Jochen; Rees, Andrew J.; Clayton, David G.; Smith, Kenneth G.C.

2013-01-01

BACKGROUND Antineutrophil cytoplasmic antibody (ANCA)–associated vasculitis is a severe condition encompassing two major syndromes: granulomatosis with polyangiitis (formerly known as Wegener’s granulomatosis) and microscopic polyangiitis. Its cause is unknown, and there is debate about whether it is a single disease entity and what role ANCA plays in its pathogenesis. We investigated its genetic basis. METHODS A genomewide association study was performed in a discovery cohort of 1233 U.K. patients with ANCA-associated vasculitis and 5884 controls and was replicated in 1454 Northern European case patients and 1666 controls. Quality control, population stratification, and statistical analyses were performed according to standard criteria. RESULTS We found both major-histocompatibility-complex (MHC) and non-MHC associations with ANCA-associated vasculitis and also that granulomatosis with polyangiitis and microscopic polyangiitis were genetically distinct. The strongest genetic associations were with the antigenic specificity of ANCA, not with the clinical syndrome. Anti–proteinase 3 ANCA was associated with HLA-DP and the genes encoding α1-antitrypsin (SERPINA1) and proteinase 3 (PRTN3) (P = 6.2×10−89, P = 5.6×10−12, and P = 2.6×10−7, respectively). Anti–myeloperoxidase ANCA was associated with HLA-DQ (P = 2.1×10−8). CONCLUSIONS This study confirms that the pathogenesis of ANCA-associated vasculitis has a genetic component, shows genetic distinctions between granulomatosis with polyangiitis and microscopic polyangiitis that are associated with ANCA specificity, and suggests that the response against the autoantigen proteinase 3 is a central pathogenic feature of proteinase 3 ANCA–associated vasculitis. These data provide preliminary support for the concept that proteinase 3 ANCA–associated vasculitis and myeloperoxidase ANCA–associated vasculitis are distinct autoimmune syndromes. (Funded by the British Heart Foundation and others.) PMID:22808956

Contrasting association of a non-synonymous leptin receptor gene polymorphism with Wegener's granulomatosis and Churg-Strauss syndrome.

PubMed

Wieczorek, Stefan; Holle, Julia U; Bremer, Jan P; Wibisono, David; Moosig, Frank; Fricke, Harald; Assmann, Gunter; Harper, Lorraine; Arning, Larissa; Gross, Wolfgang L; Epplen, Joerg T

2010-05-01

There is evidence that the leptin/ghrelin system is involved in T-cell regulation and plays a role in (auto)immune disorders such as SLE, RA and ANCA-associated vasculitides (AAVs). Here, we evaluate the genetic background of this system in WG. We screened variations in the genes encoding leptin, ghrelin and their receptors, the leptin receptor (LEPR) and the growth hormone secretagogue receptor (GHSR). Three single nucleotide polymorphisms (SNPs) in each gene region were analysed in 460 German WG cases and 878 ethnically matched healthy controls. A three-SNP haplotype of GHSR was significantly associated with WG [P = 0.0067; corrected P-value (P(c)) = 0.026; odds ratio (OR) = 1.30; 95% CI 1.08, 1.57], as was one non-synonymous SNP in LEPR (Lys656Asn, P = 0.0034; P(c) = 0.013; OR = 0.72; 95% CI 0.58, 0.90). These four SNPs were re-analysed in independent cohorts of 226 German WG cases and 519 controls. While the GHSR association was not confirmed, allele frequencies of the LEPR SNP were virtually identical to those from the initial cohorts. Analysis of this SNP in the combined WG and control panels revealed a significant association of the LEPR 656Lys allele with WG (P = 0.00032; P(c) = 0.0013; OR = 0.72; 95% CI 0.60, 0.86). Remarkably, the Lys656Asn SNP showed contrasting allele distribution in two cohorts of 108 and 88 German cases diagnosed with Churg-Strauss syndrome (CSS, combined P = 0.0067; OR = 1.41; 95% CI 1.10, 1.81), whereas identical allele frequencies were revealed when comparing British WG and microscopic polyangiitis cases. While GHSR has to be further evaluated, these data provide profound evidence for an association of the LEPR Lys656Asn SNP with AAV, resulting in opposing effects in WG and CSS.

Human alpha-enolase from endothelial cells as a target antigen of anti-endothelial cell antibody in Behçet's disease.

PubMed

Lee, Kwang Hoon; Chung, Hae-Shin; Kim, Hyoung Sup; Oh, Sang-Ho; Ha, Moon-Kyung; Baik, Ja-Hyun; Lee, Sungnack; Bang, Dongsik

2003-07-01

To identify and recombine a protein of the human dermal microvascular endothelial cell (HDMEC) that specifically reacts with anti-endothelial cell antibody (AECA) in the serum of patients with Behçet's disease (BD), and to evaluate the usefulness of this protein in BD. The proteomics technique, with 2-dimensional gel electrophoresis and matrix-assisted laser desorption ionization-time-of-flight (MALDI-TOF) mass spectrometry, was used to identify and recombine HDMEC antigen. Western blotting and enzyme-linked immunosorbent assay (ELISA) of recombinant protein isolated by gene cloning were performed on serum from healthy controls, patients with BD, and patients with other rheumatic diseases (rheumatoid arthritis, systemic lupus erythematosus, and Wegener's granulomatosis). Eighteen of 40 BD patients had serum IgM antibody to HDMEC antigen. The purified protein that reacted with AECA in BD patient sera was found to be alpha-enolase by 2-dimensional gel electrophoresis followed by immunoblotting and MALDI-TOF mass spectrometry. Recombinant alpha-enolase protein was isolated and refined by gene cloning. On Western blots, AECA-positive IgM from the sera of patients with active BD reacted strongly with recombinant human alpha-enolase. BD patient sera positive for anti-alpha-enolase did not react with human gamma-enolase. On dot-blotting, reactivity to human alpha-enolase was detected only in the IgM-positive group. Fifteen of the 18 AECA-positive sera that were positive for the HDMEC antigen showed reactivity to recombinant alpha-enolase IgM antibody by ELISA. The alpha-enolase protein is the target protein of serum AECA in BD patients. This is the first report of the presence of IgM antibodies to alpha-enolase in endothelial cells from the serum of BD patients. Although further studies relating this protein to the pathogenesis of BD will be necessary, alpha-enolase and its antibody may prove useful in the development of new diagnostic and treatment modalities in BD.

A case series of patients diagnosed with orofacial granulomatosis presenting primarily with dense infiltrates and severe periorbital edema.

PubMed

Sabet-Peyman, Esfandiar J; Woodward, Julie A

2014-01-01

Orofacial granulomatosis is a relapsing nonnecrotizing granulomatous syndrome that classically presents with lip and perioral swelling. Over the years, several patients have been referred to the Duke Eye Center Oculoplastics Department for severe, progressive, recurrent eyelid swelling interfering with both their functional vision and their appearance. In this IRB approved retrospective case series, we describe the clinical course of 5 such patients, including their presenting symptoms, diagnosis, and response to treatment. We hope that oculoplastics specialists will consider this entity in the differential diagnosis of periorbital edema and consider initiating localized anti-inflammatory treatment once the diagnosis has been made.

[Eosinophilic granulomatosis with polyangiitis (Churg-Strauss syndrome)].

PubMed

Guillevin, Loïc

2012-10-01

Eosinophilic granulomatosis with polyangiitis (EGPA) (Churg-Strauss), is a rare necrotizing vasculitis of small-sized vessels, associated to antimyeloperoxydase ANCA in 40% of patients. EGPA occurs in patients with asthma. Asthma is sever, associated with eosinophilia and extrapulmonary symptoms. Among them, mononeuritis multiplex is the most frequent symptom. When cardiac involvement is present, prognosis is poor. Despite a good overall prognosis, deaths are caused by vasculitis activity, gastrointestinal and cardiac involvement. Treatment is well codified based on steroids, which are quickly effective. Immunosuppressants combined with corticosteroids are compulsory to treat the most sever forms, mainly when cardiac and gastrointestinal or renal symptoms are present. Copyright © 2012. Published by Elsevier Masson SAS.

Genetic Susceptibility to ANCA-Associated Vasculitis: State of the Art

PubMed Central

Bonatti, Francesco; Reina, Michele; Neri, Tauro Maria; Martorana, Davide

2014-01-01

ANCA-associated vasculitis (AAV) is a group of disorders that is caused by inflammation affecting small blood vessels. Both arteries and veins are affected. AAV includes microscopic polyangiitis (MPA), granulomatosis with polyangiitis (GPA) renamed from Wegener’s granulomatosis, and eosinophilic granulomatosis with polyangiitis (EGPA), renamed from Churg–Strauss syndrome. AAV is primarily due to leukocyte migration and resultant damage. Despite decades of research, the mechanisms behind AAV disease etiology are still not fully understood, although it is clear that genetic and environmental factors are involved. To improve the understanding of the disease, the genetic component has been extensively studied by candidate association studies and two genome-wide association studies. The majority of the identified genetic AAV risk factors are common variants. These have uncovered information that still needs further investigation to clarify its importance. In this review, we summarize and discuss the results of the genetic studies in AAV. We also present the novel approaches to identifying the causal variants in complex susceptibility loci and disease mechanisms. Finally, we discuss the limitations of current methods and the challenges that we still have to face in order to incorporate genomic and epigenomic data into clinical practice. PMID:25452756

[Spontaneous hemothorax revealing Wegener's vasculitis in a pregnant woman].

PubMed

Serhane, Hind; Yassine, Msougar; Amro, Lamyae

2016-01-01

Spontaneous hemothorax is a rare condition. Its causes are multiple but sometimes they remain unknown. In some patients, thoracotomy may be the only means to determine hemothorax origin. Vasculitis have not been reported as a common cause of spontaneous hemothorax. Pregnancy does not appear to have causal or aggravating effect on spontaneous hemothorax or on vasculitis. We here report the peculiar case of a young patient presenting during pregnancy with spontaneous hemothorax secondary to Wegener's vasculitis. The latter was diagnosed by pleural biopsy performed during exploratory thoracotomy and confirmed by ANCA assays.

WegenerNet climate station network region Feldbach/Austria: From local measurements to weather and climate data products at 1 km-scale resolution

NASA Astrophysics Data System (ADS)

Kabas, T.; Leuprecht, A.; Bichler, C.; Kirchengast, G.

2010-12-01

South-eastern Austria is characteristic for experiencing a rich variety of weather and climate patterns. For this reason, the county of Feldbach was selected by the Wegener Center as a focus area for a pioneering observation experiment at very high resolution: The WegenerNet climate station network (in brief WegenerNet) comprises 151 meteorological stations within an area of about 20 km × 15 km (~ 1.4 km × 1.4 km station grid). All stations measure the main parameters temperature, humidity and precipitation with 5 minute sampling. Selected further stations include measurements of wind speed and direction completed by soil parameters as well as air pressure and net radiation. The collected data is integrated in an automatic processing system including data transfer, quality control, product generation, and visualization. Each station is equipped with an internet-attached data logger and the measurements are transferred as binary files via GPRS to the WegenerNet server in 1 hour intervals. The incoming raw data files of measured parameters as well as several operating values of the data logger are stored in a relational database (PostgreSQL). Next, the raw data pass the Quality Control System (QCS) in which the data are checked for its technical and physical plausibility (e.g., sensor specifications, temporal and spatial variability). In consideration of the data quality (quality flag), the Data Product Generator (DPG) results in weather and climate data products on various temporal scales (from 5 min to annual) for single stations and regular grids. Gridded data are derived by vertical scaling and squared inverse distance interpolation (1 km × 1 km and 0.01° × 0.01° grids). Both subsystems (QCS and DPG) are realized by the programming language Python. For application purposes the resulting data products are available via the bi-lingual (dt, en) WegenerNet data portal (www.wegenernet.org). At this time, the main interface is still online in a system in which MapServer is used to import spatial data by its database interface and to generate images of static geographic formats. However, a Java applet is additionally needed to display these images on the users local host. Furthermore, station data are visualized as time series by the scripting language PHP. Since February 2010, the visualization of gridded data products is a first step to a new data portal based on OpenLayers. In this GIS framework, all geographic information (e.g., OpenStreetMap) is displayed with MapServer. Furthermore, the visualization of all meteorological parameters are generated on the fly by a Python CGI script and transparently overlayed on the maps. Hence, station data and gridded data are visualized and further prepared for download in common data formats (csv, NetCDF). In conclusion, measured data and generated data products are provided with a data latency less than 1-2 hours in standard operation (near real time). Following an introduction of the processing system along the lines above, resulting data products are presented online at the WegenerNet data portal.

Illicit narcotic injection masquerading as acute pulmonary embolism.

PubMed

Klochan, Shelley A; Taleb, Mohammed; Hoover, Matthew J; Mauro, Vincent F; Anandan, Vasuki; Willey, James; Cooper, Christopher J

2013-04-01

A 23-year-old male presented from a nursing home with hypotension, tachycardia, diaphoresis and electrocardiographic evidence of right ventricular strain that was confirmed by echocardiography. His differential diagnosis included sepsis and pulmonary embolism. A high-resolution computed tomography scan demonstrated no pulmonary emboli but did demonstrate multiple bilateral pulmonary nodules. Upon questioning he admitted to injecting a long-acting narcotic that had been manually macerated, dissolved in saline, and injected through an indwelling intravenous line. Lung biopsy findings were consistent with cellulose-induced perivascular granulomatosis. Cellulose granulomatosis can be seen in patients who inject medications designed for oral use and should be considered in patients who present with acute pulmonary hypertension.

Cardiac tamponade leading to the diagnosis of eosinophilic granulomatosis with polyangiitis (Churg-Strauss syndrome): a case report and review of the literature.

PubMed

Yano, Toshiyuki; Ishimura, Shutaro; Furukawa, Tetsuaki; Koyama, Masayuki; Tanaka, Marenao; Shimoshige, Shinya; Hashimoto, Akiyoshi; Miura, Tetsuji

2015-11-01

Eosinophilic granulomatosis with polyangiitis (EGPA), which was previously called Churg-Strauss syndrome, is a necrotizing systemic vasculitis of unknown cause accompanied by prominent eosinophilia. Cardiovascular complications, including eosinophilic myocarditis, are a major cause of mortality in this disorder. Acute pericarditis with slight pericardial effusion is a typical manifestation in EGPA, though hemodynamically significant pericardial effusion has been reported in a few cases. We report a case that initially presented with isolated cardiac tamponade, which was followed by systemic manifestations of EGPA over 3 weeks. Including the present case, previous EGPA cases with cardiac tamponade are reviewed to delineate its clinical characteristics.

Granulomatosis with polyangiitis confined to lacrimal gland, a case report.

PubMed

Zuazo, F; González, M; Abdala, A; Olvera-Morales, O; Monroy, M H; Rodríguez-Reyes, A; Tovilla-Canales, J L; Nava-Castañeda, Á

2017-11-01

A 43 year-old woman consulted due to 2 months of swelling on the superolateral side of the left orbit, with pain and erythema. An excisional biopsy was performed that revealed vasculitis with polyangiitis of the lacrimal gland. A systemic study showed that no other system was compromised. Orbital involvement occurs in up to 60% of patients with granulomatosis with polyangiitis. The involvement of the lacrimal gland is rare and often unilateral. Serological tests are generally negative, both in initial stages, as in localized forms of the disease. Copyright © 2016 Sociedad Española de Oftalmología. Publicado por Elsevier España, S.L.U. All rights reserved.

MDX-010 in Treating Patients With Recurrent or Refractory Lymphoma

ClinicalTrials.gov

2014-05-22

Adult Grade III Lymphomatoid Granulomatosis; B-cell Chronic Lymphocytic Leukemia; Cutaneous B-cell Non-Hodgkin Lymphoma; Extranodal Marginal Zone B-cell Lymphoma of Mucosa-associated Lymphoid Tissue; Intraocular Lymphoma; Nodal Marginal Zone B-cell Lymphoma; Recurrent Adult Burkitt Lymphoma; Recurrent Adult Diffuse Large Cell Lymphoma; Recurrent Adult Diffuse Mixed Cell Lymphoma; Recurrent Adult Diffuse Small Cleaved Cell Lymphoma; Recurrent Adult Grade III Lymphomatoid Granulomatosis; Recurrent Adult Hodgkin Lymphoma; Recurrent Adult Immunoblastic Large Cell Lymphoma; Recurrent Adult Lymphoblastic Lymphoma; Recurrent Grade 1 Follicular Lymphoma; Recurrent Grade 2 Follicular Lymphoma; Recurrent Mantle Cell Lymphoma; Recurrent Marginal Zone Lymphoma; Refractory Hairy Cell Leukemia; Small Intestine Lymphoma; Splenic Marginal Zone Lymphoma; Testicular Lymphoma; Waldenström Macroglobulinemia

Cohort profile: the Welsh Geriatric Registrar-Led Research Network (WeGeN): rationale, design and description.

PubMed

Jelley, Benjamin; Long, Sara; Butler, John; Hewitt, Jonathan

2017-02-14

Medical trainees are required to undertake audit and quality improvement projects. They must also have an understanding of the principles of research and are encouraged to participate in research projects. However, the constraints of time, a lack of formal training and rotation between different training posts create barriers to audit cycle completion and pursuing research. This leads to trainees being reluctant to undertake research, facilitates poor quality research and risks incomplete audit. The Welsh Geriatricians Network (WeGeN) has been created with the aims of facilitating collaborative, trainee-led research within Geriatric Medicine in Wales, promoting research engagement and improving the research evidence base for older patients. By coordinating collaborative research projects across different sites within Wales, trainees continue existing projects at new sites, allowing completion of projects and establishing the long-term infrastructure and experienced personnel needed for high-quality research data to be gathered. WeGeN has facilitated 4 national audits, all of which are intended for peer review publication. The first project considers the service provision for the older person in the emergency department, the second Parkinson's disease, the third reviews delirium management and the fourth project considers epidemiology of surgical disease in older people. The objective of this project is to further establish and develop WeGeN as a group which facilitates high-quality research and provides the opportunity for geriatric trainees to engage in research activity. It is anticipated that the establishment of this research platform will provide a blueprint for the development of other such networks in the UK and beyond. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Successful management with CHOP for pulmonary lymphomatoid granulomatosis in a dog.

PubMed

Hatoya, Singo; Kumagai, Daijiro; Takeda, Seiko; Yamamoto, Emi; Nakanishi, Masako; Kuwamura, Mitsuru; Sugiura, Kikuya; Sasai, Hiroshi; Yamate, Jyoji; Inaba, Toshio

2011-04-01

A 3-year-old, spayed female miniature dachshund was presented for vomiting and anorexia. Thoracic radiographs and CT scan revealed abnormal pulmonary opacities at bilateral caudal lobe. Cytological analysis of the pulmonary mass revealed the presence of large lymphohistiocytic cells and small lymphocytes with occasional neutrophils and plasma cells. An open lung biopsy was performed and a diagnosis of pulmonary lymphomatoid granulomatosis (LYG) was made. The dog was administered CHOP based therapy (modified UW-25), and it survived for 1,022 days after admission. Immunohistochemistry revealed pulmonary lesions consisted of many CD79a positive B cells aggregation and proliferation with prominent angiocentric pattern. This was the first case of canine pulmonary LYG managed by CHOP chemotherapy.

Spinal aspergillus abscess in a patient with bronchocentric granulomatosis.

PubMed

Collier, J; Wolfe, R; Lerner, R; Nathan, S; Mohsenifar, Z

1995-01-01

Aspergillus fumigatus hyphae is often found in the lung tissue of patients with bronchocentric granulomatosis (BCG). This organism is believed to be one agent responsible for inciting the hypersensitivity response and subsequent development of the characteristic pathology that defines BCG. The definitive etiology of this disease, however, remains conjectural. Corticosteroids represent the mainstay of therapy. The fungi recovered from patients with BCG are considered noninvasive; thus, the risk of fungal invasion secondary to steroid-induced immunosuppression is believed to be negligible. However, we report a case of spinal aspergillus abscess that developed in a patient with BCG subsequent to steroid therapy. This case also highlights the necessity for aggressive medical and neurosurgical intervention to avert the development of neurological sequelae.

[Antineutrophil cytoplasmic antibodies associated with infective endocarditis: Literature review].

PubMed

Langlois, V; Marie, I

2017-07-01

Antineutrophil cytoplasmic antibodies (ANCA) associated with infective endocarditis are a rare disorder. The condition can mimic primary systemic vasculitis (i.e. granulomatosis with polyangiitis, microscopic polyangiitis, and eosinophilic granulomatosis with polyangiitis). Thus, a wrong diagnosis of valvular involvement related to primary systemic vasculitis can be made in patients exhibiting ANCA associated with infective endocarditis. Because treatment of both conditions is different, this wrong diagnosis will lead to dramatic consequences in these latter patients. This review reports the state of knowledge and proposes an algorithm to follow when confronted to a possible case of ANCA associated with infective endocarditis. Copyright © 2016 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier SAS. All rights reserved.

Yellow Fever Vaccine in Patients With Rheumatic Diseases

ClinicalTrials.gov

2018-04-05

Systemic Lupus; Rheumatoid Arthritis; Spondyloarthritis; Inflammatory Myopathy; Systemic Sclerosis; Mixed Connective Tissue Disease; Takayasu Arteritis; Granulomatosis With Polyangiitis; Sjogren's Syndrome; Juvenile Idiopathic Arthritis; Juvenile Dermatomyositis

Serum, liver, and lung levels of the major extracellular matrix components at the early stage of BCG-induced granulomatosis depending on the infection route.

PubMed

Kim, L B; Shkurupy, V A; Putyatina, A N

2015-01-01

Experiments on the model of mouse BCG-induced granulomatous showed that the content of glycosaminoglycans and proteoglycans in the extracellular matrix of the liver and lungs are changed at the early stages of inflammation (days 3 and 30 postinfection) before cell destruction in the organs begins. This is related to degradation of extracellular matrix structures. Their high content in the blood and interstitium probably contributes to the formation of granulomas, fibroblast proliferation and organ fibrosis. These processes depend on the infection route that determines different conditions for generalization of the inflammation process. Intravenous method of vaccine injection is preferable to use when designing the experiments simulating tuberculosis granulomatosis, especially for the analysis of its early stages.

Two cases of granulomatosis polyangiitis presenting with Strawberry gingivitis and a review of the literature.

PubMed

Thompson, Grace; Benwell, Nicola; Hollingsworth, Peter; McLean-Tooke, Andrew

2018-02-01

Hyperplastic gingivitis is a rare manifestation of granulomatosis with polyangiitis (GPA). This gingivitis has a very distinctive clinical appearance (so-called Strawberry gingivitis) and when seen is virtually pathognomic for GPA. Gingivitis often precedes other organ involvement therefore making awareness of this manifestation particularly important to aid early diagnosis and treatment. Furthermore, histopathological findings of gingival specimens rarely reveal necrotizing granulomatous vasculitis, which is classically seen at other sites of involvement. As a result a delay in diagnosis is not uncommon. GPA if left untreated has a high mortality rate and early immunosuppressive treatment is associated with an improved prognosis. We present two cases of patients with GPA presenting with characteristic strawberry gingivitis and review the reported cases. Copyright © 2018 Elsevier Inc. All rights reserved.

The Complete Remission of Acquired Immunodeficiency Syndrome-associated Isolated Central Nervous System Lymphomatoid Granulomatosis: A Case Report and Review of the Literature.

PubMed

Kano, Yasuhiro; Kodaira, Minori; Ushiki, Atsuhito; Kosaka, Makoto; Yamada, Mitsunori; Shingu, Kunihiko; Nishihara, Hiroshi; Hanaoka, Masayuki; Sekijima, Yoshiki

2017-09-15

A 49-year-old man presented with gradually progressive aphasia one month after being diagnosed with acquired immunodeficiency syndrome (AIDS). Brain magnetic resonance imaging showed multiple brain lesions with punctate and linear enhancement. A polymerase chain reaction detected Epstein-Barr virus (EBV) in the patient's cerebrospinal fluid. A diagnosis of isolated central nervous system lymphomatoid granulomatosis (CNS-LYG) was made based on the brain biopsy findings. The complete remission of CNS-LYG was achieved by anti-retroviral therapy (ART) alone. In the present case, the development of AIDS-associated CNS-LYG was considered to have been initiated by the reactivation of EBV in the CNS under immunosuppressive conditions. The patient's condition improved with the reconstitution of the patient's immune system.

Genetically Modified T-cell Infusion Following Peripheral Blood Stem Cell Transplant in Treating Patients With Recurrent or High-Risk Non-Hodgkin Lymphoma

ClinicalTrials.gov

2018-01-26

Adult Grade III Lymphomatoid Granulomatosis; Cutaneous B-cell Non-Hodgkin Lymphoma; Extranodal Marginal Zone B-cell Lymphoma of Mucosa-associated Lymphoid Tissue; Intraocular Lymphoma; Nodal Marginal Zone B-cell Lymphoma; Post-transplant Lymphoproliferative Disorder; Recurrent Adult Burkitt Lymphoma; Recurrent Adult Diffuse Large Cell Lymphoma; Recurrent Adult Diffuse Mixed Cell Lymphoma; Recurrent Adult Diffuse Small Cleaved Cell Lymphoma; Recurrent Adult Grade III Lymphomatoid Granulomatosis; Recurrent Adult Immunoblastic Large Cell Lymphoma; Recurrent Adult Lymphoblastic Lymphoma; Recurrent Grade 1 Follicular Lymphoma; Recurrent Grade 2 Follicular Lymphoma; Recurrent Grade 3 Follicular Lymphoma; Recurrent Mantle Cell Lymphoma; Recurrent Marginal Zone Lymphoma; Recurrent Small Lymphocytic Lymphoma; Refractory Hairy Cell Leukemia; Small Intestine Lymphoma; Splenic Marginal Zone Lymphoma; Testicular Lymphoma; Waldenström Macroglobulinemia

Mepolizumab or Placebo for Eosinophilic Granulomatosis with Polyangiitis.

PubMed

Wechsler, Michael E; Akuthota, Praveen; Jayne, David; Khoury, Paneez; Klion, Amy; Langford, Carol A; Merkel, Peter A; Moosig, Frank; Specks, Ulrich; Cid, Maria C; Luqmani, Raashid; Brown, Judith; Mallett, Stephen; Philipson, Richard; Yancey, Steve W; Steinfeld, Jonathan; Weller, Peter F; Gleich, Gerald J

2017-05-18

Eosinophilic granulomatosis with polyangiitis is an eosinophilic vasculitis. Mepolizumab, an anti-interleukin-5 monoclonal antibody, reduces blood eosinophil counts and may have value in the treatment of eosinophilic granulomatosis with polyangiitis. In this multicenter, double-blind, parallel-group, phase 3 trial, we randomly assigned participants with relapsing or refractory eosinophilic granulomatosis with polyangiitis who had received treatment for at least 4 weeks and were taking a stable prednisolone or prednisone dose to receive 300 mg of mepolizumab or placebo, administered subcutaneously every 4 weeks, plus standard care, for 52 weeks. The two primary end points were the accrued weeks of remission over a 52-week period, according to categorical quantification, and the proportion of participants in remission at both week 36 and week 48. Secondary end points included the time to first relapse and the average daily glucocorticoid dose (during weeks 48 through 52). The annualized relapse rate and safety were assessed. A total of 136 participants underwent randomization, with 68 participants assigned to receive mepolizumab and 68 to receive placebo. Mepolizumab treatment led to significantly more accrued weeks of remission than placebo (28% vs. 3% of the participants had ≥24 weeks of accrued remission; odds ratio, 5.91; 95% confidence interval [CI], 2.68 to 13.03; P<0.001) and a higher percentage of participants in remission at both week 36 and week 48 (32% vs. 3%; odds ratio, 16.74; 95% CI, 3.61 to 77.56; P<0.001). Remission did not occur in 47% of the participants in the mepolizumab group versus 81% of those in the placebo group. The annualized relapse rate was 1.14 in the mepolizumab group, as compared with 2.27 in the placebo group (rate ratio, 0.50; 95% CI, 0.36 to 0.70; P<0.001). A total of 44% of the participants in the mepolizumab group, as compared with 7% of those in the placebo group, had an average daily dose of prednisolone or prednisone of 4.0 mg or less per day during weeks 48 through 52 (odds ratio, 0.20; 95% CI, 0.09 to 0.41; P<0.001). The safety profile of mepolizumab was similar to that observed in previous studies. In participants with eosinophilic granulomatosis with polyangiitis, mepolizumab resulted in significantly more weeks in remission and a higher proportion of participants in remission than did placebo, thus allowing for reduced glucocorticoid use. Even so, only approximately half the participants treated with mepolizumab had protocol-defined remission. (Funded by GlaxoSmithKline and the National Institute of Allergy and Infectious Diseases; ClinicalTrials.gov number, NCT02020889 .).

Mepolizumab or Placebo for Eosinophilic Granulomatosis with Polyangiitis

PubMed Central

Wechsler, M.E.; Akuthota, P.; Jayne, D.; Khoury, P.; Klion, A.; Langford, C.A.; Merkel, P.A.; Moosig, F.; Specks, U.; Cid, M.C.; Luqmani, R.; Brown, J.; Mallett, S.; Philipson, R.; Yancey, S.W.; Steinfeld, J.; Weller, P.F.; Gleich, G.J.

2017-01-01

Background Eosinophilic granulomatosis with polyangiitis is an eosinophilic vasculitis. Mepolizumab, an anti–interleukin-5 monoclonal antibody, reduces blood eosinophil counts and may have value in the treatment of eosinophilic granulomatosis with polyangiitis. Methods In this multicenter, double-blind, parallel-group, phase 3 trial, we randomly assigned participants with relapsing or refractory eosinophilic granulomatosis with polyangiitis who had received treatment for at least 4 weeks and were taking a stable prednisolone or prednisone dose to receive 300 mg of mepolizumab or placebo, administered subcutaneously every 4 weeks, plus standard care, for 52 weeks. The two primary end points were the accrued weeks of remission over a 52-week period, according to categorical quantification, and the proportion of participants in remission at both week 36 and week 48. Secondary end points included the time to first relapse and the average daily glucocorticoid dose (during weeks 48 through 52). The annualized relapse rate and safety were assessed. Results A total of 136 participants underwent randomization, with 68 participants assigned to receive mepolizumab and 68 to receive placebo. Mepolizumab treatment led to significantly more accrued weeks of remission than placebo (28% vs. 3% of the participants had ≥ 24 weeks of accrued remission; odds ratio, 5.91; 95% confidence interval [CI], 2.68 to 13.03; P<0.001) and a higher percentage of participants in remission at both week 36 and week 48 (32% vs. 3%; odds ratio, 16.74; 95% CI, 3.61 to 77.56; P<0.001). Remission did not occur in 47% of the participants in the mepolizumab group versus 81% of those in the placebo group. The annualized relapse rate was 1.14 in the mepolizumab group, as compared with 2.27 in the placebo group (rate ratio, 0.50; 95% CI, 0.36 to 0.70; P<0.001). A total of 44% of the participants in the mepolizumab group, as compared with 7% of those in the placebo group, had an average daily dose of prednisolone or prednisone of 4.0 mg or less per day during weeks 48 through 52 (odds ratio, 0.20; 95% CI, 0.09 to 0.41; P<0.001). The safety profile of mepolizumab was similar to that observed in previous studies. Conclusions In participants with eosinophilic granulomatosis with polyangiitis, mepolizumab resulted in significantly more weeks in remission and a higher proportion of participants in remission than did placebo, thus allowing for reduced glucocorticoid use. Even so, only approximately half the participants treated with mepolizumab had protocol-defined remission. (Funded by GlaxoSmithKline and the National Institute of Allergy and Infectious Diseases; ClinicalTrials.gov number, NCT02020889.) PMID:28514601

Granulomatosis with polyangiitis

MedlinePlus

... ncbi.nlm.nih.gov/pubmed/21372195 . Specks U, Merkel PA, Seo P, et al. Efficacy of remission- ... PA: Elsevier Saunders; 2016:chap 270. Stone JH, Merkel PA, Spiera R, et al. Rituximab versus cyclophosphamide ...

Rituximab Injection

MedlinePlus

... Rasuvo, Xatmep, others) to treat the symptoms of rheumatoid arthritis (RA; a condition in which the body attacks ... and CLL by killing cancer cells. It treats rheumatoid arthritis, granulomatosis with polyangiitis, and microscopic polyangiitis by blocking ...

Granulomatosis with Polyangiitis (GPA): Symptoms and Causes

MedlinePlus

... of the nose (saddling) caused by weakened cartilage Deep vein thrombosis By Mayo Clinic ... is a not-for-profit organization and proceeds from Web advertising help support our mission. Mayo Clinic does ...

Oxaliplatin and Irinotecan in Treating Young Patients With Refractory Solid Tumors or Lymphomas

ClinicalTrials.gov

2013-06-04

Childhood Burkitt Lymphoma; Childhood Central Nervous System Germ Cell Tumor; Childhood Diffuse Large Cell Lymphoma; Childhood Grade III Lymphomatoid Granulomatosis; Childhood Immunoblastic Large Cell Lymphoma; Recurrent Childhood Brain Stem Glioma; Recurrent Childhood Cerebellar Astrocytoma; Recurrent Childhood Cerebral Astrocytoma; Recurrent Childhood Ependymoma; Recurrent Childhood Grade III Lymphomatoid Granulomatosis; Recurrent Childhood Large Cell Lymphoma; Recurrent Childhood Liver Cancer; Recurrent Childhood Lymphoblastic Lymphoma; Recurrent Childhood Malignant Germ Cell Tumor; Recurrent Childhood Medulloblastoma; Recurrent Childhood Rhabdomyosarcoma; Recurrent Childhood Small Noncleaved Cell Lymphoma; Recurrent Childhood Soft Tissue Sarcoma; Recurrent Childhood Supratentorial Primitive Neuroectodermal Tumor; Recurrent Childhood Visual Pathway Glioma; Recurrent Colon Cancer; Recurrent Ewing Sarcoma/Peripheral Primitive Neuroectodermal Tumor; Recurrent Melanoma; Recurrent Nasopharyngeal Cancer; Recurrent Neuroblastoma; Recurrent Osteosarcoma; Recurrent Wilms Tumor and Other Childhood Kidney Tumors; Recurrent/Refractory Childhood Hodgkin Lymphoma; Unspecified Childhood Solid Tumor, Protocol Specific

Development of eosinophilic granulomatosis with poliangiitis (Churg-Strauss syndrome) and brain tumor in a patient after more than 7 years of omalizumab use: A case report.

PubMed

Borekci, S; Aydin, O; Hatemi, G; Gemicioglu, B

2015-03-01

Omalizumab is a monoclonal anti-immunoglobulin E antibody used for the treatment of severe perennial allergic asthma. Previous reports have suggested that omalizumab treatment can be associated with the development of eosinophilic granulomatosis with poliangiitis (EGPA) (formerly known as Churg-Strauss syndrome) and an increased risk of malignancy. Long-term risks of omalizumab treatment are not very well defined. Here, we report the case of a 75-year-old woman with concurrent occurrence of EGPA and brain tumor after more than 7 years of omalizumab treatment. The possibility of EGPA should be borne in mind during long-term treatment with omalizumab. Despite the absence of definitive data, an association may also exist between the development of malignancy and omalizumab use. © The Author(s) 2015.

A case of probable trimethoprim-sulfamethoxazole induced circulating antineutrophil cytoplasmic antibody-positive small vessel vasculitis.

PubMed

Woodring, Therese; Abraham, Ronnie; Frisch, Stephanie

2017-08-15

Cutaneous leukocytoclastic vasculitis (LCV) can occur as skin-limited disease or as part a systemic vasculitis. Appropriate workup includes the evaluation of antineutrophil cytoplasmic antibodies (ANCAs), with a positive titer raising concern for the associated primary vasculitides including microscopic polyangiitis (MPA), granulomatosis with polyangiitis (GPA), or eosinophilic granulomatosis with polyangiitis (EGPA). In the absence of systemic findings, however, a drug etiology must also be considered. Tumor necrosis factor (TNF) inhibitors, propylthiouracil, levamisole-adulterated cocaine, hydralazine, and minocycline have been previously documented to induce ANCA-positive vasculitis (APV), which may present with conspicuously high ANCA titers. Herein we report trimethoprim-sulfamethoxazole as another culprit in drug-induced APV. Our case reinforces the need to consider drug etiology for APV and cautions against interpreting positive ANCAs as equivalent to evidence of systemic disease.

The Complete Remission of Acquired Immunodeficiency Syndrome-associated Isolated Central Nervous System Lymphomatoid Granulomatosis: A Case Report and Review of the Literature

PubMed Central

Kano, Yasuhiro; Kodaira, Minori; Ushiki, Atsuhito; Kosaka, Makoto; Yamada, Mitsunori; Shingu, Kunihiko; Nishihara, Hiroshi; Hanaoka, Masayuki; Sekijima, Yoshiki

2017-01-01

A 49-year-old man presented with gradually progressive aphasia one month after being diagnosed with acquired immunodeficiency syndrome (AIDS). Brain magnetic resonance imaging showed multiple brain lesions with punctate and linear enhancement. A polymerase chain reaction detected Epstein-Barr virus (EBV) in the patient's cerebrospinal fluid. A diagnosis of isolated central nervous system lymphomatoid granulomatosis (CNS-LYG) was made based on the brain biopsy findings. The complete remission of CNS-LYG was achieved by anti-retroviral therapy (ART) alone. In the present case, the development of AIDS-associated CNS-LYG was considered to have been initiated by the reactivation of EBV in the CNS under immunosuppressive conditions. The patient's condition improved with the reconstitution of the patient's immune system. PMID:28824078

Eosinophilic Granulomatosis with Polyangiitis (Churg-Strauss Syndrome) Complicated by Perforation of the Small Intestine and Cholecystitis.

PubMed

Ohnuki, Yoichi; Moriya, Yusuke; Yutani, Sachiko; Mizuma, Atsushi; Nakayama, Taira; Ohnuki, Yuko; Uda, Shuji; Inomoto, Chie; Yamamoto, Soichiro; Nakamura, Naoya; Takizawa, Shunya

2018-03-01

We report a case of eosinophilic granulomatosis with polyangiitis (EGPA; formerly known as Churg-Strauss syndrome) complicated by perforation of the small intestine and necrotizing cholecystitis. A 69-year-old man with a history of bronchial asthma was admitted with mononeuritis multiplex. The laboratory findings included remarkable eosinophilia. He was treated with corticosteroids and his laboratory indices showed improvement; however, his functional deficits remained. His neuropathy gradually improved after the addition of intravenous immunoglobulin (IVIG). He was subsequently treated with oral prednisolone (40 mg/day) as maintenance therapy. Within a month after finishing IVIG, he developed perforation of the small intestine and necrotizing cholecystitis. Intestinal perforation has often been reported as a gastrointestinal complication of EGPA. In contrast, cholecystitis is a rare complication. We report this case because the manifestation of more than one complication is extremely rare. Gastrointestinal symptoms may be a complication of EGPA itself and/or immunosuppressive treatment.

[C-ANCA positive necrotising scleritis and multiple sclerosis compatible with ocular Wegener: treatment with rituximab].

PubMed

Aldasoro-Cáceres, V; Aldasoro-Cáceres, I; Pérez-Moreiras, J V; Murié-Fernández, M; Ibáñez-Bosch, R

2014-01-01

A patient diagnosed with necrotizing scleritis, c-ANCA+ an orbital pseudotumour, and possible multiple sclerosis in 2003 was treated with oral cyclophosphamide and steroids with partial response. Between 2005-2010 she suffered self-limited episodes. In 2010 a first scleral transplant was performed with poor outcome. She was treated with rituximab, and a second graft was performed with good results. At 12 months there was no change in magnetic resonance and the second graft healed. Wegener's disease with limited involvement of the orbit and/or the eye is a rare condition. The histopathology, blood analysis, symptoms and good response to treatment are the key to its diagnosis. Copyright © 2011 Sociedad Española de Oftalmología. Published by Elsevier Espana. All rights reserved.

Genetics Home Reference: granulomatosis with polyangiitis

MedlinePlus

... other regions of the body, including the eyes, middle and inner ear structures, skin, joints, nerves, heart, and brain. Depending ... involved, additional symptoms can include skin rashes, inner ear pain, swollen and ... is most common in middle-aged adults, although it can occur at any ...

Hémothorax spontané révélant une vascularite de Wegener chez une femme enceinte

PubMed Central

Serhane, Hind; Yassine, Msougar; Amro, Lamyae

2016-01-01

L’hémothorax spontané demeure une pathologie rare. Ses étiologies sont multiples mais restent parfois inconnues. Chez certains patients, la thoracotomie peut être le seul recours pour déterminer son origine. Les vascularites n’ont pas été rapporté comme cause habituelle des hémothorax spontanés. La grossesse ne semble pas avoir d’effet causal, ni aggravant des hémothorax spontanés, ni des vascularites. Nous rapportons une observation assez particulière d’une jeune patiente, présentant au cours de sa grossesse un hémothorax spontané secondaire à une vasularite de type Wegener, diagnostiquée par la biopsie pleurale faite au cours d’une thoracotomie exploratrice et confirmée par le dosage des ANCA. PMID:28154726

A Case Report on Suspected Levamisole-Induced Pseudovasculitis.

PubMed

Fan, Tiffany; Macaraeg, Jeffrey; Haddad, Toufik Mahfood; Bacon, Holly; Le, Duc; Mirza, Mohsin; Valenta, Carrie; Wichman, Tammy

2017-02-01

Levamisole-induced pseudovasculitis should be considered in patients with inconsistent anti-neutrophil cytoplasmic antibodies (ANCA) pattern and history of cocaine use. A 50-year-old man presented to the emergency department with symptoms of bilateral pulmonary emboli. His hospital course was complicated by multiple end organ failure, which improved dramatically with prednisone. Although he was diagnosed previously with granulomatosis with polyangiitis due to positive proteinase 3 (PR3), myeloperoxidase (MPO), perinuclear anti-neutrophil cytoplasmic antibodies (P-ANCA) and cytoplasmic anti-neutrophil cytoplasmic antibodies (C-ANCA) markers, his longstanding cocaine use and history of skin ulcers, thrombotic events, and febrile illnesses suggested a diagnosis of levamisole-induced pseudovasculitis instead. Differentiating between vasculitides can be challenging due to similar clinical and laboratory findings. To differentiate the two, biopsies should be obtained. The absence of granulomas or leukocytoclasia, and the presence of vasculopathic purpura, should guide clinicians toward pseudovasculitis. It is important to maintain a high index of suspicion for pseudovasculitis because long-term corticosteroid use to treat granulomatosis with polyangiitis can lead to detrimental effects.

Granulomatosis with polyangiitis mimicking infective endocarditis in an adolescent male.

PubMed

Varnier, Giulia Camilla; Sebire, Neil; Christov, Georgi; Eleftheriou, Despina; Brogan, Paul A

2016-09-01

Granulomatosis with polyangiitis (GPA) is a rare but serious small vessel vasculitis with heterogeneous clinical presentation ranging from mainly localised disease with a chronic course, to a florid, acute small vessel vasculitic form characterised by severe pulmonary haemorrhage and/or rapidly progressive vasculitis or other severe systemic vasculitic manifestations. Cardiac involvement is, however, uncommon in the paediatric population. We report a case of a 16-year-old male who presented with peripheral gangrene and vegetation with unusual location on the supporting apparatus of the tricuspid valve, initially considered to have infective endocarditis but ultimately diagnosed with GPA. We provide an overview of the limited literature relating to cardiac involvement in GPA, and the diagnostic challenge relating to infective endocarditis in this context, especially focusing on the interpretation of the antineutrophil cytoplasmic antibody (ANCA) and the characteristic clinical features to identify in order to promptly recognise GPA, since timely diagnosis and treatment are essential for this potentially life-threatening condition.

Orofacial granulomatosis affecting lip and gingiva in a 15-year-old patient: A rare case report.

PubMed

Bansal, Monika; Singh, Nootan; Patne, Shashikant; Singh, Satyendra Kumar

2015-03-01

Orofacial granulomatosis (OFG) is a rare disorder affecting the orofacial region, and clinically characterized by diffuse, nontender, soft to firm, painless swelling restricted to one or both lips and intraoral sites such as tongue, gingiva and buccal mucosa. Histologically, OFG is characterized by noncaseating granulomatous inflammation. The early diagnosis of OFG is essential for the better prognosis of the lesion. Delay in diagnosis of OFG results into formation of indurated and permanent swelling of the lip that not only compromises esthetic appearance but also causes impairment in function such as speaking and eating. Early diagnosis of OFG is challenging to the health care professionals due to clinical and histological resemblance to other chronic granulomatous disorders. Thus, dentists may act as a first person to diagnose the lesion and play an important role in the multidisciplinary treatment of granulomatous disorders. Here, we present a case of OFG affecting lips and gingiva in a 15-year-old patient without any identifiable systemic or local causes.

Sequential rituximab and omalizumab for the treatment of eosinophilic granulomatosis with polyangiitis (Churg-Strauss syndrome).

PubMed

Aguirre-Valencia, David; Posso-Osorio, Iván; Bravo, Juan-Carlos; Bonilla-Abadía, Fabio; Tobón, Gabriel J; Cañas, Carlos A

2017-09-01

Eosinophilic granulomatosis with polyangiitis (EGPA), formerly known as Churg-Strauss syndrome (CSS), is a small vessel vasculitis associated with eosinophilia and asthma. Clinical manifestations commonly seen in patients presenting with EGPA range from upper airway and lung involvement to neurological, cardiac, cutaneous, and renal manifestations. Treatment for severe presentations includes steroids, cyclophosphamide, plasmapheresis, and recently, rituximab. Rituximab is associated with a good response in the treatment of vasculitis, but a variable response for the control of allergic symptoms. Here, we report a 16-year-old female patient with severe EGPA (gastrointestinal and cutaneous vasculitis, rhinitis and asthma) refractory to conventional treatment. She was treated with rituximab, which enabled rapid control of the vasculitis component of the disease, but there was no response to rhinitis and asthma. Additionally, she developed severe bronchospasm during rituximab infusion. Sequential rituximab and omalizumab were initiated, leading to remission of all manifestations of vasculitis, rhinitis, and asthma, in addition to bronchospasm related to rituximab infusion.

Chronic active EBV infection with features of granulomatosis with polyangiitis.

PubMed

Shimomura, Masaki; Morishita, Hideaki; Meguro, Takaaki; Seto, Shiro; Kimura, Mitsuaki; Hamazaki, Minoru; Hashimoto, Ayako; Sugiyama, Yuka; Kimura, Hiroshi

2016-07-01

Herein, we report the case of a 13-year-old boy with multiple recurrent ulcers on his legs. He developed severe sinusitis at 10 years of age and had significant weight loss (6 kg) in the 2 months prior to admission. Histology of tissue biopsied from the ulcer indicated small vessel vasculitis and granulomatous inflammation. Given that these findings met the diagnostic criteria for granulomatosis with polyangiitis (GPA), he was treated with immunosuppressive agents. Further pathology, however, indicated Epstein-Barr virus (EBV)-encoded RNA (EBER) in most lymphocytes in the same sample. The EBER-positive lymphocytes were mainly CD4-positive T cells. The EBV-DNA load in the peripheral blood was also abnormally increased (1.0 × 10(4) copies/μg DNA). Thus, the diagnosis was established as chronic active EBV infection (CAEBV). This case illustrates the necessity of careful differential diagnosis of CAEBV owing to its clinical resemblance and pathological overlap with GPA. © 2016 Japan Pediatric Society.

Fludarabine Phosphate, Melphalan, and Low-Dose Total-Body Irradiation Followed by Donor Peripheral Blood Stem Cell Transplant in Treating Patients With Hematologic Malignancies

ClinicalTrials.gov

2017-09-08

Accelerated Phase Chronic Myelogenous Leukemia; Adult Acute Lymphoblastic Leukemia in Remission; Adult Acute Myeloid Leukemia in Remission; Adult Acute Myeloid Leukemia With 11q23 (MLL) Abnormalities; Adult Acute Myeloid Leukemia With Del(5q); Adult Acute Myeloid Leukemia With Inv(16)(p13;q22); Adult Acute Myeloid Leukemia With t(15;17)(q22;q12); Adult Acute Myeloid Leukemia With t(16;16)(p13;q22); Adult Acute Myeloid Leukemia With t(8;21)(q22;q22); Adult Grade III Lymphomatoid Granulomatosis; Adult Nasal Type Extranodal NK/T-cell Lymphoma; Anaplastic Large Cell Lymphoma; Angioimmunoblastic T-cell Lymphoma; Aplastic Anemia; Burkitt Lymphoma; Childhood Acute Lymphoblastic Leukemia in Remission; Childhood Acute Myeloid Leukemia in Remission; Childhood Chronic Myelogenous Leukemia; Childhood Diffuse Large Cell Lymphoma; Childhood Grade III Lymphomatoid Granulomatosis; Childhood Immunoblastic Large Cell Lymphoma; Childhood Myelodysplastic Syndromes; Childhood Nasal Type Extranodal NK/T-cell Lymphoma; Chronic Myelomonocytic Leukemia; Chronic Phase Chronic Myelogenous Leukemia; Congenital Amegakaryocytic Thrombocytopenia; Diamond-Blackfan Anemia; Extranodal Marginal Zone B-cell Lymphoma of Mucosa-associated Lymphoid Tissue; Hepatosplenic T-cell Lymphoma; Juvenile Myelomonocytic Leukemia; Myelodysplastic/Myeloproliferative Neoplasm, Unclassifiable; Nodal Marginal Zone B-cell Lymphoma; Paroxysmal Nocturnal Hemoglobinuria; Peripheral T-cell Lymphoma; Polycythemia Vera; Post-transplant Lymphoproliferative Disorder; Previously Treated Myelodysplastic Syndromes; Primary Myelofibrosis; Recurrent Adult Acute Lymphoblastic Leukemia; Recurrent Adult Acute Myeloid Leukemia; Recurrent Adult Burkitt Lymphoma; Recurrent Adult Diffuse Large Cell Lymphoma; Recurrent Adult Diffuse Mixed Cell Lymphoma; Recurrent Adult Diffuse Small Cleaved Cell Lymphoma; Recurrent Adult Grade III Lymphomatoid Granulomatosis; Recurrent Adult Hodgkin Lymphoma; Recurrent Adult Immunoblastic Large Cell Lymphoma; Recurrent Adult Lymphoblastic Lymphoma; Recurrent Adult T-cell Leukemia/Lymphoma; Recurrent Childhood Acute Lymphoblastic Leukemia; Recurrent Childhood Acute Myeloid Leukemia; Recurrent Childhood Anaplastic Large Cell Lymphoma; Recurrent Childhood Grade III Lymphomatoid Granulomatosis; Recurrent Childhood Large Cell Lymphoma; Recurrent Childhood Lymphoblastic Lymphoma; Recurrent Childhood Small Noncleaved Cell Lymphoma; Recurrent Cutaneous T-cell Non-Hodgkin Lymphoma; Recurrent Grade 1 Follicular Lymphoma; Recurrent Grade 2 Follicular Lymphoma; Recurrent Grade 3 Follicular Lymphoma; Recurrent Mantle Cell Lymphoma; Recurrent Marginal Zone Lymphoma; Recurrent Mycosis Fungoides/Sezary Syndrome; Recurrent Small Lymphocytic Lymphoma; Recurrent/Refractory Childhood Hodgkin Lymphoma; Refractory Chronic Lymphocytic Leukemia; Refractory Hairy Cell Leukemia; Refractory Multiple Myeloma; Secondary Acute Myeloid Leukemia; Secondary Myelodysplastic Syndromes; Secondary Myelofibrosis; Severe Combined Immunodeficiency; Severe Congenital Neutropenia; Shwachman-Diamond Syndrome; Splenic Marginal Zone Lymphoma; T-cell Large Granular Lymphocyte Leukemia; Waldenstrom Macroglobulinemia; Wiskott-Aldrich Syndrome

Mitomycin C and the endoscopic treatment of laryngotracheal stenosis: are two applications better than one?

PubMed

Smith, Marshall E; Elstad, Mark

2009-02-01

Endoscopic treatment of laryngotracheal stenosis by airway dilation, despite short-term improvement, is often associated with long-term relapse. Mitomycin-C (MMC) inhibits fibroblast proliferation and synthesis of extracellular matrix proteins, and thereby modulates wound healing and scarring. MMC application at the time of endoscopic dilation and laser surgery has been suggested to improve outcomes, but this has not been studied in a rigorous manner. This study examines the hypothesis that two topical applications of MMC given 3-6 weeks apart will result in decreased scarring/restenosis of the airway, when compared to a single topical application. A randomized, prospective, double-blind, placebo-controlled clinical trial. Twenty-six patients with laryngotracheal stenosis due to idiopathic subglottic stenosis, postintubation stenosis, or Wegener's granulomatosis entered a protocol to receive three endoscopic CO(2) laser and dilation procedures over a 3-month interval. At the first procedure, after radial CO(2) laser incision and airway dilation, all patients received topical application of MMC (0.5 mg/mL) to the airway lesion. One month later, a second endoscopic incision and dilation was performed and the patients were randomized to either a second application of mitomycin-C or to application of saline placebo. A third dilation procedure was performed 2 months later, without MMC application. Patients were followed for up to 5 years for relapse of airway stenosis with clinical symptoms sufficient to require a subsequent procedure. The relapse rates at 1, 3, and 5 years were 7%, 36%, and 69% for patients treated with two applications of MMC compared to 33%, 58%, and 70% for patients treated with one application of MMC. The median interval to relapse was 3.8 years in the two-application group, compared with 2.4 years in the one-application group. This prospective randomized double-blind placebo-controlled trial suggests that, in the endoscopic management of laryngotracheal stenosis, two applications of MMC given 3-4 weeks apart after airway radial incision and dilation reduces the restenosis rate for 2 to 3 years after treatment when compared to a single application. However, restenosis and delayed symptom recurrence continues so that at 5 years the relapse rates are the same. Thus, MMC may postpone, but does not prevent, the recurrence of symptomatic stenosis in the majority of patients.

Impact and safety of open lung biopsy in patients with acute respiratory distress syndrome (ARDS).

PubMed

Ortiz, G; Garay, M; Mendoza, D; Cardinal-Fernández, P

2018-02-28

Acute respiratory distress syndrome (ARDS) is an inflammatory lung disorder, and its pathological hallmark is diffuse alveolar damage (DAD). Given that open lung biopsy (OLB) can sometimes result in severe side effects, it is rarely performed in patients with ARDS. The aims of this study were to describe: (a) the rate of treatment change associated with the histological result; and (b) the incidence of side effects induced by OLB. A retrospective, single-center, descriptive observational study was carried out in Hospital Santa Clara (Bogotá, Colombia) from February 2007 to January 2014. Critically ill patients over 18 years of age, undergoing invasive mechanical ventilation, diagnosed with ARDS of unknown etiology, and with OLB performed at the bedside. ARDS was diagnosed according to the Berlin definition. DAD was defined by the presence of a hyaline membrane plus at least one of the following: intra-alveolar edema, alveolar type I cell necrosis, alveolar type II cell (cuboidal cells) proliferation progressively covering the denuded alveolar-capillary membrane, interstitial proliferation of fibroblasts and myofibroblasts, or organizing interstitial fibrosis. The rate of treatment change (RTC) was established according to whether the OLB pathology report resulted in: a) the prescription or discontinuation of an antimicrobial; b) the indication of new procedures; c) medical interconsultation; or d) limitation of therapeutic effort. Patients were followed-up until death or hospital discharge. This study was approved by the Ethics Committee. A total of 32 OLBs were performed during the study period; 17 were ruled out as they did not involve ARDS, and 15 were considered for further analysis. A histological diagnosis was reached in 14 of the 15 patients (12 DAD, one case of bronchiolitis obliterans organizing pneumonia and one case of Wegener's granulomatosis with alveolar hemorrhage). The RTC rate was 0.73. The most frequent intervention was discontinuation of antimicrobial or corticosteroid treatment. No deaths but four side effects (3 airway leaks and one hemothorax) were associated with the OLB procedure. All were resolved before ICU discharge. The information provided by OLB performed at the bedside in ARDS patients of unknown etiology could be relevant, as it may optimize treatment. The risk associated with OLB seems to be acceptable. Copyright © 2018 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

[IgG4-related disease: patient group characterization and rituximab therapy].

PubMed

Sedyshev, S Kh; Vasil'ev, V I; Kovrigina, A M; Logvinenko, O A; Rodionova, E B; Safonova, T N; Gaĭduk, I V; Silin, A Iu; Komov, D V; Nasonov, E L

2013-01-01

To characterize a group of patients with IgG4-related disease (IgG4-RD) in a Russian population and to evaluate the efficiency of rituximab therapy. In 2009 to 2011, at the Research Institute of Rheumatology, Russian Academy of Medical Sciences, 30 patients (16 men and 14 women; mean age 44 years) were diagnosed with IgG4-RD that was confirmed by determination of serum IgG4 levels and immunohistochemical study of biopsy samples stained for IgG4-positive plasma cells. Seven patients received rituximab therapy. It was assumed at baseline that there were different types of neoplasias in 12 (40%), non-Hodgkin's and Hodgkin's lymphomas in 10 (33.3%), Sjögren's syndrome in 5 (16.7%), and Wegener's granulomatosis in 3 (10%). When 2 or more locations were involved, the condition was regarded as multifocal fibrosclerosis (33.3%). Localized forms were revealed in 20 (66.7%) patients. Among them, the largest number of patients was those who had orbital pseudotumor, Mikulicz's disease, or retroperitoneal fibrosclerosis. The most common sites of involvement were orbits (66.7%), salivary glands (70%) and lymph nodes (36.7%). Comparison of serum IgG4 levels in 28 patients with IgG4-RD, 22 patients with Sjögren's disease, salivary and lacrimal gland lymphomas, and 10 healthy controls showed that the concentration of IgG4 was significantly higher in Group 1 (median 2.6 g/I; IQR 1.22-4.65 (p < 0.001). Tissue IgG4/IgG ratio varied from 25 to 50% and averaged 38%. A moiré-like pattern of varying fibrosis was noted in 83% of cases. Analysis of laboratory data revealed elevated C-reactive protein concentrations (46.7% with a mean of 39.5 mg/l; normal values < 5.0 mg/l), increased erythrocyte sedimentation rate (60% with a mean of 37.6 mm/h), hypergammaglobulinemia (30% with a mean of 29.4%; normal range 13-22%), and rheumatoid factor (23.3%). After rituximab therapy, all the patients showed a decrease of IgG4 levels to the normal levels and positive changes evidenced by visualization techniques (computed tomography, magnetic resonance imaging). IgG4-RD is a novel problem in modern medicine, which requires a multidisciplinary approach and further study. Rituximab therapy is a promising treatment.

Frank Bursley Taylor - Forgotten Pioneer of Continental Drift.

ERIC Educational Resources Information Center

Black, George W., Jr.

1979-01-01

Frank B. Taylor was an American geologist who specialized in the glacial geology of the Great Lakes. This article discusses his work on the Continental Drift theory, which preceeded the work of Alfred Wegener by a year and a half. (MA)

[Vasculitic neuropathy: novel classification, diagnosis and treatment].

PubMed

Kanda, Takashi

2014-01-01

The international standard of nomenclature and classification in vasculitis, CHCC 1994,was revised as CHCC 2012. In the first part of this review article I briefly summarized the CHCC 2012 and pointed out the changes in this revision, especially on the disorders related to vasculitic neuropathy. Notable changes include the introduction of new terms such as granulomatosis with polyangiitis and eosinophilic granulomatosis with polyangiitis. In the second part, I mentioned the tips for the diagnosis and treatment of vasculitic neuropathy. Because most of the vasculitic neuropathy patients require rigorous, long-standing immunosuppressive therapy, the accurate diagnosis based on the pathological detection of vasculitic changes is mandatory. In this regard, the value of sural nerve biopsy is still not ignorable. In the treatment of vascultic neuropathy, there are no controlled treatment trials and clinical practice is guided by experience from case series and indirectly by analogy with systemic vasculitis. Although combined therapy using prednisolone and cyclophosphamide is usually recommended by experts, tailor-made treatment regimen based on the conditions of each patient would produce the best outcome in vasculitic neuropathy.

Histologic Findings of Severe/Therapy-Resistant Asthma From Video-assisted Thoracoscopic Surgery Biopsies.

PubMed

Trejo Bittar, Humberto E; Doberer, Daniel; Mehrad, Mitra; Strollo, Diane C; Leader, Joseph K; Wenzel, Sally; Yousem, Samuel A

2017-02-01

The histologic changes occurring in severe/therapy-resistant asthma (SA) as defined by the European Respiratory Society/American Thoracic Society guidelines, particularly at the level of the distal airways are unknown. This study describes the clinical, radiologic, and histologic characteristics of 29 SA patients who underwent video-assisted thoracoscopic surgery lung biopsy. Pathologic observations were correlated with clinical features, especially the presence of autoimmune disease (AID) (15/29, 51.7%). Ten biopsies (10/29, 34.5%) showed only small airway manifestations of asthma, whereas in 19 (65.5%) asthmatic granulomatosis, manifested by asthmatic bronchiolitis supplemented by an alveolar septal mononuclear infiltrates with non-necrotizing granulomas, was present. SA patients without asthmatic granulomatosis showed more striking small airway injury, subbasement membrane thickening, and neutrophilic infiltrates. Cases with concurrent AID had a tendency to more parenchymal eosinophilic inflammation, more bronchiolocentric granulomas, and a suggestion of increased responsivity to nonsteroidal immunosuppressive therapy. Histologic examination of video-assisted thoracoscopic surgery lung biopsies in SA demonstrates diverse pathologies including cases associated with granulomatous inflammation in addition to eosinophilic infiltrates. This spectrum of histologies may link to a high incidence of AID.

Etoposide, Filgrastim, and Plerixafor in Improving Stem Cell Mobilization in Treating Patients With Non-Hodgkin Lymphoma

ClinicalTrials.gov

2016-12-06

Adult Acute Lymphoblastic Leukemia in Remission; Adult Grade III Lymphomatoid Granulomatosis; Adult Nasal Type Extranodal NK/T-cell Lymphoma; Anaplastic Large Cell Lymphoma; Angioimmunoblastic T-cell Lymphoma; Cutaneous B-cell Non-Hodgkin Lymphoma; Extranodal Marginal Zone B-cell Lymphoma of Mucosa-associated Lymphoid Tissue; Hepatosplenic T-cell Lymphoma; Nodal Marginal Zone B-cell Lymphoma; Noncutaneous Extranodal Lymphoma; Peripheral T-cell Lymphoma; Recurrent Adult Burkitt Lymphoma; Recurrent Adult Diffuse Large Cell Lymphoma; Recurrent Adult Diffuse Mixed Cell Lymphoma; Recurrent Adult Diffuse Small Cleaved Cell Lymphoma; Recurrent Adult Grade III Lymphomatoid Granulomatosis; Recurrent Adult Immunoblastic Large Cell Lymphoma; Recurrent Adult Lymphoblastic Lymphoma; Recurrent Adult T-cell Leukemia/Lymphoma; Recurrent Cutaneous T-cell Non-Hodgkin Lymphoma; Recurrent Grade 1 Follicular Lymphoma; Recurrent Grade 2 Follicular Lymphoma; Recurrent Grade 3 Follicular Lymphoma; Recurrent Mantle Cell Lymphoma; Recurrent Marginal Zone Lymphoma; Recurrent Mycosis Fungoides/Sezary Syndrome; Recurrent Small Lymphocytic Lymphoma; Refractory Chronic Lymphocytic Leukemia; Refractory Hairy Cell Leukemia; Small Intestine Lymphoma; Splenic Marginal Zone Lymphoma; T-cell Large Granular Lymphocyte Leukemia; Testicular Lymphoma; Waldenström Macroglobulinemia

Revisiting the systemic vasculitis in eosinophilic granulomatosis with polyangiitis (Churg-Strauss): A study of 157 patients by the Groupe d'Etudes et de Recherche sur les Maladies Orphelines Pulmonaires and the European Respiratory Society Taskforce on eosinophilic granulomatosis with polyangiitis (Churg-Strauss).

PubMed

Cottin, Vincent; Bel, Elisabeth; Bottero, Paolo; Dalhoff, Klaus; Humbert, Marc; Lazor, Romain; Sinico, Renato A; Sivasothy, Pasupathy; Wechsler, Michael E; Groh, Matthieu; Marchand-Adam, Sylvain; Khouatra, Chahéra; Wallaert, Benoit; Taillé, Camille; Delaval, Philippe; Cadranel, Jacques; Bonniaud, Philippe; Prévot, Grégoire; Hirschi, Sandrine; Gondouin, Anne; Dunogué, Bertrand; Chatté, Gérard; Briault, Christophe; Pagnoux, Christian; Jayne, David; Guillevin, Loïc; Cordier, Jean-François

2017-01-01

To guide nosology and classification of patients with eosinophilic granulomatosis with polyangiitis (EGPA) based on phenotype and presence or absence of ANCA. Organ manifestations and ANCA status were retrospectively analyzed based on the presence or not of predefined definite vasculitis features or surrogates of vasculitis in patients asthma, eosinophilia, and at least one systemic organ manifestation attributable to systemic disease. The study population included 157 patients (mean age 49.4±14.1), with a follow-up of 7.4±6.4years. Patients with ANCA (31%) more frequently had weight loss, myalgias, arthralgias, biopsy-proven vasculitis, glomerulonephritis on biopsy, hematuria, leukocytoclastic capillaritis and/or eosinophilic infiltration of arterial wall on biopsy, and other renal disease. A total of 41% of patients had definite vasculitis manifestations (37%) or strong surrogates of vasculitis (4%), of whom only 53% had ANCA. Mononeuritis multiplex was associated with systemic vasculitis (p=0.005) and with the presence of ANCA (p<0.001). Overall, 59% of patients had polyangiitis as defined by definite vasculitis, strong surrogate of vasculitis, mononeuritis multiplex, and/or ANCA with at least one systemic manifestation other than ENT or respiratory. Patients with polyangiitis had more systemic manifestations including arthralgias (p=0.02) and renal disease (p=0.024), had higher peripheral eosinophilia (p=0.027), and a trend towards less myocarditis (p=0.057). Using predefined criteria of vasculitis and surrogates of vasculitis, ANCA alone were found to be insufficient to categorise patients with vasculitis features. We suggest a revised nomenclature and definition for EGPA and a new proposed entity referred to as hypereosinophilic asthma with systemic (non vasculitic) manifestations. Copyright © 2016 Elsevier B.V. All rights reserved.

Fludarabine Phosphate, Low-Dose Total-Body Irradiation, and Donor Stem Cell Transplant Followed by Cyclosporine, Mycophenolate Mofetil, Donor Lymphocyte Infusion in Treating Patients With Hematopoietic Cancer

ClinicalTrials.gov

2017-08-09

Acute Undifferentiated Leukemia; Adult Nasal Type Extranodal NK/T-cell Lymphoma; Anaplastic Large Cell Lymphoma; Angioimmunoblastic T-cell Lymphoma; Childhood Burkitt Lymphoma; Childhood Diffuse Large Cell Lymphoma; Childhood Grade III Lymphomatoid Granulomatosis; Childhood Immunoblastic Large Cell Lymphoma; Childhood Myelodysplastic Syndromes; Childhood Nasal Type Extranodal NK/T-cell Lymphoma; Chronic Myelomonocytic Leukemia; Cutaneous B-cell Non-Hodgkin Lymphoma; de Novo Myelodysplastic Syndromes; Extranodal Marginal Zone B-cell Lymphoma of Mucosa-associated Lymphoid Tissue; Hepatosplenic T-cell Lymphoma; Intraocular Lymphoma; Juvenile Myelomonocytic Leukemia; Mast Cell Leukemia; Myelodysplastic/Myeloproliferative Neoplasm, Unclassifiable; Myeloid/NK-cell Acute Leukemia; Nodal Marginal Zone B-cell Lymphoma; Noncutaneous Extranodal Lymphoma; Peripheral T-cell Lymphoma; Post-transplant Lymphoproliferative Disorder; Previously Treated Myelodysplastic Syndromes; Primary Systemic Amyloidosis; Recurrent Adult Acute Lymphoblastic Leukemia; Recurrent Adult Acute Myeloid Leukemia; Recurrent Adult Burkitt Lymphoma; Recurrent Adult Diffuse Large Cell Lymphoma; Recurrent Adult Diffuse Mixed Cell Lymphoma; Recurrent Adult Diffuse Small Cleaved Cell Lymphoma; Recurrent Adult Grade III Lymphomatoid Granulomatosis; Recurrent Adult Hodgkin Lymphoma; Recurrent Adult Immunoblastic Large Cell Lymphoma; Recurrent Adult Lymphoblastic Lymphoma; Recurrent Adult T-cell Leukemia/Lymphoma; Recurrent Childhood Acute Lymphoblastic Leukemia; Recurrent Childhood Acute Myeloid Leukemia; Recurrent Childhood Anaplastic Large Cell Lymphoma; Recurrent Childhood Grade III Lymphomatoid Granulomatosis; Recurrent Childhood Large Cell Lymphoma; Recurrent Childhood Lymphoblastic Lymphoma; Recurrent Childhood Small Noncleaved Cell Lymphoma; Recurrent Cutaneous T-cell Non-Hodgkin Lymphoma; Recurrent Grade 1 Follicular Lymphoma; Recurrent Grade 2 Follicular Lymphoma; Recurrent Grade 3 Follicular Lymphoma; Recurrent Mantle Cell Lymphoma; Recurrent Marginal Zone Lymphoma; Recurrent Mycosis Fungoides/Sezary Syndrome; Recurrent Renal Cell Cancer; Recurrent Small Lymphocytic Lymphoma; Recurrent/Refractory Childhood Hodgkin Lymphoma; Refractory Chronic Lymphocytic Leukemia; Refractory Hairy Cell Leukemia; Refractory Multiple Myeloma; Small Intestine Lymphoma; Splenic Marginal Zone Lymphoma; Stage II Multiple Myeloma; Stage III Multiple Myeloma; T-cell Large Granular Lymphocyte Leukemia; Testicular Lymphoma; Waldenström Macroglobulinemia

The role of latitude in mobilism debates

PubMed Central

Irving, Edward

2005-01-01

In the early 1920s, the continental displacement theory of Wegener, latitude studies of Köppen and Wegener, and Argand's ideas on mountain building led to the first mobilistic paleogeography. In the 1930s and 1940s, many factors caused its general abandonment. Mobilism was revived in the 1950s and 1960s by measurements of long-term displacement of crustal blocks relative to each other (tectonic displacement) and to Earth's geographic pole (latitudinal displacement). Also, short-term or current displacements can now be measured. I briefly outline the categories of tectonic and current displacement and focus on latitudinal displacement. Integration of tectonic and latitudinal displacement in the early 1970s completed the new mobilistic paleogeography, in which the transformation of rock magnetization directions into paleopoles and latitudes and the finite rotation of spherical plates about pivot points play complementary roles; this new synthesis now provides a quantitative basis for studying long-term evolution of Earth's surface features and climate, the changing environments in which life evolves. PMID:15684058

[The development of Rein van Bemmelens (1904-1983) undation theory: forty years of Dutch geology].

PubMed

Barzilay, Willemjan

2009-01-01

The Dutch geologist Rein van Bemmelen was the greatest opponent of plate tectonics in The Netherlands. He lived and worked during an important period in the history of earth sciences. He had studied geology when Wegeners theory was introduced and enthusiastically received in the Netherlands and he worked as a geologists during the period in which, after Wegeners theory was rejected in The Netherlands, several Dutch geologists came with their own theories to explain the origin of continents and oceans and in which plate tectonics was introduced in The Netherlands. He had proposed his own theory, the undation theory, at the beginning of the 1930s and kept on developing it during the following years. He continued to do so until his death in 1983. The history of the undation theory thus sheds light on the history of geology in The Netherlands. I will trace the history of geology in The Netherlands using Rein van Bemmelen and his undation theory as a lens.

The role of latitude in mobilism debates.

PubMed

Irving, Edward

2005-02-08

In the early 1920s, the continental displacement theory of Wegener, latitude studies of Koppen and Wegener, and Argand's ideas on mountain building led to the first mobilistic paleogeography. In the 1930s and 1940s, many factors caused its general abandonment. Mobilism was revived in the 1950s and 1960s by measurements of long-term displacement of crustal blocks relative to each other (tectonic displacement) and to Earth's geographic pole (latitudinal displacement). Also, short-term or current displacements can now be measured. I briefly outline the categories of tectonic and current displacement and focus on latitudinal displacement. Integration of tectonic and latitudinal displacement in the early 1970s completed the new mobilistic paleogeography, in which the transformation of rock magnetization directions into paleopoles and latitudes and the finite rotation of spherical plates about pivot points play complementary roles; this new synthesis now provides a quantitative basis for studying long-term evolution of Earth's surface features and climate, the changing environments in which life evolves.

Fabrication of Metamaterials by Drawing Techniques

DTIC Science & Technology

2011-03-03

Rill, M. Thiel, E. Müller, S. Essig, A. Frölich, G. von Freymann, S. Linden, D. Gerthsen, H. Hahn, K. Busch and M. Wegener, “Transition between...characterization and homogenization of nanostructured metamaterials,” J. Opt. 13, 013001 (2011). 25. L. H. Sperling , Introduction to physical polymer

Update on Orofacial Granulomatosis.

PubMed

Hullah, Esther A; Escudier, Michael P

2016-02-01

Orofacial granulomatosis (OFG) is a condition manifesting clinically with chronic swelling of the mouth and/or face, notably with swelling of the lips and oral mucosa, a full-thickness, erythematous gingivitis and mucosal ulceration of various clinical types. Some patients may also present with neurological findings, for example facial palsy. Biopsy of affected tissue shows lymphoedema, with or without granulomatous inflammation. The oral lesions in OFG are histologically indistinguishable from the oral lesions in Crohn's disease (CD) and other systemic granulomatous disorders. It is a condition which may respond to the exclusion of certain food-related chemicals from the diet in up to 60% of patients and, as such, is distinct from gastrointestinal CD. CD is a relapsing systemic inflammatory disease which predominantly affects the gut, and patients suffering from this disease frequently present with abdominal pain, fever and altered bowel habit. A proportion of patients with clinical OFG (without other systemic disease) may have asymptomatic gastrointestinal involvement or go on to develop gut CD suggesting an association between the two diseases. It is estimated that 1% of CD sufferers may have a diagnosis of OFG, but the majority of patients in specialist OFG clinics do not have gut symptoms.

Optimal therapy and prospects for new medicines in eosinophilic granulomatosis with polyangiitis (Churg-Strauss syndrome).

PubMed

Pagnoux, Christian; Groh, Matthieu

2016-10-01

The prevalence of eosinophilic granulomatosis with polyangiitis (EGPA; previously known as Churg-Strauss syndrome) is lower than that of other antineutrophil cytoplasm antibody (ANCA)-associated vasculitides (AAV's), and only a few randomized controlled trials have been conducted for this rare disease. However, recent international efforts have helped delineate the best treatment approach. At present, EGPA conventional therapy is by default similar to that of other AAVs. Limited, non-severe EGPA can initially be treated with glucocorticoids (GCs) alone. Patients with life-threatening manifestations and/or major organ involvement must receive a combination of GCs and an immunosuppressant, mainly cyclophosphamide. Remission can be achieved in >85% of patients with these first-line treatments, but vasculitis relapses occur in more than one-third of patients, and about 85% cannot stop GC treatment because of GC-dependent asthma and/or ENT manifestations. A few biologic agents, including rituximab or mepolizumab, are now under investigation after interesting preliminary results. Expert commentary: Treatment for EGPA still has several unmet needs. Several biologic agents are now under investigation in randomized controlled trials, but a few others should be considered soon. Their benefit should be demonstrated for devising more EGPA-tailored therapeutic strategies (ideally GC-free).

Purpura, petechiae, and bullae as first signs of juvenile granulomatosis with polyangiitis.

PubMed

Rawn, Saara; Miettunen, Paivi; Brown, Holly A; Schmeling, Heinrike

2014-12-01

We present a case of a 14-year-old girl who had a severe form of granulomatosis with polyangiitis (GPA) with extensive dermatological involvement, whose initial presentation was nonspecific leading to diagnostic confusion and initial consideration of infectious and other vasculitis causes. The patient presented with fever, congestion, malaise, and sinus pain. She was diagnosed with bacterial sinusitis and treated with antibiotics. Within weeks, she developed abdominal pain, hematuria, migratory arthritis, and palpable purpura and was diagnosed with Henoch-Schonlein purpura. She went on to develop hemoptysis and progression of the rash into erosive bullae. Investigations revealed that she was ANCA positive and had pauci-immune glomerulonephritis. Given her upper airway, pulmonary and renal involvement, and antineutrophil cytoplasmic antibodies positivity, a definitive diagnosis of a severe form of GPA was made. GPA is a chronic relapsing, life threatening vasculitis that predominantly affects small vessels. Our case demonstrates that GPA can present initially with nonspecific symptoms, including extensive dermatological involvement, leading to diagnostic confusion, and delays in treatment. In the case of a severe peripheral rash in the juvenile population and/or resistant upper airway symptoms, it is vital to consider a diagnosis of GPA to avoid serious organ or life threatening consequences.

Rituximab in Treating Patients Undergoing Donor Peripheral Blood Stem Cell Transplant for Relapsed or Refractory B-cell Lymphoma

ClinicalTrials.gov

2017-12-05

B-cell Adult Acute Lymphoblastic Leukemia; B-cell Childhood Acute Lymphoblastic Leukemia; B-cell Chronic Lymphocytic Leukemia; Childhood Burkitt Lymphoma; Childhood Diffuse Large Cell Lymphoma; Childhood Immunoblastic Large Cell Lymphoma; Cutaneous B-cell Non-Hodgkin Lymphoma; Extranodal Marginal Zone B-cell Lymphoma of Mucosa-associated Lymphoid Tissue; Intraocular Lymphoma; Nodal Marginal Zone B-cell Lymphoma; Post-transplant Lymphoproliferative Disorder; Recurrent Adult Acute Lymphoblastic Leukemia; Recurrent Adult Burkitt Lymphoma; Recurrent Adult Diffuse Large Cell Lymphoma; Recurrent Adult Diffuse Mixed Cell Lymphoma; Recurrent Adult Diffuse Small Cleaved Cell Lymphoma; Recurrent Adult Grade III Lymphomatoid Granulomatosis; Recurrent Adult Hodgkin Lymphoma; Recurrent Adult Immunoblastic Large Cell Lymphoma; Recurrent Adult Lymphoblastic Lymphoma; Recurrent Childhood Acute Lymphoblastic Leukemia; Recurrent Childhood Grade III Lymphomatoid Granulomatosis; Recurrent Childhood Large Cell Lymphoma; Recurrent Childhood Lymphoblastic Lymphoma; Recurrent Childhood Small Noncleaved Cell Lymphoma; Recurrent Grade 1 Follicular Lymphoma; Recurrent Grade 2 Follicular Lymphoma; Recurrent Grade 3 Follicular Lymphoma; Recurrent Mantle Cell Lymphoma; Recurrent Marginal Zone Lymphoma; Recurrent Small Lymphocytic Lymphoma; Recurrent/Refractory Childhood Hodgkin Lymphoma; Refractory Chronic Lymphocytic Leukemia; Refractory Hairy Cell Leukemia; Small Intestine Lymphoma; Splenic Marginal Zone Lymphoma; Testicular Lymphoma; Waldenström Macroglobulinemia

Discussion of the design of satellite-laser measurement stations in the eastern Mediterranean under the geological aspect. Contribution to the earthquake prediction research by the Wegener Group and to NASA's Crustal Dynamics Project

NASA Technical Reports Server (NTRS)

Paluska, A.; Pavoni, N.

1983-01-01

Research conducted for determining the location of stations for measuring crustal dynamics and predicting earthquakes is discussed. Procedural aspects, the extraregional kinematic tendencies, and regional tectonic deformation mechanisms are described.

Development and Implementation of Joint Programs in Laser Ranging and Other Space Geodetic Techniques

NASA Technical Reports Server (NTRS)

Pearlman, Michael R.; Carter, David (Technical Monitor)

2004-01-01

This progress report discusses the status and progress made in joint international programs including: 1) WEGENER; 2) Arabian Peninsula program; 3) Asia-Pacific Space Geodynamics (APSG) program; 4) the Fourteenth International Workshop on Laser Ranging; 5) the International Laser Ranging Service; and 6) current support for the NASA network.

Earthquakes and plate tectonics

USGS Publications Warehouse

Spall, H.

1977-01-01

An explanation is to be found in plate tectonics, a concept which has revolutionized thinking in the Earth sciences in the last 10 years. The theory of plate tectonics combines many of the ideas about continental drift (originally proposed in 1912 by Alfred Wegener in Germany) and sea-floor spreading (suggested originally by Harry Hess of Princeton University). 

Modeling of the Wegener Bergeron Findeisen process—implications for aerosol indirect effects

NASA Astrophysics Data System (ADS)

Storelvmo, T.; Kristjánsson, J. E.; Lohmann, U.; Iversen, T.; Kirkevåg, A.; Seland, Ø.

2008-10-01

A new parameterization of the Wegener-Bergeron-Findeisen (WBF) process has been developed, and implemented in the general circulation model CAM-Oslo. The new parameterization scheme has important implications for the process of phase transition in mixed-phase clouds. The new treatment of the WBF process replaces a previous formulation, in which the onset of the WBF effect depended on a threshold value of the mixing ratio of cloud ice. As no observational guidance for such a threshold value exists, the previous treatment added uncertainty to estimates of aerosol effects on mixed-phase clouds. The new scheme takes subgrid variability into account when simulating the WBF process, allowing for smoother phase transitions in mixed-phase clouds compared to the previous approach. The new parameterization yields a model state which gives reasonable agreement with observed quantities, allowing for calculations of aerosol effects on mixed-phase clouds involving a reduced number of tunable parameters. Furthermore, we find a significant sensitivity to perturbations in ice nuclei concentrations with the new parameterization, which leads to a reversal of the traditional cloud lifetime effect.

The Growth of Hydrological Understanding: Technologies, Ideas, and Societal Needs Shape the Field

NASA Astrophysics Data System (ADS)

Sivapalan, Murugesu; Blöschl, Günter

2017-10-01

Inspired by the work of Newton, Darwin, and Wegener, this paper tracks the drivers and dynamics that have shaped the growth of hydrological understanding over the last century. On the basis of an interpretation of this history, the paper then speculates about what kind of future is in store for hydrology and how we can better prepare for it. The historical narrative underpinning this analysis indicates that progress in hydrological understanding is brought about by changing societal needs and technological opportunities: new ideas are generated by hydrologists through addressing societal needs with the technologies of their time. We suggest that progress in hydrological understanding over the last century has expressed itself through repeated cycles of euphoria and disenchantment, which have served as stimuli for the progress. The progress, for it to happen, also needed inspirational leaders as well as a supportive scientific community that provided the backdrop to major advances in the field. The paper concludes that, in a similar way to how Newton, Darwin, and Wegener conducted their research, hydrology too can benefit from synthesis activities aimed at "connecting the dots."

Rituximab in the treatment of refractory or relapsing eosinophilic granulomatosis with polyangiitis (Churg-Strauss syndrome).

PubMed

Thiel, Jens; Hässler, Fabian; Salzer, Ulrich; Voll, Reinhard E; Venhoff, Nils

2013-09-24

Eosinophilic granulomatosis with polyangiitis (EGPA) is part of antineutrophil cytoplasmic antibodies (ANCAs)-associated vasculitides. In EGPA small-vessel vasculitis is associated with eosinophilia and asthma. About 40% of EGPA patients are ANCA-positive, suggesting a role for B cells in the pathogenesis of EGPA. B cell-depleting therapy with rituximab (RTX) can be effective in ANCA-positive EGPA, but very few patients have been published to date. The role of RTX in the treatment of ANCA-negative EGPA is unclear. We report a single-center cohort of patients with eosinophilic granulomatosis with polyangiitis. Of these patients, nine (six ANCA-positive, three ANCA-negative) had been treated with RTX for relapsing or refractory disease on standard immunosuppressive treatment. In a retrospective analysis, data on treatment response, frequency of relapses, adverse events, and peripheral B-cell reconstitution were evaluated. Furthermore, serum immunoglobulin concentrations, ANCA status, and peripheral B cell subpopulations were assessed after RTX treatment. All patients had high disease activity before RTX treatment. At presentation 3 months after RTX therapy, all ANCA-positive and ANCA-negative patients had responded to RTX, with one patient being in complete remission, and eight patients being in partial remission. After a mean follow-up of 9 months, C-reactive protein concentrations had normalized, eosinophils had significantly decreased, and prednisone had been tapered in all patients. In all patients, RTX therapy was combined with a standard immunosuppressive therapy. Within the 9-month observation period, no relapse was recorded. Three patients were preemptively retreated with RTX, and during the median follow-up time of 3 years, no relapse occurred in these patients. During the follow-up of 13 patient-years, five minor but no major infections were recorded. In our analysis on nine patients with EGPA resistant to standard therapy, rituximab proved to be an efficient and safe treatment for ANCA-positive and ANCA-negative patients. Preemptive retreatment with RTX, combined with standard maintenance immunosuppressants, resulted in a sustained treatment response. Prospective, randomized trials evaluating the use of RTX in EGPA are warranted.

Intravenous immunoglobulin for chronic residual peripheral neuropathy in eosinophilic granulomatosis with polyangiitis (Churg-Strauss syndrome): a multicenter, double-blind trial.

PubMed

Koike, Haruki; Akiyama, Kazuo; Saito, Toyokazu; Sobue, Gen

2015-03-01

Eosinophilic granulomatosis with polyangiitis (EGPA), previously called Churg-Strauss syndrome, frequently affects the peripheral nervous system. We conducted a multicenter, double-blind, three-arm treatment period, randomized, pre-post trial to assess the efficacy of intravenous immunoglobulin (IVIg) administration for residual peripheral neuropathy in patients with EGPA that is in remission, indicated by laboratory indices. Twenty-three patients were randomly assigned into three groups, in which the timing of IVIg and placebo administration was different. Each group received one course of intervention and two courses of placebo at 2-week intervals. Treatment effects were assessed every 2 weeks for 8 weeks. The primary outcome measure, the amount of change in the manual muscle testing sum score 2 weeks after IVIg administration, significantly increased (p = 0.002). The results over time suggested that this effect continued until the last assessment was done 8 weeks later. The number of muscles with manual muscle testing scores of three or less (p = 0.004) and the neuropathic pain scores represented by the visual analogue scale (p = 0.005) also improved significantly 2 weeks after IVIg administration. This study indicates that IVIg treatment for EGPA patients with residual peripheral neuropathy should be considered even when laboratory indices suggest remission of the disease.

How does a tidal embayment morphodynamically react on sea level rise?

NASA Astrophysics Data System (ADS)

van der Wegen, Mick

2010-05-01

Conditions for (assumed) equilibrium in tidal embayments have been studied extensively in the past years with morphodynamic 1D models (Van Dongeren and De Vriend, 1994; Schuttelaars and de Swart, 1996, 2000; Lanzoni and Seminara, 2002) and 2D models (Hibma et al. [2003], Van der Wegen and Roelvink [2008]) Van der Wegen et al 2008). The current research addresses the impact of sea level rise on tidal embayments. Although effects of sea level rise may only become apparent after decades, the character of the embayment can change considerably. Examples are the (dis)appearance or re-allocation of intertidal flats, increased tidal resonance, shift from sediment export to import, deepening of channel area and other related (ecological) parameters. The research applies a 2D morphodynamic model (Delft3D) in an idealized environment. The model is based on the 2 D shallow water equations, the Engelund -Hansen transport formula and includes bed slope effects, drying and flooding procedures and an advanced morphodynamic update scheme (Roelvink 2006). The initial condition of the bathymetry is generated by 3000 years of morphodynamic calculations in a 80 km long and 2.5 km wide rectangular tidal embayment under constant M2 tidal forcing conditions (Van der Wegen and Roelvink [2008]). After this period sea level rise gradually developing towards a rate of 0.4 m/century is added to the boundary conditions. Model results describe development towards less intertidal area and a transition from an exporting system to a importing system. Model results are evaluated in terms of M2, M4 and M6 tidal constituents as well as against Vs/Vc (shoal volume over channel volume) versus a/h (amplitude over water depth) relationship as proposed by Friedrichs and Aubrey (1988). Although the model describes morphodynamic development in a strongly idealized environment the results can provide an excellent tool to systematically study the impact of sea level rise in tidal embayments as well as the time scales of dominant underlying resulting transport mechanisms and processes. DISSANAYAKE, D.M.P.K; RANASINGHE, R. and ROELVINK, J.A., 2009. Effect of Sea Level Rise in tidal inlet evolution: a numerical modelling approach. Journal of Coastal Research, SI 56 (Proceedings of the 10th International Coastal Symposium), pg - pg. Lisbon, Portugal. Friedrichs, C. T., and D. G. Aubrey (1988), Non-linear tidal distortion in shallow well mixed estuaries: A synthesis, Estuarine Coastal Shelf Sci.,27, 521- 545, doi:10.1016/0272-7714(88)90082-0. Hibma, A., H.M. Schuttelaars, and H. J. de Vriend (2003b), Initial formation and long-term evolution of channel-shoal patterns in estuaries, in Proc. 3rd RCEM conf.edited by A. Sánchez -Acrilla and A. Bateman, pp. 740-760, IAHR., Barcelona, Spain. Lanzoni, S., and G. Seminara (2002), Long-term evolution and morphodynamic equilibrium of tidal channels, J. Geophys. Res., 107(C1), 3001, doi:10.1029/2000JC000468. Roelvink, J. A. (2006), Coastal morphodynamic evolution techniques, J. Coastal Eng., 53, 177-187. Schuttelaars, H. M., and H. E. De Swart (1996), An idealized long termmorphodynamic model of a tidal embayment, Eur. J. Mech. B Fluids, 15(1), 55-80. Schuttelaars, H. M., and H. E. De Swart (2000), Multiple morphodynamic equilibria in tidal embayments, J. Geophys. Res., 105(C10), 24,105 - 24,118. Van Dongeren, A. D., and H. J. De Vriend (1994), A model of morphological behaviour of tidal basins, Coastal Eng., 22, 287- 310. van der Wegen, M., and J. A. Roelvink (2008), Long-term morphodynamic evolution of a tidal embayment using a twodimensional, process-based model, J. Geophys. Res., 113, C03016, doi:10.1029/2006JC003983 van der Wegen, M., Z. B. Wang, H. H. G. Savenije, and J. A. Roelvink (2008), Long-term morphodynamic evolution and energy dissipation in a coastal plain, tidal embayment, J. Geophys. Res., 113, F03001, doi:10.1029/2007JF000898

Fusion Protein Cytokine Therapy After Rituximab in Treating Patients With B-Cell Non-Hodgkin Lymphoma

ClinicalTrials.gov

2015-06-03

Anaplastic Large Cell Lymphoma; Cutaneous B-cell Non-Hodgkin Lymphoma; Extranodal Marginal Zone B-cell Lymphoma of Mucosa-associated Lymphoid Tissue; Intraocular Lymphoma; Nodal Marginal Zone B-cell Lymphoma; Recurrent Adult Diffuse Small Cleaved Cell Lymphoma; Recurrent Adult Grade III Lymphomatoid Granulomatosis; Recurrent Grade 1 Follicular Lymphoma; Recurrent Grade 2 Follicular Lymphoma; Recurrent Marginal Zone Lymphoma; Small Intestine Lymphoma; Splenic Marginal Zone Lymphoma; Testicular Lymphoma; Waldenstrom Macroglobulinemia

Normzahlen, Toleranzen, Passungen

NASA Astrophysics Data System (ADS)

Böge, Gert; Böge, Wolfgang

Vor allem wegen der Kosten ist es sinnvoll, sich beim Festlegen von Maßen aller Art auf Vorzugszahlen zu beschränken (Baugrößen, Drehzahlen, Drehmomente, Leistungen, Drücke usw.). Man verwendet dazu eine geometrisch gestufte Zahlenfolge (siehe Teil Mathematik). Abb. 40.1 zeigt, dass bei der geometrischen Stufung die Werte im unteren Bereich fein, im oberen grob gestuft sind. Das ist nicht nur technisch sinnvoll.

Nuclear Planetology: Constraining the Driving Force in Wegener's Continental Drift Theory

NASA Astrophysics Data System (ADS)

Roller, G.

2015-12-01

Nuclear planetology [1] is a new research field, which aims at deciphering the nuclear physics processes responsible for the evolution of ultra-substellar objects and the driving force in Wegener's continental drift theory by means of Re-Os nuclear geochronometry [2]. Terrestrial Re/Os ratios observed within diamond sulphide inclusions [3], compatible with lunar r-process production ratios of Th/U≈1≈Au/Ir [4], drop from ≈0.8 to 0.2-0.05 for nucleogeochronometric ages between 2.3 Ga and 1.4 Ga [5]. It has therefore been argued [5,6] that the Re/Os fractionation is related to a change in oxygen fugacity due to the physics/chemistry of Earth's core after a possibly Fermi-pressure controlled core collapse [4]. Here, Pd/Ru, Pd/Pt, Pd/Ir, Pd/Os, Ru/Ir, Ru/Os, Pt/Ir or Pt/Os ratios from 24 published H chondrite components [7] are connected to their respective nucleogeochronometric ages to constrain an extended fossil fractionation record over 800 Ma. The following ranges are obtained: 0.06-1.04 (Pd/Ru), 0.06-0.79 (Pd/Pt), 0.06-1.76 (Pd/Os), 0.07-1.94 (Pd/Ir), 1.08-1.99 (Ru/Ir), 0.83-2.41 (Pt/Os), 0.82-2.64 (Pt/Ir). Comparing the Re/Os fractionation pattern of the diamond sulphide inclusions with these results and considering that Re is readily oxidized even at ultra-low oxygen fugacity, it may be concluded that (i) extremely reducing conditions within Earth's core basically preserve any unfractionated r-process element ratio until today; and (ii) nuclear/quantum physics processes leading to the observed ratios and fractionation pattern are ultimately the driving force in Wegener's continental drift theory. [1] Roller (2015), Abstract T34B-0407, AGU Spring Meeting. [2] Roller (2015), Geophys. Res. Abstr. 17, EGU2015-17. [3] Smit et al. (2010), GCA 74, 3292. [4] Roller (2015), Abstract #5041, 78th Ann. Met. Soc. Meeting. [5] Roller (2015), Geophys. Res. Abstr. 17, EGU2015-2399. [6] Roller (2015), Abstract PG34A-0283, AGU Spring Meeting. [7] Horan et al. (2009), GCA 73, 6984.

Ultrastructural characteristics of type A epithelioid cells during BCG-granulomatosis and treatment with lysosomotropic isoniazid.

PubMed

Shkurupii, V A; Kozyaev, M A; Nadeev, A P

2006-04-01

We studied BCG-granulomas, their cellular composition, and ultrastructure of type A epithelioid cells in the liver of male BALB/c mice with spontaneous granulomatous inflammation. The animals received free isoniazid or isoniazid conjugated with lysosomotropic intracellularly prolonged matrix (dialdehyde dextran, molecular weight 65-75 kDa). Lysosomotropic isoniazid was accumulated in the vacuolar apparatus of epithelioid cells and produced a stimulatory effect on plastic processes in these cells.

A 92-Year-Old Male with Eosinophilic Asthma Presenting with Recurrent Palpable Purpuric Plaques

PubMed Central

Negbenebor, Nicole A.; Khalifian, Saami; Foreman, Ruth K.; Kroshinsky, Daniela

2018-01-01

Churg-Strauss syndrome or eosinophilic granulomatosis with polyangiitis is a systemic vasculitis affecting the small and medium-sized vasculature. It is commonly associated with asthma and eosinophilia. Most patients are diagnosed at around the age of 40. We report a case of biopsy-confirmed Churg-Strauss syndrome in a 92-year-old male with a history of eosinophilic asthma and peripheral eosinophilia who was later diagnosed with Churg-Strauss syndrome. PMID:29719830

A nationwide survey on the epidemiology and clinical features of eosinophilic granulomatosis with polyangiitis (Churg-Strauss) in Japan.

PubMed

Sada, Ken-Ei; Amano, Koichi; Uehara, Ritei; Yamamura, Masahiro; Arimura, Yoshihiro; Nakamura, Yoshikazu; Makino, Hirofumi

2014-07-01

We conducted a cross-sectional nationwide survey to determine eosinophilic granulomatosis with polyangiitis (Churg-Strauss) (EGPA) prevalence and clinical features in Japan. Data for EGPA patients in 2008 were collected from 1,564 hospitals. In total, 965 patients were reported from 365 departments. In a second survey, clinical data for 473 patients were obtained. We estimated that 1,866 (95% CI: 1,640-2,092) patients have EGPA in Japan (prevalence, 17.8/1,000,000). Of the 473 patients in the second survey, 315 fulfilled American College of Rheumatology (ACR) criteria or Lanham's criteria for EGPA. The mean age (± SD) of the 315 at onset was 55 ± 14 years, male to female ratio 1:2. 93% of patients had neurological manifestations, which were the organ system most frequently involved. Among 277 patients tested for myeloperoxidase (MPO)-/p anti-neutrophil cytoplasmic antibody (ANCA), 139 (50%) were positive, while only 6 of 238 were positive for proteinase3 (PR3)-/cANCA. MPO-ANCA-positive patients had renal involvement, mucous membrane or ophthalmological symptoms, and ENT symptoms more frequently, whereas cutaneous lesions and cardiovascular involvement were less common. The prevalence of EGPA and the frequency of MPO-/p-ANCA-positivity in Japanese EGPA patients were mostly similar to those of Western countries. However, female predominance and a high frequency of neurological manifestations characterized Japanese patients.

Clinical Characteristics and Treatment Response of Peripheral Neuropathy in the Presence of Eosinophilic Granulomatosis with Polyangiitis (Churg-Strauss Syndrome): Experience at a Single Tertiary Center.

PubMed

Cho, Hye Jin; Yune, Sehyo; Seok, Jin Myoung; Cho, Eun Bin; Min, Ju Hong; Seo, Yeon Lim; Lee, Byung Jae; Kim, Byoung Joon; Choi, Dong Chull

2017-01-01

Eosinophilic granulomatosis with polyangiitis (EGPA) is a rare systemic small-vessel vasculitis accompanied by asthma, eosinophilia, and eosinophilic inflammation of various tissues including the peripheral nerves. This study investigated the clinical course and long-term outcomes of peripheral neuropathy in patients with EGPA. Seventy-one patients with physician-diagnosed EGPA were identified at Samsung Medical Center between January 1995 and April 2014. Sixty-one of these patients were followed-up for more than 1 year and received corticosteroid therapy with or without intravenous cyclophosphamide pulse therapy for 6 to 18 months. Medical records of the 61 patients including demographic data, clinical features, laboratory and pathological findings, treatments, and outcomes were reviewed. Peripheral neuropathy as a manifestation of EGPA was present in 46 (75%) of the 61 patients. The mean follow-up duration of the patients with neuropathy was 6.4 years (range 1.2-18.8 years). The scores on the neurological functional disability scale before and after the combination treatment with corticosteroid and cyclophosphamide were 2.43±0.86 and 0.54±0.95 (mean±SD; p<0.001), respectively. The peripheral neuropathy relapsed in one patient. The long-term clinical outcome of peripheral neuropathy in patients with EGPA receiving initial corticosteroid and cyclophosphamide combination therapy was favorable with a very low relapse rate.

Anterior ischaemic optic neuropathy in eosinophilic granulomatosis with polyangiitis (Churg-Strauss syndrome): a case report and review of the literature.

PubMed

Padovano, Ilaria; Pazzola, Giulia; Pipitone, Nicolò; Cimino, Luca; Salvarani, Carlo

2014-01-01

We report a 62-year-old man with mild fever, headache and acute visual loss in his right eye due to anterior ischaemic optic neuropathy (AION), followed a few days later by pain in the legs and left arm associated with numbness and weakness. Giant cell arteritis complicated by AION was suspected at the beginning and high-dose oral glucocorticoids were started. However, on the basis of the past medical history of nasal polyposis, asthma, and hypereosynophilia as well as of further investigations (biopsy of the nasal mucosa showing granulomatous inflammation with a rich eosinophilic infiltrate, electromyography demonstrating, mononeuritis multiplex and positive p-ANCA), eosinophilic granulomatosis with polyangiitis (EGPA), previously known as Churg-Strauss syndrome, was diagnosed. Because visual acuity in the right eye deteriorated despite glucocorticoid therapy, pulse intravenous cyclophosphamide was started, subsequently replaced by oral azathioprine, while prednisone was slowly tapered. This treatment led to gradual improvement of the neurological symptoms, whereas the right visual impairment remained unchanged. EGPA-related AION is an uncommon lesion that is probably due to vasculitic involvement of posterior ciliary and/or chorioretinal arteries. The prognosis of established AION is poor for the affected eye, even when glucocorticoid treatment is started immediately. However, early recognition of AION and prompt aggressive treatment with high-dose glucocorticoids plus cyclophosphamide can prevent visual loss in the unaffected eye.

[Clinical Characteristics of antineutrophil cytoplasmic antibody-associated vasculitis in a respiratory diseases referral center in Mexico (1982-2010)].

PubMed

Flores-Suárez, Luis Felipe; Alba, Marco A

2015-01-01

Respiratory manifestations in antineutrophil cytoplasmic antibody-associated vasculitis (AASV) are common, though their suspicion is lower than expected in respiratory devoted centers, with few descriptions coming from them. To describe the clinical, paraclinical and radiological manifestations, plus the prognosis of AASV patients seen in a respiratory referral center in Mexico City. Retrospective review of patients with final diagnosis of AASV, based on the American College of Rheumatology criteria and the 1994 Chapel Hill Consensus Conference Nomenclature, from 1982 to 2010. The characteristics of 74 granulomatosis with polyangiitis, 10 microscopic polyangiitis, and six eosinophilic granulomatosis with polyangiitis cases are described. Mean time elapsed from initial suspicion to definitive diagnosis was 30 months. As expected, respiratory findings dominated this cohort, but no significant differences were observed when compared to other series with AAS\\1, except for a higher frequency of subglottic stenosis. After a mean follow-up of 22 months, 83% of patients were alive, with remission being achieved in 87% and response in 9%. Seven patients died, mostly from infectious complications. This study documents that airway manifestations in Mexican patients with AASV are similar to what has been previously described. However, time to diagnosis is long. Respiratory specialists should be more aware of the modes of presentation in AASV patients in order to facilitate their recognition.

MK2206 in Treating Younger Patients With Recurrent or Refractory Solid Tumors or Leukemia

ClinicalTrials.gov

2014-04-28

Accelerated Phase Chronic Myelogenous Leukemia; Acute Leukemias of Ambiguous Lineage; Acute Myeloid Leukemia/Transient Myeloproliferative Disorder; Acute Undifferentiated Leukemia; Aggressive NK-cell Leukemia; Atypical Chronic Myeloid Leukemia, BCR-ABL1 Negative; Blastic Phase Chronic Myelogenous Leukemia; Blastic Plasmacytoid Dendritic Cell Neoplasm; Childhood Burkitt Lymphoma; Childhood Chronic Myelogenous Leukemia; Childhood Diffuse Large Cell Lymphoma; Childhood Grade III Lymphomatoid Granulomatosis; Childhood Immunoblastic Large Cell Lymphoma; Childhood Nasal Type Extranodal NK/T-cell Lymphoma; Chronic Eosinophilic Leukemia; Chronic Myelomonocytic Leukemia; Chronic Neutrophilic Leukemia; Chronic Phase Chronic Myelogenous Leukemia; Intraocular Lymphoma; Juvenile Myelomonocytic Leukemia; Mast Cell Leukemia; Myeloid/NK-cell Acute Leukemia; Noncutaneous Extranodal Lymphoma; Post-transplant Lymphoproliferative Disorder; Primary Central Nervous System Hodgkin Lymphoma; Primary Central Nervous System Non-Hodgkin Lymphoma; Progressive Hairy Cell Leukemia, Initial Treatment; Prolymphocytic Leukemia; Recurrent Childhood Acute Lymphoblastic Leukemia; Recurrent Childhood Acute Myeloid Leukemia; Recurrent Childhood Anaplastic Large Cell Lymphoma; Recurrent Childhood Grade III Lymphomatoid Granulomatosis; Recurrent Childhood Large Cell Lymphoma; Recurrent Childhood Lymphoblastic Lymphoma; Recurrent Childhood Small Noncleaved Cell Lymphoma; Recurrent Grade 1 Follicular Lymphoma; Recurrent Grade 2 Follicular Lymphoma; Recurrent Grade 3 Follicular Lymphoma; Recurrent Mantle Cell Lymphoma; Recurrent Marginal Zone Lymphoma; Recurrent Mycosis Fungoides/Sezary Syndrome; Recurrent Small Lymphocytic Lymphoma; Recurrent/Refractory Childhood Hodgkin Lymphoma; Refractory Chronic Lymphocytic Leukemia; Refractory Hairy Cell Leukemia; Relapsing Chronic Myelogenous Leukemia; Secondary Acute Myeloid Leukemia; Small Intestine Lymphoma; Splenic Marginal Zone Lymphoma; Unspecified Childhood Solid Tumor, Protocol Specific; Waldenström Macroglobulinemia

MORAb-004 in Treating Young Patients With Recurrent or Refractory Solid Tumors or Lymphoma

ClinicalTrials.gov

2016-01-07

Adult Nasal Type Extranodal NK/T-cell Lymphoma; Anaplastic Large Cell Lymphoma; Angioimmunoblastic T-cell Lymphoma; Childhood Burkitt Lymphoma; Childhood Diffuse Large Cell Lymphoma; Childhood Immunoblastic Large Cell Lymphoma; Childhood Nasal Type Extranodal NK/T-cell Lymphoma; Cutaneous B-cell Non-Hodgkin Lymphoma; Extranodal Marginal Zone B-cell Lymphoma of Mucosa-associated Lymphoid Tissue; Hepatosplenic T-cell Lymphoma; Intraocular Lymphoma; Nodal Marginal Zone B-cell Lymphoma; Noncutaneous Extranodal Lymphoma; Peripheral T-cell Lymphoma; Post-transplant Lymphoproliferative Disorder; Recurrent Adult Burkitt Lymphoma; Recurrent Adult Diffuse Large Cell Lymphoma; Recurrent Adult Diffuse Mixed Cell Lymphoma; Recurrent Adult Diffuse Small Cleaved Cell Lymphoma; Recurrent Adult Grade III Lymphomatoid Granulomatosis; Recurrent Adult Hodgkin Lymphoma; Recurrent Adult Immunoblastic Large Cell Lymphoma; Recurrent Adult Lymphoblastic Lymphoma; Recurrent Adult T-cell Leukemia/Lymphoma; Recurrent Childhood Anaplastic Large Cell Lymphoma; Recurrent Childhood Grade III Lymphomatoid Granulomatosis; Recurrent Childhood Large Cell Lymphoma; Recurrent Childhood Lymphoblastic Lymphoma; Recurrent Childhood Small Noncleaved Cell Lymphoma; Recurrent Cutaneous T-cell Non-Hodgkin Lymphoma; Recurrent Grade 1 Follicular Lymphoma; Recurrent Grade 2 Follicular Lymphoma; Recurrent Grade 3 Follicular Lymphoma; Recurrent Mantle Cell Lymphoma; Recurrent Marginal Zone Lymphoma; Recurrent Mycosis Fungoides/Sezary Syndrome; Recurrent Small Lymphocytic Lymphoma; Recurrent/Refractory Childhood Hodgkin Lymphoma; Refractory Hairy Cell Leukemia; Small Intestine Lymphoma; Splenic Marginal Zone Lymphoma; T-cell Large Granular Lymphocyte Leukemia; Testicular Lymphoma; Unspecified Adult Solid Tumor, Protocol Specific; Unspecified Childhood Solid Tumor, Protocol Specific; Waldenström Macroglobulinemia

Risk of subsequent ischemic and hemorrhagic stroke in patients hospitalized for immune-mediated diseases: a nationwide follow-up study from Sweden

PubMed Central

2012-01-01

Background Certain immune-mediated diseases (IMDs) have been associated with increased risk for cardiovascular disorders. The aim of the present study was to examine whether there is an association between 32 different IMDs and first hospitalization for ischemic or hemorrhagic stroke. Methods All individuals in Sweden hospitalized with a main diagnosis of IMD (without previous or coexisting stroke), between January 1, 1987 and December 31, 2008 (n = 216,291), were followed for first hospitalization for ischemic or hemorrhagic stroke. The reference population was the total population of Sweden. Adjusted standardized incidence ratios (SIRs) for ischemic and hemorrhagic stroke were calculated. Results Totally 20 and 15 of the 32 IMDs studied, respectively, were associated with an increased risk of ischemic and hemorrhagic stroke during the follow-up. The overall risks of ischemic and hemorrhagic stroke during the first year after hospitalization for IMD were 2.02 (95% CI 1.90–2.14) and 2.65 (95% CI 2.27–3.08), respectively. The overall risk of ischemic or hemorrhagic stroke decreased over time, to 1.50 (95% CI 1.46–1.55) and 1.83 (95% CI 1.69–1.98), respectively, after 1–5 years, and 1.29 (95% CI 1.23–1.35) and 1.47 (95% CI 1.31–1.65), respectively, after 10+ years. The risk of hemorrhagic stroke was ≥2 during the first year after hospitalization for seven IMDs: ankylosing spondylitis (SIR = 8.11), immune thrombocytopenic purpura (SIR = 8.60), polymyalgia rheumatica (SIR = 2.06), psoriasis (SIR = 2.88), rheumatoid arthritis (SIR = 3.27), systemic lupus erythematosus (SIR = 8.65), and Wegener´s granulomatosis (SIR = 5.83). The risk of ischemic stroke was ≥2 during the first year after hospitalization for twelve IMDs: Addison’s disease (SIR = 2.71), Crohn´s disease (SIR = 2.15), Grave´s disease (SIR = 2.15), Hashimoto´s thyroiditis (SIR = 2.99), immune thrombocytopenic purpura (SIR = 2.35), multiple sclerosis (SIR = 3.05), polymyositis/dermatomyositis (SIR = 3.46), rheumatic fever (SIR = 3.91), rheumatoid arthritis (SIR = 2.08), Sjögren’s syndrome (SIR = 2.57), systemic lupus erythematosus (SIR = 2.21), and ulcerative colitis (SIR = 2.15). Conclusions Hospitalization for many IMDs is associated with increased risk of ischemic or hemorrhagic stroke. The findings suggest that several IMDs are linked to cerebrovascular disease. PMID:22708578

[Differential diagnosis of rheumatic diseases and blood cancers involving the nasal cavity and accessory sinuses].

PubMed

Vasil'ev, V I; Sokol, E V; Sedyshev, S Kh; Gorodetskiĭ, V R; Aleksandrova, E N; Logvinenko, O A; Pal'shina, S G; Rodionova, E B; Radenska-Lopovok, S G; Probatova, N A; Kokosadze, N V; Pavlovskaia, A I; Kovrigina, A M; Varlamova, E Iu; Safonova, T N; Borovskaia, A B; Gaĭduk, I V; Mukhortova, O V; Aslanidi, I P; Nasonov, E L

2014-01-01

To provide the clinical, laboratory, radiological, morphological, and immunomorphological signs that permit the differential diagnosis to be made in patients with involvement of the nasal cavity and accessory sinuses (NCAS). In the period 2009 to 2013, the Laboratory for Intensive Therapy for Rheumatic Diseases, V.A. Nasonova Research Institute of Rheumatology, Russian Academy of Medical Sciences, associated the disease onset with NCAS involvement in 39 (7.6%) of 512 examinees. NCAS involvement was present at disease onset in 100% of the patients with natural killer (NK) cell lymphoma (NK/T lymphoma), in 84.5% of those with Wegener granulomatosis (WG), in 29.5% of those with IgG4-related disease (IgG4-RD), and in 17.5% of those with sarcoidosis. Such an onset could be extremely rarely observed in histiocytosis. Despite the similar clinical manifestations, NCAS involvements in NK/T lymphoma of nasal type and WG at disease onset show clear differences in the laboratory and systemic manifestations of these diseases. The patients with lymphoma have no characteristic laboratory abnormalities at disease onset, except the 100% presence of Epstein-Barr virus (EBV) DNA in blood and, only as a tumor grows, fever appears and there are elevated C-reactive protein and lactate dehydrogenase levels and pronounced destructive changes in the facial bones with mandatory hard palate destruction; at the same time the signs of systemic involvement are virtually absent. The patients with WG at disease onset have fever, high erythrocyte sedimentation rate, elevated C-reactive level, significant anemia, leukocytosis and 90% are found to have anti-neutrophil cytoplasmic antibodies with the rapid development of systemic manifestations: involvements of the lung, kidney, and peripheral nervous system. Destructive changes in the facial bones are minimal and hard palate destructions are absent. The patients with IgG4-RD, sarcoidosis, and juvenile xanthogranuloma have similar clinical and laboratory manifestations in the absence of hemorrhagic nasal discharge, nasal septal perforation, and facial bone destruction, with the practically involvement of the salivary/lacrimal glands and orbital regions. A third of the patients are observed to have different allergic manifestations, moderate eosinophilia, and signs of autoimmune disorders (the presence of rheumatoid and antinuclear factors, hypergammaglobulinemia). Elevated serum IgG4 levels are characteristic of IgG4-RD. Blood anti-neutrophil cytoplasmic antibodies, EBV DNA, and IgG4 levels should be determined in all patients with NCAS involvement. Mini-invasive incision biopsies of the nasal mucosa, orbital regions, and major salivary glands should be done, by morphologically verifying the diagnosis of sarcoidosis, histiocytosis, and WG and by making an immunomorphological examination to diagnose NK/T lymphoma and IgG4-RD.

Coherent Control of Scattering Processes in Semiconductors

NASA Astrophysics Data System (ADS)

Wehner, M. U.

1998-03-01

On a timescale which compares to the duration of single scattering events, the relaxation of optical excitations in semiconductors has to be described by the quantum kinetic theory. Instead of simple scattering rates this theory delivers a non-Markovian dephasing. Related memory effects have so far been observed for the case of electron-LO-phonon scattering in four-wave-mixing experiments on GaAs at T = 77 K using 15 fs pulses (L. Bányai, D.B. Tran Thoai, E. Reitsamer, H. Haug, D. Steinbach, M.U. Wehner, T. Marschner, M. Wegener and W. Stolz, Phys. Rev. Lett. 75), 2188 (1995). It is crucial for the quantum kinetic time regime that scattering processes must not be considered as completed and irreversibel. The reversibility of the scattering shortly after optical excitation is demonstrated in four-wave-mixing experiments using coherent control. By adjusting the relative phase of two phase-locked pulses, the non-Markovian phonon oscillations observed in Ref.1 can be either suppressed or amplified (M. U. Wehner, M. H. Ulm, D. S. Chemla and M. Wegener, Phys. Rev. Lett. submitted). The behavior of the coherently controlled scattering amplitude is discussed using a simple model Hamiltonian, which describes the variation of the phonon oscillations in amplitude and phase very well.

Familial Churg-Strauss Syndrome in a Sister and Brother.

PubMed

Alyasin, Soheyla; Khoshkhui, Maryam; Amin, Reza

2015-06-01

Churg-Strauss syndrome (CSS) is a granulomatous small vessel vasculitis. It is characterized by asthma, allergic granulomatosis and vasculitis. This syndrome is rare in children. A 5 years old boy was admitted with cough, fever and dyspnea for 2 weeks. On the basis of laboratory data (peripheral eosinophilia), associated with skin biopsy, and history of CSS in his sister, this disease was eventually diagnosed. The patient had good response to corticosteroid. In every asthmatic patient with prolonged fever, eosinophilia and multisystemic involvment, CSS should be considered.

[Otolaryngologic manifestations of Churg-Strauss sindrome. Report of a case and review of the literature].

PubMed

Pino Rivero, V; González Palomino, A; Pantoja Hernández, C G; Trinidad Ruíz, G; Pardo Romero, G; Montero García, C; Blasco Huelva, A

2006-01-01

Churg-Strauss Sindrome or allergic granulomatosis is a small vessel systemic vasculitis characterized by asthma, hypereosinophilia and necrotizing vasculitis with extravascular eosinophil granulomas. We describe a case assisted in our hospital who presented pulmonary infiltrates, fever, peripherical neuropathy, weight loss, myalgia, rhinosinusitis, with antecedents of nasal polyposis, and facial edema. Our aim is to review the main otolaryngologic manifestations of this rare illness that is treated with oral corticosteroids, immunosupresor drugs like ciclofosfamide and plasmapheresis.

Q-Ships of the Great War

DTIC Science & Technology

2000-04-01

excitement came in responding to a distress call from Lusitania , sunk by a U-boat in April. Herbert and his crew were deeply affected by this incident as...they saw first- hand the recovered bodies of Lusitania passengers that had been laid out on the Queenstown jetty.5 At mid-day 19 August, Baralong was...Germans. Baralong‘s crew reveled in its actions, having avenged Lusitania and Arabic. Although accounts vary, eyewitnesses reported that Wegener was

MS-275 and Isotretinoin in Treating Patients With Metastatic or Advanced Solid Tumors or Lymphomas

ClinicalTrials.gov

2013-01-23

Adult Grade III Lymphomatoid Granulomatosis; Anaplastic Large Cell Lymphoma; Angioimmunoblastic T-cell Lymphoma; Extranodal Marginal Zone B-cell Lymphoma of Mucosa-associated Lymphoid Tissue; Intraocular Lymphoma; Nodal Marginal Zone B-cell Lymphoma; Primary Central Nervous System Non-Hodgkin Lymphoma; Recurrent Adult Burkitt Lymphoma; Recurrent Adult Diffuse Large Cell Lymphoma; Recurrent Adult Diffuse Mixed Cell Lymphoma; Recurrent Adult Diffuse Small Cleaved Cell Lymphoma; Recurrent Adult Grade III Lymphomatoid Granulomatosis; Recurrent Adult Hodgkin Lymphoma; Recurrent Adult Immunoblastic Large Cell Lymphoma; Recurrent Adult Lymphoblastic Lymphoma; Recurrent Adult T-cell Leukemia/Lymphoma; Recurrent Cutaneous T-cell Non-Hodgkin Lymphoma; Recurrent Grade 1 Follicular Lymphoma; Recurrent Grade 2 Follicular Lymphoma; Recurrent Grade 3 Follicular Lymphoma; Recurrent Mantle Cell Lymphoma; Recurrent Marginal Zone Lymphoma; Recurrent Mycosis Fungoides/Sezary Syndrome; Recurrent Small Lymphocytic Lymphoma; Small Intestine Lymphoma; Splenic Marginal Zone Lymphoma; Stage IV Adult Burkitt Lymphoma; Stage IV Adult Diffuse Large Cell Lymphoma; Stage IV Adult Diffuse Mixed Cell Lymphoma; Stage IV Adult Diffuse Small Cleaved Cell Lymphoma; Stage IV Adult Hodgkin Lymphoma; Stage IV Adult Immunoblastic Large Cell Lymphoma; Stage IV Adult Lymphoblastic Lymphoma; Stage IV Adult T-cell Leukemia/Lymphoma; Stage IV Cutaneous T-cell Non-Hodgkin Lymphoma; Stage IV Grade 1 Follicular Lymphoma; Stage IV Grade 2 Follicular Lymphoma; Stage IV Grade 3 Follicular Lymphoma; Stage IV Mantle Cell Lymphoma; Stage IV Marginal Zone Lymphoma; Stage IV Mycosis Fungoides/Sezary Syndrome; Stage IV Small Lymphocytic Lymphoma; Unspecified Adult Solid Tumor, Protocol Specific; Waldenström Macroglobulinemia

Diagnosis and classification of eosinophilic granulomatosis with polyangiitis (formerly named Churg-Strauss syndrome).

PubMed

Mouthon, Luc; Dunogue, Bertrand; Guillevin, Loïc

2014-01-01

Recently, a group of experts in the field suggested to rename Churg-Strauss syndrome as eosinophilic granulomatosis with polyangiitis (EGPA). This condition, first described in 1951, is a rare small- and medium-sized-vessel vasculitis characterized by an almost constant association with asthma and eosinophilia, and, by the presence of anti-myeloperoxidase (MPO) antineutrophil cytoplasm antibodies (ANCA) in 30-38% of the patients. Vasculitis typically develops in a previously asthmatic and eosinophilic middle-aged patient. Asthma is severe, associated with eosinophilia and extrapulmonary symptoms. Most frequently EGPA involves the peripheral nerves and skin. Other organs, however, may be affected and must be screened for vasculitis, especially those associated with a poorer prognosis, such as the heart, kidney and gastrointestinal tract, as assessed by the recently revised Five-Factor Score (FFS). Recent insights, particularly concerning clinical differences associated with ANCA status, showed that EGPA patients might constitute a heterogeneous group. Thus, EGPA patients with anti-MPO ANCA suffered more, albeit not exclusively, from vasculitis symptoms, such as glomerulonephritis, mononeuritis multiplex and alveolar hemorrhage, whereas ANCA-negative patients more frequently develop heart involvement. This observation led to the hypothesis that EGPA might be divided into different clinical and pathophysiological subtypes, which could be managed better with more specifically adapted therapies. For now, EGPA treatment still relies mainly on corticosteroids and, when necessary for patients with poorer prognoses, combined immunosuppressant drugs, especially cyclophosphamide. Overall survival of EGPA patients is good, despite not uncommon relapses. Copyright © 2014 Elsevier Ltd. All rights reserved.

Heart transplantation in patients with eosinophilic granulomatosis with polyangiitis (Churg-Strauss syndrome).

PubMed

Groh, Matthieu; Masciocco, Gabriella; Kirchner, Elizabeth; Kristen, Arnt; Pellegrini, Carlo; Varnous, Shaïda; Bortman, Guillermo; Rosenberg, Mark; Brucato, Antonio; Waterworth, Paul; Bonacina, Edgardo; Facchetti, Fabio; Calabrese, Leonard; Gregorini, Gina; Scali, Juan Jose; Starling, Randall; Frigerio, Maria; D'Armini, Andrea Maria; Guillevin, Loïc

2014-08-01

Heart involvement is the leading cause of death of patients with eosinophilic granulomatosis with polyangiitis (EGPA; formerly Churg-Strauss syndrome) and is more frequent in anti-neutrophil cytoplasm antibody (ANCA)-negative patients. Post-transplant outcome has only been reported once. We conducted a retrospective international multicenter study. Patients satisfying the criteria of the American College of Rheumatology and/or revised Chapel Hill Consensus Conference Nomenclature were identified by collaborating vasculitis and transplant specialists, and the help of the Churg-Strauss Syndrome Association. Nine ANCA(-) patients who received transplants between October 1987 and December 2009 were identified. The vasculitis and cardiomyopathy diagnoses were concomitant for 5 patients and separated by 12 to 288 months for the remaining 4 patients. Despite ongoing immunosuppression, histologic examination of 7 (78%) patients' explanted hearts showed histologic patterns suggestive of active vasculitis. The overall 5-year survival rate was low (57%), but rose to 80% when considering only the 6 patients transplanted during the last decade. After survival lasting 3 to 60 months, 4 (44%) patients died sudden deaths. The search for EGPA-related cardiomyopathy is mandatory early in the course of this type of vasculitis. Indeed, prompt treatment with corticosteroids and cyclophosphamide may achieve restore cardiac function. Most patients in this series were undertreated. For patients with refractory EGPA, heart transplantation should be performed, which carries a fair prognosis. No optimal immunosuppressive strategy has yet been identified. Copyright © 2014 International Society for Heart and Lung Transplantation. All rights reserved.

Proteinase 3 Is a Phosphatidylserine-binding Protein That Affects the Production and Function of Microvesicles.

PubMed

Martin, Katherine R; Kantari-Mimoun, Chahrazade; Yin, Min; Pederzoli-Ribeil, Magali; Angelot-Delettre, Fanny; Ceroi, Adam; Grauffel, Cédric; Benhamou, Marc; Reuter, Nathalie; Saas, Philippe; Frachet, Philippe; Boulanger, Chantal M; Witko-Sarsat, Véronique

2016-05-13

Proteinase 3 (PR3), the autoantigen in granulomatosis with polyangiitis, is expressed at the plasma membrane of resting neutrophils, and this membrane expression increases during both activation and apoptosis. Using surface plasmon resonance and protein-lipid overlay assays, this study demonstrates that PR3 is a phosphatidylserine-binding protein and this interaction is dependent on the hydrophobic patch responsible for membrane anchorage. Molecular simulations suggest that PR3 interacts with phosphatidylserine via a small number of amino acids, which engage in long lasting interactions with the lipid heads. As phosphatidylserine is a major component of microvesicles (MVs), this study also examined the consequences of this interaction on MV production and function. PR3-expressing cells produced significantly fewer MVs during both activation and apoptosis, and this reduction was dependent on the ability of PR3 to associate with the membrane as mutating the hydrophobic patch restored MV production. Functionally, activation-evoked MVs from PR3-expressing cells induced a significantly larger respiratory burst in human neutrophils compared with control MVs. Conversely, MVs generated during apoptosis inhibited the basal respiratory burst in human neutrophils, and those generated from PR3-expressing cells hampered this inhibition. Given that membrane expression of PR3 is increased in patients with granulomatosis with polyangiitis, MVs generated from neutrophils expressing membrane PR3 may potentiate oxidative damage of endothelial cells and promote the systemic inflammation observed in this disease. © 2016 by The American Society for Biochemistry and Molecular Biology, Inc.

Proteinase 3 Is a Phosphatidylserine-binding Protein That Affects the Production and Function of Microvesicles*

PubMed Central

Martin, Katherine R.; Kantari-Mimoun, Chahrazade; Yin, Min; Pederzoli-Ribeil, Magali; Angelot-Delettre, Fanny; Ceroi, Adam; Grauffel, Cédric; Benhamou, Marc; Reuter, Nathalie; Saas, Philippe; Frachet, Philippe; Boulanger, Chantal M.; Witko-Sarsat, Véronique

2016-01-01

Proteinase 3 (PR3), the autoantigen in granulomatosis with polyangiitis, is expressed at the plasma membrane of resting neutrophils, and this membrane expression increases during both activation and apoptosis. Using surface plasmon resonance and protein-lipid overlay assays, this study demonstrates that PR3 is a phosphatidylserine-binding protein and this interaction is dependent on the hydrophobic patch responsible for membrane anchorage. Molecular simulations suggest that PR3 interacts with phosphatidylserine via a small number of amino acids, which engage in long lasting interactions with the lipid heads. As phosphatidylserine is a major component of microvesicles (MVs), this study also examined the consequences of this interaction on MV production and function. PR3-expressing cells produced significantly fewer MVs during both activation and apoptosis, and this reduction was dependent on the ability of PR3 to associate with the membrane as mutating the hydrophobic patch restored MV production. Functionally, activation-evoked MVs from PR3-expressing cells induced a significantly larger respiratory burst in human neutrophils compared with control MVs. Conversely, MVs generated during apoptosis inhibited the basal respiratory burst in human neutrophils, and those generated from PR3-expressing cells hampered this inhibition. Given that membrane expression of PR3 is increased in patients with granulomatosis with polyangiitis, MVs generated from neutrophils expressing membrane PR3 may potentiate oxidative damage of endothelial cells and promote the systemic inflammation observed in this disease. PMID:26961880

A diagnostic pitfall in IgG4-related hypophysitis: infiltration of IgG4-positive cells in the pituitary of granulomatosis with polyangiitis.

PubMed

Bando, Hironori; Iguchi, Genzo; Fukuoka, Hidenori; Taniguchi, Masaaki; Kawano, Seiji; Saitoh, Miki; Yoshida, Kenichi; Matsumoto, Ryusaku; Suda, Kentaro; Nishizawa, Hitoshi; Takahashi, Michiko; Morinobu, Akio; Kohmura, Eiji; Ogawa, Wataru; Takahashi, Yutaka

2015-10-01

Immunoglobulin (Ig) G4-related hypophysitis is an emerging clinical entity, which is characterized by an elevated serum IgG4 concentration and infiltration of IgG4-positive plasma cells in the pituitary. Although some criteria for its diagnosis have been proposed, they have not been fully established. In particular, differential diagnosis from secondary chronic inflammation including granulomatosis with polyangiitis (GPA) is difficult in some cases. We describe central diabetes insipidus with pituitary swelling exhibiting infiltration of IgG4-positive cells. A 43-year-old woman in the remission stage of GPA presented with sudden-onset polyuria and polydipsia. Pituitary magnetic resonance imaging revealed swelling of the anterior and posterior pituitary and stalk, with heterogeneous gadolinium enhancement and disappearance of the high signal intensity of the posterior pituitary. Evaluation of biochemical markers for GPA suggested that the disease activity was well-controlled. Endocrinological examination revealed the presence of central diabetes insipidus and growth hormone deficiency. Pituitary biopsy specimen showed IgG4-positive cells, with a 43% IgG4(+)/IgG(+) ratio, which met the criteria for IgG4-related hypophysitis. However, substantial infiltration of polymorphonuclear neutrophils with giant cells was also noted, resulting in a final diagnosis of pituitary involvement of GPA. These results suggest that pituitary involvement of GPA should be taken into account for the differential diagnosis of IgG4-related hypophysitis.

The Role of the Immune Response in the Pathogenesis of Thyroid Eye Disease: A Reassessment

PubMed Central

Rosenbaum, James T.; Choi, Dongseok; Wong, Amanda; Wilson, David J.; Grossniklaus, Hans E.; Harrington, Christina A.; Dailey, Roger A.; Ng, John D.; Steele, Eric A.; Czyz, Craig N.; Foster, Jill A.; Tse, David; Alabiad, Chris; Dubovy, Sander; Parekh, Prashant K.; Harris, Gerald J.; Kazim, Michael; Patel, Payal J.; White, Valerie A.; Dolman, Peter J.; Edward, Deepak P.; Alkatan, Hind M.; al Hussain, Hailah; Selva, Dinesh; Yeatts, R. Patrick; Korn, Bobby S.; Kikkawa, Don O.; Stauffer, Patrick; Planck, Stephen R.

2015-01-01

Background Although thyroid eye disease is a common complication of Graves’ disease, the pathogenesis of the orbital disease is poorly understood. Most authorities implicate the immune response as an important causal factor. We sought to clarify pathogenesis by using gene expression microarray. Methods An international consortium of ocular pathologists and orbital surgeons contributed formalin fixed orbital biopsies. RNA was extracted from orbital tissue from 20 healthy controls, 25 patients with thyroid eye disease (TED), 25 patients with nonspecific orbital inflammation (NSOI), 7 patients with sarcoidosis and 6 patients with granulomatosis with polyangiitis (GPA). Tissue was divided into a discovery set and a validation set. Gene expression was quantified using Affymetrix U133 Plus 2.0 microarrays which include 54,000 probe sets. Results Principal component analysis showed that gene expression from tissue from patients with TED more closely resembled gene expression from healthy control tissue in comparison to gene expression characteristic of sarcoidosis, NSOI, or granulomatosis with polyangiitis. Unsupervised cluster dendrograms further indicated the similarity between TED and healthy controls. Heat maps based on gene expression for cytokines, chemokines, or their receptors showed that these inflammatory markers were associated with NSOI, sarcoidosis, or GPA much more frequently than with TED. Conclusion This is the first study to compare gene expression in TED to gene expression associated with other causes of exophthalmos. The juxtaposition shows that inflammatory markers are far less characteristic of TED relative to other orbital inflammatory diseases. PMID:26371757

Gene Expression Profiling and Heterogeneity of Nonspecific Orbital Inflammation Affecting the Lacrimal Gland.

PubMed

Rosenbaum, James T; Choi, Dongseok; Harrington, Christina A; Wilson, David J; Grossniklaus, Hans E; Sibley, Cailin H; Salek, Sherveen S; Ng, John D; Dailey, Roger A; Steele, Eric A; Hayek, Brent; Craven, Caroline M; Edward, Deepak P; Maktabi, Azza M Y; Al Hussain, Hailah; White, Valerie A; Dolman, Peter J; Czyz, Craig N; Foster, Jill A; Harris, Gerald J; Bee, Youn-Shen; Tse, David T; Alabiad, Chrisfouad R; Dubovy, Sander R; Kazim, Michael; Selva, Dinesh; Yeatts, R Patrick; Korn, Bobby S; Kikkawa, Don O; Silkiss, Rona Z; Sivak-Callcott, Jennifer A; Stauffer, Patrick; Planck, Stephen R

2017-11-01

Although a variety of well-characterized diseases, such as sarcoidosis and granulomatosis with polyangiitis, affect the lacrimal gland, many patients with dacryoadenitis are diagnosed as having nonspecific orbital inflammation (NSOI) on the basis of histology and systemic disease evaluation. The ability to further classify the disease in these patients should facilitate selection of effective therapies. To test the a priori hypothesis that gene expression profiles would complement clinical and histopathologic evaluations in identifying well-characterized diseases and in subdividing NSOI into clinically relevant groups. In this cohort study, gene expression levels in biopsy specimens of inflamed and control lacrimal glands were measured with microarrays. Stained sections of the same biopsy specimens were used for evaluation of histopathology. Tissue samples of patients were obtained from oculoplastic surgeons at 7 international centers representing 4 countries (United States, Saudi Arabia, Canada, and Taiwan). Gene expression analysis was done at Oregon Health & Science University. Participants were 48 patients, including 3 with granulomatosis with polyangiitis, 28 with NSOI, 7 with sarcoidosis, 4 with thyroid eye disease, and 6 healthy controls. The study dates were March 2012 to April 2017. The primary outcome was subdivision of biopsy specimens based on gene expression of a published list of approximately 40 differentially expressed transcripts in blood, lacrimal gland, and orbital adipose tissue from patients with sarcoidosis. Stained sections were evaluated for inflammation (none, mild, moderate, or marked), granulomas, nodules, or fibrosis by 2 independent ocular pathologists masked to the clinical diagnosis. Among 48 patients (mean [SD] age, 41.6 [19.0] years; 32 [67%] female), the mclust algorithm segregated the biopsy specimens into 4 subsets, with the differences illustrated by a heat map and multidimensional scaling plots. Most of the sarcoidosis biopsy specimens were in subset 1, which had the highest granuloma score. Three NSOI biopsy specimens in subset 1 had no apparent granulomas. Thirty-two percent (9 of 28) of the NSOI biopsy specimens could not be distinguished from biopsy specimens of healthy controls in subset 4, while other examples of NSOI tended to group with gene expression resembling granulomatosis with polyangiitis or thyroid eye disease. The 4 subsets could also be partially differentiated by their fibrosis, granulomas, and inflammation pathology scores but not their lymphoid nodule scores. Gene expression profiling discloses clear heterogeneity among patients with lacrimal inflammatory disease. Comparison of the expression profiles suggests that a subset of patients with nonspecific dacryoadenitis might have a limited form of sarcoidosis, while other patients with NSOI cannot be distinguished from healthy controls.

Risk for Sporadic Breast Cancer in Ataxia Telangiectasia Heterozygotes

DTIC Science & Technology

2001-08-01

assess whether heterozygosity for the ATM gene, due to a loss of function mutation in one of the 2 alleles and found in about 1% of the general population...suppressor role in breast cancer, a loss of wild type ATM expression rather than mutational inactivation could be expected. With this rationale, we...genes. The latter indicates that in p53-deficient tumor cells with activated oncogenic pathways, clonal outgrowth favors loss of p73 function. Taken

The Concept of Comprehensive Security: A Distinctive Feature of a Shared Security Culture in Europe

DTIC Science & Technology

2007-12-01

Sicherheitsbegriff, ed. Bundesakademie für Sicherheitspolitik (Hamburg: Mittler, 2001), 18. 92. Emil Kirchner and James Sperling , “The New Security Threats in...im 21. Jahrhundert - Keine allein militärische Aufgabe. Rede von Heidi Wegener, MdB, am 23.03.2006 im Marshall Center. www.marshallcenter.org/site...Wenger (Zürich: Forschungsstelle für Sicherheitspolitik, 2005), 11 217. Kurt R. Spillmann, " Von der bewaffneten Neutralität zur kooperativen

Two rare cases of Epstein-Barr virus-associated lymphoproliferative disorders in inflammatory bowel disease patients on thiopurines and other immunosuppressive medications.

PubMed

Subramaniam, K; Cherian, M; Jain, S; Latimer, M; Corbett, M; D'Rozario, J; Pavli, P

2013-12-01

The setting of chronic immunosuppression in inflammatory bowel disease (IBD) may promote the proliferation of Epstein-Barr virus-positive neoplastic clones. We report two rare cases of Epstein-Barr virus-associated lymphoproliferative disorder in IBD patients: one resembled lymphomatoid granulomatosis, and the other was a lymphoma resembling Hodgkin lymphoma. There are currently no guidelines for the prevention of lymphoproliferative disorder in IBD patients on immunosuppressive therapy. © 2013 The Authors; Internal Medicine Journal © 2013 Royal Australasian College of Physicians.

An unusual presentation of eosinophilic angiocentric fibrosis.

PubMed

Hardman, Joel; Toon, Christopher; Nirmalananda, Arjuna

2017-12-01

Eosinophilic angiocentric fibrosis (EAF) is a rare, benign condition affecting the respiratory mucosa and is generally characterized by a locally destructive growth. We present a case of a lady with a saddle nose deformity that had for many years been treated as granulomatosis with polyangiitis (GPA), of which saddle nose deformity is a classic feature. At the time of surgery, she was found to have subglottic stenosis another classic feature of GPA, however, histology demonstrated EAF. We discuss the difference between the two conditions and highlight the importance of making the correct diagnosis.

ESSReS-PEP, an international and interdisciplinary postgraduate education concept on Earth and Environmental Sciences

NASA Astrophysics Data System (ADS)

Grosfeld, Klaus; Lohmann, Gerrit; Ladstätter-Weißenmayer, Annette; Burrows, John

2013-04-01

Promoting young researchers is a major priority of the German Helmholtz Association. Since more than five years graduate and postgraduate education in the field of Earth System and Environmental Science has been established in Bremen and Bremerhaven, north-western Germany. Using the network and collaboration of experts and specialists on observational and paleoclimate data as well as on statistical data analysis and climate modelling from two Universities and the Helmholtz research institute on Polar and Marine Research, master and PhD students are trained to understand, decipher and cope with the challenges of recent climate change on an highly interdisciplinary and inter-institutional level. The existing research infrastructure at the Alfred Wegener Institute in Bremerhaven (AWI), University of Bremen, and Jacobs University Bremen offers a unique research environment to study past, present and future changes of the climate system, with special focus on high latitudinal processes. It covers all kind of disciplines, climate science, geosciences and biosciences, and provides a consistent framework for education and qualification of a new generation of expertly trained, internationally competitive master and PhD students. On postgraduate level, the Postgraduate Programme Environmental Physics (PEP) at the University of Bremen (www.pep.uni-bremen.de) educates the participants on the complex relationship between atmosphere, hydrosphere (ocean), cryosphere (ice region) and solid earth (land). Here, the learning of experimental methods in environmental physics at the most advanced level, numerical data analysis using supercomputers, and data interpretation via sophisticated methods prepare students for a scientific career. Within cooperation with the Ocean University of China (OUC) students are participating one year in the PEP programme during their master studies since 2006, to get finally a double degree of both universities. At the Alfred Wegener Institute for Polar and Marine Research in Bremerhaven, a Helmholtz Research School on Earth System Sciences ESSReS (www.earth-system-science.org) has been funded since 2007 in collaboration with the University of Bremen and the Jacobs University Bremen. ESSReS brings together up to 24 outstanding young doctoral students to conduct research on a specific topic and thus gain valuable experience working together closely in teams - an absolutely essential skill for topnotch research today. In addition, the Helmholtz Association works with distinguished partners such as the Imperial College London, enabling it to provide a curriculum that includes a range of courses that aim to foster professional qualification and personal development and to equip graduates for careers in management positions, both in science and the business world. The set-up of a structured doctoral programme like ESSReS combines both, strong scientific cutting-edge research and an interdisciplinary education that bridges the gap between the traditional disciplines. The young students are motivated to learn on an interdisciplinary and trans-institutional basis, guiding their way in modern research. The success and outcome of the first 3-years phase of ESSReS and its structural framework is documented in the Springer book series "SpringerBriefs in Earth System Sciences" (http://link.springer.com/book/10.1007/978-3-642-32235-8/page/1). Together with the graduate school POLMAR at the Alfred Wegener Institute, ESSReS provides a new level with binding rules for doctoral education at the Alfred Wegener Institute, satisfying the enduring efforts on the improvement of doctoral education in the Helmholtz Association.

Elektrische Scheepsvoortstuwing en Supergeleiding: Een Literatuurstudie (Electric Ship Propulsion and Superconductivity: A Desk Study)

DTIC Science & Technology

1992-06-01

opdraCmlgoeVO en e; opdrachtnemer verweren naar doeha ’Algemen. Voorwearden voor Onderzoeks- ONGERTJBRICEERD opdrachlefl son TNO’, dan wel do belreflende...Opomp’kaneal NaK isolatielaag mom ankerstroomn NaK max. niveau van NaK -as Figuur 4.7 Seriewchakeling van de schijven met NaK TNO-rappert PML 2824880131Pgn De...suporgeleidend worden uitgovocrd kin de constructie aanmerkelijk worden vereenvoudigd. Voor generatoren onder de 100 MW wegen de kosten, verbonden son de grotere

Arctic biomass burning aerosol event-microphysical property retrieval

NASA Astrophysics Data System (ADS)

Böckmann, Christine; Ritter, Christoph; Ortiz-Amezcua, Pablo

2018-04-01

An intense biomass-burning (BB) event from North America in July 2015 was observed over Ny-Ålesund (Spitsbergen, European Arctic). An extreme air pollution took place and aerosol optical depth (AOD) of more than 1 at 500nm occurs in middle and lower troposphere. We analyse data from the multi-wavelength Raman-lidar KARL of Alfred Wegener Institute to derive microphysical properties of the aerosol of one interesting layer from 3186 to 3306 m via regularization. We found credible and confidential microphysical parameters.

Aberrant cytokine pattern of the nasal mucosa in granulomatosis with polyangiitis

PubMed Central

2012-01-01

Introduction In granulomatosis with polyangiitis (GPA), a complex autoimmune small-vessel vasculitis frequently associated with chronic necrotizing inflammation of the nasal mucosa, elevated nasal Staphylococcus (S.) aureus carrier rates are a risk factor for relapse. As cytokines are primarily involved in the regulation of defense against potentially pathogenic microorganisms, the aim of this study was to compare healthy individuals and GPA patients with respect to their baseline cytokine expression of nasal epithelial cells (NEC), which form the first barrier against such triggers. The ability of S. aureus to influence the nasal microenvironment's cytokine secretion was assessed by exemplary stimulation experiments. Methods Baseline expression of 19 cytokines of primary NEC of GPA patients and normal controls (NC) was quantified by a multiplex cytokine assay. Stimulation experiments were performed with supernatants of S. aureus and expression of interleukin-8 was determined by ELISA. Results In GPA, an altered pattern of baseline cytokine expression with significantly up-regulated G-CSF and reduced interleukin (IL)-8 concentrations was observed. Both NEC of GPA patients and NC responded to stimulation with S. aureus, but GPA patients displayed a significantly lower IL-8 secretion and a diminished dynamic range of response towards the stimulus. Conclusions The data presented underline the hypothesis of a disturbed epithelial nasal barrier function in GPA. The dysregulated baseline expression of G-CSF and IL-8 and the reduced response to microbial stimulation may facilitate changes in the composition of the nasal flora and favour an imbalanced inflammatory response, which might be relevant for the disease course. PMID:23031229

Risk factors and treatment of pneumothorax secondary to granulomatosis with polyangiitis: a clinical analysis of 25 cases.

PubMed

Shi, Xuhua; Zhang, Yongfeng; Lu, Yuewu

2018-01-15

To investigate the risk factors and treatment strategies for pneumothorax secondary to granulomatosis with polyangiitis (GPA). Retrospective analysis of cases with pneumothorax secondary to GPA from our own practice and published on literature. A total of 25 patients, 18 males and 7 females, mean age 44 ± 15.7 years, were analyzed. Diagnosis included pneumothorax (11 cases), hydropneumothorax (n = 5), empyema (n = 8) and hemopneumothorax (n = 1). 88% (22/25) patients showed single/multiple pulmonary/ subpleural nodules with/without cavitation on chest imaging. Erythrocyte sedimentation rate and C-reactive protein were both elevated. Corticosteroids and immunosuppressive agents were used in 16 cases. Five cases received steroid pulse therapy, of which 4 patients survived. Pleural drainage was effective in some patients. Seven patients underwent surgical operations. In the 10 fatal cases, infection and respiratory failure were the most common cause. Lung biopsy/ autopsy showed lung/pleural necrotizing granulomatous vasculitis, breaking into the chest cavity, pleural fibrosis, bronchial pleural fistula, etc. The mean age in the death group was greater than the survival group (53 ± 12.9 years vs 40.1 ± 14.7 years, p = 0.05), the ineffective pleural drainage was also higher in the death group (5/5 vs 0/7, p = 0.01). Pneumothorax was seen in the active GPA, due to a variety of reasons, and gave rise to high fatality rate. Aggressive treatment of GPA can improve the prognosis. Older and lack of response for pleural drainage indicates poor prognosis.

Childhood-onset eosinophilic granulomatosis with polyangiitis (formerly Churg-Strauss syndrome): a contemporary single-center cohort.

PubMed

Gendelman, Samantha; Zeft, Andrew; Spalding, Steven J

2013-06-01

To date only 38 cases of childhood-onset eosinophilic granulomatosis with polyangiitis (cEGPA; formerly Churg-Strauss syndrome) have been reported. Additional patients with cEGPA could enhance the understanding of this rare and life-threatening condition. Our objectives were (1) to determine the frequency of specific organ system involvement; (2) to examine initial therapeutic regimen; and (3) to document disease and therapy-related morbidity in a contemporary cohort of patients with cEGPA. Retrospective review of patients evaluated at the Cleveland Clinic between 2003 and 2011 who met either American College of Rheumatology or Lanham criteria for EGPA and whose age was < 18 years at symptom onset. Nine patients (8 female; 7 white) were identified. Median age at onset of rhinitis/asthma symptom was 13 years and median age at diagnosis of cEGPA was 15 years. All patients demonstrated eosinophilia, upper airway disease (allergic rhinitis, chronic sinusitis, and/or nasal polyps), and pulmonary involvement. Other frequently involved organ systems included musculoskeletal (67%), gastrointestinal (67%), cutaneous (67%), neurologic (56%), and cardiac (44%). Antineutrophil cytoplasmic antibody (ANCA) serologies were negative in all patients. The medications used most frequently for initial therapy included oral (44%) or intravenous corticosteroids (56%) and azathioprine (67%). Disease or therapeutic complications occurred in half of the cohort and included heart failure, stroke, and sequela from longterm, high-dose steroids. Eosinophilia, in combination with upper airway, pulmonary, musculoskeletal, neurologic, and cardiac manifestations, is frequently observed in cEGPA. ANCA titers are often negative. Steroids are the mainstay of initial therapy but steroid-related side effects occur regularly.

Lenalidomide After Donor Bone Marrow Transplant in Treating Patients With High-Risk Hematologic Cancers

ClinicalTrials.gov

2017-09-22

Adult Acute Myeloid Leukemia in Remission; Adult Acute Myeloid Leukemia With Inv(16)(p13.1q22); CBFB-MYH11; Adult Acute Myeloid Leukemia With t(16;16)(p13.1;q22); CBFB-MYH11; Adult Acute Myeloid Leukemia With t(8;21); (q22; q22.1); RUNX1-RUNX1T1; Adult Acute Myeloid Leukemia With t(9;11)(p22.3;q23.3); MLLT3-KMT2A; Adult Acute Promyelocytic Leukemia With PML-RARA; Adult Grade III Lymphomatoid Granulomatosis; Adult Nasal Type Extranodal NK/T-Cell Lymphoma; Alkylating Agent-Related Acute Myeloid Leukemia; Anaplastic Large Cell Lymphoma; Angioimmunoblastic T-Cell Lymphoma; Extranodal Marginal Zone Lymphoma of Mucosa-Associated Lymphoid Tissue; Hepatosplenic T-Cell Lymphoma; Intraocular Lymphoma; Lymphomatous Involvement of Non-Cutaneous Extranodal Site; Mature T-Cell and NK-Cell Non-Hodgkin Lymphoma; Nodal Marginal Zone Lymphoma; Post-Transplant Lymphoproliferative Disorder; Primary Cutaneous B-Cell Non-Hodgkin Lymphoma; Prolymphocytic Leukemia; Recurrent Adult Burkitt Lymphoma; Recurrent Adult Grade III Lymphomatoid Granulomatosis; Recurrent Adult Immunoblastic Lymphoma; Recurrent Adult Lymphoblastic Lymphoma; Recurrent Adult T-Cell Leukemia/Lymphoma; Recurrent Grade 1 Follicular Lymphoma; Recurrent Grade 2 Follicular Lymphoma; Recurrent Grade 3 Follicular Lymphoma; Recurrent Mantle Cell Lymphoma; Recurrent Marginal Zone Lymphoma; Recurrent Mycosis Fungoides and Sezary Syndrome; Recurrent Non-Hodgkin Lymphoma; Recurrent Primary Cutaneous T-Cell Non-Hodgkin Lymphoma; Recurrent Small Lymphocytic Lymphoma; Refractory Chronic Lymphocytic Leukemia; Refractory Hairy Cell Leukemia; Richter Syndrome; Small Intestinal Lymphoma; Splenic Marginal Zone Lymphoma; T-Cell Large Granular Lymphocyte Leukemia; Testicular Lymphoma; Waldenstrom Macroglobulinemia

Anti-neutrophil cytoplasmic antibody-associated vasculitis with renal involvement: Analysis of 89 cases.

PubMed

Caravaca-Fontán, Fernando; Yerovi, Estefanía; Delgado-Yagu E, María; Galeano, Cristina; Pampa-Saico, Saúl; Tenorio, Maria Teresa; Liaño, Fernando

2017-01-06

The anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis with renal involvement are associated with high morbi-mortality. In this study we analyse if the prognosis of these diseases have improved in recent years, and which factors influence the outcomes. Retrospective single-centre observational study, which included all patients diagnosed with microscopic polyangiitis and granulomatosis with polyangiitis with renal involvement in the last 25 years. Demographic, clinical and biochemical parameters of prognostic interest were recorded. The differences between four chronological periods were analysed, along with the determinants of a poor outcome (death or end-stage renal disease). Eighty-nine patients were included (mean age 64±15 years). Sixty-four patients (72%) had microscopic polyangiitis and 25 (28%) granulomatosis with polyangiitis. During the study period, 37 (42%) patients died. Through Cox regression analysis, the best determinants of mortality were the initial glomerular filtration rate (HR 0.911; P=.003), Charlson comorbidity index (HR 1.513; P<.0001) and tobacco smoking (HR 1.816; P=.003). 35% developed end-stage renal disease, and the best determinants (by competing-risk regression) were: initial glomerular filtration rate (sub-hazard ratio [SHR]: 0.791; P<.0001), proteinuria (SHR: 1.313; P<.0001), and smoking status (SHR: 1.848; P=.023). No differences were found in patients' mortality or renal survival between the different study periods. Prognosis of anti-neutrophil cytoplasm antibodies vasculitis with renal involvement treated with conventional immunosuppressive therapy remains unsatisfactory, and continues to have increased long-term complications and mortality. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

Central Diabetes Insipidus in Refractory Antineutrophil Cytoplasmic Antibody-associated Vasculitis

PubMed Central

Ohashi, Keiji; Morishita, Michiko; Watanabe, Haruki; Sada, Ken-Ei; Katsuyama, Takayuki; Miyawaki, Yoshia; Katsuyama, Eri; Narazaki, Mariko; Tatebe, Noriko; Watanabe, Katsue; Kawabata, Tomoko; Wada, Jun

2017-01-01

We herein describe two cases of refractory antineutrophil cytoplasmic antibody-associated vasculitis (AAV) complicated with diabetes insipidus (DI) possibly related to hypertrophic pachymeningitis (HP). One patient had microscopic polyangiitis and HP, which were refractory to cyclophosphamide, azathioprine, rituximab, mycophenolate mofetil (MMF), and mizoribine. Remission was finally achieved with the use of etanercept, but DI occurred 5 years later. The other patient had granulomatosis with polyangiitis, which that was refractory to cyclophosphamide, methotrexate, MMF, and rituximab. DI subsequently developed, but was successfully treated with etanercept. Dura mater hypertrophy was macroscopically observed in the latter case. PMID:28943556

[Pachymeningitis].

PubMed

Fain, O; Mekinian, A

2017-09-01

Pachymeningitis is a fibrosing and inflammatory process, which involves the dura mater. Some pachymeningitis are cranial and induce headaches and cranial nerve palsies. Others are spinal and responsible for nerve roots or spinal cord compression. MRI shows contrast enhancement thickening of the dura mater. Etiologies are infectious (syphilis, tuberculosis, etc.) or inflammatory (sarcoidosis, granulomatosis with polyangiitis, IgG4-related disease, idiopathic). Corticosteroids are the main treatment. The use of immunosuppressive drugs or rituximab is yet to be determined and probably adapted to each etiology. Copyright © 2017 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier SAS. All rights reserved.

Central Diabetes Insipidus in Refractory Antineutrophil Cytoplasmic Antibody-associated Vasculitis.

PubMed

Ohashi, Keiji; Morishita, Michiko; Watanabe, Haruki; Sada, Ken-Ei; Katsuyama, Takayuki; Miyawaki, Yoshia; Katsuyama, Eri; Narazaki, Mariko; Tatebe, Noriko; Watanabe, Katsue; Kawabata, Tomoko; Wada, Jun

2017-11-01

We herein describe two cases of refractory antineutrophil cytoplasmic antibody-associated vasculitis (AAV) complicated with diabetes insipidus (DI) possibly related to hypertrophic pachymeningitis (HP). One patient had microscopic polyangiitis and HP, which were refractory to cyclophosphamide, azathioprine, rituximab, mycophenolate mofetil (MMF), and mizoribine. Remission was finally achieved with the use of etanercept, but DI occurred 5 years later. The other patient had granulomatosis with polyangiitis, which that was refractory to cyclophosphamide, methotrexate, MMF, and rituximab. DI subsequently developed, but was successfully treated with etanercept. Dura mater hypertrophy was macroscopically observed in the latter case.

Vorinostat With or Without Isotretinoin in Treating Young Patients With Recurrent or Refractory Solid Tumors, Lymphoma, or Leukemia

ClinicalTrials.gov

2014-06-16

Childhood Acute Promyelocytic Leukemia (M3); Childhood Atypical Teratoid/Rhabdoid Tumor; Childhood Burkitt Lymphoma; Childhood Chronic Myelogenous Leukemia; Childhood Diffuse Large Cell Lymphoma; Childhood Immunoblastic Large Cell Lymphoma; Juvenile Myelomonocytic Leukemia; Recurrent Childhood Acute Lymphoblastic Leukemia; Recurrent Childhood Acute Myeloid Leukemia; Recurrent Childhood Grade III Lymphomatoid Granulomatosis; Recurrent Childhood Large Cell Lymphoma; Recurrent Childhood Lymphoblastic Lymphoma; Recurrent Childhood Medulloblastoma; Recurrent Childhood Small Noncleaved Cell Lymphoma; Recurrent Childhood Supratentorial Primitive Neuroectodermal Tumor; Recurrent Neuroblastoma; Recurrent/Refractory Childhood Hodgkin Lymphoma; Relapsing Chronic Myelogenous Leukemia; Unspecified Childhood Solid Tumor, Protocol Specific

Chest neoplasms with infectious etiologies.

PubMed

Restrepo, Carlos S; Chen, Melissa M; Martinez-Jimenez, Santiago; Carrillo, Jorge; Restrepo, Catalina

2011-12-28

A wide spectrum of thoracic tumors have known or suspected viral etiologies. Oncogenic viruses can be classified by the type of genomic material they contain. Neoplastic conditions found to have viral etiologies include post-transplant lymphoproliferative disease, lymphoid granulomatosis, Kaposi's sarcoma, Castleman's disease, recurrent respiratory papillomatosis, lung cancer, malignant mesothelioma, leukemia and lymphomas. Viruses involved in these conditions include Epstein-Barr virus, human herpes virus 8, human papillomavirus, Simian virus 40, human immunodeficiency virus, and Human T-lymphotropic virus. Imaging findings, epidemiology and mechanism of transmission for these diseases are reviewed in detail to gain a more thorough appreciation of disease pathophysiology for the chest radiologist.

Yttrium Y 90 Ibritumomab Tiuxetan, Fludarabine, Radiation Therapy, and Donor Stem Cell Transplant in Treating Patients With Relapsed or Refractory Non-Hodgkin's Lymphoma

ClinicalTrials.gov

2017-04-17

B-cell Chronic Lymphocytic Leukemia; Nodal Marginal Zone B-cell Lymphoma; Recurrent Adult Burkitt Lymphoma; Recurrent Adult Diffuse Large Cell Lymphoma; Recurrent Adult Diffuse Mixed Cell Lymphoma; Recurrent Adult Diffuse Small Cleaved Cell Lymphoma; Recurrent Adult Grade III Lymphomatoid Granulomatosis; Recurrent Adult Immunoblastic Large Cell Lymphoma; Recurrent Adult Lymphoblastic Lymphoma; Recurrent Grade 1 Follicular Lymphoma; Recurrent Grade 2 Follicular Lymphoma; Recurrent Grade 3 Follicular Lymphoma; Recurrent Mantle Cell Lymphoma; Recurrent Marginal Zone Lymphoma; Recurrent Small Lymphocytic Lymphoma; Splenic Marginal Zone Lymphoma; Waldenström Macroglobulinemia

Physik

NASA Astrophysics Data System (ADS)

Gerthsen, Christian; Vogel, Helmut

Die siebzehnte Auflage des Gerthsen ist zugleich die sechste in der Bearbeitung Helmut Vogels. Der Autor bereichert das klassische Studien- und Nachschlagewerk mit einem neuen Kapitel zur nichtlinearen Dynamik (auch Chaos und Fraktale werden besprochen) sowie acht instruktiven Farbtafeln. Daneben gibt es wieder kleinere Ergänzungen und Korrekturen. Wo die Darstellung wegen der selbstauferlegten Beschränkung im Umfang nicht alle Themen behandeln kann, helfen die mehr als zahlreichen Übungsaufgaben, die im Band Vogel, Probleme aus der Physik, ISBN 3-540-51217-9, mit Beiheft nun auch zur 17. Auflage verwendbar, ausführlich besprochen werden.

Focus on the Involvement of the Nose and Paranasal Sinuses in Eosinophilic Granulomatosis with Polyangiitis (Churg-Strauss Syndrome): Nasal Cytology Reveals Infiltration of Eosinophils as a Very Common Feature.

PubMed

Seccia, Veronica; Baldini, Chiara; Latorre, Manuela; Gelardi, Matteo; Dallan, Iacopo; Cristofani-Mencacci, Lodovica; Sellari-Franceschini, Stefano; Bartoli, Maria Laura; Bacci, Elena; Paggiaro, Pierluigi

2018-01-01

Eosinophilic granulomatosis with polyangiitis (EGPA) is a necrotizing vasculitis that predominantly affects small- to medium-sized vessels. It is characterized by a wide spectrum of extrapulmonary symptoms, including sinonasal and paranasal sinus abnormalities. These are the most common features of this disease, constituting diagnostic criteria for EGPA. However, the actual clinical features, cellular mechanisms and impact on patients' quality of life (QoL) are still a matter of study. Thirty-nine EGPA patients underwent multidimensional rhinological evaluations, including rhinofibroscopy, nasal cytology, and QoL questionnaires. This was coupled with respiratory and rheumatological assessments. Twenty-eight patients were diagnosed with chronic rhinosinusitis (CRS). Of these, 18 had nasal polyposis (NP). Chronic rhinitis was diagnosed in 10 patients. Of these, 3 had allergic rhinitis (AR) and seven had non-AR (NAR). Overall, only 1 patient (2.6%) was normal. Nasal cytology showed that hypereosinophilia was present in 17/28 patients with CRS, 4/7 patients with NAR and all patients with AR. SNOT-22 and SF-36 showed a severe impact of nasal symptoms on QoL. No differences in asthma control or rheumatological patterns for EGPA were observed among patients with or without NP. Even when the rheumatological assessment scored EGPA "under control" according to the Birmingham Vasculitis Activity Score and Vasculitis Damage Index, sinonasal diseases and related nasal inflammatory processes were not controlled. Therefore, there is a need for clinical monitoring and targeted treatment to control the inflammatory processes and improve the QoL of EGPA patients. © 2018 S. Karger AG, Basel.

Relationship among antineutrophil cytoplasmic antibody, blood urea nitrogen and complement in patients with eosinophilic granulomatosis polyangiitis (Churg-Strauss syndrome).

PubMed

Kawakami, Tamihiro; Kimura, Satoko; Takeuchi, Sora; Soma, Yoshinao

2013-07-01

Eosinophilic granulomatosis with polyangiitis (EGPA), also known as Churg-Strauss syndrome, is an antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis characterized by a history of asthma, hypereosinophilia. The prevalence of ANCA in EGPA is less common than in other ANCA-associated vasculitis. Increasing evidence of complement activation in the pathogenesis of ANCA-associated vasculitis has been provided by studies in animal models. We examined EGPA patients with cutaneous manifestations as an initial sign and investigated the correlations among clinical, serological and histopathological findings. We focused on differences among ANCA, blood urea nitrogen and complement levels such as complement 3 (C3), C4 and total complement hemolytic activity (CH50). We retrospectively investigated the records of 22 patients (11 male and 11 female) with EGPA admitted to our hospital from 1997-2012. Ten of the 22 patients (46%) were positive for serum myeloperoxidase (MPO)-ANCA. In contrast, all the patients were negative for serum proteinase 3 ANCA. There was a significantly positive correlation between serum CH50 and C4 levels in patients with EGPA. Serum blood urea nitrogen (BUN) levels differed significantly between MPO-ANCA-positive and -negative patients. Serum CH50 levels were higher in MPO-ANCA-positive patients compared to negative patients. Serum BUN levels were higher in elevated CH50 patients compared to normal and low CH50-negative patients. We propose that positive findings for MPO-ANCA with CH50 high activity may be a risk factor for developing renal insufficiency. Assuming there are correlations between the presence of ANCA and complements, earlier diagnosis based on initial efficacious treatment for EGPA. © 2013 Japanese Dermatological Association.

Development and Validation of Case-Finding Algorithms for the Identification of Patients with ANCA-Associated Vasculitis in Large Healthcare Administrative Databases

PubMed Central

Sreih, Antoine G.; Annapureddy, Narender; Springer, Jason; Casey, George; Byram, Kevin; Cruz, Andy; Estephan, Maya; Frangiosa, Vince; George, Michael D.; Liu, Mei; Parker, Adam; Sangani, Sapna; Sharim, Rebecca; Merkel, Peter A.

2016-01-01

Purpose To develop and validate case-finding algorithms for granulomatosis with polyangiitis (Wegener’s, GPA), microscopic polyangiitis (MPA), and eosinophilic granulomatosis with polyangiitis (Churg-Strauss, EGPA). Methods 250 patients per disease were randomly selected from 2 large healthcare systems using the International Classification of Diseases version 9 (ICD9) codes for GPA/EGPA (446.4) and MPA (446.0). 16 case-finding algorithms were constructed using a combination of ICD9 code, encounter type (inpatient or outpatient), physician specialty, use of immunosuppressive medications, and the anti-neutrophil cytoplasmic antibody (ANCA) type. Algorithms with the highest average positive predictive value (PPV) were validated in a third healthcare system. Results An algorithm excluding patients with eosinophilia or asthma and including the encounter type and physician specialty had the highest PPV for GPA (92.4%). An algorithm including patients with eosinophilia and asthma and the physician specialty had the highest PPV for EGPA (100%). An algorithm including patients with one of the following diagnoses: alveolar hemorrhage, interstitial lung disease, glomerulonephritis, acute or chronic kidney disease, the encounter type, physician specialty, and immunosuppressive medications had the highest PPV for MPA (76.2%). When validated in a third healthcare system, these algorithms had high PPV (85.9% for GPA, 85.7% for EGPA, and 61.5% for MPA). Adding the ANCA type increased the PPV to 94.4%, 100%, and 81.2% for GPA, EGPA, and MPA respectively. Conclusion Case-finding algorithms accurately identify patients with GPA, EGPA, and MPA in administrative databases. These algorithms can be used to assemble population-based cohorts and facilitate future research in epidemiology, drug safety, and comparative effectiveness. PMID:27804171

Hypocomplementemia is associated with worse renal survival in ANCA-positive granulomatosis with polyangiitis and microscopic polyangiitis

PubMed Central

Aouba, Achille; Khoy, Kathy; Mariotte, Delphine; Lobbedez, Thierry; Martin Silva, Nicolas

2018-01-01

Recent data suggest the existence of a complement alternative pathway activation in the pathogenesis of antineutrophilic cytoplasmic antibody (ANCA)-associated vasculitis (AAV), a condition that remains poorly understood. This study aims to assess the clinical characteristics and outcomes of granulomatosis with polyangiitis (GPA) and microscopic polyangiitis (MPA) patients with regard to their plasma complement levels at diagnosis. A retrospective monocentric study carried out at Caen University Hospital led to the identification of proteinase-3- or myeloperoxidase-ANCA-positive GPA and MPA patients from January 2000 to June 2016 and from September 2011 to June 2016, respectively. All patients with available C3 and C4 levels at diagnosis were included. Patients were categorized in the hypocomplementemia group if their C3 and/or C4 levels at diagnosis were below the lower limit of the normal range. Among the 76 AAV patients (43 GPA, 33 MPA), 4 (5%) had hypocomplementemia, and the 72 remaining patients exhibited normal plasma complement levels. All 4 hypocomplementemia patients had renal involvement. Hypocomplementemia was followed in 1 patient whose post-treatment complement level normalized within 1 month. Among all clinical and ANCA specificity, including relapse-free survival (p = 0.093), only overall and renal survival rates were significantly lower in the hypocomplementemia group (p = 0.0011 and p<0.001, respectively). Hypocomplementemia with low C3 and/or C4 levels at GPA or MPA diagnosis may be responsible for worse survival and renal prognosis. These results argue for larger and prospective studies to better determine the epidemiology of the disease and to assess complement-targeting therapy in these patients. PMID:29621352

Progranulin antibodies in autoimmune diseases.

PubMed

Thurner, Lorenz; Preuss, Klaus-Dieter; Fadle, Natalie; Regitz, Evi; Klemm, Philipp; Zaks, Marina; Kemele, Maria; Hasenfus, Andrea; Csernok, Elena; Gross, Wolfgang L; Pasquali, Jean-Louis; Martin, Thierry; Bohle, Rainer Maria; Pfreundschuh, Michael

2013-05-01

Systemic vasculitides constitute a heterogeneous group of diseases. Autoimmunity mediated by B lymphocytes and their humoral effector mechanisms play a major role in ANCA-associated vasculitis (AAV) as well as in non-ANCA associated primary systemic vasculitides and in the different types of autoimmune connective tissue disorders and rheumatoid arthritis. In order to detect autoantibodies in systemic vasculitides, we screened protein macroarrays of human cDNA expression libraries with sera from patients with ANCA-associated and ANCA-negative primary systemic vasculitides. This approach led to the identification of antibodies against progranulin, a 88 kDA secreted glycoprotein with strong anti-inflammatory activity in the course of disease of giant-cell arteritis/polymyalgia rheumatica (14/65), Takayasu's arteritis (4/13), classical panarteritis nodosa (4/10), Behcet's disease (2/6) and in the course of disease in granulomatosis with polyangiitis (31/75), Churg-Strauss syndrome (7/23) and in microscopic polyangiitis (7/19). In extended screenings the progranulin antibodies were also detected in other autoimmune diseases such as systemic lupus erythematosus (39/91) and rheumatoid arthritis (16/44). Progranulin antibodies were detected only in 1 of 97 healthy controls. Anti-progranulin positive patients with systemic vasculitides, systemic lupus erythematosus or rheumatoid arthritis had significant lower progranulin plasma levels, indicating a neutralizing effect. In light of the anti-inflammatory effects of progranulin, progranulin antibodies might exert pro-inflammatory effects thus contributing to the pathogenesis of the respective autoimmune diseases and might serve as a marker for disease activity. This hypothesis is supported by the fact that a positive progranulin antibody status was associated with active disease in granulomatosis with polyangiitis. Copyright © 2012 Elsevier Ltd. All rights reserved.

Central nervous system involvement in eosinophilic granulomatosis with polyangiitis (Churg-Strauss): Report of 26 patients and review of the literature.

PubMed

André, Raphaël; Cottin, Vincent; Saraux, Jean-Luc; Blaison, Gilles; Bienvenu, Boris; Cathebras, Pascal; Dhote, Robin; Foucher, Aurélie; Gil, Helder; Lapoirie, Joëlle; Launay, David; Loustau, Valentine; Maurier, François; Pertuiset, Edouard; Zénone, Thierry; Seebach, Jörg; Costedoat-Chalumeau, Nathalie; Puéchal, Xavier; Mouthon, Luc; Guillevin, Loïc; Terrier, Benjamin

2017-09-01

Although peripheral nervous system involvement is common in eosinophilic granulomatosis with polyangiitis (EGPA), central nervous system (CNS) manifestations are poorly described. This study aimed to describe CNS involvement in EGPA. This retrospective, observational, multicenter study included patients with EGPA and CNS involvement affecting cranial nerves, brain and/or spinal cord. We also undertook a systematic literature review. We analyzed 26 personal cases and 62 previously reported cases. At EGPA diagnosis, asthma was noted in 97%, eosinophilia in 98%, peripheral neuropathy in 55% and cardiac involvement in 41%. 38/71 (54%) were ANCA-positive, with a perinuclear-labeling pattern and/or anti-MPO specificity. CNS was involved in 86% at EGPA diagnosis, preceded EGPA in 2%, and occurred during follow-up in 12% after a median of 24months. Main neurological manifestations were ischemic cerebrovascular lesions in 46 (52%), intracerebral hemorrhage and/or subarachnoid hemorrhage in 21 (24%), loss of visual acuity in 28 (33%) (15 with optic neuritis, 9 with central retinal artery occlusion, 4 with cortical blindness), and cranial nerves palsies in 18 (21%), with 25 patients having ≥1 of these clinical CNS manifestations. Among the 81 patients with assessable neurological responses, 43% had complete responses without sequelae, 43% had partial responses with long-term sequelae and 14% refractory disease. After a mean follow-up of 36months, 11 patients died including 5 from intracerebral hemorrhages. EGPA-related CNS manifestations form 4 distinct neurological pictures: ischemic lesions, intracerebral hemorrhages, cranial nerve palsies and loss of visual acuity. Such manifestation should prompt practitioners to consider EGPA in such conditions. Long-term neurological sequelae were common, and intracerebral hemorrhages had the worst prognostic impact. Copyright © 2017 Elsevier B.V. All rights reserved.

Improved survival with renal transplantation for end-stage renal disease due to granulomatosis with polyangiitis: data from the United States Renal Data System.

PubMed

Wallace, Zachary S; Wallwork, Rachel; Zhang, Yuqing; Lu, Na; Cortazar, Frank; Niles, John L; Heher, Eliot; Stone, John H; Choi, Hyon K

2018-05-14

Renal transplantation is the optimal treatment for selected patients with end-stage renal disease (ESRD). However, the survival benefit of renal transplantation among patients with ESRD attributed to granulomatosis with polyangiitis (GPA) is unknown. We identified patients from the United States Renal Data System with ESRD due to GPA (ESRD-GPA) between 1995 and 2014. We restricted our analysis to waitlisted subjects to evaluate the impact of transplantation on mortality. We followed patients until death or the end of follow-up. We compared the relative risk (RR) of all-cause and cause-specific mortality in patients who received a transplant versus non-transplanted patients using a pooled logistic regression model with transplantation as a time-varying exposure. During the study period, 1525 patients were waitlisted and 946 received a renal transplant. Receiving a renal transplant was associated with a 70% reduction in the risk of all-cause mortality in multivariable-adjusted analyses (RR=0.30, 95% CI 0.25 to 0.37), largely attributed to a 90% reduction in the risk of death due to cardiovascular disease (CVD) (RR=0.10, 95% 0.06-0.16). Renal transplantation is associated with a significant decrease in all-cause mortality among patients with ESRD attributed to GPA, largely due to a decrease in the risk of death to CVD. Prompt referral for transplantation is critical to optimise outcomes for this patient population. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

The Incidence of Primary Systemic Vasculitis in Jerusalem: A 20-year Hospital-based Retrospective Study.

PubMed

Nesher, Gideon; Ben-Chetrit, Eli; Mazal, Bracha; Breuer, Gabriel S

2016-06-01

The incidence of primary systemic vasculitides varies among different geographic regions and ethnic origins. The aim of this study was to examine the incidence rates of vasculitides in the Jerusalem Jewish population, and to examine possible trends in incidence rates over a 20-year period. The clinical databases of inpatients at the 2 medical centers in Jerusalem were searched for patients with vasculitis diagnosed between 1990-2009. Individual records were then reviewed by one of the authors. The significance of trends in incidence rates throughout the study period was evaluated by Pearson correlation coefficient. The average annual incidence rate of polyarteritis nodosa was 3.6/million adults (95% CI 1.6-4.7). Incidence rates did not change significantly during this period (r = 0.39, p = 0.088). The incidence of granulomatosis with polyangiitis (GPA) was 4.1 (2.2-5.9) for the whole period, during which it increased significantly (r = 0.53, p < 0.05). The incidence of microscopic polyangiitis (MPA) was lower: 2.3 (1.2-3.5)/million. It also increased significantly (r = 0.55, p < 0.05). The incidence of eosinophilic granulomatosis with polyangiitis was 1.2 (0.4-1.9), which remained stable throughout the study period. The incidence of Takayasu arteritis was 2.1/million (95% CI 1.2-2.9), and it also remained stable. Giant cell arteritis (GCA) incidence was 8.1 (5.7-10.6)/100,000 population aged 50 years or older. In sharp contrast with other vasculitides, its incidence decreased significantly throughout the study period (r = -0.61, p < 0.01). The incidence rates of vasculitides in the Jewish population of Jerusalem are in the lower range of global incidence rates. While GPA and MPA incidence are increasing, GCA incidence is decreasing.

Methotrexate versus cyclophosphamide for remission maintenance in ANCA-associated vasculitis: A randomised trial.

PubMed

Maritati, Federica; Alberici, Federico; Oliva, Elena; Urban, Maria L; Palmisano, Alessandra; Santarsia, Francesca; Andrulli, Simeone; Pavone, Laura; Pesci, Alberto; Grasselli, Chiara; Santi, Rosaria; Tumiati, Bruno; Manenti, Lucio; Buzio, Carlo; Vaglio, Augusto

2017-01-01

The treatment of anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is based on remission-induction and remission-maintenance. Methotrexate is a widely used immunosuppressant but only a few studies explored its role for maintenance in AAV. This trial investigated the efficacy and safety of methotrexate as maintenance therapy for AAV. In this single-centre, open-label, randomised trial we compared methotrexate and cyclophosphamide for maintenance in AAV. We enrolled patients with granulomatosis with polyangiitis (GPA), microscopic polyangiitis (MPA) and eosinophilic granulomatosis with polyangiitis (EGPA), the latter with poor-prognosis factors and/or peripheral neuropathy. Remission was induced with cyclophosphamide. At remission, the patients were randomised to receive methotrexate or to continue with cyclophosphamide for 12 months; after treatment, they were followed for another 12 months. The primary end-point was relapse; secondary end-points included renal outcomes and treatment-related toxicity. Of the 94 enrolled patients, 23 were excluded during remission-induction or did not achieve remission; the remaining 71 were randomised to cyclophosphamide (n = 33) or methotrexate (n = 38). Relapse frequencies at months 12 and 24 after randomisation were not different between the two groups (p = 1.00 and 1.00). Relapse-free survival was also comparable (log-rank test p = 0.99). No differences in relapses were detected between the two treatments when GPA+MPA and EGPA were analysed separately. There were no differences in eGFR at months 12 and 24; proteinuria declined significantly (from diagnosis to month 24) only in the cyclophosphamide group (p = 0.0007). No significant differences in adverse event frequencies were observed. MTX may be effective and safe for remission-maintenance in AAV. clinicaltrials.gov NCT00751517.

Representation of Arctic mixed-phase clouds and the Wegener-Bergeron-Findeisen process in climate models: Perspectives from a cloud-resolving study

NASA Astrophysics Data System (ADS)

Fan, Jiwen; Ghan, Steven; Ovchinnikov, Mikhail; Liu, Xiaohong; Rasch, Philip J.; Korolev, Alexei

2011-01-01

Two types of Arctic mixed-phase clouds observed during the ISDAC and M-PACE field campaigns are simulated using a 3-dimensional cloud-resolving model (CRM) with size-resolved cloud microphysics. The modeled cloud properties agree reasonably well with aircraft measurements and surface-based retrievals. Cloud properties such as the probability density function (PDF) of vertical velocity (w), cloud liquid and ice, regimes of cloud particle growth, including the Wegener-Bergeron-Findeisen (WBF) process, and the relationships among properties/processes in mixed-phase clouds are examined to gain insights for improving their representation in General Circulation Models (GCMs). The PDF of the simulated w is well represented by a Gaussian function, validating, at least for arctic clouds, the subgrid treatment used in GCMs. The PDFs of liquid and ice water contents can be approximated by Gamma functions, and a Gaussian function can describe the total water distribution, but a fixed variance assumption should be avoided in both cases. The CRM results support the assumption frequently used in GCMs that mixed phase clouds maintain water vapor near liquid saturation. Thus, ice continues to grow throughout the stratiform cloud but the WBF process occurs in about 50% of cloud volume where liquid and ice co-exist, predominantly in downdrafts. In updrafts, liquid and ice particles grow simultaneously. The relationship between the ice depositional growth rate and cloud ice strongly depends on the capacitance of ice particles. The simplified size-independent capacitance of ice particles used in GCMs could lead to large deviations in ice depositional growth.

Myocarditis in auto-immune or auto-inflammatory diseases.

PubMed

Comarmond, Cloé; Cacoub, Patrice

2017-08-01

Myocarditis is a major cause of heart disease in young patients and a common precursor of heart failure due to dilated cardiomyopathy. Some auto-immune and/or auto-inflammatory diseases may be accompanied by myocarditis, such as sarcoidosis, Behçet's disease, eosinophilic granulomatosis with polyangiitis, myositis, and systemic lupus erythematosus. However, data concerning myocarditis in such auto-immune and/or auto-inflammatory diseases are sparse. New therapeutic strategies should better target the modulation of the immune system, depending on the phase of the disease and the type of underlying auto-immune and/or auto-inflammatory disease. Copyright © 2017 Elsevier B.V. All rights reserved.

Addison's disease presenting with perimyocarditis.

PubMed

Baranski Lamback, Elisa; Morandi, Grazia; Rapti, Eleni; Christov, Georgi; Brogan, Paul A; Hindmarsh, Peter

2018-01-26

Polyglandular autoimmune syndrome (PGA) and eosinophilic granulomatosis with polyangiitis (EGPA) do not seem to represent a coincidental association. A case of a 15-year-old boy is reported who presented with severe systemic inflammation, perimyocarditis and cardiogenic shock, in whom EGPA was initially suspected and later diagnosed with autoimmune adrenalitis with PGA. The severity of the systemic inflammation and perimyocarditis suggests a more widespread autoimmune-mediated process. Autoimmune adrenal insufficiency should be considered in all cases of pericarditis and perimyocarditis, especially when the severity of clinical manifestations exceeds the expected for the severity of the cardiac findings, as timely identification and prompt treatment may be life-saving.

Chest neoplasms with infectious etiologies

PubMed Central

Restrepo, Carlos S; Chen, Melissa M; Martinez-Jimenez, Santiago; Carrillo, Jorge; Restrepo, Catalina

2011-01-01

A wide spectrum of thoracic tumors have known or suspected viral etiologies. Oncogenic viruses can be classified by the type of genomic material they contain. Neoplastic conditions found to have viral etiologies include post-transplant lymphoproliferative disease, lymphoid granulomatosis, Kaposi’s sarcoma, Castleman’s disease, recurrent respiratory papillomatosis, lung cancer, malignant mesothelioma, leukemia and lymphomas. Viruses involved in these conditions include Epstein-Barr virus, human herpes virus 8, human papillomavirus, Simian virus 40, human immunodeficiency virus, and Human T-lymphotropic virus. Imaging findings, epidemiology and mechanism of transmission for these diseases are reviewed in detail to gain a more thorough appreciation of disease pathophysiology for the chest radiologist. PMID:22224176

The cloud-phase feedback in the Super-parameterized Community Earth System Model

NASA Astrophysics Data System (ADS)

Burt, M. A.; Randall, D. A.

2016-12-01

Recent comparisons of observations and climate model simulations by I. Tan and colleagues have suggested that the Wegener-Bergeron-Findeisen (WBF) process tends to be too active in climate models, making too much cloud ice, and resulting in an exaggerated negative cloud-phase feedback on climate change. We explore the WBF process and its effect on shortwave cloud forcing in present-day and future climate simulations with the Community Earth System Model, and its super-parameterized counterpart. Results show that SP-CESM has much less cloud ice and a weaker cloud-phase feedback than CESM.

Chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS): A lymphocytic reactive response of the central nervous system? A case report.

PubMed

Wang, Xiaolin; Huang, Dehui; Huang, Xusheng; Zhang, Jiatang; Ran, Ye; Lou, Xin; Gui, Qiuping; Yu, Shengyuan

2017-04-15

Chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroid (CLIPPERS) was first described in 2010. The characteristic clinical picture, radiological distribution and steroid response have been well-described in previous reports. However, the underlying pathogenesis and nosological position of CLIPPERS in the CNS require further investigation for the primary CNS lymphoma have been identified by autopsy subsequently. Here, we report a 51-year-old woman who was diagnosed with CLIPPERS but progressed to primary CNS lymphomatoid granulomatosis, which supports that CLIPPERS is not just an inflammatory CNS disorder. Copyright © 2017 Elsevier B.V. All rights reserved.

Two-Year Chronic Toxicity Study in Rats

DTIC Science & Technology

1976-08-27

LD C. 0- N. 00 C! cc ’. 0 C- Nl CD c n * co CD C;’. Ln Lo Ln fn ’. 1cC c; 0 N N cm0 w jL- v; c I’ioON0 17 r’-O COOr c.,J C’o co ŕ " C’, C9f COW ...Focal granulomatosis 1% Chronic abscesses 1% Integument Pyogenic granuloma 1% Abscess 1% Mammary Gland Cystic hyperplasia 1% Chronic mastiti I... mastitis 1 73 I Uterus *Neopl asms 1 73 Hydrometra 1 73 Multiple Distribution oF ter-tis 1 73 S~Integument Neoplasm 2 73 -4No Oran Speci :ied Neoplasm 6

Ispinesib in Treating Young Patients With Relapsed or Refractory Solid Tumors or Lymphoma

ClinicalTrials.gov

2013-01-15

Childhood Burkitt Lymphoma; Childhood Central Nervous System Germ Cell Tumor; Childhood Choroid Plexus Tumor; Childhood Craniopharyngioma; Childhood Grade I Meningioma; Childhood Grade II Meningioma; Childhood Grade III Meningioma; Childhood High-grade Cerebral Astrocytoma; Childhood Infratentorial Ependymoma; Childhood Low-grade Cerebral Astrocytoma; Childhood Spinal Cord Neoplasm; Childhood Supratentorial Ependymoma; Recurrent Childhood Brain Stem Glioma; Recurrent Childhood Brain Tumor; Recurrent Childhood Cerebellar Astrocytoma; Recurrent Childhood Cerebral Astrocytoma; Recurrent Childhood Ependymoma; Recurrent Childhood Grade III Lymphomatoid Granulomatosis; Recurrent Childhood Large Cell Lymphoma; Recurrent Childhood Lymphoblastic Lymphoma; Recurrent Childhood Medulloblastoma; Recurrent Childhood Small Noncleaved Cell Lymphoma; Recurrent Childhood Supratentorial Primitive Neuroectodermal Tumor; Recurrent Childhood Visual Pathway and Hypothalamic Glioma; Unspecified Childhood Solid Tumor, Protocol Specific

[Pathomorphology of the intestine and regional lymphatic system in pseudotuberculosis].

PubMed

Isachkoa, L M; Zhavoronkov, A A; Antonenko, F F; Timchenko, N F

1988-01-01

Available are data obtained at light and electron microscopy of operative specimens from patients with abdominal pseudotuberculosis and animals challenged orally with Yersinia pseudotuberculosis. The authors are the first to outline detailed characteristics of the intestinal and regional lymph node lesion arising in response to the infection and reflecting growing resistance to it. These features of pathological process involve marked tissue eosinophilia, necrosis due to phagocytes rexis, and granulomatosis suggesting a pronounced role in the pathogenesis of the body allergization in the course of infection. It is proposed to consider pseudotuberculosis-related changes in lymph nodes as lymphoblastic (early affection) and granulomatous-necrotic (advanced infection) lymphadenitis. The evidence obtained can promote differential diagnosis of pseudotuberculosis.

Simulations of arctic mixed-phase clouds in forecasts with CAM3 and AM2 for M-PACE

DOE PAGES

Xie, Shaocheng; Boyle, James; Klein, Stephen A.; ...

2008-02-27

[1] Simulations of mixed-phase clouds in forecasts with the NCAR Atmosphere Model version 3 (CAM3) and the GFDL Atmospheric Model version 2 (AM2) for the Mixed-Phase Arctic Cloud Experiment (M-PACE) are performed using analysis data from numerical weather prediction centers. CAM3 significantly underestimates the observed boundary layer mixed-phase cloud fraction and cannot realistically simulate the variations of liquid water fraction with temperature and cloud height due to its oversimplified cloud microphysical scheme. In contrast, AM2 reasonably reproduces the observed boundary layer cloud fraction while its clouds contain much less cloud condensate than CAM3 and the observations. The simulation of themore » boundary layer mixed-phase clouds and their microphysical properties is considerably improved in CAM3 when a new physically based cloud microphysical scheme is used (CAM3LIU). The new scheme also leads to an improved simulation of the surface and top of the atmosphere longwave radiative fluxes. Sensitivity tests show that these results are not sensitive to the analysis data used for model initialization. Increasing model horizontal resolution helps capture the subgrid-scale features in Arctic frontal clouds but does not help improve the simulation of the single-layer boundary layer clouds. AM2 simulated cloud fraction and LWP are sensitive to the change in cloud ice number concentrations used in the Wegener-Bergeron-Findeisen process while CAM3LIU only shows moderate sensitivity in its cloud fields to this change. Furthermore, this paper shows that the Wegener-Bergeron-Findeisen process is important for these models to correctly simulate the observed features of mixed-phase clouds.« less

Simulations of Arctic mixed-phase clouds in forecasts with CAM3 and AM2 for M-PACE

NASA Astrophysics Data System (ADS)

Xie, Shaocheng; Boyle, James; Klein, Stephen A.; Liu, Xiaohong; Ghan, Steven

2008-02-01

Simulations of mixed-phase clouds in forecasts with the NCAR Atmosphere Model version 3 (CAM3) and the GFDL Atmospheric Model version 2 (AM2) for the Mixed-Phase Arctic Cloud Experiment (M-PACE) are performed using analysis data from numerical weather prediction centers. CAM3 significantly underestimates the observed boundary layer mixed-phase cloud fraction and cannot realistically simulate the variations of liquid water fraction with temperature and cloud height due to its oversimplified cloud microphysical scheme. In contrast, AM2 reasonably reproduces the observed boundary layer cloud fraction while its clouds contain much less cloud condensate than CAM3 and the observations. The simulation of the boundary layer mixed-phase clouds and their microphysical properties is considerably improved in CAM3 when a new physically based cloud microphysical scheme is used (CAM3LIU). The new scheme also leads to an improved simulation of the surface and top of the atmosphere longwave radiative fluxes. Sensitivity tests show that these results are not sensitive to the analysis data used for model initialization. Increasing model horizontal resolution helps capture the subgrid-scale features in Arctic frontal clouds but does not help improve the simulation of the single-layer boundary layer clouds. AM2 simulated cloud fraction and LWP are sensitive to the change in cloud ice number concentrations used in the Wegener-Bergeron-Findeisen process while CAM3LIU only shows moderate sensitivity in its cloud fields to this change. This paper shows that the Wegener-Bergeron-Findeisen process is important for these models to correctly simulate the observed features of mixed-phase clouds.

Classification of Arctic, midlatitude and tropical clouds in the mixed-phase temperature regime

NASA Astrophysics Data System (ADS)

Costa, Anja; Meyer, Jessica; Afchine, Armin; Luebke, Anna; Günther, Gebhard; Dorsey, James R.; Gallagher, Martin W.; Ehrlich, Andre; Wendisch, Manfred; Baumgardner, Darrel; Wex, Heike; Krämer, Martina

2017-10-01

The degree of glaciation of mixed-phase clouds constitutes one of the largest uncertainties in climate prediction. In order to better understand cloud glaciation, cloud spectrometer observations are presented in this paper, which were made in the mixed-phase temperature regime between 0 and -38 °C (273 to 235 K), where cloud particles can either be frozen or liquid. The extensive data set covers four airborne field campaigns providing a total of 139 000 1 Hz data points (38.6 h within clouds) over Arctic, midlatitude and tropical regions. We develop algorithms, combining the information on number concentration, size and asphericity of the observed cloud particles to classify four cloud types: liquid clouds, clouds in which liquid droplets and ice crystals coexist, fully glaciated clouds after the Wegener-Bergeron-Findeisen process and clouds where secondary ice formation occurred. We quantify the occurrence of these cloud groups depending on the geographical region and temperature and find that liquid clouds dominate our measurements during the Arctic spring, while clouds dominated by the Wegener-Bergeron-Findeisen process are most common in midlatitude spring. The coexistence of liquid water and ice crystals is found over the whole mixed-phase temperature range in tropical convective towers in the dry season. Secondary ice is found at midlatitudes at -5 to -10 °C (268 to 263 K) and at higher altitudes, i.e. lower temperatures in the tropics. The distribution of the cloud types with decreasing temperature is shown to be consistent with the theory of evolution of mixed-phase clouds. With this study, we aim to contribute to a large statistical database on cloud types in the mixed-phase temperature regime.

The contemporary North Pangea supercontinent and the geodynamic causes of its formation

NASA Astrophysics Data System (ADS)

Kovalenko, V. I.; Yarmolyuk, V. V.; Bogatikov, O. A.

2010-11-01

The supercontinental status of the contemporary aggregation of continents called North Pangea is substantiated. This supercontinent comprises all continents with the probable exception of Antarctica. In addition to the spatial contiguity of continents, the supercontinent is characterized by the prevalence of the continental crust that combines North America and Eurasia, Eurasia and Africa, and Eurasia and Australia. Over the course of the 300-250-Ma evolution from Wegener's Pangea to contemporary North Pangea, the aggregation of continents has not lost its supercontinental status, despite modification of the supercontinent shape and opening and closure of the newly formed Paleotethys, Tethys, Atlantic, and Indian oceans. Over the last 250-300 Ma, all movements of the lithospheric plates have most likely occurred within the Indo-Atlantic segment of the Earth, whereas the Pacific segment has remained oceanic. In short, the formation of the North Pangea supercontinent can be outlined in the following terms. The long and deep subduction of the lithospheric plates beneath Eurasia and North America gave rise to the stabilization of the continents and accumulation of huge bodies of the cold lithosphere commensurable in volume with the upper mantle at the deeper mantle levels. This brought about compensation ascent of hot mantle (mantle plumes) near the convergent plate boundaries and far from them. A special geodynamic setting develops beneath the supercontinent. Due to encircling subduction of the lithospheric plates and related squeezing of the hot mantle, an ascending flow, or plume (superplume) formed beneath the central part of the supercontinent. In our view, the African superplume broke up Wegener's Pangea in the Atlantic region, caused the opening of the Atlantic and Indian oceans, and migrated to the Arctic Region 53 Ma ago.

Long-term outcomes of 118 patients with eosinophilic granulomatosis with polyangiitis (Churg-Strauss syndrome) enrolled in two prospective trials.

PubMed

Samson, Maxime; Puéchal, Xavier; Devilliers, Hervé; Ribi, Camillo; Cohen, Pascal; Stern, Marc; Pagnoux, Christian; Mouthon, Luc; Guillevin, Loïc

2013-06-01

The purpose of this study was to assess the outcomes of 118 patients with eosinophilic granulomatosis with polyangiitis (EGPA) enrolled in 2 prospective, randomized, open-label clinical trials (1994-2005), with or without Five-Factor Score (FFS)-defined poor-prognosis factors, focusing on survival, disease-free survival, relapses, clinical and laboratory findings, therapeutic responses, and factors predictive of relapse. Forty-four patients with FFS ≥ 1 were assigned to receive 6 or 12 cyclophosphamide pulses plus corticosteroids and the seventy-four with FFS = 0 received corticosteroids alone, with immunosuppressant adjunction when corticosteroids failed. Patients were followed (2005-2011) under routine clinical care in an extended study and data were recorded prospectively. Mean ± SD follow-up was 81.3 ± 39.6 months. Among the 118 patients studied, 29% achieved long-term remission and 10% died. Among the 115 patients achieving a first remission, 41% experienced ≥1 relapses, 26.1 ± 26.8 months after treatment onset, with 57% of relapses occurring when corticosteroid-tapering reached <10 mg/day. Treatment achieved new remissions in >90%, but relapses recurred in 38%. Overall survival was good, reaching 90% at 7 years, regardless of baseline severity. Age ≥65 years was the only factor associated with a higher risk of death during follow-up. The risk of relapse was higher for patients with anti-myeloperoxidase antibodies and lower for those with >3000 eosinophils/mm(3). Sequelae remained frequent, usually chronic asthma and peripheral neuropathy. In conclusion, EGPA patients' survival rate is very good when treatment is stratified according to the baseline FFS. Relapses are frequent, especially in patients with anti-myeloperoxidase antibodies and baseline eosinophilia <3000/mm(3). Copyright © 2013 Elsevier Ltd. All rights reserved.

Environmental factor and inflammation-driven alteration of the total peripheral T-cell compartment in granulomatosis with polyangiitis.

PubMed

Kerstein, Anja; Schüler, Silke; Cabral-Marques, Otávio; Fazio, Juliane; Häsler, Robert; Müller, Antje; Pitann, Silke; Moosig, Frank; Klapa, Sebastian; Haas, Christian; Kabelitz, Dieter; Riemekasten, Gabriela; Wolters, Steffen; Lamprecht, Peter

2017-03-01

Autoimmune diseases are initiated by a combination of predisposing genetic and environmental factors resulting in self-perpetuating chronic inflammation and tissue damage. Autoantibody production and an imbalance of effector and regulatory T-cells are hallmarks of autoimmune dysregulation. While expansion of circulating effector memory T-cells is linked to disease pathogenesis and progression, the causes driving alterations of the peripheral T-cell compartment have remained poorly understood so far. In granulomatosis with polyangiitis (GPA), a prototypical autoimmune disorder of unknown aetiology, we performed for the first time a combined approach using phenotyping, transcriptome and functional analyses of T-cell populations to evaluate triggers of memory T-cell expansion. In more detail, we found increased percentages of circulating CD4+CD28-, CD8+CD28- and CD4+CD161+ single-positive and CD4+CD8+ double-positive T-cells in GPA. Transcriptomic profiling of sorted T-cell populations showed major differences between GPA and healthy controls reflecting antigen- (bacteria, viruses, fungi) and cytokine-driven impact on T-cell populations in GPA. Concomitant cytomegalovirus (CMV) and Epstein-Barr virus (EBV) - positivity was associated with a significant increase in the percentage of CD28- T-cells in GPA-patients compared to sole CMV- or EBV-positivity or CMV- and EBV-negativity. T-cells specific for other viruses (influenza A virus, metapneumovirus, respiratory syncytial virus) and the autoantigen proteinase 3 (PR3) were infrequently detected in GPA. Antigen-specific T-cells were not specifically enriched in any of the T-cell subsets. Altogether, on a genetic and cellular basis, here we show that alterations of the peripheral T-cell compartment are driven by inflammation and various environmental factors including concomitant CMV and EBV infection. Our study provides novel insights into mechanisms driving autoimmune disease and on potential therapeutic targets. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Different responses to treatment across classified diseases and severities in Japanese patients with microscopic polyangiitis and granulomatosis with polyangiitis: a nationwide prospective inception cohort study.

PubMed

Sada, Ken-ei; Yamamura, Masahiro; Harigai, Masayoshi; Fujii, Takao; Takasaki, Yoshinari; Amano, Koichi; Fujimoto, Shouichi; Muso, Eri; Murakawa, Yohko; Arimura, Yoshihiro; Makino, Hirofumi

2015-11-02

This study aims to elucidate the prognosis and the effectiveness of current treatments for Japanese patients with microscopic polyangiitis (MPA) and granulomatosis with polyangiitis (GPA). Patients with newly diagnosed MPA and GPA were enrolled in a nationwide, prospective, inception cohort study from 22 tertiary Japanese institutions, and treatment patterns and responses were evaluated for 24 months. Primary outcome measures were rates of remission (Birmingham Vasculitis Activity Score, 0) and remission with low-dose glucocorticoids (GC) (prednisolone ≤ 10 mg) (GC remission). Of 156 enrolled patients, 78 MPA patients and 33 GPA patients were included. Concomitant cyclophosphamide (CY) was used in 24 MPA (31 %) and 20 GPA (60 %) patients during the initial 3 weeks of treatment. After 6 months, remission was achieved in 66 MPA (85 %) and 29 GPA (87 %) patients, while GC remission was obtained in only 31 MPA (40 %) and 13 GPA (39 %) patients. During the 24-month period, 14 MPA patients and 2 GPA patients died; end stage renal disease (ESRD) was noted in 13 MPA patients but no GPA patients. Patients with severe disease, according to the European Vasculitis Study Group (EUVAS) classification, showed poorer ESRD-free and overall survival rates than those with generalized disease (p < 0.0001). There were no differences in relapse-free survival rates between GPA and MPA, among EUVAS-defined disease severity categories, and between anti-neutrophil cytoplasmic antibody subspecialties. The majority of Japanese patients with MPA and GPA received treatment with high-dose GC and limited CY use, and showed high remission and relapse-free survival rates but low GC remission rates in clinical practice. University Hospital Medical Information Network Clinical Trials Registry UMIN000001648 . Registered 28 February 2009.

Improving Mortality in End-Stage Renal Disease due to Granulomatosis with Polyangiitis from 1995 to 2014.

PubMed

Wallace, Zachary S; Zhang, Yuqing; Lu, Na; Stone, John H; Choi, Hyon K

2018-01-23

Granulomatosis with polyangiitis (GPA) often affects the kidneys, frequently leading to end-stage renal disease (ESRD). Cardiovascular disease (CVD) and infections are common causes of death in GPA and ESRD. Our objective was to examine temporal trends in the mortality of GPA-ESRD in a large nationwide cohort. We identified ESRD due to GPA in the US Renal Data System (USRDS) between 1995 and 2014, using nephrologists' coding for the ESRD etiology. The cohort was divided into four five-year subcohorts based on year of ESRD onset (1995-1999; 2000-2004; 2005-2009; 2010-2014) to assess trends in mortality rates and hazard ratios (HRs) for overall death and cause-specific death, adjusting for potential confounders. Between 1995 and 2014, there were 5,929 incident cases of GPA-ESRD. The mortality rate (per 100 patient-years) declined from 19.0 in 1995-1999 to 15.3 in 2010-2014 (P=0.01). The adjusted mortality HR of the 2010-2014 cohort was 0.77 (95% CI, 0.66-0.90), compared with the 1995-1999 cohort (P-for-trend <0.001). The corresponding cause-specific mortality HRs after accounting for competing risk were 0.61 (95% CI, 0.47-0.80) for CVD death and 0.42 (95% CI, 0.28-0.63) for infection death (both P-for-trends <0.001). In this study of nearly all patients who developed ESRD due to GPA in the US over two decades, we found significant improvements in mortality among GPA-ESRD patients. Cause-specific death due to CVD and infections each declined significantly during the study period. These findings are encouraging and likely reflect improved management of both GPA and ESRD. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Alemtuzumab, Fludarabine Phosphate, and Total-Body Irradiation Followed by Cyclosporine and Mycophenolate Mofetil in Treating Patients Who Are Undergoing Donor Stem Cell Transplant for Hematologic Cancer

ClinicalTrials.gov

2017-04-25

Acute Undifferentiated Leukemia; Adult Acute Lymphoblastic Leukemia in Remission; Adult Acute Myeloid Leukemia in Remission; Adult Nasal Type Extranodal NK/T-cell Lymphoma; Anaplastic Large Cell Lymphoma; Angioimmunoblastic T-cell Lymphoma; Atypical Chronic Myeloid Leukemia, BCR-ABL1 Negative; Childhood Acute Lymphoblastic Leukemia in Remission; Childhood Acute Myeloid Leukemia in Remission; Childhood Burkitt Lymphoma; Childhood Chronic Myelogenous Leukemia; Childhood Diffuse Large Cell Lymphoma; Childhood Immunoblastic Large Cell Lymphoma; Childhood Myelodysplastic Syndromes; Childhood Nasal Type Extranodal NK/T-cell Lymphoma; Chronic Myelomonocytic Leukemia; Chronic Phase Chronic Myelogenous Leukemia; Cutaneous B-cell Non-Hodgkin Lymphoma; Extranodal Marginal Zone B-cell Lymphoma of Mucosa-associated Lymphoid Tissue; Hepatosplenic T-cell Lymphoma; Intraocular Lymphoma; Juvenile Myelomonocytic Leukemia; Mast Cell Leukemia; Myelodysplastic/Myeloproliferative Neoplasm, Unclassifiable; Nodal Marginal Zone B-cell Lymphoma; Noncutaneous Extranodal Lymphoma; Peripheral T-cell Lymphoma; Previously Treated Myelodysplastic Syndromes; Recurrent Adult Acute Lymphoblastic Leukemia; Recurrent Adult Acute Myeloid Leukemia; Recurrent Adult Burkitt Lymphoma; Recurrent Adult Diffuse Large Cell Lymphoma; Recurrent Adult Diffuse Mixed Cell Lymphoma; Recurrent Adult Diffuse Small Cleaved Cell Lymphoma; Recurrent Adult Grade III Lymphomatoid Granulomatosis; Recurrent Adult Hodgkin Lymphoma; Recurrent Adult Immunoblastic Large Cell Lymphoma; Recurrent Adult Lymphoblastic Lymphoma; Recurrent Adult T-cell Leukemia/Lymphoma; Recurrent Childhood Acute Lymphoblastic Leukemia; Recurrent Childhood Acute Myeloid Leukemia; Recurrent Childhood Anaplastic Large Cell Lymphoma; Recurrent Childhood Grade III Lymphomatoid Granulomatosis; Recurrent Childhood Large Cell Lymphoma; Recurrent Childhood Lymphoblastic Lymphoma; Recurrent Childhood Small Noncleaved Cell Lymphoma; Recurrent Cutaneous T-cell Non-Hodgkin Lymphoma; Recurrent Grade 1 Follicular Lymphoma; Recurrent Grade 2 Follicular Lymphoma; Recurrent Grade 3 Follicular Lymphoma; Recurrent Mantle Cell Lymphoma; Recurrent Marginal Zone Lymphoma; Recurrent Mycosis Fungoides/Sezary Syndrome; Recurrent Small Lymphocytic Lymphoma; Recurrent/Refractory Childhood Hodgkin Lymphoma; Refractory Chronic Lymphocytic Leukemia; Refractory Hairy Cell Leukemia; Refractory Multiple Myeloma; Relapsing Chronic Myelogenous Leukemia; Secondary Myelodysplastic Syndromes; Small Intestine Lymphoma; Splenic Marginal Zone Lymphoma; Testicular Lymphoma; Waldenström Macroglobulinemia

Unfavorably Altered Fibrin Clot Properties in Patients with Eosinophilic Granulomatosis with Polyangiitis (Churg-Strauss Syndrome): Association with Thrombin Generation and Eosinophilia.

PubMed

Mastalerz, Lucyna; Celińska-Lӧwenhoff, Magdalena; Krawiec, Piotr; Batko, Bogdan; Tłustochowicz, Witold; Undas, Anetta

2015-01-01

Given reports on the increased prevalence of thromboembolic incidents in patients with eosinophilic granulomatosis with polyangiitis (EGPA; Churg-Strauss syndrome), we investigated whether fibrin clot properties are unfavorably altered in EGPA. Ex vivo plasma fibrin clot characteristics, including clot permeability, turbidimetry and efficiency of fibrinolysis using two assays, were investigated in 34 consecutive patients with remission in EGPA according to the Birmingham Vasculitis Activity Score version 3 (23 female, 11 male), aged 48 (range, 21-80) years. The control group comprised 34 age- and sex- matched volunteers. Compared with controls, patients with EGPA were characterized by denser fiber clots (estimated pore size, Ks, 7.30±0.93 vs 10.14±1.07 10-9 cm2), faster fibrin polymerization (lag phase in a turbidimetric curve, 41.8±3.6 vs 47.4±2.9 s), thicker fibrin fibers (maximum absorbance, ΔAbs, 0.87±0.09 vs 0.72±0.07), higher maximum levels of D-dimer released from clots (DDmax 4.10±0.46 vs 3.54±0.35 mg/L), and prolonged clot lysis time (t50%; 9.50±1.45 vs 7.56±0.87 min); all p<0.0001. Scanning electron microscopy images confirmed denser plasma fibrin networks composed of thinner fibers formed in EGPA. Antineutrophil cytoplasmic antibody status and C-reactive protein did not affect clot variables. Multivariate analysis adjusted for fibrinogen showed that Ks was predicted by eosinophil count, peak thrombin generation, factor VIII, and soluble CD40 ligand, whereas eosinophil count, peak thrombin generation and antiplasmin predicted t50%. This study is the first to show that EGPA is associated with prothrombotic plasma fibrin clot phenotype, which may contribute to thromboembolic manifestations reported in this disease.

Unfavorably Altered Fibrin Clot Properties in Patients with Eosinophilic Granulomatosis with Polyangiitis (Churg-Strauss Syndrome): Association with Thrombin Generation and Eosinophilia

PubMed Central

Mastalerz, Lucyna; Celińska-Lӧwenhoff, Magdalena; Krawiec, Piotr; Batko, Bogdan; Tłustochowicz, Witold; Undas, Anetta

2015-01-01

Objectives Given reports on the increased prevalence of thromboembolic incidents in patients with eosinophilic granulomatosis with polyangiitis (EGPA; Churg-Strauss syndrome), we investigated whether fibrin clot properties are unfavorably altered in EGPA. Methods Ex vivo plasma fibrin clot characteristics, including clot permeability, turbidimetry and efficiency of fibrinolysis using two assays, were investigated in 34 consecutive patients with remission in EGPA according to the Birmingham Vasculitis Activity Score version 3 (23 female, 11 male), aged 48 (range, 21–80) years. The control group comprised 34 age- and sex- matched volunteers. Results Compared with controls, patients with EGPA were characterized by denser fiber clots (estimated pore size, Ks, 7.30±0.93 vs 10.14±1.07 10−9 cm2), faster fibrin polymerization (lag phase in a turbidimetric curve, 41.8±3.6 vs 47.4±2.9 s), thicker fibrin fibers (maximum absorbance, ΔAbs, 0.87±0.09 vs 0.72±0.07), higher maximum levels of D-dimer released from clots (DDmax 4.10±0.46 vs 3.54±0.35 mg/L), and prolonged clot lysis time (t50%; 9.50±1.45 vs 7.56±0.87 min); all p<0.0001. Scanning electron microscopy images confirmed denser plasma fibrin networks composed of thinner fibers formed in EGPA. Antineutrophil cytoplasmic antibody status and C-reactive protein did not affect clot variables. Multivariate analysis adjusted for fibrinogen showed that Ks was predicted by eosinophil count, peak thrombin generation, factor VIII, and soluble CD40 ligand, whereas eosinophil count, peak thrombin generation and antiplasmin predicted t50%. Conclusion This study is the first to show that EGPA is associated with prothrombotic plasma fibrin clot phenotype, which may contribute to thromboembolic manifestations reported in this disease. PMID:26540111

Anti-IgE Monoclonal Antibody (Omalizumab) in Refractory and Relapsing Eosinophilic Granulomatosis With Polyangiitis (Churg-Strauss): Data on Seventeen Patients.

PubMed

Jachiet, Marie; Samson, Maxime; Cottin, Vincent; Kahn, Jean-Emmanuel; Le Guenno, Guillaume; Bonniaud, Philippe; Devilliers, Hervé; Bouillet, Laurence; Gondouin, Anne; Makhlouf, Fatma; Meaux-Ruault, Nadine; Gil, Helder; Bienvenu, Boris; Coste, André; Groh, Matthieu; Giraud, Violaine; Dominique, Stéphane; Godeau, Bertrand; Puéchal, Xavier; Khouatra, Chahera; Ruivard, Marc; Le Jeunne, Claire; Mouthon, Luc; Guillevin, Loïc; Terrier, Benjamin

2016-09-01

To describe the efficacy and safety of omalizumab, an anti-IgE monoclonal antibody, in patients with refractory and/or relapsing eosinophilic granulomatosis with polyangiitis (Churg-Strauss) (EGPA). We conducted a nationwide retrospective study including EGPA patients who received omalizumab. Response was defined as the absence of asthma and/or sinonasal exacerbations with a prednisone dosage of ≤7.5 mg/day (complete response) or >7.5 mg/day (partial response). Seventeen patients (median age 45 years) received omalizumab for severe steroid-dependent asthma (88%) and/or sinonasal involvement (18%). After a median follow-up of 22 months, 6 patients (35%) achieved a complete response, 5 patients (30%) achieved a partial response, and 6 patients (35%) had no improvement. The median Birmingham Vasculitis Activity Score decreased from 2.5 at baseline to 0.5 at 12 months. The median number of exacerbations per month decreased from 1 at baseline to 0 at 12 months, and the median forced expiratory volume in 1 second increased from 63% of the percent predicted at baseline to 85% of the percent predicted at 12 months. The median prednisone dosage decreased from 16 mg/day at baseline to 11 mg/day at 6 months and 9 mg/day at 12 months. Omalizumab was discontinued in 8 patients (47%) during follow-up, because of remission (12.5%), adverse event despite disease remission (12.5%), refractory disease (25%), or relapse (50%). Relapses included retrobulbar optic neuritis attributable to EGPA in 2 patients and severe asthma flare in 2 others. The results of this study suggest that omalizumab may have a corticosteroid-sparing effect in EGPA patients with asthmatic and/or sinonasal manifestations, but reducing the corticosteroid dose may also increase the risk of severe EGPA flares, which raises the question of the safety of omalizumab in patients with EGPA. © 2016, American College of Rheumatology.

Alpha1-Antitrypsin Deficiency–Related Alleles Z and S and the Risk of Wegener’s Granulomatosis

PubMed Central

Mahr, Alfred D.; Edberg, Jeffrey C.; Stone, John H.; Hoffman, Gary S.; St. Clair, E. William; Specks, Ulrich; Dellaripa, Paul F.; Seo, Philip; Spiera, Robert F.; Rouhani, Farshid N.; Brantly, Mark L.; Merkel, Peter A.

2011-01-01

Objective Deficiency of α1-antitrypsin (α1AT) may be a determinant of susceptibility to Wegener’s granulomatosis (WG). Several previous, mainly small, case–control studies have shown that 5–27% of patients with WG carried the α1AT deficiency Z allele. It is not clear whether the S allele, the other major α1AT deficiency variant, is associated with WG. This study investigated the relationship of the α1AT deficiency Z and S alleles with the risk of developing WG in a large cohort. Methods We studied the distribution of the α1AT deficiency alleles Z and S in 433 unrelated Caucasian patients with WG and 421 ethnically matched controls. Genotyping was performed using an allele discrimination assay. Results were compared between cases and controls using exact statistical methods. Results Among the patients with WG, the allele carriage frequencies of Z and S were 7.4% and 11.5%, respectively. The frequencies of the 6 possible genotypes differed in a statistically significant manner between cases and controls (P = 0.01). The general genetic 2-parameter codominant model provided the best fit to the data. Compared with the normal MM genotype, the odds ratio (OR) for MZ or MS genotypes was 1.47 (95% confidence interval [95% CI] 0.98–2.22), and the OR for ZZ, SS, or SZ genotypes was 14.58 (95% CI 2.33–∞). ORs of similar direction and magnitude were observed within the restricted cohorts that excluded cases and controls carrying ≥1 Z or ≥1 S allele. Conclusion Both Z and S alleles display associations with risk of WG in a codominant genetic pattern. These findings strengthen the evidence of a causal link between α1AT deficiency and susceptibility to WG. PMID:20827781

Relationship Between Markers of Platelet Activation and Inflammation with Disease Activity in Wegener’s Granulomatosis

PubMed Central

TOMASSON, GUNNAR; LAVALLEY, MICHAEL; TANRIVERDI, KAHRAMAN; FINKIELMAN, JAVIER D.; DAVIS, JOHN C.; HOFFMAN, GARY S.; McCUNE, W. JOSEPH; St. CLAIR, E. WILLIAM; SPECKS, ULRICH; SPIERA, ROBERT; STONE, JOHN H.; FREEDMAN, JANE E.; MERKEL, PETER A.

2013-01-01

Objective There remains a need for biomarkers to guide therapy in antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis. Our objective was to determine whether measures of platelet activation or inflammation are associated with disease activity in Wegener’s granulomatosis (WG). Methods Study subjects were participants in a clinical trial. Soluble CD40 ligand (sCD40L), C-reactive protein, interleukin 6 (IL-6), IL-8, monocyte chemoattractant protein 1 (MCP-1), P-selectin, vascular endothelial growth factor, and proteinase 3 (PR3)-specific ANCA were measured by ELISA using plasma samples obtained at baseline (active disease), at remission, and prior to, during, and after first flares. Disease activity was assessed by the Birmingham Vasculitis Activity Score for WG (BVAS/WG). Association of biomarkers with disease activity was determined with conditional logistic and linear regression. Results Over a mean followup of 27 months, 180 subjects underwent 2044 visits; markers were measured in 563 samples. Longitudinally, all markers other than IL-6 were associated with disease activity. The strongest associations for active disease at baseline versus remission were observed for sCD40L (OR 4.72, 95% CI 2.47–9.03), P-selectin (OR 6.26, 95% CI 2.78–14.10), PR3-ANCA (OR 9.41, 4.03–21.99), and inversely for MCP-1 (OR 0.36, 95% CI 0.22–0.57). BVAS/WG increased by 0.80 (95% CI 0.44–1.16), 0.83 (95% CI 0.42–1.25), and 0.81 (95% CI 0.48–1.15) per unit-increase in PR3-ANCA, sCD40L, and P-selectin, respectively; and decreased by 1.54 (95% CI 0.96–2.12) per unit-increase in MCP-1. Conclusion Cytokines arising from within the circulation, including those of platelet activation, correlate with disease activity in WG. PMID:21411717

Tanespimycin and Bortezomib in Treating Patients With Advanced Solid Tumors or Lymphomas

ClinicalTrials.gov

2014-02-21

Adult Grade III Lymphomatoid Granulomatosis; AIDS-related Peripheral/Systemic Lymphoma; Anaplastic Large Cell Lymphoma; Angioimmunoblastic T-cell Lymphoma; Extranodal Marginal Zone B-cell Lymphoma of Mucosa-associated Lymphoid Tissue; Nodal Marginal Zone B-cell Lymphoma; Recurrent Adult Burkitt Lymphoma; Recurrent Adult Diffuse Large Cell Lymphoma; Recurrent Adult Diffuse Mixed Cell Lymphoma; Recurrent Adult Diffuse Small Cleaved Cell Lymphoma; Recurrent Adult Grade III Lymphomatoid Granulomatosis; Recurrent Adult Hodgkin Lymphoma; Recurrent Adult Immunoblastic Large Cell Lymphoma; Recurrent Adult Lymphoblastic Lymphoma; Recurrent Adult T-cell Leukemia/Lymphoma; Recurrent Cutaneous T-cell Non-Hodgkin Lymphoma; Recurrent Grade 1 Follicular Lymphoma; Recurrent Grade 2 Follicular Lymphoma; Recurrent Grade 3 Follicular Lymphoma; Recurrent Mantle Cell Lymphoma; Recurrent Marginal Zone Lymphoma; Recurrent Mycosis Fungoides/Sezary Syndrome; Recurrent Small Lymphocytic Lymphoma; Stage III Adult Burkitt Lymphoma; Stage III Adult Diffuse Large Cell Lymphoma; Stage III Adult Diffuse Mixed Cell Lymphoma; Stage III Adult Diffuse Small Cleaved Cell Lymphoma; Stage III Adult Hodgkin Lymphoma; Stage III Adult Immunoblastic Large Cell Lymphoma; Stage III Adult Lymphoblastic Lymphoma; Stage III Adult T-cell Leukemia/Lymphoma; Stage III Cutaneous T-cell Non-Hodgkin Lymphoma; Stage III Grade 1 Follicular Lymphoma; Stage III Grade 2 Follicular Lymphoma; Stage III Grade 3 Follicular Lymphoma; Stage III Mantle Cell Lymphoma; Stage III Marginal Zone Lymphoma; Stage III Mycosis Fungoides/Sezary Syndrome; Stage III Small Lymphocytic Lymphoma; Stage IV Adult Burkitt Lymphoma; Stage IV Adult Diffuse Large Cell Lymphoma; Stage IV Adult Diffuse Mixed Cell Lymphoma; Stage IV Adult Diffuse Small Cleaved Cell Lymphoma; Stage IV Adult Hodgkin Lymphoma; Stage IV Adult Immunoblastic Large Cell Lymphoma; Stage IV Adult Lymphoblastic Lymphoma; Stage IV Adult T-cell Leukemia/Lymphoma; Stage IV Cutaneous T-cell Non-Hodgkin Lymphoma; Stage IV Grade 1 Follicular Lymphoma; Stage IV Grade 2 Follicular Lymphoma; Stage IV Grade 3 Follicular Lymphoma; Stage IV Mantle Cell Lymphoma; Stage IV Marginal Zone Lymphoma; Stage IV Mycosis Fungoides/Sezary Syndrome; Stage IV Small Lymphocytic Lymphoma; Unspecified Adult Solid Tumor, Protocol Specific; Waldenström Macroglobulinemia

[Tyson's glands. On eponymic and discussion in urology and dermatology].

PubMed

Moll, F H; Halling, T; Leissner, J; Fangerau, H

2015-06-01

The use of eponyms in scientific terminology and particularly in medical terminology has a long tradition but discussion often arises especially since the involvement of the protagonists in the National Socialist regime which led to strong controversies (e. g. Clara, Stieve, Reiter, Wegener). They are a component of cultural specialist memories and contribute to the conciseness of the nomenclature. For the specialization of urology a total list of eponyms in general use or an analysis of the use of eponyms does not exist. The eponym Tyson's glands is a good example of the tradition of eponyms in urology and the discussion about the related anatomical facts.

Segmentierung von Aortenaneurysmen in CTA-Bildern mit dem statistischen Verfahren der Active Appearance Models

NASA Astrophysics Data System (ADS)

Greiner, Katharina; Egger, Jan; Großkopf, Stefan; Kaftan, Jens N.; Dörner, Ralf; Freisleben, Bernd

In diesem Beitrag werden Active Appearance Models (AAMs) zur Segmentierung der äußeren Kontur von Aortenaneurysmen eingesetzt. Diese Aufgabe ist wegen des geringen Kontrastes zum umliegenden Gewebe und des Aufbaus der teils thrombotisierten oder kalzifizierten Gefäßwände im Bereich eines Aneurysmas so komplex, dass sie aufgrund der Vielgestalt der Kontur in CT-Angiographie-Bildern die Verwendung eines statistischen Modells für Form und eingeschlossene Textur rechtfertigt. Für die Evaluation des Verfahrens wurden verschiedene statistische Modelle aus Schichten von neun CTA-Datensätzen trainiert und die Segmentierung anhand von Leave-One-Out-Tests überprüft.

Continental drift under the Third Reich.

PubMed

Buffetaut, Eric

2003-12-01

Contrary to what happened in many other countries in the 1930s and 1940s, Alfred Wegener's theory of continental drift was not generally rejected in Nazi Germany, although several leading German geologists of the time did not accept it. It was actually presented as the modern view of Earth history in books and magazine articles aimed at the general public. Although outlandish geological theories such as Hörbiger's Welteislehre were favoured by some Nazi dignitaries, they were not widely accepted in scientific circles. On the other hand, continental drift received official support under the Third Reich, at a time when it was ignored or ridiculed by most earth scientists outside Germany.

Rituximab, Romidepsin, and Lenalidomide in Treating Patients With Recurrent or Refractory B-cell Non-Hodgkin Lymphoma

ClinicalTrials.gov

2016-08-09

B-cell Adult Acute Lymphoblastic Leukemia; Extranodal Marginal Zone B-cell Lymphoma of Mucosa-associated Lymphoid Tissue; Intraocular Lymphoma; Nodal Marginal Zone B-cell Lymphoma; Recurrent Adult Acute Lymphoblastic Leukemia; Recurrent Adult Burkitt Lymphoma; Recurrent Adult Diffuse Large Cell Lymphoma; Recurrent Adult Diffuse Mixed Cell Lymphoma; Recurrent Adult Diffuse Small Cleaved Cell Lymphoma; Recurrent Adult Grade III Lymphomatoid Granulomatosis; Recurrent Adult Immunoblastic Large Cell Lymphoma; Recurrent Adult Lymphoblastic Lymphoma; Recurrent Grade 1 Follicular Lymphoma; Recurrent Grade 2 Follicular Lymphoma; Recurrent Grade 3 Follicular Lymphoma; Recurrent Mantle Cell Lymphoma; Recurrent Marginal Zone Lymphoma; Recurrent Small Lymphocytic Lymphoma; Refractory Hairy Cell Leukemia; Small Intestine Lymphoma; Splenic Marginal Zone Lymphoma; Testicular Lymphoma; Waldenström Macroglobulinemia

Sarcoid-like lung granulomas in a hemodialysis patient treated with a dipeptidyl peptidase-4 inhibitor.

PubMed

Sada, Ken-Ei; Wada, Jun; Morinaga, Hiroshi; Tuchimochi, Shigeyuki; Uka, Mayu; Makino, Hirofumi

2014-04-01

It has been reported that the inhibition of dipeptidyl peptidase-4 (DPP-4)/CD26 on T-cells by DPP-4 enzymatic inhibitors suppresses lymphocyte proliferation and reduces the production of various cytokines, including tumor necrosis factor (TNF)-α. A 72-year-old female with diabetic nephropathy on hemodialysis developed multiple lung nodules following the administration of vildagliptin. A biopsy demonstrated the histology of granulomas without caseous necrosis. The discontinuation of vildagliptin resulted in the disappearance of the granulomas within 4 months. As granulomatosis often develops in patients under anti-TNF-α therapy, the accumulation of DPP-4 inhibitors or its metabolites is possibly linked to unrecognized complications, such as sarcoid-like lung granulomas.

Sarcoid-like lung granulomas in a hemodialysis patient treated with a dipeptidyl peptidase-4 inhibitor

PubMed Central

Sada, Ken-ei; Wada, Jun; Morinaga, Hiroshi; Tuchimochi, Shigeyuki; Uka, Mayu; Makino, Hirofumi

2014-01-01

It has been reported that the inhibition of dipeptidyl peptidase-4 (DPP-4)/CD26 on T-cells by DPP-4 enzymatic inhibitors suppresses lymphocyte proliferation and reduces the production of various cytokines, including tumor necrosis factor (TNF)-α. A 72-year-old female with diabetic nephropathy on hemodialysis developed multiple lung nodules following the administration of vildagliptin. A biopsy demonstrated the histology of granulomas without caseous necrosis. The discontinuation of vildagliptin resulted in the disappearance of the granulomas within 4 months. As granulomatosis often develops in patients under anti-TNF-α therapy, the accumulation of DPP-4 inhibitors or its metabolites is possibly linked to unrecognized complications, such as sarcoid-like lung granulomas. PMID:25852868

Experience and results of the 1991 MTLRS-1 USSR campaign

NASA Technical Reports Server (NTRS)

Sperber, Peter; Hauck, H.

1993-01-01

The year 1991 was a special year for the mobile laser ranging systems. Due to the scheduled upgrades of the Modular Transportable Laser Ranging Systems, MTLRS#1 and MTLRS#2, neither a WEGENER MEDLAS nor a Crustal Dynamics Project campaign was carried out in 1991. After the successful upgrade of MTLRS#1 in the first half of 1991 the system departed from Wettzell in August to make measurements at two sites in the USSR. In Riga/Latvia, we operated close to the fixed SLR system. In Simeiz/Ucrainea, the place for MTLRS#1 pad was choosen to collocate the two fixed SLR stations in Simeiz (300 m distance to MTLRS#1) and Kazivelli (about 3 km distance).

[Amateurism in Geology: the French Reception of the Continental Drift Theory (1920-1950)].

PubMed

Le Vigouroux, Philippe; Gohau, Gabriel

At the beginning of the XXth century, Wegener proposed a theory – that of the roaming drift of the continents – unifying the rival theories of the Europeans and the Americans. As the work of a non-specialist who didn’t trouble himself with specific details, it raised numerous criticisms from specialists in various disciplines though others welcomed and supported it. Some even understood that despite its flaws, it started a new research program. Paradoxically, as regards its simplicity, nonspecialists – engineers, popularizers, secondary school teachers and even believers in para-sciences – gave it a favorable reception. Being amateurs, they continued to endorse it when specialists abandoned it.

Clinical and Economic Burden of Elevated Blood Eosinophils in Patients With and Without Uncontrolled Asthma.

PubMed

Casciano, Julian; Krishnan, Jerry; Dotiwala, Zenobia; Li, Chenghui; Sun, Shawn X

2017-01-01

The European Respiratory Society and American Thoracic Society (ERS/ATS) published guidelines in 2014 for the evaluation and treatment of asthma. These guidelines draw attention to management of patients with asthma that remains uncontrolled despite therapy. One phenotypic characteristic of therapy-resistant asthma is eosinophil elevation. It is important to better understand the burden of care gaps in this patient subgroup in order to support improved treatment strategies in the future. To quantify the economic burden of asthma patients with and without peripheral blood eosinophil elevation. A retrospective cohort study was conducted using data from patients aged 12 years or older with a diagnosis of asthma using electronic health records of over 2 million patients between 2004-2010. Patients with a diagnosis of chronic obstructive pulmonary disease, Churg Strauss syndrome/Wegener's granulomatosis, eosinophilia, cystic/pulmonary fibrosis, allergic bronchopulmonary aspergillosis, or lung cancer in the 12-month period before the date of asthma diagnosis were excluded. Patients with asthma were followed for 12 months after their initial asthma diagnosis to identify those with controlled versus uncontrolled asthma based on ERS/ATS criteria. Patients with at least 1 peripheral blood eosinophil test result of ≥ 400 cells/µL were classified as those with elevated eosinophils. Total annual paid-claim cost was compared by eosinophil levels within the controlled and uncontrolled asthma subgroups. Costs were adjusted to 2015 U.S. dollars. Patients were stratified by control level, and generalized linear modeling regressions were used to assess the magnitude of increase in cost of the elevated eosinophil group. A total of 2,701 patients were included in the study, of which 17% had uncontrolled asthma and 21% had elevated eosinophils. The mean total annual cost of patients with uncontrolled asthma was more than 2 times the cost of those with controlled asthma ($18,341 vs. $8,670, P < 0.001). Patients with uncontrolled asthma in the elevated eosinophil group had almost double the total cost ($28,644 vs. $14,188, P = 0.008) compared with those with blood eosinophil levels in a normal range. Similarly, patients classified as those with controlled asthma in the elevated eosinophil group had almost twice the average costs as those without elevated eosinophils ($14,754 vs. $7,203, P < 0.001). Uncontrolled asthma with elevated eosinophils had 4 times greater hospital admissions and over 4 times higher total costs than controlled asthma without elevated eosinophils. Among patients with uncontrolled asthma, patients with elevated eosinophils had a 53% increase in mean cost ($17,723 vs. $11,581, P < 0.001) compared with patients without elevated eosinophils. Among patients with controlled asthma, patients with elevated eosinophils had a 62% increase in mean cost ($8,897 vs. $5,486, P < 0.001) compared with patients without elevated eosinophils. Elevated peripheral blood eosinophil level is associated with higher cost irrespective of disease control status. This study was funded by Teva Pharmaceuticals. Dotiwala and Casciano report consulting and writing fees from Teva Pharmaceuticals for work on this study. Sun is an employee and stockholder of Teva Pharmaceuticals. Li reports consulting fees from eMAX Health. All authors contributed to study design. Dotiwala took the lead in data collection, along with the other authors, and data interpretation was performed primarily by Krishnan, Sun, and Li, along with Casciano and Dotiwala. The manuscript was written by Casciano, Dotiwala, and Li, along with Sun and Krishnan, and revised by Casciano, Dotiwala, Sun, and Li, with assistance from Krishnan.

Ibrutinib in Treating Relapsed or Refractory B-Cell Non-Hodgkin Lymphoma in Patients With HIV Infection

ClinicalTrials.gov

2015-08-18

Adult B Acute Lymphoblastic Leukemia; Chronic Lymphocytic Leukemia; Cutaneous B-Cell Non-Hodgkin Lymphoma; Extranodal Marginal Zone Lymphoma of Mucosa-Associated Lymphoid Tissue; HIV Infection; Intraocular Lymphoma; Multicentric Angiofollicular Lymphoid Hyperplasia; Nodal Marginal Zone Lymphoma; Recurrent Adult Acute Lymphoblastic Leukemia; Recurrent Adult Burkitt Lymphoma; Recurrent Adult Diffuse Large Cell Lymphoma; Recurrent Adult Diffuse Mixed Cell Lymphoma; Recurrent Adult Diffuse Small Cleaved Cell Lymphoma; Recurrent Adult Grade III Lymphomatoid Granulomatosis; Recurrent Adult Immunoblastic Lymphoma; Recurrent Adult Lymphoblastic Lymphoma; Recurrent Grade 1 Follicular Lymphoma; Recurrent Grade 2 Follicular Lymphoma; Recurrent Grade 3 Follicular Lymphoma; Recurrent Mantle Cell Lymphoma; Recurrent Marginal Zone Lymphoma; Recurrent Small Lymphocytic Lymphoma; Refractory Chronic Lymphocytic Leukemia; Refractory Hairy Cell Leukemia; Refractory Plasma Cell Myeloma; Small Intestinal Lymphoma; Splenic Marginal Zone Lymphoma; Testicular Lymphoma; Waldenstrom Macroglobulinemia

Clinically granulomatous cheilitis with plasma cells

PubMed Central

Sarkar, Somenath; Ghosh, Sarmistha; Sengupta, Dipayan

2016-01-01

Plasma cell cheilitis, also known as plasma cell orificial mucositis is a benign inflammatory condition clinically characterized by erythematous plaque on lips that may be ulcerated. Histopathologically it is characterized by dense plasma cell infiltrates in a band-like pattern in dermis, which corresponds to Zoon's plasma cell balanitis. On the other hand, granulomatous cheilitis, as a part of orofacial granulomatosis, manifests as sudden diffuse or nodular swelling involving lip and cheek. Initial swelling is soft to firm, but with recurrent episodes swelling gradually become firm rubbery in consistency. We hereby report a case of cheilitis in a 52-year-old man with diffuse swelling involving lower lip, which clinically resembles granulomatous cheilitis, but histopathological examination showed diffuse infiltrate of plasma cells predominantly in upper and mid-dermis. PMID:27057489

Evaluation of GPM IMERG Early, Late, and Final rainfall estimates using WegenerNet gauge data in southeastern Austria

NASA Astrophysics Data System (ADS)

O, Sungmin; Foelsche, Ulrich; Kirchengast, Gottfried; Fuchsberger, Juergen; Tan, Jackson; Petersen, Walter A.

2017-12-01

The Global Precipitation Measurement (GPM) Integrated Multi-satellite Retrievals for GPM (IMERG) products provide quasi-global (60° N-60° S) precipitation estimates, beginning March 2014, from the combined use of passive microwave (PMW) and infrared (IR) satellites comprising the GPM constellation. The IMERG products are available in the form of near-real-time data, i.e., IMERG Early and Late, and in the form of post-real-time research data, i.e., IMERG Final, after monthly rain gauge analysis is received and taken into account. In this study, IMERG version 3 Early, Late, and Final (IMERG-E,IMERG-L, and IMERG-F) half-hourly rainfall estimates are compared with gauge-based gridded rainfall data from the WegenerNet Feldbach region (WEGN) high-density climate station network in southeastern Austria. The comparison is conducted over two IMERG 0.1° × 0.1° grid cells, entirely covered by 40 and 39 WEGN stations each, using data from the extended summer season (April-October) for the first two years of the GPM mission. The entire data are divided into two rainfall intensity ranges (low and high) and two seasons (warm and hot), and we evaluate the performance of IMERG, using both statistical and graphical methods. Results show that IMERG-F rainfall estimates are in the best overall agreement with the WEGN data, followed by IMERG-L and IMERG-E estimates, particularly for the hot season. We also illustrate, through rainfall event cases, how insufficient PMW sources and errors in motion vectors can lead to wide discrepancies in the IMERG estimates. Finally, by applying the method of Villarini and Krajewski (2007), we find that IMERG-F half-hourly rainfall estimates can be regarded as a 25 min gauge accumulation, with an offset of +40 min relative to its nominal time.

Quality aspects of the Wegener Center multi-satellite GPS radio occultation record OPSv5.6

NASA Astrophysics Data System (ADS)

Angerer, Barbara; Ladstädter, Florian; Scherllin-Pirscher, Barbara; Schwärz, Marc; Steiner, Andrea K.; Foelsche, Ulrich; Kirchengast, Gottfried

2017-12-01

The demand for high-quality atmospheric data records, which are applicable in climate studies, is undisputed. Using such records requires knowledge of the quality and the specific characteristics of all contained data sources. The latest version of the Wegener Center (WEGC) multi-satellite Global Positioning System (GPS) radio occultation (RO) record, OPSv5.6, provides globally distributed upper-air satellite data of high quality, usable for climate and other high-accuracy applications. The GPS RO technique has been deployed in several satellite missions since 2001. Consistency among data from these missions is essential to create a homogeneous long-term multi-satellite climate record. In order to enable a qualified usage of the WEGC OPSv5.6 data set we performed a detailed analysis of satellite-dependent quality aspects from 2001 to 2017. We present the impact of the OPSv5.6 quality control on the processed data and reveal time-dependent and satellite-specific quality characteristics. The highest quality data are found for MetOp (Meteorological Operational satellite) and GRACE (Gravity Recovery and Climate Experiment). Data from FORMOSAT-3/COSMIC (Formosa Satellite mission-3/Constellation Observing System for Meteorology, Ionosphere, and Climate) are also of high quality. However, comparatively large day-to-day variations and satellite-dependent irregularities need to be taken into account when using these data. We validate the consistency among the various satellite missions by calculating monthly mean temperature deviations from the multi-satellite mean, including a correction for the different sampling characteristics. The results are highly consistent in the altitude range from 8 to 25 km, with mean temperature deviations less than 0.1 K. At higher altitudes the OPSv5.6 RO temperature record is increasingly influenced by the characteristics of the bending angle initialization, with the amount of impact depending on the receiver quality.

Cyclophosphamide for Prevention of Graft-Versus-Host Disease After Allogeneic Peripheral Blood Stem Cell Transplantation in Patients With Hematological Malignancies

ClinicalTrials.gov

2017-05-17

Accelerated Phase Chronic Myelogenous Leukemia; Adult Acute Lymphoblastic Leukemia in Remission; Adult Acute Megakaryoblastic Leukemia (M7); Adult Acute Myeloid Leukemia in Remission; Adult Erythroleukemia (M6a); Adult Nasal Type Extranodal NK/T-cell Lymphoma; Adult Pure Erythroid Leukemia (M6b); Anaplastic Large Cell Lymphoma; Angioimmunoblastic T-cell Lymphoma; Blastic Phase Chronic Myelogenous Leukemia; Childhood Acute Erythroleukemia (M6); Childhood Acute Lymphoblastic Leukemia in Remission; Childhood Acute Megakaryocytic Leukemia (M7); Childhood Acute Myeloid Leukemia in Remission; Childhood Burkitt Lymphoma; Childhood Chronic Myelogenous Leukemia; Childhood Diffuse Large Cell Lymphoma; Childhood Immunoblastic Large Cell Lymphoma; Childhood Myelodysplastic Syndromes; Childhood Nasal Type Extranodal NK/T-cell Lymphoma; Chronic Myelomonocytic Leukemia; Chronic Phase Chronic Myelogenous Leukemia; Cutaneous B-cell Non-Hodgkin Lymphoma; de Novo Myelodysplastic Syndromes; Extranodal Marginal Zone B-cell Lymphoma of Mucosa-associated Lymphoid Tissue; Hepatosplenic T-cell Lymphoma; Intraocular Lymphoma; Nodal Marginal Zone B-cell Lymphoma; Noncutaneous Extranodal Lymphoma; Peripheral T-cell Lymphoma; Philadelphia Chromosome Negative Chronic Myelogenous Leukemia; Post-transplant Lymphoproliferative Disorder; Previously Treated Myelodysplastic Syndromes; Recurrent Adult Acute Lymphoblastic Leukemia; Recurrent Adult Acute Myeloid Leukemia; Recurrent Adult Burkitt Lymphoma; Recurrent Adult Diffuse Large Cell Lymphoma; Recurrent Adult Diffuse Mixed Cell Lymphoma; Recurrent Adult Diffuse Small Cleaved Cell Lymphoma; Recurrent Adult Grade III Lymphomatoid Granulomatosis; Recurrent Adult Hodgkin Lymphoma; Recurrent Adult Immunoblastic Large Cell Lymphoma; Recurrent Adult Lymphoblastic Lymphoma; Recurrent Adult T-cell Leukemia/Lymphoma; Recurrent Childhood Acute Lymphoblastic Leukemia; Recurrent Childhood Acute Myeloid Leukemia; Recurrent Childhood Anaplastic Large Cell Lymphoma; Recurrent Childhood Grade III Lymphomatoid Granulomatosis; Recurrent Childhood Large Cell Lymphoma; Recurrent Childhood Lymphoblastic Lymphoma; Recurrent Childhood Small Noncleaved Cell Lymphoma; Recurrent Cutaneous T-cell Non-Hodgkin Lymphoma; Recurrent Grade 1 Follicular Lymphoma; Recurrent Grade 2 Follicular Lymphoma; Recurrent Grade 3 Follicular Lymphoma; Recurrent Mantle Cell Lymphoma; Recurrent Marginal Zone Lymphoma; Recurrent Mycosis Fungoides/Sezary Syndrome; Recurrent Small Lymphocytic Lymphoma; Recurrent/Refractory Childhood Hodgkin Lymphoma; Relapsing Chronic Myelogenous Leukemia; Secondary Acute Myeloid Leukemia; Secondary Myelodysplastic Syndromes; Small Intestine Lymphoma; Splenic Marginal Zone Lymphoma; Stage III Multiple Myeloma; Testicular Lymphoma; Waldenström Macroglobulinemia

Vorinostat in Treating Patients With Metastatic or Unresectable Solid Tumors or Lymphoma and Liver Dysfunction

ClinicalTrials.gov

2014-02-21

Adult Grade III Lymphomatoid Granulomatosis; Adult Nasal Type Extranodal NK/T-cell Lymphoma; Anaplastic Large Cell Lymphoma; Angioimmunoblastic T-cell Lymphoma; Cutaneous B-cell Non-Hodgkin Lymphoma; Extranodal Marginal Zone B-cell Lymphoma of Mucosa-associated Lymphoid Tissue; Intraocular Lymphoma; Nodal Marginal Zone B-cell Lymphoma; Primary Central Nervous System Hodgkin Lymphoma; Primary Central Nervous System Non-Hodgkin Lymphoma; Recurrent Adult Burkitt Lymphoma; Recurrent Adult Diffuse Large Cell Lymphoma; Recurrent Adult Diffuse Mixed Cell Lymphoma; Recurrent Adult Diffuse Small Cleaved Cell Lymphoma; Recurrent Adult Grade III Lymphomatoid Granulomatosis; Recurrent Adult Hodgkin Lymphoma; Recurrent Adult Immunoblastic Large Cell Lymphoma; Recurrent Adult Lymphoblastic Lymphoma; Recurrent Adult T-cell Leukemia/Lymphoma; Recurrent Cutaneous T-cell Non-Hodgkin Lymphoma; Recurrent Grade 1 Follicular Lymphoma; Recurrent Grade 2 Follicular Lymphoma; Recurrent Grade 3 Follicular Lymphoma; Recurrent Mantle Cell Lymphoma; Recurrent Marginal Zone Lymphoma; Recurrent Mycosis Fungoides/Sezary Syndrome; Recurrent Small Lymphocytic Lymphoma; Small Intestine Lymphoma; Splenic Marginal Zone Lymphoma; Stage III Adult Burkitt Lymphoma; Stage III Adult Diffuse Large Cell Lymphoma; Stage III Adult Diffuse Mixed Cell Lymphoma; Stage III Adult Diffuse Small Cleaved Cell Lymphoma; Stage III Adult Hodgkin Lymphoma; Stage III Adult Immunoblastic Large Cell Lymphoma; Stage III Adult Lymphoblastic Lymphoma; Stage III Adult T-cell Leukemia/Lymphoma; Stage III Cutaneous T-cell Non-Hodgkin Lymphoma; Stage III Grade 1 Follicular Lymphoma; Stage III Grade 2 Follicular Lymphoma; Stage III Grade 3 Follicular Lymphoma; Stage III Mantle Cell Lymphoma; Stage III Marginal Zone Lymphoma; Stage III Mycosis Fungoides/Sezary Syndrome; Stage III Small Lymphocytic Lymphoma; Stage IV Adult Burkitt Lymphoma; Stage IV Adult Diffuse Large Cell Lymphoma; Stage IV Adult Diffuse Mixed Cell Lymphoma; Stage IV Adult Diffuse Small Cleaved Cell Lymphoma; Stage IV Adult Hodgkin Lymphoma; Stage IV Adult Immunoblastic Large Cell Lymphoma; Stage IV Adult Lymphoblastic Lymphoma; Stage IV Adult T-cell Leukemia/Lymphoma; Stage IV Cutaneous T-cell Non-Hodgkin Lymphoma; Stage IV Grade 1 Follicular Lymphoma; Stage IV Grade 2 Follicular Lymphoma; Stage IV Grade 3 Follicular Lymphoma; Stage IV Mantle Cell Lymphoma; Stage IV Marginal Zone Lymphoma; Stage IV Mycosis Fungoides/Sezary Syndrome; Stage IV Small Lymphocytic Lymphoma; Unspecified Adult Solid Tumor, Protocol Specific; Waldenström Macroglobulinemia

Cutaneous lymphomatoid granulomatosis: correlation of clinical and biologic features.

PubMed

Beaty, M W; Toro, J; Sorbara, L; Stern, J B; Pittaluga, S; Raffeld, M; Wilson, W H; Jaffe, E S

2001-09-01

Lymphomatoid granulomatosis (LYG) is a rare angiocentric and angiodestructive Epstein-Barr virus-associated B-cell lymphoproliferative disorder (EBV-BLPD), varying widely from an indolent process to an aggressive large cell lymphoma. The skin is the extrapulmonary organ most commonly involved in LYG. We studied 32 skin lesions from 20 patients with known pulmonary LYG, using immunohistochemistry, in situ hybridization for EBV, and polymerase chain reaction for the presence of antigen receptor gene rearrangements (IgH and TCR) to better define both the clinicopathologic spectrum and pathogenesis of the cutaneous lesions. We describe two distinct patterns of cutaneous involvement. Multiple erythematous dermal papules and/or subcutaneous nodules, with or without ulceration, were present in 17 patients (85%). These lesions demonstrate a marked angiocentric lymphohistiocytic infiltrate, composed predominantly of CD4-positive T-cells, with a high propensity for involving the subcutaneous tissues, and exhibiting angiodestruction, necrosis, and cytologic atypia. EBV-positive B-cells were detected in the nodules from five patients; clonal immunoglobulin heavy chain gene (IgH) rearrangements were detected by polymerase chain reaction in two patients. Multiple indurated, erythematous to white plaques were present in three patients (15%). The plaque lesions were negative for EBV and clonal IgH gene rearrangements in all cases studied. The clinical course of overall disease was variable, ranging from spontaneous regression without treatment (1 of 13; 7%), resolution with chemo/immunomodulatory therapy (8 of 13; 62%), and progression (4 of 13; 31%). The clinical and histopathologic features of cutaneous LYG are extremely diverse. However, the majority (85%) of the cutaneous lesions mirrors to some extent LYG in the lung, although EBV+ cells are less frequently identified. This subset of cases shows the histopathologic triad of angiodestruction with associated necrosis, panniculitis, and in some cases atypical lymphoid cells. The commonality of the histologic features in this group suggests a common pathophysiologic basis, possibly mediated by cytokines and chemokines induced by EBV. A small percentage of the lesions (15%) presented as indurated and atrophic plaques, and EBV was not identified in the small number of cases studied. The relationship of the plaque-like lesions to LYG remains uncertain. Whereas some cases of LYG regress spontaneously, most require therapy.

Bevacizumab and Cediranib Maleate in Treating Patients With Metastatic or Unresectable Solid Tumor, Lymphoma, Intracranial Glioblastoma, Gliosarcoma or Anaplastic Astrocytoma

ClinicalTrials.gov

2014-02-14

Adult Grade III Lymphomatoid Granulomatosis; Adult Nasal Type Extranodal NK/T-cell Lymphoma; Anaplastic Large Cell Lymphoma; Angioimmunoblastic T-cell Lymphoma; Childhood Burkitt Lymphoma; Childhood Diffuse Large Cell Lymphoma; Childhood Grade III Lymphomatoid Granulomatosis; Childhood Immunoblastic Large Cell Lymphoma; Childhood Nasal Type Extranodal NK/T-cell Lymphoma; Cutaneous B-cell Non-Hodgkin Lymphoma; Extranodal Marginal Zone B-cell Lymphoma of Mucosa-associated Lymphoid Tissue; Hepatosplenic T-cell Lymphoma; Intraocular Lymphoma; Nodal Marginal Zone B-cell Lymphoma; Noncutaneous Extranodal Lymphoma; Peripheral T-cell Lymphoma; Progressive Hairy Cell Leukemia, Initial Treatment; Recurrent Adult Burkitt Lymphoma; Recurrent Adult Diffuse Large Cell Lymphoma; Recurrent Adult Diffuse Mixed Cell Lymphoma; Recurrent Adult Diffuse Small Cleaved Cell Lymphoma; Recurrent Adult Hodgkin Lymphoma; Recurrent Adult Immunoblastic Large Cell Lymphoma; Recurrent Adult Lymphoblastic Lymphoma; Recurrent Adult T-cell Leukemia/Lymphoma; Recurrent Childhood Anaplastic Large Cell Lymphoma; Recurrent Childhood Large Cell Lymphoma; Recurrent Childhood Lymphoblastic Lymphoma; Recurrent Childhood Small Noncleaved Cell Lymphoma; Recurrent Grade 1 Follicular Lymphoma; Recurrent Grade 2 Follicular Lymphoma; Recurrent Grade 3 Follicular Lymphoma; Recurrent Mantle Cell Lymphoma; Recurrent Mycosis Fungoides/Sezary Syndrome; Recurrent/Refractory Childhood Hodgkin Lymphoma; Refractory Hairy Cell Leukemia; Small Intestine Lymphoma; Splenic Marginal Zone Lymphoma; Stage IV Adult Burkitt Lymphoma; Stage IV Adult Diffuse Large Cell Lymphoma; Stage IV Adult Diffuse Mixed Cell Lymphoma; Stage IV Adult Diffuse Small Cleaved Cell Lymphoma; Stage IV Adult Hodgkin Lymphoma; Stage IV Adult Immunoblastic Large Cell Lymphoma; Stage IV Adult Lymphoblastic Lymphoma; Stage IV Adult T-cell Leukemia/Lymphoma; Stage IV Childhood Anaplastic Large Cell Lymphoma; Stage IV Childhood Hodgkin Lymphoma; Stage IV Childhood Large Cell Lymphoma; Stage IV Childhood Lymphoblastic Lymphoma; Stage IV Childhood Small Noncleaved Cell Lymphoma; Stage IV Grade 1 Follicular Lymphoma; Stage IV Grade 2 Follicular Lymphoma; Stage IV Grade 3 Follicular Lymphoma; Stage IV Mantle Cell Lymphoma; Stage IVA Mycosis Fungoides/Sezary Syndrome; Stage IVB Mycosis Fungoides/Sezary Syndrome; T-cell Large Granular Lymphocyte Leukemia; Testicular Lymphoma; Unspecified Adult Solid Tumor, Protocol Specific; Unspecified Childhood Solid Tumor, Protocol Specific; Waldenström Macroglobulinemia

High-Dose Chemotherapy With or Without Total-Body Irradiation Followed by Autologous Stem Cell Transplant in Treating Patients With Hematologic Cancer or Solid Tumors

ClinicalTrials.gov

2018-04-05

Adult Acute Lymphoblastic Leukemia in Remission; Adult Acute Myeloid Leukemia in Remission; Adult Acute Myeloid Leukemia With 11q23 (MLL) Abnormalities; Adult Acute Myeloid Leukemia With Del(5q); Adult Acute Myeloid Leukemia With Inv(16)(p13;q22); Adult Acute Myeloid Leukemia With t(15;17)(q22;q12); Adult Acute Myeloid Leukemia With t(16;16)(p13;q22); Adult Acute Myeloid Leukemia With t(8;21)(q22;q22); Adult Nasal Type Extranodal NK/T-cell Lymphoma; Childhood Acute Lymphoblastic Leukemia in Remission; Childhood Acute Myeloid Leukemia in Remission; Childhood Burkitt Lymphoma; Childhood Diffuse Large Cell Lymphoma; Childhood Immunoblastic Large Cell Lymphoma; Childhood Nasal Type Extranodal NK/T-cell Lymphoma; Ewing Sarcoma/Peripheral Primitive Neuroectodermal Tumor (PNET); Extranodal Marginal Zone B-cell Lymphoma of Mucosa-associated Lymphoid Tissue; Hepatosplenic T-cell Lymphoma; Intraocular Lymphoma; Nodal Marginal Zone B-cell Lymphoma; Peripheral T-cell Lymphoma; Plasma Cell Neoplasm; Primary Systemic Amyloidosis; Recurrent Adult Acute Lymphoblastic Leukemia; Recurrent Adult Acute Myeloid Leukemia; Recurrent Adult Burkitt Lymphoma; Recurrent Adult Diffuse Large Cell Lymphoma; Recurrent Adult Diffuse Mixed Cell Lymphoma; Recurrent Adult Diffuse Small Cleaved Cell Lymphoma; Recurrent Adult Grade III Lymphomatoid Granulomatosis; Recurrent Adult Hodgkin Lymphoma; Recurrent Adult Immunoblastic Large Cell Lymphoma; Recurrent Adult Lymphoblastic Lymphoma; Recurrent Childhood Acute Lymphoblastic Leukemia; Recurrent Childhood Acute Myeloid Leukemia; Recurrent Childhood Anaplastic Large Cell Lymphoma; Recurrent Childhood Grade III Lymphomatoid Granulomatosis; Recurrent Childhood Large Cell Lymphoma; Recurrent Childhood Lymphoblastic Lymphoma; Recurrent Childhood Small Noncleaved Cell Lymphoma; Recurrent Cutaneous T-cell Non-Hodgkin Lymphoma; Recurrent Ewing Sarcoma/Peripheral Primitive Neuroectodermal Tumor; Recurrent Grade 1 Follicular Lymphoma; Recurrent Grade 2 Follicular Lymphoma; Recurrent Grade 3 Follicular Lymphoma; Recurrent Malignant Testicular Germ Cell Tumor; Recurrent Mantle Cell Lymphoma; Recurrent Marginal Zone Lymphoma; Recurrent Neuroblastoma; Recurrent Small Lymphocytic Lymphoma; Recurrent/Refractory Childhood Hodgkin Lymphoma; Refractory Chronic Lymphocytic Leukemia; Refractory Multiple Myeloma; Regional Neuroblastoma; Splenic Marginal Zone Lymphoma; Testicular Lymphoma; Unspecified Adult Solid Tumor, Protocol Specific; Unspecified Childhood Solid Tumor, Protocol Specific; Waldenström Macroglobulinemia

Reduced-Intensity Conditioning Before Donor Stem Cell Transplant in Treating Patients With High-Risk Hematologic Malignancies

ClinicalTrials.gov

2018-03-02

Accelerated Phase Chronic Myelogenous Leukemia; Adult Acute Lymphoblastic Leukemia in Remission; Adult Acute Myeloid Leukemia With 11q23 (MLL) Abnormalities; Adult Acute Myeloid Leukemia With Del(5q); Adult Nasal Type Extranodal NK/T-cell Lymphoma; Anaplastic Large Cell Lymphoma; Angioimmunoblastic T-cell Lymphoma; Blastic Phase Chronic Myelogenous Leukemia; Childhood Acute Lymphoblastic Leukemia in Remission; Childhood Burkitt Lymphoma; Childhood Chronic Myelogenous Leukemia; Childhood Diffuse Large Cell Lymphoma; Childhood Immunoblastic Large Cell Lymphoma; Childhood Myelodysplastic Syndromes; Childhood Nasal Type Extranodal NK/T-cell Lymphoma; Chronic Myelomonocytic Leukemia; Chronic Phase Chronic Myelogenous Leukemia; Cutaneous B-cell Non-Hodgkin Lymphoma; de Novo Myelodysplastic Syndromes; Essential Thrombocythemia; Extranodal Marginal Zone B-cell Lymphoma of Mucosa-associated Lymphoid Tissue; Hepatosplenic T-cell Lymphoma; Intraocular Lymphoma; Juvenile Myelomonocytic Leukemia; Nodal Marginal Zone B-cell Lymphoma; Noncutaneous Extranodal Lymphoma; Peripheral T-cell Lymphoma; Polycythemia Vera; Post-transplant Lymphoproliferative Disorder; Previously Treated Myelodysplastic Syndromes; Primary Myelofibrosis; Recurrent Adult Acute Myeloid Leukemia; Recurrent Adult Burkitt Lymphoma; Recurrent Adult Diffuse Large Cell Lymphoma; Recurrent Adult Diffuse Mixed Cell Lymphoma; Recurrent Adult Diffuse Small Cleaved Cell Lymphoma; Recurrent Adult Grade III Lymphomatoid Granulomatosis; Recurrent Adult Hodgkin Lymphoma; Recurrent Adult Immunoblastic Large Cell Lymphoma; Recurrent Adult Lymphoblastic Lymphoma; Recurrent Adult T-cell Leukemia/Lymphoma; Recurrent Childhood Acute Myeloid Leukemia; Recurrent Childhood Anaplastic Large Cell Lymphoma; Recurrent Childhood Grade III Lymphomatoid Granulomatosis; Recurrent Childhood Large Cell Lymphoma; Recurrent Childhood Lymphoblastic Lymphoma; Recurrent Childhood Small Noncleaved Cell Lymphoma; Recurrent Cutaneous T-cell Non-Hodgkin Lymphoma; Recurrent Grade 1 Follicular Lymphoma; Recurrent Grade 2 Follicular Lymphoma; Recurrent Grade 3 Follicular Lymphoma; Recurrent Mantle Cell Lymphoma; Recurrent Marginal Zone Lymphoma; Recurrent Mycosis Fungoides/Sezary Syndrome; Recurrent Small Lymphocytic Lymphoma; Recurrent/Refractory Childhood Hodgkin Lymphoma; Refractory Anemia With Excess Blasts; Refractory Anemia With Excess Blasts in Transformation; Refractory Cytopenia With Multilineage Dysplasia; Refractory Hairy Cell Leukemia; Refractory Multiple Myeloma; Relapsing Chronic Myelogenous Leukemia; Secondary Acute Myeloid Leukemia; Small Intestine Lymphoma; Splenic Marginal Zone Lymphoma; T-cell Large Granular Lymphocyte Leukemia; Testicular Lymphoma; Waldenström Macroglobulinemia

Mixed phase clouds: observations and theoretical advances (overview)

NASA Astrophysics Data System (ADS)

Korolev, Alexei

2013-04-01

Mixed phase clouds play important role in precipitation formation and radiation budget of the Earth. The microphysical measurements in mixed phase clouds are notoriously difficult due to many technical challenges. The airborne instrumentation for characterization of the microstructure of mixed phase clouds is discussed. The results multiyear airborne observations and measurements of frequency of occurrence of mixed phase, characteristic spatial scales, humidity in mixed phase and ice clouds are presented. A theoretical framework describing the thermodynamics and phase transformation of a three phase component system consisting of ice particles, liquid droplets and water vapor is discussed. It is shown that the Wegener-Bergeron-Findeisen process plays different role in clouds with different dynamics. The problem of maintenance and longevity of mixed phase clouds is discussed.

Zeitspiel ist keine Alternative - Warum der Wandel zur Pflicht wird

NASA Astrophysics Data System (ADS)

Dieper, Stephan

"Wege entstehen dadurch, dass man sie geht." (Franz Kafka) Die Welt der Digitalisierung ist voll von Wegen, die jemand gegangen ist, bevor dort ein Weg war. Manche dieser Wege stellten sich als Sackgasse heraus, manche als Abkürzung und aus anderen wurden ganze Wegenetze und Städte. Die Energiewelt wird durch den digitalen Wandel nicht verschont bleiben. Durch die intelligenten Messsysteme und die zugehörigen, neuen Strukturen werden energiefremden Wettbewerbern Chancen zum Markteintritt eröffnet. EVUs müssen sich darauf einstellen, dass der permanente Wandel nicht mehr enden wird. Doch auch den EVUs eröffnen sich Optionen. Um erfolgreich zu sein, müssen sie lernen loszugehen, ohne das genaue Ziel zu kennen.

CPI-613, Bendamustine Hydrochloride, and Rituximab in Treating Patients With Relapsed or Refractory B-Cell Non-Hodgkin Lymphoma

ClinicalTrials.gov

2017-05-25

B-cell Adult Acute Lymphoblastic Leukemia; B-cell Chronic Lymphocytic Leukemia; Cutaneous B-cell Non-Hodgkin Lymphoma; Extranodal Marginal Zone B-cell Lymphoma of Mucosa-associated Lymphoid Tissue; Intraocular Lymphoma; Nodal Marginal Zone B-cell Lymphoma; Recurrent Adult Acute Lymphoblastic Leukemia; Recurrent Adult Burkitt Lymphoma; Recurrent Adult Diffuse Large Cell Lymphoma; Recurrent Adult Diffuse Mixed Cell Lymphoma; Recurrent Adult Diffuse Small Cleaved Cell Lymphoma; Recurrent Adult Grade III Lymphomatoid Granulomatosis; Recurrent Adult Immunoblastic Large Cell Lymphoma; Recurrent Adult Lymphoblastic Lymphoma; Recurrent Grade 1 Follicular Lymphoma; Recurrent Grade 2 Follicular Lymphoma; Recurrent Grade 3 Follicular Lymphoma; Recurrent Mantle Cell Lymphoma; Recurrent Marginal Zone Lymphoma; Recurrent Mycosis Fungoides/Sezary Syndrome; Recurrent Small Lymphocytic Lymphoma; Refractory Chronic Lymphocytic Leukemia; Refractory Hairy Cell Leukemia; Small Intestine Lymphoma; Splenic Marginal Zone Lymphoma; Testicular Lymphoma; Waldenström Macroglobulinemia

Saddle-nose and bilateral cauliflower ear deformities with pyoderma gangrenosum-like ulcers, cavitary pulmonary lesions, digital gangrene and pulselessness in a young female.

PubMed

Subhadarshani, Sweta; Gupta, Vishal; Chahal, Anurag; Verma, Kaushal K

2017-06-15

We report a young female who presented with saddle-nose and bilateral cauliflower ear deformities along with pyoderma gangrenosum-like ulcers, digital gangrene and pulselessness. Subsequently, she was found to have bilateral conductive hearing loss, a corneal opacity, mild aortic regurgitation and radiological evidence of cavitary changes in lungs and aortoarteritis. Our patient had a constellation of symptoms which posed a diagnostic challenge. Finally, a diagnosis of relapsing polychondritis with several unusual features was made. Overlap with Takayasu's arteritis and granulomatosis with polyangitis, which has been reported rarely in the literature, cannot be excluded. © 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.

Pulmonary Foreign Body Granulomatosis in Dental Technician.

PubMed

Chung, Sung Jun; Koo, Gun Woo; Park, Dong Won; Kwak, Hyun Jung; Yhi, Ji Young; Moon, Ji-Yong; Kim, Sang-Heon; Sohn, Jang Won; Yoon, Ho Joo; Shin, Dong Ho; Park, Sung Soo; Pyo, Ju Yeon; Oh, Young-Ha; Kim, Tae-Hyung

2015-10-01

Occupational lung diseases are caused by several toxic substances including heavy metals; however, the exact pathologic mechanisms remain unknown. In the workplace, dental technicians are often exposed to heavy metals such as cobalt, nickel, or beryllium and occasionally develop occupational lung diseases. We described a case of occupational lung disease in a patient who was employed as a dental technician for over a decade. A 31-year-old, non-smoking woman presented with productive cough and shortness of breath of several weeks duration. Chest computed tomography revealed a large number of scattered, bilateral small pulmonary nodules throughout the lung field, and multiple mediastinal lymph nodes enlargement. Percutaneous needle biopsy showed multifocal small granulomas with foreign body type giant cells suggestive of heavy metals inhalation. The patient's condition improved on simple avoidance strategy for several months. This case highlighted the importance of proper workplace safety.

Mycophenolate Mofetil and Cyclosporine in Reducing Graft-Versus-Host Disease in Patients With Hematologic Malignancies or Metastatic Kidney Cancer Undergoing Donor Stem Cell Transplant

ClinicalTrials.gov

2018-02-26

Accelerated Phase Chronic Myelogenous Leukemia; Adult Acute Lymphoblastic Leukemia in Remission; Adult Acute Myeloid Leukemia in Remission; Adult Acute Myeloid Leukemia With 11q23 (MLL) Abnormalities; Adult Acute Myeloid Leukemia With Del(5q); Adult Acute Myeloid Leukemia With Inv(16)(p13;q22); Adult Acute Myeloid Leukemia With t(15;17)(q22;q12); Adult Acute Myeloid Leukemia With t(16;16)(p13;q22); Adult Acute Myeloid Leukemia With t(8;21)(q22;q22); Adult Grade III Lymphomatoid Granulomatosis; Adult Nasal Type Extranodal NK/T-cell Lymphoma; Anaplastic Large Cell Lymphoma; Angioimmunoblastic T-cell Lymphoma; Childhood Acute Lymphoblastic Leukemia in Remission; Childhood Acute Myeloid Leukemia in Remission; Childhood Burkitt Lymphoma; Childhood Chronic Myelogenous Leukemia; Childhood Diffuse Large Cell Lymphoma; Childhood Grade III Lymphomatoid Granulomatosis; Childhood Immunoblastic Large Cell Lymphoma; Childhood Myelodysplastic Syndromes; Childhood Nasal Type Extranodal NK/T-cell Lymphoma; Childhood Renal Cell Carcinoma; Chronic Myelomonocytic Leukemia; Chronic Phase Chronic Myelogenous Leukemia; Clear Cell Renal Cell Carcinoma; Contiguous Stage II Adult Burkitt Lymphoma; Contiguous Stage II Adult Diffuse Large Cell Lymphoma; Contiguous Stage II Adult Diffuse Mixed Cell Lymphoma; Contiguous Stage II Adult Immunoblastic Large Cell Lymphoma; Contiguous Stage II Adult Lymphoblastic Lymphoma; Contiguous Stage II Grade 3 Follicular Lymphoma; Contiguous Stage II Mantle Cell Lymphoma; de Novo Myelodysplastic Syndromes; Extranodal Marginal Zone B-cell Lymphoma of Mucosa-associated Lymphoid Tissue; Hepatosplenic T-cell Lymphoma; Juvenile Myelomonocytic Leukemia; Myelodysplastic/Myeloproliferative Neoplasm, Unclassifiable; Nodal Marginal Zone B-cell Lymphoma; Noncontiguous Stage II Adult Burkitt Lymphoma; Noncontiguous Stage II Adult Diffuse Large Cell Lymphoma; Noncontiguous Stage II Adult Diffuse Mixed Cell Lymphoma; Noncontiguous Stage II Adult Immunoblastic Large Cell Lymphoma; Noncontiguous Stage II Adult Lymphoblastic Lymphoma; Noncontiguous Stage II Grade 3 Follicular Lymphoma; Noncontiguous Stage II Mantle Cell Lymphoma; Noncutaneous Extranodal Lymphoma; Peripheral T-cell Lymphoma; Post-transplant Lymphoproliferative Disorder; Previously Treated Myelodysplastic Syndromes; Recurrent Adult Acute Lymphoblastic Leukemia; Recurrent Adult Acute Myeloid Leukemia; Recurrent Adult Burkitt Lymphoma; Recurrent Adult Diffuse Large Cell Lymphoma; Recurrent Adult Diffuse Mixed Cell Lymphoma; Recurrent Adult Diffuse Small Cleaved Cell Lymphoma; Recurrent Adult Grade III Lymphomatoid Granulomatosis; Recurrent Adult Hodgkin Lymphoma; Recurrent Adult Immunoblastic Large Cell Lymphoma; Recurrent Adult Lymphoblastic Lymphoma; Recurrent Adult T-cell Leukemia/Lymphoma; Recurrent Childhood Acute Lymphoblastic Leukemia; Recurrent Childhood Acute Myeloid Leukemia; Recurrent Childhood Anaplastic Large Cell Lymphoma; Recurrent Childhood Grade III Lymphomatoid Granulomatosis; Recurrent Childhood Large Cell Lymphoma; Recurrent Childhood Lymphoblastic Lymphoma; Recurrent Childhood Small Noncleaved Cell Lymphoma; Recurrent Cutaneous T-cell Non-Hodgkin Lymphoma; Recurrent Grade 1 Follicular Lymphoma; Recurrent Grade 2 Follicular Lymphoma; Recurrent Grade 3 Follicular Lymphoma; Recurrent Mantle Cell Lymphoma; Recurrent Marginal Zone Lymphoma; Recurrent Mycosis Fungoides/Sezary Syndrome; Recurrent Renal Cell Cancer; Recurrent Small Lymphocytic Lymphoma; Recurrent/Refractory Childhood Hodgkin Lymphoma; Refractory Anemia; Refractory Anemia With Ringed Sideroblasts; Refractory Chronic Lymphocytic Leukemia; Refractory Hairy Cell Leukemia; Refractory Multiple Myeloma; Relapsing Chronic Myelogenous Leukemia; Splenic Marginal Zone Lymphoma; Stage I Adult Burkitt Lymphoma; Stage I Adult Diffuse Large Cell Lymphoma; Stage I Adult Diffuse Mixed Cell Lymphoma; Stage I Adult Immunoblastic Large Cell Lymphoma; Stage I Adult Lymphoblastic Lymphoma; Stage I Adult T-cell Leukemia/Lymphoma; Stage I Childhood Anaplastic Large Cell Lymphoma; Stage I Childhood Large Cell Lymphoma; Stage I Childhood Lymphoblastic Lymphoma; Stage I Childhood Small Noncleaved Cell Lymphoma; Stage I Grade 3 Follicular Lymphoma; Stage I Mantle Cell Lymphoma; Stage II Adult T-cell Leukemia/Lymphoma; Stage II Childhood Anaplastic Large Cell Lymphoma; Stage II Childhood Large Cell Lymphoma; Stage II Childhood Lymphoblastic Lymphoma; Stage II Childhood Small Noncleaved Cell Lymphoma; Stage III Adult Burkitt Lymphoma; Stage III Adult Diffuse Large Cell Lymphoma; Stage III Adult Diffuse Mixed Cell Lymphoma; Stage III Adult Immunoblastic Large Cell Lymphoma; Stage III Adult Lymphoblastic Lymphoma; Stage III Adult T-cell Leukemia/Lymphoma; Stage III Childhood Anaplastic Large Cell Lymphoma; Stage III Childhood Large Cell Lymphoma; Stage III Childhood Lymphoblastic Lymphoma; Stage III Childhood Small Noncleaved Cell Lymphoma; Stage III Grade 3 Follicular Lymphoma; Stage III Mantle Cell Lymphoma; Stage IV Adult Burkitt Lymphoma; Stage IV Adult Diffuse Large Cell Lymphoma; Stage IV Adult Diffuse Mixed Cell Lymphoma; Stage IV Adult Immunoblastic Large Cell Lymphoma; Stage IV Adult Lymphoblastic Lymphoma; Stage IV Adult T-cell Leukemia/Lymphoma; Stage IV Childhood Anaplastic Large Cell Lymphoma; Stage IV Childhood Large Cell Lymphoma; Stage IV Childhood Lymphoblastic Lymphoma; Stage IV Childhood Small Noncleaved Cell Lymphoma; Stage IV Grade 3 Follicular Lymphoma; Stage IV Mantle Cell Lymphoma; Stage IV Renal Cell Cancer; T-cell Large Granular Lymphocyte Leukemia; Type 1 Papillary Renal Cell Carcinoma; Type 2 Papillary Renal Cell Carcinoma; Untreated Adult Acute Lymphoblastic Leukemia; Untreated Adult Acute Myeloid Leukemia; Untreated Childhood Acute Lymphoblastic Leukemia; Untreated Childhood Acute Myeloid Leukemia and Other Myeloid Malignancies; Waldenström Macroglobulinemia

Flavopiridol in Treating Patients With Relapsed or Refractory Lymphoma or Multiple Myeloma

ClinicalTrials.gov

2016-06-27

Adult Lymphocyte Depletion Hodgkin Lymphoma; Adult Lymphocyte Predominant Hodgkin Lymphoma; Adult Mixed Cellularity Hodgkin Lymphoma; Adult Nodular Sclerosis Hodgkin Lymphoma; Anaplastic Large Cell Lymphoma; Angioimmunoblastic T-cell Lymphoma; Extranodal Marginal Zone B-cell Lymphoma of Mucosa-associated Lymphoid Tissue; Nodal Marginal Zone B-cell Lymphoma; Recurrent Adult Diffuse Large Cell Lymphoma; Recurrent Adult Diffuse Mixed Cell Lymphoma; Recurrent Adult Diffuse Small Cleaved Cell Lymphoma; Recurrent Adult Grade III Lymphomatoid Granulomatosis; Recurrent Adult Hodgkin Lymphoma; Recurrent Adult T-cell Leukemia/Lymphoma; Recurrent Cutaneous T-cell Non-Hodgkin Lymphoma; Recurrent Grade 1 Follicular Lymphoma; Recurrent Grade 2 Follicular Lymphoma; Recurrent Grade 3 Follicular Lymphoma; Recurrent Mantle Cell Lymphoma; Recurrent Marginal Zone Lymphoma; Recurrent Mycosis Fungoides/Sezary Syndrome; Recurrent Small Lymphocytic Lymphoma; Refractory Multiple Myeloma; Splenic Marginal Zone Lymphoma; Stage I Multiple Myeloma; Stage II Multiple Myeloma; Stage III Multiple Myeloma; Waldenström Macroglobulinemia

Study of fibrotic complications and hydroxyproline content in mouse liver at different stages of generalized BCG-induced granulomatosis.

PubMed

Shkurupii, V A; Kim, L B; Potapova, O V; Sharkova, T V; Putyatina, A N; Nikonova, I K

2014-08-01

Generalized BCG-induced granulomatous was simulated in BALB/c male mice. The number of tuberculous granulomas in the liver and their size as well as the number of hepatocytes showing vacuolar degeneration increased from day 3 to 180 postinfection. Necrotic changes in hepatocytes were most pronounced at the acute phase of inflammation (days 3 to 30). Proliferative processes in the liver parenchyma in the experimental group were less marked than in the control. Increased content of collagen fibers in the liver was determined by excessive collagen synthesis in necrotic areas as well as increased amount of granulomas and fibroblasts. Enhanced proliferative and fibroplastic activity of fibroblasts in granulomas and liver parenchyma was evidently determined by activated granuloma macrophages. These shifts determined changes in the liver content of hydroxyproline during the acute and chronic periods of the disease.

Strategy of Infection Control in Immunosuppressive Therapy for ANCA-Associated Vasculitis

PubMed Central

2013-01-01

Antineutrophil cytoplasmic antibodies (ANCA) are well known to be associated with small vessel vasculitic diseases such as microscopic polyangiitis (MPA), allergic granulomatous angiitis (AGA), and Granulomatosis with poly angiitis: GPA (Wegener’s). Disease assessment by 1) vasculitic activity, 2) damage resulting from vasculitis, and 3) patient function, were the required endpoints for the therapeutic trials in ANCA-associated vasculitis (AAV). Harmonized steroids and cyclophosphamide or azathioprine are effective for active AAV. In evaluating tools for monitoring disease, titers of ANCA and the levels of CRP were found useful in AAV. However, it will be important for clinicians to observe AAV patients more closely and reduce immunosuppressive drug doses more cautiously, especially to prevent several infections (i.e., deep mycosis, pneumocystis jirovecii pneumonia and cytomegalovirus). We indicated that strategy of infection control in immunosuppressive therapy for AAV. (J Jpn Coll Angiol, 2009, 49: 93-99) PMID:23641277

CHURG–STRAUSS SYNDROME

PubMed Central

Ghosh, Subhasish; Bhattacharya, Maitreyee; Dhar, Sandipan

2011-01-01

Churg–Strauss syndrome (CSS) is a rare granulomatous necrotizing small vessel vasculitis characterized by the presence of asthma, sinusitis, and hypereosinophilia. The cause of this allergic angiitis and granulomatosis is unknown. Other common manifestations are pulmonary infiltrates, skin, gastrointestinal, and cardiovascular involvement. No data have been reported regarding the role of immune complexes or cell mediated mechanisms in this disease, although autoimmunity is evident with the presence hypergammaglobulinemia, increased levels of IgE and Antineutrophil cytoplasmic antibody (positive in 40%). We report the case of a 27-year-old lady presenting with painful swelling of predominantly lower limbs with extensive vesicles and ecchymotic patches and fever shortly after stopping systemic steroids taken for a prolonged duration (2002--2010). The aim of this case report is to point to the possibility of CSS in patients presenting with extensive skin lesions masquerading as Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis Syndrome (SJS/TENS). PMID:22345778

ANCA-Negative Churg-Strauss Syndrome Presenting as Acute Multiple Cerebral Infarcts: A Case Report.

PubMed

Psychogios, Klearchos; Evmorfiadis, Ilias; Dragomanovits, Spyros; Stavridis, Athanasios; Takis, Konstantinos; Kaklamanis, Loukas; Stathis, Pantelis

2017-03-01

Eosinophilic granulomatosis with polyangiitis (EGPA, previously named Churg-Strauss syndrome) is a form of necrotizing vasculitis occurring in patients with asthma and eosinophilia. Ischemic stroke is a relatively rare complication of the disease. We report a case of a 63-year-old woman with multiple embolic infarcts, hypereosinophilia (for >7 years), and skin rash. Elevated cardiac enzymes and cardiac magnetic resonance imaging were consistent with endomyocarditis. The simultaneous presence of history of asthma, sinusitis, hypereosinophilia, and vasculitis led to the diagnosis of EGPA. This case contributes to the recent debate of the 2 possible presentations of the disease according to the ANCA (antineutrophil cytoplasmic antibodies) status. We furthermore underscore the need for careful differential diagnosis of the "ANCA negative" cases with persistent hypereosinophilia from the idiopathic hypereosinophilic syndrome. Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Churg-Strauss syndrome presenting with acute kidney injury in a case of primary focal segmental glomerulosclerosis.

PubMed

Patil, Sachin B; Vanikar, Aruna V; Gumber, Manoj R; Kute, Vivek B; Shah, Pankaj R; Patel, Himanshu V; Trivedi, Hargovind L

2014-01-01

Churg-Strauss syndrome (CSS) also called allergic granulomatosis and angiitis is a multisystem disorder. Churg-Strauss syndrome is defined as an eosinophil-rich, granulomatous inflammation involving the respiratory tract, along with necrotizing vasculitis affecting small- to medium-sized vessels, and is associated with asthma and eosinophilia. Renal involvement in CSS varies from 26 to 88 % but is usually of mild to moderate stage, and advanced renal failure is uncommon. We encountered an unusual case of 27-year-old man with asthma and primary focal segmental glomerulosclerosis diagnosed as CSS showing myeloperoxidase anti-neutrophil cytoplasmic antibody-associated acute kidney injury with crescentic glomerulonephritis. Patient responded to steroid and cyclophosphamide. Over a follow-up of 2 months, he has no hematuria/eosinophilia and serum creatinine of 2.3 mg/dL has decreased to 1.7 mg/dL.

Gemcitabine Hydrochloride, Carboplatin, Dexamethasone, and Rituximab in Treating Patients With Previously Treated Lymphoid Malignancies

ClinicalTrials.gov

2017-05-28

Adult Nasal Type Extranodal NK/T-cell Lymphoma; Anaplastic Large Cell Lymphoma; Angioimmunoblastic T-cell Lymphoma; Cutaneous B-cell Non-Hodgkin Lymphoma; Extranodal Marginal Zone B-cell Lymphoma of Mucosa-associated Lymphoid Tissue; Hepatosplenic T-cell Lymphoma; Intraocular Lymphoma; Nodal Marginal Zone B-cell Lymphoma; Noncutaneous Extranodal Lymphoma; Peripheral T-cell Lymphoma; Recurrent Adult Burkitt Lymphoma; Recurrent Adult Diffuse Large Cell Lymphoma; Recurrent Adult Diffuse Mixed Cell Lymphoma; Recurrent Adult Diffuse Small Cleaved Cell Lymphoma; Recurrent Adult Grade III Lymphomatoid Granulomatosis; Recurrent Adult Hodgkin Lymphoma; Recurrent Adult Immunoblastic Large Cell Lymphoma; Recurrent Adult Lymphoblastic Lymphoma; Recurrent Adult T-cell Leukemia/Lymphoma; Recurrent Cutaneous T-cell Non-Hodgkin Lymphoma; Recurrent Grade 1 Follicular Lymphoma; Recurrent Grade 2 Follicular Lymphoma; Recurrent Grade 3 Follicular Lymphoma; Recurrent Mantle Cell Lymphoma; Recurrent Marginal Zone Lymphoma; Recurrent Mycosis Fungoides/Sezary Syndrome; Recurrent Small Lymphocytic Lymphoma; Small Intestine Lymphoma; Splenic Marginal Zone Lymphoma; Testicular Lymphoma; Waldenstrom Macroglobulinemia

Obatoclax Mesylate, Vincristine Sulfate, Doxorubicin Hydrochloride, and Dexrazoxane Hydrochloride in Treating Young Patients With Relapsed or Refractory Solid Tumors, Lymphoma, or Leukemia

ClinicalTrials.gov

2014-04-30

Acute Leukemias of Ambiguous Lineage; Acute Undifferentiated Leukemia; Angioimmunoblastic T-cell Lymphoma; Blastic Phase Chronic Myelogenous Leukemia; Childhood Burkitt Lymphoma; Childhood Chronic Myelogenous Leukemia; Childhood Diffuse Large Cell Lymphoma; Childhood Immunoblastic Large Cell Lymphoma; Childhood Nasal Type Extranodal NK/T-cell Lymphoma; Cutaneous B-cell Non-Hodgkin Lymphoma; Hepatosplenic T-cell Lymphoma; Intraocular Lymphoma; Noncutaneous Extranodal Lymphoma; Peripheral T-cell Lymphoma; Recurrent Childhood Acute Lymphoblastic Leukemia; Recurrent Childhood Acute Myeloid Leukemia; Recurrent Childhood Anaplastic Large Cell Lymphoma; Recurrent Childhood Grade III Lymphomatoid Granulomatosis; Recurrent Childhood Large Cell Lymphoma; Recurrent Childhood Lymphoblastic Lymphoma; Recurrent Childhood Small Noncleaved Cell Lymphoma; Recurrent Cutaneous T-cell Non-Hodgkin Lymphoma; Recurrent Mycosis Fungoides/Sezary Syndrome; Recurrent/Refractory Childhood Hodgkin Lymphoma; Refractory Chronic Lymphocytic Leukemia; Refractory Hairy Cell Leukemia; Relapsing Chronic Myelogenous Leukemia; Small Intestine Lymphoma; Unspecified Childhood Solid Tumor, Protocol Specific

Orbital complications:diagnosis of different rhinological causes.

PubMed

Matsuba, Yumiko; Strassen, Ulrich; Hofauer, Benedikt; Bas, Murat; Knopf, Andreas

2015-09-01

To evaluate the clinical course of orbital complication using a standardised diagnostic pathway. Seventy-three patients with orbital complications underwent a multimodal diagnostic pathway comprising ENT examination, leucocytes/CRP, CT-/MRI-scanning and disease-related data. Twenty-nine patients suffered from rhinosinusitis, 28 from mucoceles, 13 patients from neoplasms and three patients from rheumatic disorders. Clinical examination diagnosed 60 patients with eyelid swelling, 55 patients with ocular pain, 14 patients with diplopia, 4 patients with exophthalmus, 29 patients with visual field defect and 4 patients with visual loss. The diagnostic pathway identified acute rhinosinusitis with a sensitivity/specificity of 90 %/90 %, mucoceles with 79 %/100 %, neoplasms with 100 %/96 % and granulomatosis with polyangiitis with 100 %/100 %, respectively. All patients left the hospital in good general condition and with regular ocular motility; two patients suffered persistent visual loss. The standardised application of a widely accepted diagnostic pathway reliably distinguishes different causes of orbital complication.

Autoimmune lymphoproliferative syndrome and non-Hodgkin lymphoma: what 18F-fluorodeoxyglucose positron emission tomography/computed tomography can do in the management of these patients? Suggestions from a case report.

PubMed

Cistaro, A; Pazè, F; Durando, S; Cogoni, M; Faletti, R; Vesco, S; Vallero, S; Quartuccio, N; Treglia, G; Ramenghi, U

2014-01-01

A young patient with undefined autoimmune lymphoproliferative syndrome (ALPS-U) and low back pain underwent a CT and MRI study that showed enhancing vertebral lesions, some pulmonary nodules and diffuse latero-cervical lymphadenopathy. A (18)F-FDG-PET/CT scan showed many areas of intense (18)F-FDG uptake in multiple vertebrae, in some ribs, in the sacrum, in the liver, in both lungs, in multiple lymph nodes spread in the cervical, thoracic and abdominal chains. A bone marrow biopsy showed a "lymphomatoid granulomatosis", a rare variant of B-cell non-Hodgkin lymphoma (NHL). After the treatment, the (18)F-FDG-PET/CT scan showed a complete metabolic response. Copyright © 2013 Elsevier España, S.L. and SEMNIM. All rights reserved.

Thermal Models of the Ocean Floor: from Wegener to Cerro Prieto

NASA Astrophysics Data System (ADS)

Sclater, J. G.; Negrete-Aranda, R.

2017-12-01

Wegener (1925) argued that hot rock could explain the shallower depths of ridges in the center of the Atlantic Ocean. Hess (1963) proposed that the intrusion of molten rock occurred at a world encircling mid-ocean ridge system. However, he accounted for the elevation of the ridges by the formation of serpentinite and thermal convection. Langseth et al. (1966) provided the major advance by using a 100 km thick plate to argue such a concept could not explain the depth, heat flow versus distance relations. They had the correct model but misinterpreted the data. Reformulating theoretically, McKenzie (1967) created the generally accepted thermal model for the ocean floor. Unfortunately, in attempting to match erroneously low heat flow data, he used a 50 km thick plate. Addition of the effect of water and the realization of the importance of advective flow, enabled various groups to create thermal plate models that accounted for the heat flow and depth age relations. From this came the understanding of hydrothermal circulation in the oceanic crust, the thermal boundary layer concept of the oceanic plate and the realization that all thermal models differed only in the way the different groups had chosen to analyze the data. During the past 40 years many have applied similar concepts to continental margins: (1) Measurement of subsidence of the Atlantic margin, continental stretching and a Time Temperature, Depth and Maturation analysis of continental basins have created the field of Basin Analysis; (2) Changes in heat flow at ocean continent boundaries have determined the position of the transition and (3) In attempting to examine the ocean continent transition process in the northernmost basin of the Gulf of California, Neumann et al (in press) observed conductive heat flow values greater than 0.75 Watts, at a depth of < 150 m, along a 10 km section of a profile across the southern extension of the Cerro Prieto fault. The magnitude of these values overwhelms local environmental effects and indicates a very large thermal output. Their full potential depends upon the amount of advective flow. Whatever the case, these measurements have opened up shallow continental margins as a new area for geothermic investigation.

Effect of Wegener-Bergeron-Findeisen Process to Black Carbon Simulation

NASA Astrophysics Data System (ADS)

Qi, Ling; Li, Qinbin; He, Cenlin; Wang, Xin; Huang, Jianping

2016-04-01

We systematically investigated the effect of Wegener-Bergeron-Findeisen (WBF) process to black carbon (BC) simulation by a global 3D chemical transport model GEOS-Chem constrained by measurements of BC scavenging efficiencies, concentration in air, deposition fluxes, concentration in snow and washout ratios. Including effect of WBF process reduces the annual mean BC scavenging efficiencies (the ratio of BC in cloud droplets to total BC) at all altitudes by 43-76% in the Arctic. For mid latitude BC scavenging efficiencies decrease by 8-22%, 23-39%, and 41-50% in lower (0-2 km), middle (2-5 km) and upper troposphere (5-10 km), respectively. Simulated BC in air in the Arctic and at mid altitude (˜4 km) in mid latitude increases by ˜40%, and the discrepancy reduces from -65% to -30%. Simulated median BC in snow decreases from 25.7 to 22.4 ng g-1, by 15% in mid latitude and increases from 8.7 to 11.0 ng g-1, by 26% in the Arctic and the comparison with observations improves. The model overestimates washout ratios (ratio of BC in fresh snow/rain to BC in surface air) at most of the sites by up to a factor of 165. With effect of WBF process included, the discrepancy decreases to a factor of 72. The simulated BC burden increases from 0.22 to 0.35 mg m-2 yr-1 when effect of WBF process is included, partly explains the scaled up of BC burden in Bond et al., 2013. Moreover, burden above 5 km increases from 22% to 27% when WBF process is included, indicating a higher forcing efficiency. We also found that BC simulation is insensitive to the temperature criteria between mixed phase clouds and ice clouds. The simulated BC burden is the same when the temperature is set as -15° C and -25° C. This study also suggests that more observations are needed to better distinguish riming dominated and WBF dominated conditions and better parameterize BC scavenging efficiency under the two conditions.

Sources of history for "a psychology of verbal communication".

PubMed

O'Connell, Daniel C; Kowal, Sabine

2011-02-01

There is a standard version of the history of modern mainstream psycholinguistics that emphasizes an extraordinary explosion of research in mid twentieth century under the guidance and leadership of George A. Miller and Noam Chomsky. The narrative is cast as a dramatic shift away from behavioristic principles and toward mentalistic principles based largely on transformational linguistics. A closer view of the literature diminishes the historical importance of behaviorism, shows a prevailing "written language bias" (Linell in The written language bias in linguistics: Its nature, origins and transformations, Routledge, London, 2005, p. 4) in psycholinguistic research, and elevates some theoretical and empirical thinking of the late nineteenth and the early twentieth centuries on language and language use to a far more important role than has heretofore been acknowledged. In keeping with the theoretical and methodological perspective of the present article, it is particularly appropriate that the German philologist Philipp Wegener be "given his due in the annals of linguistic sciences" (Koerner 1991, p. VI*). In his (1885/1991) Untersuchungen über die Grundfragen des Sprachlebens (Investigations regarding the fundamental questions of the life of language; our translation), he began his philological research with the investigation of actual speaking in everyday settings rather than with analyses of purely formal structure. Moreover, he emphasized understanding language and localized this function in the listener. Compatible with Wegener's own investigations is another aspect of speaking that has been most seriously neglected throughout the history of research on the psychology of verbal communication. For him, as well as for Esper (In C. Murchison [Ed.], A handbook of social psychology, Clark University Press, Worchester, MA, 1935), the basic and primary genre of dialogical discourse was not ongoing conversation, but the occasional use of speech in association with other activities. Both Bühler (Sprachtheorie, Fischer, Stuttgart, 1934/1982) and Wittgenstein (Philosophische Untersuchungen/Philosophical investigations, Basil Blackwell, Oxford, 1958) have also emphasized the importance of the genre of occasional speaking. The article concludes with a discussion of historical shifts in the relationship between psychology and linguistics.

How Earth works 100 years after Wegener's continental drift theory and IGCP 648

NASA Astrophysics Data System (ADS)

Li, Z. X.; Evans, D. A.; Zhong, S.; Eglington, B. M.

2015-12-01

It took half a century for Wegener's continental drift theory to be accepted as a fundamental element of the plate tectonic theory. Another half a century on, we are still unsure of the driving mechanism for plate tectonics: is it dominated by thermal convection, gravitational forces, or by a combination of mechanisms? Nonetheless, breakthroughs in the past decades put us in a position to make a major stride in answering this question. These include: (1) widely accepted cyclic occurrences of supercontinent assembly and break-up (whereas random occurrence of supercontinents was an equal possibility in the 1990s); (2) the discovery of two equatorial and antipodal large low seismic velocity provinces (LLSVPs) that dominate the lower mantle and appear to have been the base for almost all mantle plumes since at the Mesozoic, and of subduction of oceanic slabs all the way to the core-mantle boundary, which together suggesting whole-mantle convection; (3) the recognition of true polar wander (TPW) as an important process in Earth history, likely reflecting Earth's major internal mass redistribution events; and (4) rapidly enhancing computer modelling power enabling us to simulate all aspect of Earth's dynamic inner working. Many new yet often controversial ideas have been proposed, such a possible coupling in time (with an offset) and space between supercontinent cycle and superplume (LLSVP) events which oppose to the idea of static and long-lived LLSVPs, and the orthoversion v.s. introversion or extroversion models for supercontinent transition. To fully utilise these advances as well as the rapidly expanding global geoscience databases to address the question of how Earth works, an UNESCO-IUGS sponsored IGCP project No. 648 was formed to coordinate a global cross-disciplinary effort. We aim to achieve a better understanding of the supercontinent cycle, and examine the relationship between supercontinent cycle and global plume events. We will establish a series of global geological and geophysical databases to enable the geoscience community to make data-rich visual paleogeographic reconstructions using software like GPlates. In addition, the project will bring the geotectonic and the geodynamic modelling communities together to test global geodynamic models into the geological deep time.

Werner Heisenberg zum 100. Geburtstag: Pionier der Quantenmechanik

NASA Astrophysics Data System (ADS)

Jacobi, Manfred

2001-11-01

Werner Heisenberg war eine der prägendsten Gestalten der Physik des 20. Jahrhunderts. Zu seinen wichtigsten Verdiensten gehören die Grundlegung der Quantenmechanik, die Formulierung der Unschärferelationen sowie die Beteiligung an der Ausarbeitung der Kopenhagener Deutung der Quantenmechanik. Darüber hinaus lieferte er Arbeiten von fundamentalem Charakter zur Theorie des Atomkerns, zur kosmischen Strahlung und zur Quantenfeldtheorie. Während des Krieges war er an den Arbeiten des Uranvereins beteiligt, der die Möglichkeit einer Entwicklung von Kernwaffen untersuchte, jedoch über Vorarbeiten zur Reaktorphysik nicht hinauskam. Wegen dieser Tätigkeit wurde er bei Kriegsende für einige Monate in England interniert. Nach seiner Rückkehr widmete er sich vor allem dem Aufbau der Physik in Deutschland, die während der NS-Zeit nahezu ihrer gesamten Substanz beraubt worden war.

Four-Wave-Mixing Oscillations in a simplified Boltzmannian semiconductor model with LO-phonons

NASA Astrophysics Data System (ADS)

Tamborenea, P. I.; Bányai, L.; Haug, H.

1996-03-01

The recently discovered(L. Bányai, D. B. Tran Thoai, E. Reitsamer, H. Haug, D. Steinbach, M. U. Wehner, M. Wegener, T. Marschner and W. Stolz, Phys. Rev. Lett. 75), 2188 (1995). oscillations of the integrated four-wave-mixing signal in semiconductors due to electron-LO-phonon scattering are studied within a simplified Boltzmann-type model. Although several aspects of the experimental results require a description within the framework of non-Markovian quantum-kinetic theory, our simplified Boltzmannian model is well suited to analyze the origin of the observed novel oscillations of frequency (1+m_e/m_h) hbarω_LO. To this end, we developed a third-order, analytic solution of the semiconductor Bloch equations (SBE) with Boltzmann-type, LO-phonon collision terms. Results of this theory along with numerical solutions of the SBE will be presented.

[Central nervous system involvement in systemic diseases: Spectrum of MRI findings].

PubMed

Drier, A; Bonneville, F; Haroche, J; Amoura, Z; Dormont, D; Chiras, J

2010-12-01

Central nervous system (CNS) involvement in systemic disease (SD) is unusual. MRI features of such lesions are unfamiliar to most radiologists. The diagnosis of SD is still based on clinical features and laboratory findings but some characteristic MRI findings exist for each SD: micronodular leptomeningeal enhancement in sarcoidosis, diffuse or focal pachymeningeal involvement in Wegener disease, dentate nuclei and brain stem lesions in Langerhans cell histiocytosis, meningeal masses, dentate nuclei lesions and periarterial infiltration in Erdheim-Chester disease, meningeal masses in Rosai-Dorfman disease, veinular pontic lesions and cerebral vein thrombosis in Behçet, supratentorial microvascular lesions in lupus and antiphospholipid and Gougerot-Sjögren syndrome. In this work, we explain, describe and illustrate the most characteristic MRI findings for each disease. Copyright © 2010 Elsevier Masson SAS. All rights reserved.

Phase transformations in an ascending adiabatic mixed-phase cloud volume

NASA Astrophysics Data System (ADS)

Pinsky, M.; Khain, A.; Korolev, A.

2015-04-01

Regimes of liquid-ice coexistence that may form in an adiabatic parcel ascending at constant velocity at freezing temperatures are investigated. Four zones with different microphysical structures succeeding one another along the vertical direction have been established. On the basis of a novel balance equation, analytical expressions are derived to determine the conditions specific for each of these zones. In particular, the necessary and sufficient conditions for formation of liquid water phase within an ascending parcel containing only ice particles are determined. The results are compared to findings reported in earlier studies. The role of the Wegener-Bergeron-Findeisen mechanism in the phase transformation is analyzed. The dependence of the phase relaxation time on height in the four zones is investigated on the basis of a novel analytical expression. The results obtained in the study can be instrumental for analysis and interpretation of observed mixed-phase clouds.

Phase transformation of mixed-phase clouds

NASA Astrophysics Data System (ADS)

Korolev, Alexei; Isaac, George

2003-01-01

The glaciation time of a mixed-phase cloud due to the Wegener-Bergeron-Findeisen mechanism is calculated using an adiabatic one-dimensional numerical model for the cases of zero, ascending, descending and oscillating vertical velocities. The characteristic values of the glaciation time are obtained for different concentrations of ice particles and liquid-water content. Steady state is not possible for the ice-water content/total water content ratio in a uniformly vertically moving mixed-phase parcel. The vertical oscillation of a cloud parcel may result in a periodic evaporation and activation of liquid droplets in the presence of ice particles during infinite time. After a certain time, the average ice-water content and liquid-water content reach a steady state. This phenomenon may explain the existence of long-lived mixed-phase stratiform layers. The obtained results are important for understanding the mechanisms of formation and life cycle of mixed-phase clouds.

A case study of microphysical structures and hydrometeor phase in convection using radar Doppler spectra at Darwin, Australia

NASA Astrophysics Data System (ADS)

Riihimaki, L. D.; Comstock, J. M.; Luke, E.; Thorsen, T. J.; Fu, Q.

2017-07-01

To understand the microphysical processes that impact diabatic heating and cloud lifetimes in convection, we need to characterize the spatial distribution of supercooled liquid water. To address this observational challenge, ground-based vertically pointing active sensors at the Darwin Atmospheric Radiation Measurement site are used to classify cloud phase within a deep convective cloud. The cloud cannot be fully observed by a lidar due to signal attenuation. Therefore, we developed an objective method for identifying hydrometeor classes, including mixed-phase conditions, using k-means clustering on parameters that describe the shape of the Doppler spectra from vertically pointing Ka-band cloud radar. This approach shows that multiple, overlapping mixed-phase layers exist within the cloud, rather than a single region of supercooled liquid. Diffusional growth calculations show that the conditions for the Wegener-Bergeron-Findeisen process exist within one of these mixed-phase microstructures.

Boris Choubert: The forgotten fit of the circum-Atlantic continents

NASA Astrophysics Data System (ADS)

Kornprobst, Jacques

2017-01-01

Boris Choubert was a strong supporter of Wegener's continental drift theory. In 1935, he published a very accurate fit of the circum-Atlantic continents, which was based on continental edges instead of coastlines; in the same paper, he interpreted the Palaeozoic belts as the result of horizontal movements of the Precambrian blocks; so, he greatly expanded the role of continental drift through time. This original and very prophetic work was almost completely ignored by his contemporaries. Thirty years later (1965), Bullard, Everett and Smith published in turn a similar but more sophisticated fit; they did not acknowledge Choubert's initial work. Bullard's fit was met with immediate and tremendous success. The present paper analyses the reasons why Boris Choubert was frustrated of his pioneering role. This lack of recognition is related to: (1) a great evolution in the geological concepts between 1935 and 1965, and (2) a poor choice of Choubert, regarding the title of his 1935 article.

Caribbean tectonics and relative plate motions

NASA Technical Reports Server (NTRS)

Burke, K.; Dewey, J. F.; Cooper, C.; Mann, P.; Pindell, J. L.

1984-01-01

During the last century, three different ways of interpreting the tectonic evolution of the Gulf of Mexico and the Caribbean have been proposed, taking into account the Bailey Willis School of a permanent pre-Jurassic deep sea basin, the Edward Suess School of a subsided continental terrain, and the Alfred Wegener School of continental separation. The present investigation is concerned with an outline of an interpretation which follows that of Pindell and Dewey (1982). An attempt is made to point out ways in which the advanced hypotheses can be tested. The fit of Africa, North America, and South America is considered along with aspects of relative motion between North and South America since the early Jurasic. Attention is given to a framework for reconstructing Caribbean plate evolution, the evolution of the Caribbean, the plate boundary zones of the northern and southern Caribbean, and the active deformation of the Caribbean plate.

Positive mood can increase or decrease message scrutiny: the hedonic contingency view of mood and message processing.

PubMed

Wegener, D T; Petty, R E; Smith, S M

1995-07-01

Currently dominant explanations of mood effects on persuasive message processing (i.e., cognitive capacity and feelings as information) predict that happy moods lead to less message scrutiny than neutral or sad moods. The hedonic contingency view (D. T. Wegener & R. E. Petty, 1994) predicts that happy moods can sometimes be associated with greater message processing activity because people in a happy mood are more attentive than neutral or sad people to the hedonic consequences of their actions. Consistent with this view, Experiment 1 finds that a happy mood can lead to greater message scrutiny than a neutral mood when the message is not mood threatening. Experiment 2 finds that a happy mood leads to greater message scrutiny than a sad mood when an uplifting message is encountered, but to less message scrutiny when a depressing message is encountered.

ERAST: Scientific Applications and Technology Commercialization

NASA Technical Reports Server (NTRS)

Hunley, John D. (Compiler); Kellogg, Yvonne (Compiler)

2000-01-01

This is a conference publication for an event designed to inform potential contractors and appropriate personnel in various scientific disciplines that the ERAST (Environmental Research Aircraft and Sensor Technology) vehicles have reached a certain level of maturity and are available to perform a variety of missions ranging from data gathering to telecommunications. There are multiple applications of the technology and a great many potential commercial and governmental markets. As high altitude platforms, the ERAST vehicles can gather data at higher resolution than satellites and can do so continuously, whereas satellites pass over a particular area only once each orbit. Formal addresses are given by Rich Christiansen, (Director of Programs, NASA Aerospace Technology Ent.), Larry Roeder, (Senior Policy Advisor, U.S. Dept. of State), and Dr. Marianne McCarthy, (DFRC Education Dept.). The Commercialization Workshop is chaired by Dale Tietz (President, New Vista International) and the Science Workshop is chaired by Steve Wegener, (Deputy Manager of NASA ERAST, NASA Ames Research Center.

Uber Phosphorylierung im Licht

PubMed Central

Warburg, Otto

1962-01-01

Während bisher der Zusammenhang zwischen Dehydrierung und Phosphorylierung im Licht nur für die stöchiometrischen Chinonreactionen bewiesen worden war, ist nunmehr auch für die katalytischen Chinonreactionen, die aeroben wie die anaeroben, gezeigt worden, dass die Dehydrierung die Phosphorylierung bewirkt. Eine andere Phosphorylierung, als die Phosphorylierung durch Dehydrierung gibt es in den grünen Grana nicht. Natürlich entsteht nunmehr die Frage, welche Substanz das Substrat von Dehydrierung und Phosphorylierung ist. Da die Grana keine Dunkelatmung haben und deshalb im Dunkeln nicht phosphorylieren können, auch nicht nach Zusatz von Chinon, so muss das gesuchte Substrat im Licht entstehen; und da der Photolyt der Granareactionen eine Kohlensäureverbindung ist, so muss das gesuchte Substrat eine im Licht entstehende Kohlenstoffverbindung sein. Wegen der Gärungen und dem einzigen bisher bekannten chemischen Mechanismus der Phosphorylierung durch Dehydrierung (4) denkt man an Triosephosphat. Aber chemisch ist jeder Aldehyd möglich. PMID:14004907

Dose Monitoring of Busulfan and Combination Chemotherapy in Hodgkin or Non-Hodgkin Lymphoma Undergoing Stem Cell Transplant

ClinicalTrials.gov

2015-08-12

Adult Grade III Lymphomatoid Granulomatosis; Adult Nasal Type Extranodal NK/T-cell Lymphoma; Anaplastic Large Cell Lymphoma; Angioimmunoblastic T-cell Lymphoma; Childhood Burkitt Lymphoma; Childhood Diffuse Large Cell Lymphoma; Childhood Grade III Lymphomatoid Granulomatosis; Childhood Immunoblastic Large Cell Lymphoma; Childhood Nasal Type Extranodal NK/T-cell Lymphoma; Contiguous Stage II Adult Burkitt Lymphoma; Contiguous Stage II Adult Diffuse Large Cell Lymphoma; Contiguous Stage II Adult Diffuse Mixed Cell Lymphoma; Contiguous Stage II Adult Diffuse Small Cleaved Cell Lymphoma; Contiguous Stage II Adult Immunoblastic Large Cell Lymphoma; Contiguous Stage II Adult Lymphoblastic Lymphoma; Contiguous Stage II Grade 1 Follicular Lymphoma; Contiguous Stage II Grade 2 Follicular Lymphoma; Contiguous Stage II Grade 3 Follicular Lymphoma; Contiguous Stage II Mantle Cell Lymphoma; Contiguous Stage II Marginal Zone Lymphoma; Contiguous Stage II Small Lymphocytic Lymphoma; Cutaneous B-cell Non-Hodgkin Lymphoma; Extranodal Marginal Zone B-cell Lymphoma of Mucosa-associated Lymphoid Tissue; Hepatosplenic T-cell Lymphoma; Intraocular Lymphoma; Nodal Marginal Zone B-cell Lymphoma; Noncontiguous Stage II Adult Burkitt Lymphoma; Noncontiguous Stage II Adult Diffuse Large Cell Lymphoma; Noncontiguous Stage II Adult Diffuse Mixed Cell Lymphoma; Noncontiguous Stage II Adult Diffuse Small Cleaved Cell Lymphoma; Noncontiguous Stage II Adult Immunoblastic Large Cell Lymphoma; Noncontiguous Stage II Adult Lymphoblastic Lymphoma; Noncontiguous Stage II Grade 1 Follicular Lymphoma; Noncontiguous Stage II Grade 2 Follicular Lymphoma; Noncontiguous Stage II Grade 3 Follicular Lymphoma; Noncontiguous Stage II Mantle Cell Lymphoma; Noncontiguous Stage II Marginal Zone Lymphoma; Noncontiguous Stage II Small Lymphocytic Lymphoma; Noncutaneous Extranodal Lymphoma; Peripheral T-cell Lymphoma; Recurrent Adult Burkitt Lymphoma; Recurrent Adult Diffuse Large Cell Lymphoma; Recurrent Adult Diffuse Mixed Cell Lymphoma; Recurrent Adult Diffuse Small Cleaved Cell Lymphoma; Recurrent Adult Grade III Lymphomatoid Granulomatosis; Recurrent Adult Hodgkin Lymphoma; Recurrent Adult Immunoblastic Large Cell Lymphoma; Recurrent Adult Lymphoblastic Lymphoma; Recurrent Adult T-cell Leukemia/Lymphoma; Recurrent Childhood Anaplastic Large Cell Lymphoma; Recurrent Childhood Grade III Lymphomatoid Granulomatosis; Recurrent Childhood Large Cell Lymphoma; Recurrent Childhood Lymphoblastic Lymphoma; Recurrent Childhood Small Noncleaved Cell Lymphoma; Recurrent Cutaneous T-cell Non-Hodgkin Lymphoma; Recurrent Grade 1 Follicular Lymphoma; Recurrent Grade 2 Follicular Lymphoma; Recurrent Grade 3 Follicular Lymphoma; Recurrent Mantle Cell Lymphoma; Recurrent Marginal Zone Lymphoma; Recurrent Mycosis Fungoides/Sezary Syndrome; Recurrent Small Lymphocytic Lymphoma; Recurrent/Refractory Childhood Hodgkin Lymphoma; Refractory Hairy Cell Leukemia; Small Intestine Lymphoma; Splenic Marginal Zone Lymphoma; Stage I Adult Burkitt Lymphoma; Stage I Adult Diffuse Large Cell Lymphoma; Stage I Adult Diffuse Mixed Cell Lymphoma; Stage I Adult Diffuse Small Cleaved Cell Lymphoma; Stage I Adult Hodgkin Lymphoma; Stage I Adult Immunoblastic Large Cell Lymphoma; Stage I Adult Lymphoblastic Lymphoma; Stage I Adult T-cell Leukemia/Lymphoma; Stage I Childhood Anaplastic Large Cell Lymphoma; Stage I Childhood Hodgkin Lymphoma; Stage I Childhood Large Cell Lymphoma; Stage I Childhood Lymphoblastic Lymphoma; Stage I Childhood Small Noncleaved Cell Lymphoma; Stage I Cutaneous T-cell Non-Hodgkin Lymphoma; Stage I Grade 1 Follicular Lymphoma; Stage I Grade 2 Follicular Lymphoma; Stage I Grade 3 Follicular Lymphoma; Stage I Mantle Cell Lymphoma; Stage I Marginal Zone Lymphoma; Stage I Small Lymphocytic Lymphoma; Stage IA Mycosis Fungoides/Sezary Syndrome; Stage IB Mycosis Fungoides/Sezary Syndrome; Stage II Adult Hodgkin Lymphoma; Stage II Adult T-cell Leukemia/Lymphoma; Stage II Childhood Anaplastic Large Cell Lymphoma; Stage II Childhood Hodgkin Lymphoma; Stage II Childhood Large Cell Lymphoma; Stage II Childhood Lymphoblastic Lymphoma; Stage II Childhood Small Noncleaved Cell Lymphoma; Stage II Cutaneous T-cell Non-Hodgkin Lymphoma; Stage IIA Mycosis Fungoides/Sezary Syndrome; Stage IIB Mycosis Fungoides/Sezary Syndrome; Stage III Adult Burkitt Lymphoma; Stage III Adult Diffuse Large Cell Lymphoma; Stage III Adult Diffuse Mixed Cell Lymphoma; Stage III Adult Diffuse Small Cleaved Cell Lymphoma; Stage III Adult Hodgkin Lymphoma; Stage III Adult Immunoblastic Large Cell Lymphoma; Stage III Adult Lymphoblastic Lymphoma; Stage III Adult T-cell Leukemia/Lymphoma; Stage III Childhood Anaplastic Large Cell Lymphoma; Stage III Childhood Hodgkin Lymphoma; Stage III Childhood Large Cell Lymphoma; Stage III Childhood Lymphoblastic Lymphoma; Stage III Childhood Small Noncleaved Cell Lymphoma; Stage III Cutaneous T-cell Non-Hodgkin Lymphoma; Stage III Grade 1 Follicular Lymphoma; Stage III Grade 2 Follicular Lymphoma; Stage III Grade 3 Follicular Lymphoma; Stage III Mantle Cell Lymphoma; Stage III Marginal Zone Lymphoma; Stage III Small Lymphocytic Lymphoma; Stage IIIA Mycosis Fungoides/Sezary Syndrome; Stage IIIB Mycosis Fungoides/Sezary Syndrome; Stage IV Adult Burkitt Lymphoma; Stage IV Adult Diffuse Large Cell Lymphoma; Stage IV Adult Diffuse Mixed Cell Lymphoma; Stage IV Adult Diffuse Small Cleaved Cell Lymphoma; Stage IV Adult Hodgkin Lymphoma; Stage IV Adult Immunoblastic Large Cell Lymphoma; Stage IV Adult Lymphoblastic Lymphoma; Stage IV Adult T-cell Leukemia/Lymphoma; Stage IV Childhood Anaplastic Large Cell Lymphoma; Stage IV Childhood Hodgkin Lymphoma; Stage IV Childhood Large Cell Lymphoma; Stage IV Childhood Lymphoblastic Lymphoma; Stage IV Childhood Small Noncleaved Cell Lymphoma; Stage IV Cutaneous T-cell Non-Hodgkin Lymphoma; Stage IV Grade 1 Follicular Lymphoma; Stage IV Grade 2 Follicular Lymphoma; Stage IV Grade 3 Follicular Lymphoma; Stage IV Mantle Cell Lymphoma; Stage IV Marginal Zone Lymphoma; Stage IV Small Lymphocytic Lymphoma; Stage IVA Mycosis Fungoides/Sezary Syndrome; Stage IVB Mycosis Fungoides/Sezary Syndrome; T-cell Large Granular Lymphocyte Leukemia; Testicular Lymphoma; Waldenström Macroglobulinemia

Ipilimumab and Local Radiation Therapy in Treating Patients With Recurrent Melanoma, Non-Hodgkin Lymphoma, Colon, or Rectal Cancer

ClinicalTrials.gov

2017-01-12

Adult Nasal Type Extranodal NK/T-cell Lymphoma; Anaplastic Large Cell Lymphoma; Angioimmunoblastic T-cell Lymphoma; Cutaneous B-cell Non-Hodgkin Lymphoma; Extranodal Marginal Zone B-cell Lymphoma of Mucosa-associated Lymphoid Tissue; Hepatosplenic T-cell Lymphoma; Intraocular Lymphoma; Nodal Marginal Zone B-cell Lymphoma; Peripheral T-cell Lymphoma; Recurrent Adult Burkitt Lymphoma; Recurrent Adult Diffuse Large Cell Lymphoma; Recurrent Adult Diffuse Mixed Cell Lymphoma; Recurrent Adult Diffuse Small Cleaved Cell Lymphoma; Recurrent Adult Grade III Lymphomatoid Granulomatosis; Recurrent Adult Immunoblastic Large Cell Lymphoma; Recurrent Adult Lymphoblastic Lymphoma; Recurrent Adult T-cell Leukemia/Lymphoma; Recurrent Colon Cancer; Recurrent Cutaneous T-cell Non-Hodgkin Lymphoma; Recurrent Grade 1 Follicular Lymphoma; Recurrent Grade 2 Follicular Lymphoma; Recurrent Grade 3 Follicular Lymphoma; Recurrent Mantle Cell Lymphoma; Recurrent Marginal Zone Lymphoma; Recurrent Melanoma; Recurrent Mycosis Fungoides/Sezary Syndrome; Recurrent Rectal Cancer; Recurrent Small Lymphocytic Lymphoma; Refractory Hairy Cell Leukemia; Small Intestine Lymphoma; Splenic Marginal Zone Lymphoma; T-cell Large Granular Lymphocyte Leukemia; Testicular Lymphoma; Waldenström Macroglobulinemia

Surgical resection of a rare cutaneous manifestation of Scedosporium apiospermum in a patient who underwent renal transplant.

PubMed

Stoneham, A C S; Stoneham, S E; Wyllie, S A; Pandya, A N

2017-01-23

A man aged 47 years who was immunosuppressed following renal transplantation for focal segmental glomerulosclerosis was referred to the Plastic Surgery team for management of a painful, chronic, granulomatous lesion of the right forearm. Serial ultrasound scans and MRI scans were not diagnostic, but microbiological specimens tested positive for the fungus Scedosporium apiospermum The renal transplant graft-which was failing-was removed, allowing him to cease immunosuppression. He then underwent a resection of the lesion and reconstruction with a split thickness skin graft. Analysis of the specimen revealed fibrosis, granulomatosis and a collection of S. apiospermum He was started on voriconazole which, in conjunction with his surgical resection, appears to have kept the disease at bay. With increasing numbers of solid organ transplants and improved survival, this case highlights the growing burden of rare, opportunistic infections, the difficulty in diagnosis and the need for specialist intervention. 2017 BMJ Publishing Group Ltd.

Monoclonal Antibody Therapy Before Stem Cell Transplant in Treating Patients With Relapsed or Refractory Lymphoid Malignancies

ClinicalTrials.gov

2017-10-10

Adult Nasal Type Extranodal NK/T-cell Lymphoma; Anaplastic Large Cell Lymphoma; Angioimmunoblastic T-cell Lymphoma; Cutaneous B-cell Non-Hodgkin Lymphoma; Extranodal Marginal Zone B-cell Lymphoma of Mucosa-associated Lymphoid Tissue; Hepatosplenic T-cell Lymphoma; Intraocular Lymphoma; Nodal Marginal Zone B-cell Lymphoma; Noncutaneous Extranodal Lymphoma; Peripheral T-cell Lymphoma; Recurrent Adult Burkitt Lymphoma; Recurrent Adult Diffuse Large Cell Lymphoma; Recurrent Adult Diffuse Mixed Cell Lymphoma; Recurrent Adult Diffuse Small Cleaved Cell Lymphoma; Recurrent Adult Grade III Lymphomatoid Granulomatosis; Recurrent Adult Hodgkin Lymphoma; Recurrent Adult Immunoblastic Large Cell Lymphoma; Recurrent Adult Lymphoblastic Lymphoma; Recurrent Adult T-cell Leukemia/Lymphoma; Recurrent Cutaneous T-cell Non-Hodgkin Lymphoma; Recurrent Grade 1 Follicular Lymphoma; Recurrent Grade 2 Follicular Lymphoma; Recurrent Grade 3 Follicular Lymphoma; Recurrent Mantle Cell Lymphoma; Recurrent Marginal Zone Lymphoma; Recurrent Mycosis Fungoides/Sezary Syndrome; Recurrent Small Lymphocytic Lymphoma; Refractory Hairy Cell Leukemia; Small Intestine Lymphoma; Splenic Marginal Zone Lymphoma; T-cell Large Granular Lymphocyte Leukemia; Testicular Lymphoma; Waldenström Macroglobulinemia

Eosinophils in Autoimmune Diseases

PubMed Central

Diny, Nicola L.; Rose, Noel R.; Čiháková, Daniela

2017-01-01

Eosinophils are multifunctional granulocytes that contribute to initiation and modulation of inflammation. Their role in asthma and parasitic infections has long been recognized. Growing evidence now reveals a role for eosinophils in autoimmune diseases. In this review, we summarize the function of eosinophils in inflammatory bowel diseases, neuromyelitis optica, bullous pemphigoid, autoimmune myocarditis, primary biliary cirrhosis, eosinophilic granulomatosis with polyangiitis, and other autoimmune diseases. Clinical studies, eosinophil-targeted therapies, and experimental models have contributed to our understanding of the regulation and function of eosinophils in these diseases. By examining the role of eosinophils in autoimmune diseases of different organs, we can identify common pathogenic mechanisms. These include degranulation of cytotoxic granule proteins, induction of antibody-dependent cell-mediated cytotoxicity, release of proteases degrading extracellular matrix, immune modulation through cytokines, antigen presentation, and prothrombotic functions. The association of eosinophilic diseases with autoimmune diseases is also examined, showing a possible increase in autoimmune diseases in patients with eosinophilic esophagitis, hypereosinophilic syndrome, and non-allergic asthma. Finally, we summarize key future research needs. PMID:28496445

Bendamustine Hydrochloride, Etoposide, Dexamethasone, and Filgrastim For Peripheral Blood Stem Cell Mobilization in Treating Patients With Refractory or Recurrent Lymphoma or Multiple Myeloma

ClinicalTrials.gov

2017-04-14

Adult Nasal Type Extranodal NK/T-cell Lymphoma; Anaplastic Large Cell Lymphoma; Angioimmunoblastic T-cell Lymphoma; Cutaneous B-cell Non-Hodgkin Lymphoma; Extranodal Marginal Zone B-cell Lymphoma of Mucosa-associated Lymphoid Tissue; Intraocular Lymphoma; Nodal Marginal Zone B-cell Lymphoma; Peripheral T-cell Lymphoma; Recurrent Adult Burkitt Lymphoma; Recurrent Adult Diffuse Large Cell Lymphoma; Recurrent Adult Diffuse Mixed Cell Lymphoma; Recurrent Adult Diffuse Small Cleaved Cell Lymphoma; Recurrent Adult Grade III Lymphomatoid Granulomatosis; Recurrent Adult Hodgkin Lymphoma; Recurrent Adult Immunoblastic Large Cell Lymphoma; Recurrent Adult Lymphoblastic Lymphoma; Recurrent Adult T-cell Leukemia/Lymphoma; Recurrent Cutaneous T-cell Non-Hodgkin Lymphoma; Recurrent Grade 1 Follicular Lymphoma; Recurrent Grade 2 Follicular Lymphoma; Recurrent Grade 3 Follicular Lymphoma; Recurrent Mantle Cell Lymphoma; Recurrent Marginal Zone Lymphoma; Recurrent Mycosis Fungoides/Sezary Syndrome; Recurrent Small Lymphocytic Lymphoma; Refractory Multiple Myeloma; Small Intestine Lymphoma; Splenic Marginal Zone Lymphoma; Waldenström Macroglobulinemia

[Prostatic granulomas revealing a peripheral T-cell lymphoma].

PubMed

Foguem, C; Curlier, E; Rouamba, M-M; Regent, A; Philippe, P

2009-02-01

The presence of granulomas on tissue biopsie has been reported in a wide range of disorders. The clinical presentation and the diagnostic work-up of granulomatosis can be difficult as it is illustrated in the following report. A 59-year-old patient was referred in 2002 for a granulomatous prostatitis. Physical examination was normal. Except for the increase of prostate-specific antigen (which motivated a biopsy), the laboratory results were normal. Thoracic CT-scan disclosed mediastinal lymph nodes. A minor salivary gland biopsy was consistent with the diagnosis of sarcoidosis. In 2004, the patient presented an epidermal necrolysis, and in 2005 the deterioration of general status raised suspicion of a lymphoproliferative disorder. Liver and bone marrow biopsies revealed a granulomatous process. Despite steroid therapy, the patient died. Autopsy discloses a anaplasic T cell lymphoma. This report illustrates the relationship between sarcoidosis and lymphoma as a mode of presentation, a complication, or an accidental but misleading association? The association between anaplastic lymphoma and sarcoidosis is exceptional.

Methoxyamine and Fludarabine Phosphate in Treating Patients With Relapsed or Refractory Hematologic Malignancies

ClinicalTrials.gov

2015-08-12

Adult Nasal Type Extranodal NK/T-cell Lymphoma; Anaplastic Large Cell Lymphoma; Angioimmunoblastic T-cell Lymphoma; Cutaneous B-cell Non-Hodgkin Lymphoma; Extranodal Marginal Zone B-cell Lymphoma of Mucosa-associated Lymphoid Tissue; Hepatosplenic T-cell Lymphoma; Intraocular Lymphoma; Nodal Marginal Zone B-cell Lymphoma; Peripheral T-cell Lymphoma; Recurrent Adult Burkitt Lymphoma; Recurrent Adult Diffuse Large Cell Lymphoma; Recurrent Adult Diffuse Mixed Cell Lymphoma; Recurrent Adult Diffuse Small Cleaved Cell Lymphoma; Recurrent Adult Grade III Lymphomatoid Granulomatosis; Recurrent Adult Hodgkin Lymphoma; Recurrent Adult Immunoblastic Large Cell Lymphoma; Recurrent Adult Lymphoblastic Lymphoma; Recurrent Adult T-cell Leukemia/Lymphoma; Recurrent Cutaneous T-cell Non-Hodgkin Lymphoma; Recurrent Grade 1 Follicular Lymphoma; Recurrent Grade 2 Follicular Lymphoma; Recurrent Grade 3 Follicular Lymphoma; Recurrent Mantle Cell Lymphoma; Recurrent Marginal Zone Lymphoma; Recurrent Mycosis Fungoides/Sezary Syndrome; Recurrent Small Lymphocytic Lymphoma; Refractory Chronic Lymphocytic Leukemia; Refractory Multiple Myeloma; Relapsing Chronic Myelogenous Leukemia; Small Intestine Lymphoma; Splenic Marginal Zone Lymphoma; Stage III Chronic Lymphocytic Leukemia; Testicular Lymphoma; Waldenström Macroglobulinemia

Effects of Wegener-Bergeron-Findeisen Process on Global Black Carbon Distribution

NASA Astrophysics Data System (ADS)

Qi, L.

2016-12-01

In mixed-phase clouds, the Wegener-Bergeron-Findeisen (WBF) process (ice crystals may grow while water drops evaporate, thereby releasing black carbon (BC) particles into the interstitial air) slows down wet scavenging of BC. Rimming (snowflakes fall and collect cloud water drops and the BC in them along their pathways), in contrast, results in more efficient wet scavenging. We systematically investigate the effects of WBF on BC scavenging efficiency, surface BCair, deposition flux, concentration in snow, and washout ratio using a global 3D chemical transport model. We differentiate riming- vs WBF-dominated in-cloud scavenging based on liquid water content and temperature. Specifically, we relate WBF to either temperature or ice mass fraction in mixed-phase clouds. We find that at Jungfraujoch, Switzerland and Abisko, Sweden, where WBF dominates, the discrepancies of simulated BC scavenging efficiency and washout ratio are significantly reduced (from a factor of 3 to 10% and from a factor of 4-5 to a factor of two). However, at Zeppelin, Norway, where riming dominates, simulation of BC scavenging efficiency, BCair, and washout ratio become worse (relative to observations) when WBF is included. There is thus an urgent need for extensive observations to distinguish and characterize riming- versus WBF-dominated aerosol scavenging in mixed-phase clouds and the associated BC scavenging efficiency. We find the reduction resulting from WBF to global BC scavenging efficiency varies substantially, from 8% in the tropics to 76% in the Arctic. The resulting annual mean BCair increases by up to 156% at high altitudes and at northern high latitudes. Overall, WBF halves the model-observation discrepancy (from -65% to -30%) of BCair across North America, Europe, China and the Arctic. Globally WBF increases BC burden from 0.22 to 0.29-0.35 mg m-2 yr-1, which partially explains the gap between observed and previous model simulated BC burdens over land (Bond et al., 2013). In addition, WBF significantly increases BC lifetime from 5.7 days to 8 days. We find that WBF decreases BCsnow at mid-latitudes (by 15%) but increases it in the Arctic (by 26%) while improving model comparisons with observations. In addition, WBF dramatically reduces the model-observation discrepancy of washout ratios in winter (from a factor of 16 to 4).

WegenerNet 1km-scale sub-daily rainfall data and their application: a hydrological modeling study on the sensitivity of small-catchment runoff to spatial rainfall variability

NASA Astrophysics Data System (ADS)

Oh, Sungmin; Hohmann, Clara; Foelsche, Ulrich; Fuchsberger, Jürgen; Rieger, Wolfgang; Kirchengast, Gottfried

2017-04-01

WegenerNet Feldbach region (WEGN), a pioneering experiment for weather and climate observations, has recently completed its first 10-year precipitation measurement cycle. The WEGN has measured precipitation, temperature, humidity, and other parameters since the beginning of 2007, supporting local-level monitoring and modeling studies, over an area of about 20 km x 15 km centered near the City of Feldbach (46.93 ˚ N, 15.90 ˚ E) in the Alpine forelands of southeast Austria. All the 151 stations in the network are now equipped with high-quality Meteoservis sensors as of August 2016, following an equipment with Friedrichs sensors at most stations before, and continue to provide high-resolution (2 km2/5-min) gauge based precipitation measurements for interested users in hydro-meteorological communities. Here we will present overall characteristics of the WEGN, with a focus on sub-daily precipitation measurements, from the data processing (data quality control, gridded data products generation, etc.) to data applications (e.g., ground validation of satellite estimates). The latter includes our recent study on the propagation of uncertainty from rainfall to runoff. The study assesses responses of small-catchment runoff to spatial rainfall variability in the WEGN region over the Raab valley, using a physics-based distributed hydrological model; Water Flow and Balance Simulation Model (WaSiM), developed at ETH Zurich (Schulla, ETH Zurich, 1997). Given that uncertainty due to resolution of rainfall measurements is believed to be a significant source of error in hydrologic modeling especially for convective rainfall that dominates in the region during summer, the high-resolution of WEGN data furnishes a great opportunity to analyze effects of rainfall events on the runoff at different spatial resolutions. Furthermore, the assessment can be conducted not only for the lower Raab catchment (area of about 500 km2) but also for its sub-catchments (areas of about 30-70 km2). Beside the question how many stations are necessary for reliable hydrological modeling, different interpolation methods like Inverse Distance Interpolation, Elevation Dependent Regression, and combinations will be tested. This presentation will show the first results from a scale-depending analysis of spatial and temporal structures of heavy rainfall events and responses of simulated runoff at the event scale in the WEGN region.

Donor Umbilical Cord Blood Stem Cell Transplant in Treating Patients With Hematologic Malignancies

ClinicalTrials.gov

2015-12-18

Acute Myeloid Leukemia With Multilineage Dysplasia Following Myelodysplastic Syndrome; Adult Acute Lymphoblastic Leukemia in Remission; Adult Acute Megakaryoblastic Leukemia (M7); Adult Acute Minimally Differentiated Myeloid Leukemia (M0); Adult Acute Monoblastic Leukemia (M5a); Adult Acute Monocytic Leukemia (M5b); Adult Acute Myeloid Leukemia in Remission; Adult Acute Myeloid Leukemia With 11q23 (MLL) Abnormalities; Adult Acute Myeloid Leukemia With t(16;16)(p13;q22); Adult Erythroleukemia (M6a); Adult Nasal Type Extranodal NK/T-cell Lymphoma; Adult Pure Erythroid Leukemia (M6b); B-cell Adult Acute Lymphoblastic Leukemia; B-cell Childhood Acute Lymphoblastic Leukemia; Blastic Phase Chronic Myelogenous Leukemia; Burkitt Lymphoma; Childhood Acute Erythroleukemia (M6); Childhood Acute Lymphoblastic Leukemia in Remission; Childhood Acute Megakaryocytic Leukemia (M7); Childhood Acute Minimally Differentiated Myeloid Leukemia (M0); Childhood Acute Monoblastic Leukemia (M5a); Childhood Acute Monocytic Leukemia (M5b); Childhood Acute Myeloid Leukemia in Remission; Childhood Chronic Myelogenous Leukemia; Childhood Diffuse Large Cell Lymphoma; Childhood Immunoblastic Large Cell Lymphoma; Childhood Myelodysplastic Syndromes; Childhood Nasal Type Extranodal NK/T-cell Lymphoma; Chronic Myelomonocytic Leukemia; Chronic Phase Chronic Myelogenous Leukemia; Cutaneous B-cell Non-Hodgkin Lymphoma; de Novo Myelodysplastic Syndromes; Extranodal Marginal Zone B-cell Lymphoma of Mucosa-associated Lymphoid Tissue; Juvenile Myelomonocytic Leukemia; Myelodysplastic/Myeloproliferative Neoplasm, Unclassifiable; Nodal Marginal Zone B-cell Lymphoma; Previously Treated Myelodysplastic Syndromes; Prolymphocytic Leukemia; Recurrent Adult Acute Lymphoblastic Leukemia; Recurrent Adult Acute Myeloid Leukemia; Recurrent Adult Burkitt Lymphoma; Recurrent Adult Diffuse Large Cell Lymphoma; Recurrent Adult Diffuse Mixed Cell Lymphoma; Recurrent Adult Diffuse Small Cleaved Cell Lymphoma; Recurrent Adult Grade III Lymphomatoid Granulomatosis; Recurrent Adult Immunoblastic Large Cell Lymphoma; Recurrent Adult Lymphoblastic Lymphoma; Recurrent Childhood Acute Lymphoblastic Leukemia; Recurrent Childhood Acute Myeloid Leukemia; Recurrent Childhood Anaplastic Large Cell Lymphoma; Recurrent Childhood Grade III Lymphomatoid Granulomatosis; Recurrent Childhood Large Cell Lymphoma; Recurrent Childhood Lymphoblastic Lymphoma; Recurrent Childhood Small Noncleaved Cell Lymphoma; Recurrent Cutaneous T-cell Non-Hodgkin Lymphoma; Recurrent Grade 1 Follicular Lymphoma; Recurrent Grade 2 Follicular Lymphoma; Recurrent Grade 3 Follicular Lymphoma; Recurrent Mantle Cell Lymphoma; Recurrent Marginal Zone Lymphoma; Recurrent Mycosis Fungoides/Sezary Syndrome; Recurrent Small Lymphocytic Lymphoma; Refractory Chronic Lymphocytic Leukemia; Relapsing Chronic Myelogenous Leukemia; Secondary Acute Myeloid Leukemia; Secondary Myelodysplastic Syndromes; Secondary Myelofibrosis; Splenic Marginal Zone Lymphoma; Stage I Chronic Lymphocytic Leukemia; Stage II Chronic Lymphocytic Leukemia; Stage III Chronic Lymphocytic Leukemia; Stage IV Chronic Lymphocytic Leukemia; T-cell Adult Acute Lymphoblastic Leukemia; T-cell Childhood Acute Lymphoblastic Leukemia; T-cell Large Granular Lymphocyte Leukemia; Waldenstrom Macroglobulinemia

Classification and characteristics of Japanese patients with antineutrophil cytoplasmic antibody-associated vasculitis in a nationwide, prospective, inception cohort study.

PubMed

Sada, Ken-ei; Yamamura, Masahiro; Harigai, Masayoshi; Fujii, Takao; Dobashi, Hiroaki; Takasaki, Yoshinari; Ito, Satoshi; Yamada, Hidehiro; Wada, Takashi; Hirahashi, Junichi; Arimura, Yoshihiro; Makino, Hirofumi

2014-04-23

We investigated the clinical and serological features of patients with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) in Japan using data from a nationwide, prospective, inception cohort study. In total, 156 Japanese patients with newly diagnosed AAV were classified according to the European Medicines Agency (EMEA) algorithm with exploratory surrogate markers for AAV-related non-granulomatous pulmonary lesions, predefined as alveolar haemorrhage and interstitial lung disease (ILD), and their clinical and serological features were evaluated. Using the EMEA algorithm, we identified 14 patients (9.0%) with eosinophilic granulomatosis with polyangiitis (EGPA), 33 (21.2%) with granulomatosis with polyangiitis (GPA), 78 (50.0%) with microscopic polyangiitis and renal-limited vasculitis (MPA/RLV), and 31 (19.9%) with unclassifiable vasculitis. The average ages of patients with EGPA (male/female, 5/9), GPA (12/21), and MPA/RLV (35/43) and unclassifiable (9/22) were 58.0, 63.6, 71.1, and 70.6 years, respectively. Myeloperoxidase (MPO)-ANCA and proteinase-3 ANCA positivity was 50.0% and 0% for EGPA, 54.6% and 45.5% for GPA, 97.4% and 2.6% for MPA/RLV, and 93.5% and 3.2% for unclassifiable, respectively. According to the Birmingham Vasculitis Activity Score (BVAS), cutaneous (71.4%) and nervous system (92.9%) manifestations were prominent in EGPA and ear, nose, and throat manifestations (84.9%) and chest manifestations (66.7%) in GPA. Renal manifestations developed frequently in MPA/RLV (91.0%) and GPA (63.6%). The average serum creatinine levels were 0.71 mg/dL for EGPA, 1.51 mg/dL for GPA, 2.46 mg/dL for MPA/RLV, and 0.69 mg/dL for unclassifiable. The percentages of patients with ILD were 14.3% for EGPA, 9.0% for GPA, 47.4% for MPA/RLV, and 61.3% for unclassifiable. Patients with ILD (n = 61) had significantly lower BVAS (P = 0.019) with fewer ear, nose, and throat and cardiovascular manifestations than patients without ILD (n = 95). MPO-ANCA-positive MPA/RLV is the most common form of AAV in Japanese patients, and one-half of patients with GPA were positive for MPO-ANCA. ILD is an important clinical manifestation in Japanese patients with AAV. Unclassifiable vasculitis with MPO-ANCA positivity and ILD may represent a novel variant of MPA. The University Hospital Medical Information Network Clinical Trials Registry: UMIN000001648. Registered 28 February 2009.

Fludarabine Phosphate and Total-Body Radiation Followed by Donor Peripheral Blood Stem Cell Transplant and Immunosuppression in Treating Patients With Hematologic Malignancies

ClinicalTrials.gov

2017-11-20

Acute Myeloid Leukemia/Transient Myeloproliferative Disorder; Acute Undifferentiated Leukemia; Adult Acute Lymphoblastic Leukemia in Remission; Adult Acute Myeloid Leukemia in Remission; Adult Acute Myeloid Leukemia With 11q23 (MLL) Abnormalities; Adult Acute Myeloid Leukemia With Del(5q); Adult Acute Myeloid Leukemia With Inv(16)(p13;q22); Adult Acute Myeloid Leukemia With t(15;17)(q22;q12); Adult Acute Myeloid Leukemia With t(16;16)(p13;q22); Adult Acute Myeloid Leukemia With t(8;21)(q22;q22); Adult Nasal Type Extranodal NK/T-cell Lymphoma; Anaplastic Large Cell Lymphoma; Angioimmunoblastic T-cell Lymphoma; Blastic Plasmacytoid Dendritic Cell Neoplasm; Childhood Acute Lymphoblastic Leukemia in Remission; Childhood Acute Myeloid Leukemia in Remission; Childhood Burkitt Lymphoma; Childhood Diffuse Large Cell Lymphoma; Childhood Immunoblastic Large Cell Lymphoma; Childhood Myelodysplastic Syndromes; Childhood Nasal Type Extranodal NK/T-cell Lymphoma; Chronic Myelomonocytic Leukemia; Cutaneous B-cell Non-Hodgkin Lymphoma; de Novo Myelodysplastic Syndromes; Extranodal Marginal Zone B-cell Lymphoma of Mucosa-associated Lymphoid Tissue; Hepatosplenic T-cell Lymphoma; Intraocular Lymphoma; Juvenile Myelomonocytic Leukemia; Mast Cell Leukemia; Myelodysplastic/Myeloproliferative Neoplasm, Unclassifiable; Nodal Marginal Zone B-cell Lymphoma; Noncutaneous Extranodal Lymphoma; Peripheral T-cell Lymphoma; Post-transplant Lymphoproliferative Disorder; Previously Treated Myelodysplastic Syndromes; Primary Systemic Amyloidosis; Recurrent Adult Acute Lymphoblastic Leukemia; Recurrent Adult Acute Myeloid Leukemia; Recurrent Adult Burkitt Lymphoma; Recurrent Adult Diffuse Large Cell Lymphoma; Recurrent Adult Diffuse Mixed Cell Lymphoma; Recurrent Adult Diffuse Small Cleaved Cell Lymphoma; Recurrent Adult Grade III Lymphomatoid Granulomatosis; Recurrent Adult Hodgkin Lymphoma; Recurrent Adult Immunoblastic Large Cell Lymphoma; Recurrent Adult Lymphoblastic Lymphoma; Recurrent Adult T-cell Leukemia/Lymphoma; Recurrent Childhood Acute Lymphoblastic Leukemia; Recurrent Childhood Acute Myeloid Leukemia; Recurrent Childhood Anaplastic Large Cell Lymphoma; Recurrent Childhood Grade III Lymphomatoid Granulomatosis; Recurrent Childhood Large Cell Lymphoma; Recurrent Childhood Lymphoblastic Lymphoma; Recurrent Childhood Small Noncleaved Cell Lymphoma; Recurrent Cutaneous T-cell Non-Hodgkin Lymphoma; Recurrent Grade 1 Follicular Lymphoma; Recurrent Grade 2 Follicular Lymphoma; Recurrent Grade 3 Follicular Lymphoma; Recurrent Mantle Cell Lymphoma; Recurrent Marginal Zone Lymphoma; Recurrent Mycosis Fungoides/Sezary Syndrome; Recurrent Small Lymphocytic Lymphoma; Recurrent/Refractory Childhood Hodgkin Lymphoma; Refractory Chronic Lymphocytic Leukemia; Refractory Hairy Cell Leukemia; Refractory Multiple Myeloma; Small Intestine Lymphoma; Splenic Marginal Zone Lymphoma; Stage II Multiple Myeloma; Stage III Multiple Myeloma; T-cell Large Granular Lymphocyte Leukemia; Testicular Lymphoma; Untreated Adult Acute Lymphoblastic Leukemia; Untreated Adult Acute Myeloid Leukemia; Untreated Childhood Acute Lymphoblastic Leukemia; Untreated Childhood Acute Myeloid Leukemia and Other Myeloid Malignancies; Waldenström Macroglobulinemia

Monitoring water phase dynamics in winter clouds

NASA Astrophysics Data System (ADS)

Campos, Edwin F.; Ware, Randolph; Joe, Paul; Hudak, David

2014-10-01

This work presents observations of water phase dynamics that demonstrate the theoretical Wegener-Bergeron-Findeisen concepts in mixed-phase winter storms. The work analyzes vertical profiles of air vapor pressure, and equilibrium vapor pressure over liquid water and ice. Based only on the magnitude ranking of these vapor pressures, we identified conditions where liquid droplets and ice particles grow or deplete simultaneously, as well as the conditions where droplets evaporate and ice particles grow by vapor diffusion. The method is applied to ground-based remote-sensing observations during two snowstorms, using two distinct microwave profiling radiometers operating in different climatic regions (North American Central High Plains and Great Lakes). The results are compared with independent microwave radiometer retrievals of vertically integrated liquid water, cloud-base estimates from a co-located ceilometer, reflectivity factor and Doppler velocity observations by nearby vertically pointing radars, and radiometer estimates of liquid water layers aloft. This work thus makes a positive contribution toward monitoring and nowcasting the evolution of supercooled droplets in winter clouds.

Sticktechnologie für medizinische Textilien und Tissue Engineering

NASA Astrophysics Data System (ADS)

Karamuk, Erdal; Mayer, Jörg; Wintermantel, Erich

Textile Strukturen werden in grossem Ausmass als medizinische Implantate eingesetzt, um Weich- und Hartgewebe zu unterstützen oder zu ersetzen. Im Tissue Engineering gewinnen sie an Bedeutung als scaffolds, um biologische Gewebe in vitro zu züchten für anschliessende Implantation oder extrakorporale Anwendungen. Textilien sind gewöhnlich anisotrope zweidimensionale Strukturen mit hoher Steifigkeit in der Ebene und geringer Biegesteifigkeit. Durch eine Vielzahl textiler Prozesse und durch entsprechende Wahl des Fasermaterials ist es möglich, Oberfläche, Porosität und mechanische Anisotropie in hohem Masse zu variieren. Wegen ihrer einzigartigen strukturellen und mechanischen Eigenschaften können faserbasierte Materialien in weitem Masse biologischem Gewebe nachgeahmt werden [1]. Gesticke erweitern das Feld von technischen und besonders medizinischen Textilien, denn sie vereinen sehr hohe strukturelle Variabilität mit der Möglichkeit, mechanische Eigenschaften in einem grossen Bereich einzustellen, um so die mechanischen Anforderungen des Empfängergewebes zu erfüllen (Abb. 42.1).

Effects of various assumptions on the calculated liquid fraction in isentropic saturated equilibrium expansions

NASA Technical Reports Server (NTRS)

Bursik, J. W.; Hall, R. M.

1980-01-01

The saturated equilibrium expansion approximation for two phase flow often involves ideal-gas and latent-heat assumptions to simplify the solution procedure. This approach is well documented by Wegener and Mack and works best at low pressures where deviations from ideal-gas behavior are small. A thermodynamic expression for liquid mass fraction that is decoupled from the equations of fluid mechanics is used to compare the effects of the various assumptions on nitrogen-gas saturated equilibrium expansion flow starting at 8.81 atm, 2.99 atm, and 0.45 atm, which are conditions representative of transonic cryogenic wind tunnels. For the highest pressure case, the entire set of ideal-gas and latent-heat assumptions are shown to be in error by 62 percent for the values of heat capacity and latent heat. An approximation of the exact, real-gas expression is also developed using a constant, two phase isentropic expansion coefficient which results in an error of only 2 percent for the high pressure case.

Management of nasal septal perforation using silicone nasal septal button

PubMed Central

Mullace, M; Gorini, E; Sbrocca, M; Artesi, L; Mevio, N

2006-01-01

Summary Nasal septal perforation may present with various symptoms: epistaxis, crusting, secondary infection, whistling and nasal obstruction. Perforation may be treated by conservative pharmacological treatment or closed by surgical approach. A useful alternative is mechanical obturation, achieved inserting a prosthesis. The present report refers to a study on 15 patients (10 male, 5 female, mean age 38.5 years) treated by insertion of a one-piece or two-piece silicone septal button (Xomed). In the follow-up period, insertion of the nasal button reduced epistaxis, eliminated whistling during inspiration, and reduced nasal obstruction and crusting around the margin of the perforation. Contraindications are presence of acute infection with osteitis, chronic septal disease (Wegener), neoplasia and extremely large perforations. The latest buttons appear to be superior to the conventional type on account of plasticity and adaptability which offer greater conformity to the septum. This study also reveals that the new septal button is well tolerated by patients. PMID:18236638

A case study of microphysical structures and hydrometeor phase in convection using radar Doppler spectra at Darwin, Australia

DOE PAGES

Riihimaki, Laura D.; Comstock, J. M.; Luke, E.; ...

2017-07-12

To understand the microphysical processes that impact diabatic heating and cloud lifetimes in convection, we need to characterize the spatial distribution of supercooled liquid water. To address this observational challenge, ground-based vertically pointing active sensors at the Darwin Atmospheric Radiation Measurement site are used to classify cloud phase within a deep convective cloud. The cloud cannot be fully observed by a lidar due to signal attenuation. Therefore, we developed an objective method for identifying hydrometeor classes, including mixed-phase conditions, using k-means clustering on parameters that describe the shape of the Doppler spectra from vertically pointing Ka-band cloud radar. Furthermore, thismore » approach shows that multiple, overlapping mixed-phase layers exist within the cloud, rather than a single region of supercooled liquid. Diffusional growth calculations show that the conditions for the Wegener-Bergeron-Findeisen process exist within one of these mixed-phase microstructures.« less

A case study of microphysical structures and hydrometeor phase in convection using radar Doppler spectra at Darwin, Australia

DOE Office of Scientific and Technical Information (OSTI.GOV)

Riihimaki, Laura D.; Comstock, J. M.; Luke, E.

To understand the microphysical processes that impact diabatic heating and cloud lifetimes in convection, we need to characterize the spatial distribution of supercooled liquid water. To address this observational challenge, ground-based vertically pointing active sensors at the Darwin Atmospheric Radiation Measurement site are used to classify cloud phase within a deep convective cloud. The cloud cannot be fully observed by a lidar due to signal attenuation. Therefore, we developed an objective method for identifying hydrometeor classes, including mixed-phase conditions, using k-means clustering on parameters that describe the shape of the Doppler spectra from vertically pointing Ka-band cloud radar. Furthermore, thismore » approach shows that multiple, overlapping mixed-phase layers exist within the cloud, rather than a single region of supercooled liquid. Diffusional growth calculations show that the conditions for the Wegener-Bergeron-Findeisen process exist within one of these mixed-phase microstructures.« less

Ignition of steel alloys by impact of low-velocity iron/inert particles in gaseous oxygen

NASA Technical Reports Server (NTRS)

Benz, Frank J.; Mcilroy, Kenneth; Williams, Ralph E.

1988-01-01

The ignition of carbon steel and 316 and 304 stainless steels caused by the impact of low-velocity particles (a standard mixture consisting of 2 g of iron and 3 g of inert materials) in gaseous oxygen was investigated using NASA/White Sands Test Facility for the ignition test, and a subsonic particle impact chamber to accelerate the particles that were injected into flowing oxygen upstream of the target specimen. It was found that the oxygen velocities required to ignite the three alloys were the same as that required to ignite the particle mixture. Ignition occurred at oxygen velocities greater than 45 m/sec at 20 to 24 MPa and was found to be independent of pressure between 2 and 30 MPa. Comparison of the present results and the past results from Wegener (1964) with the Compressed Gas Association (CGA) oxygen velocity limits for safe operations indicates that the CGA limits may be excessively conservative at high pressures and too liberal at low pressures.

Immunoglobulin light chain allelic inclusion in systemic lupus erythematosus

PubMed Central

Fraser, Louise D.; Zhao, Yuan; Lutalo, Pamela M. K.; D'Cruz, David P.; Cason, John; Silva, Joselli S.; Dunn‐Walters, Deborah K.; Nayar, Saba; Cope, Andrew P.

2015-01-01

The principles of allelic exclusion state that each B cell expresses a single light and heavy chain pair. Here, we show that B cells with both kappa and lambda light chains (Igκ and Igλ) are enriched in some patients with the systemic autoimmune disease systemic lupus erythematosus (SLE), but not in the systemic autoimmune disease control granulomatosis with polyangiitis. Detection of dual Igκ and Igλ expression by flow cytometry could not be abolished by acid washing or by DNAse treatment to remove any bound polyclonal antibody or complexes, and was retained after two days in culture. Both surface and intracytoplasmic dual light chain expression was evident by flow cytometry and confocal microscopy. We observed reduced frequency of rearrangements of the kappa‐deleting element (KDE) in SLE and an inverse correlation between the frequency of KDE rearrangement and the frequency of dual light chain expressing B cells. We propose that dual expression of Igκ and Igλ by a single B cell may occur in some patients with SLE when this may be a consequence of reduced activity of the KDE. PMID:26036683

Nuclear Imaging in Sarcoidosis.

PubMed

Piekarski, Eve; Benali, Khadija; Rouzet, François

2018-05-01

Sarcoidosis is a multisystem granulomatosis which may result in a wide variety of clinical and biological presentations. Symptoms are often nonspecific, and incidental abnormal findings on chest radiography is rather common. Although sarcoidosis resolves favorably in most cases, some localizations can provoke functional impairment or even impact on patients' prognosis. The diagnosis is based on a pathological hallmark which is the non-necrotizing epithelioid-cell rich granuloma. Owing to the ability to detect inflammation throughout the body with a high sensibility, FDG-PET/CT gained a central role in sarcoidosis because it can suggest the diagnosis in certain clinical context, guide biopsy, evaluate the extent of the disease, help assess the prognosis, and monitor immunosuppressive therapy. This review will briefly describe clinical and typical findings of conventional imaging according to organ involvement, in order to highlight the additional information provided by nuclear imaging. In the future, we can expect to further improve diagnostic performance of imaging in some indications through the availability of more specific radiopharmaceuticals and the wider use of combined PET/MRI. Copyright © 2018 Elsevier Inc. All rights reserved.

Lenalidomide With or Without Rituximab in Treating Patients With Progressive or Relapsed Chronic Lymphocytic Leukemia, Small Lymphocytic Lymphoma, Prolymphocytic Leukemia, or Non-Hodgkin Lymphoma Previously Treated With Donor Stem Cell Transplant

ClinicalTrials.gov

2017-07-24

Adult Nasal Type Extranodal NK/T-cell Lymphoma; Anaplastic Large Cell Lymphoma; Angioimmunoblastic T-cell Lymphoma; Cutaneous B-cell Non-Hodgkin Lymphoma; Extranodal Marginal Zone B-cell Lymphoma of Mucosa-associated Lymphoid Tissue; Hepatosplenic T-cell Lymphoma; Intraocular Lymphoma; Nodal Marginal Zone B-cell Lymphoma; Noncutaneous Extranodal Lymphoma; Peripheral T-cell Lymphoma; Prolymphocytic Leukemia; Recurrent Adult Burkitt Lymphoma; Recurrent Adult Diffuse Large Cell Lymphoma; Recurrent Adult Diffuse Mixed Cell Lymphoma; Recurrent Adult Diffuse Small Cleaved Cell Lymphoma; Recurrent Adult Grade III Lymphomatoid Granulomatosis; Recurrent Adult Immunoblastic Large Cell Lymphoma; Recurrent Adult Lymphoblastic Lymphoma; Recurrent Adult T-cell Leukemia/Lymphoma; Recurrent Cutaneous T-cell Non-Hodgkin Lymphoma; Recurrent Grade 1 Follicular Lymphoma; Recurrent Grade 2 Follicular Lymphoma; Recurrent Grade 3 Follicular Lymphoma; Recurrent Mantle Cell Lymphoma; Recurrent Marginal Zone Lymphoma; Recurrent Mycosis Fungoides/Sezary Syndrome; Recurrent Small Lymphocytic Lymphoma; Refractory Chronic Lymphocytic Leukemia; Refractory Hairy Cell Leukemia; Small Intestine Lymphoma; Splenic Marginal Zone Lymphoma; T-cell Large Granular Lymphocyte Leukemia; Testicular Lymphoma; Waldenström Macroglobulinemia

Thalidomide prevents formation of multinucleated giant cells (Langhans-type cells) from cultured monocytes: possible pharmaceutical applications for granulomatous disorders.

PubMed

Yasui, K; Yashiro, M; Nagaoka, Y; Manki, A; Wada, T; Tsuge, M; Kondo, Y; Morishima, T

2009-01-01

Thalidomide is an effective drug for chronic inflammatory diseases, but the mechanism underlying its immunomodulatory action remains uncertain. Thalidomide has been reported to clinically improve chronic inflammatory granulomatous disorders. In such disorders, the granulomas consist of epithelioid cells, scattered lymphocytes and multinucleated giant cells (MNGC; Langhans-type cells). The present experimental approach permitted the reproduction of MNGC formation from peripheral blood monocytes and examination of thalidomides effect on it. MNGC can be effectively generated from monocytes cultured in the presence of interleukin-4 (IL-4) and macrophage colony-stimulating factor(M-CSF) for 14 days. Thalidomide can inhibit the formation of MNGC in a dose-dependent manner. MNGC formation was partly inhibited by the presence of neutralizing TNF-alpha antibody in the responses induced by IL-4 and M-CSF. Autocrinal TNF-alpha production and modulation of cadhelin expression to regulate cell adhesion might be involved in this inhibitory action of thalidomide. Our results support thalidomides clinical efficacy in the treatment of chronic granulomatous disorders (granulomatosis).

Vorinostat and Bortezomib in Treating Young Patients With Refractory or Recurrent Solid Tumors, Including Central Nervous System Tumors and Lymphoma

ClinicalTrials.gov

2013-07-01

Childhood Burkitt Lymphoma; Childhood Central Nervous System Choriocarcinoma; Childhood Central Nervous System Germ Cell Tumor; Childhood Central Nervous System Germinoma; Childhood Central Nervous System Mixed Germ Cell Tumor; Childhood Central Nervous System Teratoma; Childhood Central Nervous System Yolk Sac Tumor; Childhood Choroid Plexus Tumor; Childhood Craniopharyngioma; Childhood Diffuse Large Cell Lymphoma; Childhood Immunoblastic Large Cell Lymphoma; Childhood Medulloepithelioma; Childhood Meningioma; Childhood Mixed Glioma; Childhood Nasal Type Extranodal NK/T-cell Lymphoma; Childhood Oligodendroglioma; Recurrent Childhood Anaplastic Large Cell Lymphoma; Recurrent Childhood Brain Stem Glioma; Recurrent Childhood Central Nervous System Embryonal Tumor; Recurrent Childhood Cerebellar Astrocytoma; Recurrent Childhood Cerebral Astrocytoma; Recurrent Childhood Ependymoma; Recurrent Childhood Grade III Lymphomatoid Granulomatosis; Recurrent Childhood Large Cell Lymphoma; Recurrent Childhood Lymphoblastic Lymphoma; Recurrent Childhood Malignant Germ Cell Tumor; Recurrent Childhood Medulloblastoma; Recurrent Childhood Pineoblastoma; Recurrent Childhood Small Noncleaved Cell Lymphoma; Recurrent Childhood Subependymal Giant Cell Astrocytoma; Recurrent Childhood Supratentorial Primitive Neuroectodermal Tumor; Recurrent Childhood Visual Pathway and Hypothalamic Glioma; Recurrent Childhood Visual Pathway Glioma; Recurrent/Refractory Childhood Hodgkin Lymphoma; Unspecified Childhood Solid Tumor, Protocol Specific

Low Median Nerve Palsy as Initial Manifestation of Churg-Strauss Syndrome.

PubMed

Roh, Young Hak; Koh, Young Do; Noh, Jung Ho; Gong, Hyun Sik; Baek, Goo Hyun

2017-06-01

Anterior interosseous nerve (AIN) syndrome is typically characterized by forearm pain and partial or complete dysfunction of the AIN-innervated muscles. Although the exact etiology and pathophysiology of the disorder remain unclear, AIN syndrome is increasingly thought to be an inflammatory condition of the nerve rather than a compressive neuropathy because the symptoms often resolve spontaneously following prolonged observation. However, peripheral neuropathy can be 1 of the first symptoms of systemic vasculitis that needs early systemic immunotherapy to prevent extensive nerve damage. Churg-Strauss syndrome (CSS; eosinophilic granulomatosis with polyangiitis) is 1 type of primary systemic vasculitis that frequently damages the peripheral nervous system. CSS-associated neuropathy usually involves nerves of the lower limb, and few studies have reported on the involvement of the upper limb alone. We report on a rare case of low median nerve palsy as the initial manifestation of CSS. The patient recovered well with early steroid treatment for primary systemic vasculitis. Copyright © 2017 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

Study of Akt Inhibitor MK2206 in Patients With Relapsed Lymphoma

ClinicalTrials.gov

2015-10-09

Adult Nasal Type Extranodal NK/T-cell Lymphoma; Anaplastic Large Cell Lymphoma; Angioimmunoblastic T-cell Lymphoma; B-cell Adult Acute Lymphoblastic Leukemia; B-cell Chronic Lymphocytic Leukemia; Cutaneous B-cell Non-Hodgkin Lymphoma; Extranodal Marginal Zone B-cell Lymphoma of Mucosa-associated Lymphoid Tissue; Hepatosplenic T-cell Lymphoma; Intraocular Lymphoma; Nodal Marginal Zone B-cell Lymphoma; Noncutaneous Extranodal Lymphoma; Peripheral T-cell Lymphoma; Recurrent Adult Acute Lymphoblastic Leukemia; Recurrent Adult Diffuse Large Cell Lymphoma; Recurrent Adult Diffuse Mixed Cell Lymphoma; Recurrent Adult Diffuse Small Cleaved Cell Lymphoma; Recurrent Adult Grade III Lymphomatoid Granulomatosis; Recurrent Adult Hodgkin Lymphoma; Recurrent Adult Immunoblastic Large Cell Lymphoma; Recurrent Adult Lymphoblastic Lymphoma; Recurrent Adult T-cell Leukemia/Lymphoma; Recurrent Cutaneous T-cell Non-Hodgkin Lymphoma; Recurrent Grade 1 Follicular Lymphoma; Recurrent Grade 2 Follicular Lymphoma; Recurrent Grade 3 Follicular Lymphoma; Recurrent Mantle Cell Lymphoma; Recurrent Marginal Zone Lymphoma; Recurrent Mycosis Fungoides/Sezary Syndrome; Recurrent Small Lymphocytic Lymphoma; Refractory Hairy Cell Leukemia; Small Intestine Lymphoma; Splenic Marginal Zone Lymphoma; T-cell Adult Acute Lymphoblastic Leukemia; T-cell Large Granular Lymphocyte Leukemia; Testicular Lymphoma; Waldenström Macroglobulinemia

Alisertib in Combination With Vorinostat in Treating Patients With Relapsed or Recurrent Hodgkin Lymphoma, B-Cell Non-Hodgkin Lymphoma, or Peripheral T-Cell Lymphoma

ClinicalTrials.gov

2018-04-10

Adult B Acute Lymphoblastic Leukemia; Adult T Acute Lymphoblastic Leukemia; Anaplastic Large Cell Lymphoma; Angioimmunoblastic T-Cell Lymphoma; Chronic Lymphocytic Leukemia; Extranodal Marginal Zone Lymphoma of Mucosa-Associated Lymphoid Tissue; Hepatosplenic T-Cell Lymphoma; Intraocular Lymphoma; Lymphomatous Involvement of Non-Cutaneous Extranodal Site; Mature T-Cell and NK-Cell Non-Hodgkin Lymphoma; Nodal Marginal Zone Lymphoma; Primary Cutaneous B-Cell Non-Hodgkin Lymphoma; Recurrent Adult Acute Lymphoblastic Leukemia; Recurrent Adult Burkitt Lymphoma; Recurrent Adult Grade III Lymphomatoid Granulomatosis; Recurrent Adult Hodgkin Lymphoma; Recurrent Adult Immunoblastic Lymphoma; Recurrent Adult Lymphoblastic Lymphoma; Recurrent Adult T-Cell Leukemia/Lymphoma; Recurrent Grade 1 Follicular Lymphoma; Recurrent Grade 2 Follicular Lymphoma; Recurrent Grade 3 Follicular Lymphoma; Recurrent Mantle Cell Lymphoma; Recurrent Marginal Zone Lymphoma; Recurrent Mycosis Fungoides and Sezary Syndrome; Recurrent Non-Hodgkin Lymphoma; Recurrent Primary Cutaneous T-Cell Non-Hodgkin Lymphoma; Recurrent Small Lymphocytic Lymphoma; Refractory Chronic Lymphocytic Leukemia; Refractory Hairy Cell Leukemia; Small Intestinal Lymphoma; Splenic Marginal Zone Lymphoma; T-Cell Large Granular Lymphocyte Leukemia; Testicular Lymphoma; Waldenstrom Macroglobulinemia

Genetic linkage of familial granulomatous inflammatory arthritis, skin rash, and uveitis to chromosome 16

DOE Office of Scientific and Technical Information (OSTI.GOV)

Tromp, G.; Kuivaniemi, H.; Ala-Kokko, L.

1996-11-01

Blau syndrome (MIM 186580), first described in a large, three-generation kindred, is an autosomal, dominantly inherited disease characterized by multiorgan, tissue-specific inflammation. Its clinical phenotype includes granulomatous arthritis, skin rash, and uveitis and probably represents a subtype of a group of clinical entities referred to as {open_quotes}familial granulomatosis.{close_quotes} It is the sole human model with recognizably Mendelian inheritance for a variety of multisystem inflammatory diseases affecting a significant percentage of the population. A genomewide search for the Blau susceptibility locus was undertaken after karyotypic analysis revealed no abnormalities. Sixty-two of the 74-member pedigree were genotyped with dinucleotide-repeat markers. Linkage analysismore » was performed under dominant model of inheritance with reduced penetrance. The marker D16S298 gave a maximum LOD score of 3.75 at {theta} = .04, with two-point analysis. LOD scores for flanking markers were consistent and placed the Blau susceptibility locus within the 16p12-q21 interval. 46 refs., 3 figs., 3 tabs.« less

Sunitinib Malate in Treating HIV-Positive Patients With Cancer Receiving Antiretroviral Therapy

ClinicalTrials.gov

2014-03-14

Accelerated Phase Chronic Myelogenous Leukemia; Acute Myeloid Leukemia With Multilineage Dysplasia Following Myelodysplastic Syndrome; Acute Undifferentiated Leukemia; Adult Acute Lymphoblastic Leukemia in Remission; Adult Acute Myeloid Leukemia With 11q23 (MLL) Abnormalities; Adult Acute Myeloid Leukemia With Del(5q); Adult Acute Myeloid Leukemia With Inv(16)(p13;q22); Adult Acute Myeloid Leukemia With t(15;17)(q22;q12); Adult Acute Myeloid Leukemia With t(16;16)(p13;q22); Adult Acute Myeloid Leukemia With t(8;21)(q22;q22); Adult Grade III Lymphomatoid Granulomatosis; Adult Langerhans Cell Histiocytosis; Adult Nasal Type Extranodal NK/T-cell Lymphoma; Aggressive NK-cell Leukemia; AIDS-related Diffuse Large Cell Lymphoma; AIDS-related Diffuse Mixed Cell Lymphoma; AIDS-related Diffuse Small Cleaved Cell Lymphoma; AIDS-related Immunoblastic Large Cell Lymphoma; AIDS-related Lymphoblastic Lymphoma; AIDS-related Malignancies; AIDS-related Small Noncleaved Cell Lymphoma; Anaplastic Large Cell Lymphoma; Angioimmunoblastic T-cell Lymphoma; Atypical Chronic Myeloid Leukemia, BCR-ABL1 Negative; Chronic Eosinophilic Leukemia; Chronic Myelomonocytic Leukemia; Chronic Neutrophilic Leukemia; Chronic Phase Chronic Myelogenous Leukemia; Clear Cell Renal Cell Carcinoma; Cutaneous B-cell Non-Hodgkin Lymphoma; de Novo Myelodysplastic Syndromes; Essential Thrombocythemia; Extramedullary Plasmacytoma; Extranodal Marginal Zone B-cell Lymphoma of Mucosa-associated Lymphoid Tissue; Hepatosplenic T-cell Lymphoma; HIV Infection; HIV-associated Hodgkin Lymphoma; Intraocular Lymphoma; Isolated Plasmacytoma of Bone; Light Chain Deposition Disease; Mast Cell Leukemia; Myelodysplastic Syndrome With Isolated Del(5q); Myelodysplastic/Myeloproliferative Neoplasm, Unclassifiable; Myeloid/NK-cell Acute Leukemia; Nodal Marginal Zone B-cell Lymphoma; Noncutaneous Extranodal Lymphoma; Osteolytic Lesions of Multiple Myeloma; Peripheral T-cell Lymphoma; Plasma Cell Neoplasm; Polycythemia Vera; Post-transplant Lymphoproliferative Disorder; Previously Treated Myelodysplastic Syndromes; Primary Myelofibrosis; Primary Systemic Amyloidosis; Progressive Hairy Cell Leukemia, Initial Treatment; Prolymphocytic Leukemia; Recurrent Adult Acute Lymphoblastic Leukemia; Recurrent Adult Acute Myeloid Leukemia; Recurrent Adult Burkitt Lymphoma; Recurrent Adult Diffuse Large Cell Lymphoma; Recurrent Adult Diffuse Mixed Cell Lymphoma; Recurrent Adult Diffuse Small Cleaved Cell Lymphoma; Recurrent Adult Grade III Lymphomatoid Granulomatosis; Recurrent Adult Hodgkin Lymphoma; Recurrent Adult Immunoblastic Large Cell Lymphoma; Recurrent Adult Lymphoblastic Lymphoma; Recurrent Adult T-cell Leukemia/Lymphoma; Recurrent Cutaneous T-cell Non-Hodgkin Lymphoma; Recurrent Grade 1 Follicular Lymphoma; Recurrent Grade 2 Follicular Lymphoma; Recurrent Grade 3 Follicular Lymphoma; Recurrent Mantle Cell Lymphoma; Recurrent Marginal Zone Lymphoma; Recurrent Mycosis Fungoides/Sezary Syndrome; Recurrent Renal Cell Cancer; Recurrent Small Lymphocytic Lymphoma; Refractory Chronic Lymphocytic Leukemia; Refractory Hairy Cell Leukemia; Refractory Multiple Myeloma; Relapsing Chronic Myelogenous Leukemia; Stage IV Renal Cell Cancer; T-cell Large Granular Lymphocyte Leukemia; Testicular Lymphoma; Unspecified Adult Solid Tumor, Protocol Specific; Waldenström Macroglobulinemia

Massage Therapy Given by Caregiver in Treating Quality of Life of Young Patients Undergoing Treatment for Cancer

ClinicalTrials.gov

2018-05-24

Accelerated Phase Chronic Myelogenous Leukemia; Acute Undifferentiated Leukemia; Angioimmunoblastic T-cell Lymphoma; Atypical Chronic Myeloid Leukemia, BCR-ABL1 Negative; Blastic Phase Chronic Myelogenous Leukemia; Burkitt Lymphoma; Childhood Acute Lymphoblastic Leukemia in Remission; Childhood Acute Myeloid Leukemia in Remission; Childhood Chronic Myelogenous Leukemia; Childhood Diffuse Large Cell Lymphoma; Childhood Grade III Lymphomatoid Granulomatosis; Childhood Immunoblastic Large Cell Lymphoma; Childhood Myelodysplastic Syndromes; Childhood Nasal Type Extranodal NK/T-cell Lymphoma; Chronic Eosinophilic Leukemia; Chronic Myelomonocytic Leukemia; Chronic Neutrophilic Leukemia; Chronic Phase Chronic Myelogenous Leukemia; Contiguous Stage II Mantle Cell Lymphoma; Cutaneous B-cell Non-Hodgkin Lymphoma; Essential Thrombocythemia; Extramedullary Plasmacytoma; Intraocular Lymphoma; Isolated Plasmacytoma of Bone; Juvenile Myelomonocytic Leukemia; Mast Cell Leukemia; Meningeal Chronic Myelogenous Leukemia; Noncontiguous Stage II Mantle Cell Lymphoma; Polycythemia Vera; Post-transplant Lymphoproliferative Disorder; Primary Myelofibrosis; Primary Systemic Amyloidosis; Progressive Hairy Cell Leukemia, Initial Treatment; Prolymphocytic Leukemia; Recurrent Childhood Acute Lymphoblastic Leukemia; Recurrent Childhood Acute Myeloid Leukemia; Recurrent Childhood Anaplastic Large Cell Lymphoma; Recurrent Childhood Grade III Lymphomatoid Granulomatosis; Recurrent Childhood Large Cell Lymphoma; Recurrent Childhood Lymphoblastic Lymphoma; Recurrent Childhood Small Noncleaved Cell Lymphoma; Recurrent Cutaneous T-cell Non-Hodgkin Lymphoma; Recurrent Mycosis Fungoides/Sezary Syndrome; Recurrent/Refractory Childhood Hodgkin Lymphoma; Refractory Chronic Lymphocytic Leukemia; Refractory Hairy Cell Leukemia; Refractory Multiple Myeloma; Relapsing Chronic Myelogenous Leukemia; Secondary Acute Myeloid Leukemia; Stage 0 Chronic Lymphocytic Leukemia; Stage I Childhood Anaplastic Large Cell Lymphoma; Stage I Childhood Hodgkin Lymphoma; Stage I Childhood Large Cell Lymphoma; Stage I Childhood Lymphoblastic Lymphoma; Stage I Childhood Small Noncleaved Cell Lymphoma; Stage I Chronic Lymphocytic Leukemia; Stage I Cutaneous T-cell Non-Hodgkin Lymphoma; Stage I Multiple Myeloma; Stage I Mycosis Fungoides/Sezary Syndrome; Stage II Childhood Anaplastic Large Cell Lymphoma; Stage II Childhood Hodgkin Lymphoma; Stage II Childhood Large Cell Lymphoma; Stage II Childhood Lymphoblastic Lymphoma; Stage II Childhood Small Noncleaved Cell Lymphoma; Stage II Chronic Lymphocytic Leukemia; Stage II Cutaneous T-cell Non-Hodgkin Lymphoma; Stage II Multiple Myeloma; Stage II Mycosis Fungoides/Sezary Syndrome; Stage III Childhood Anaplastic Large Cell Lymphoma; Stage III Childhood Hodgkin Lymphoma; Stage III Childhood Large Cell Lymphoma; Stage III Childhood Lymphoblastic Lymphoma; Stage III Childhood Small Noncleaved Cell Lymphoma; Stage III Chronic Lymphocytic Leukemia; Stage III Cutaneous T-cell Non-Hodgkin Lymphoma; Stage III Multiple Myeloma; Stage III Mycosis Fungoides/Sezary Syndrome; Stage IV Childhood Anaplastic Large Cell Lymphoma; Stage IV Childhood Hodgkin Lymphoma; Stage IV Childhood Large Cell Lymphoma; Stage IV Childhood Lymphoblastic Lymphoma; Stage IV Childhood Small Noncleaved Cell Lymphoma; Stage IV Chronic Lymphocytic Leukemia; Stage IV Cutaneous T-cell Non-Hodgkin Lymphoma; Stage IV Mycosis Fungoides/Sezary Syndrome; T-cell Large Granular Lymphocyte Leukemia; Unspecified Childhood Solid Tumor, Protocol Specific

Symbiogenesis, natural selection, and the dynamic Earth.

PubMed

Kutschera, U

2009-08-01

One century ago, Constantin S. Mereschkowsky introduced the symbiogenesis theory for the origin of chloroplasts from ancient cyanobacteria which was later supplemented by Ivan E. Wallin's proposal that mitochondria evolved from once free-living bacteria. Today, this Mereschkowsky-Wallin principle of symbiogenesis, which is also known as the serial primary endosymbiosis theory, explains the evolutionary origin of eukaryotic cells and hence the emergence of all eukaryotes (protists, fungi, animals and plants). In 1858, the concept of natural selection was described independently by Charles Darwin and Alfred R. Wallace. In the same year, Antonio Snider-Pellegrini proposed the idea of shifting continents, which was later expanded by Alfred Wegener, who published his theory of continental drift eight decades ago. Today, directional selection is accepted as the major cause of adaptive evolution within natural populations of micro- and macro-organisms and the theory of the dynamic Earth (plate tectonics) is well supported. In this article, I combine the processes and principles of symbiogenesis, natural selection and the dynamic Earth and propose an integrative 'synade-model' of macroevolution which takes into account organisms from all five Kingdoms of life.

Effect of Infrared Radiation on the Healing of Diabetic Foot Ulcer

PubMed Central

Hakim, Ashrafalsadat; Sadeghi Moghadam, Ali; Shariati, Abdalali; karimi, Hamid; Haghighizadeh, Mohamad Hossien

2016-01-01

Background Diabetic foot ulcer is a worldwide health care concern affecting tens of thousands of patients. If these ulcers left untreated, they can create severe complications. Objectives This study was designed to examine the effect of infrared radiation on the healing of diabetic foot ulcer. Patients and Methods This clinical trial was performed on 50 patients referred to Dr. Ganjavian hospital in Dezful city, Iran, with diabetic foot ulcer degree 1 and 2 (based on Wegener Scale). Sample size was determined based on relevant studies of the recent decade. Patients were classified into the intervention and control groups (n = 25 in each group) in terms of age, gender, degree of ulcer, ulcer site and body mass index. In this study, work progress was evaluated according to the checklist of diabetic foot ulcer healing evaluation. Results The results of the current study showed that there was a statistically significant difference in healing ulcers (P < 0.05) and mean healing time (P < 0.05) between the two groups. Conclusions Using the infrared plus routine dressing is more effective than using merely routine dressing. PMID:27942260

Histopathology of aseptic necrosis of the femoral head in sickle cell disease.

PubMed

Mukisi-Mukaza, Martin; Gomez-Brouchet, Anne; Donkerwolcke, Monique; Hinsenkamp, Maurice; Burny, Franz

2011-08-01

This study compares the histopathology of bone biopsies from patients suffering from sickle cell anaemia (homozygote SS) to heterozygote patients (SA) and homozygotes with aseptic osteonecrosis (AA). The sensitivity to bacterial infection of sickle cell patients raises the question of the aetiology of sepsis in the onset of the necrosis. To our knowledge this study is the first to analyse the histopathology of osteonecrosis of the femoral head, at its early stages, in sickle cell anaemia. At the University Hospital of Pointe-à-Pitre, from 1994 to 2007, 38 bone biopsies were obtained from adult patients with avascular necrosis of the femoral head at the time of a core decompression procedure (SS, SC: 27; AS: 5; AA: 6). The histology of the biopsies confirmed the necrosis; all bacteriological cultures were negative. Patients displaying one S gene (SS, SC, AS) compared to homozygote subjects (AA) showed a significant increase of a nonspecific inflammatory granulomatosis (p = 0.003). No relationship was observed between the radiological stages and the histology whatever the genotype (p = 0.1). Inflammatory histopathology without sepsis or advanced alteration characterises the early stages of sickle cell necrosis. This inflammatory process is absent in idiopathic avascular necrosis.

Epizootic ulcerative syndrome caused by Aphanomyces invadans in captive bullseye snakehead Channa marulius collected from south Florida, USA

USGS Publications Warehouse

Saylor, Ryan K.; Miller, Debra L.; Vandersea, Mark W.; Bevelhimer, Mark S.; Schofield, Pamela J.; Bennett, Wayne A.

2010-01-01

Epizootic ulcerative syndrome (EUS) caused by the oomycete Aphanomyces invadans is an invasive, opportunistic disease of both freshwater and estuarine fishes. Originally documented as the cause of mycotic granulomatosis of ornamental fishes in Japan and as the cause of EUS of fishes in southeast Asia and Australia, this pathogen is also present in estuaries and freshwater bodies of the Atlantic and gulf coasts of the USA. We describe a mass mortality event of 343 captive juvenile bullseye snakehead Channa marulius collected from freshwater canals in Miami-Dade County, Florida. Clinical signs appeared within the first 2 d of captivity and included petechiae, ulceration, erratic swimming, and inappetence. Histological examination revealed hyphae invading from the skin lesions deep into the musculature and internal organs. Species identification was confirmed using a species-specific PCR assay. Despite therapeutic attempts, 100% mortality occurred. This represents the first documented case of EUS in bullseye snakehead fish collected from waters in the USA. Future investigation of the distribution and prevalence of A. invadans within the bullseye snakehead range in south Florida may give insight into this pathogen-host system.

Low-Dose Total Body Irradiation and Donor Peripheral Blood Stem Cell Transplant Followed by Donor Lymphocyte Infusion in Treating Patients With Non-Hodgkin Lymphoma, Chronic Lymphocytic Leukemia, or Multiple Myeloma

ClinicalTrials.gov

2017-10-23

Adult Nasal Type Extranodal NK/T-cell Lymphoma; Anaplastic Large Cell Lymphoma; Angioimmunoblastic T-cell Lymphoma; Cutaneous B-cell Non-Hodgkin Lymphoma; Extranodal Marginal Zone B-cell Lymphoma of Mucosa-associated Lymphoid Tissue; Hepatosplenic T-cell Lymphoma; Intraocular Lymphoma; Nodal Marginal Zone B-cell Lymphoma; Noncutaneous Extranodal Lymphoma; Peripheral T-cell Lymphoma; Recurrent Adult Acute Lymphoblastic Leukemia; Recurrent Adult Burkitt Lymphoma; Recurrent Adult Diffuse Large Cell Lymphoma; Recurrent Adult Diffuse Mixed Cell Lymphoma; Recurrent Adult Diffuse Small Cleaved Cell Lymphoma; Recurrent Adult Grade III Lymphomatoid Granulomatosis; Recurrent Adult Immunoblastic Large Cell Lymphoma; Recurrent Adult Lymphoblastic Lymphoma; Recurrent Adult T-cell Leukemia/Lymphoma; Recurrent Cutaneous T-cell Non-Hodgkin Lymphoma; Recurrent Grade 1 Follicular Lymphoma; Recurrent Grade 2 Follicular Lymphoma; Recurrent Grade 3 Follicular Lymphoma; Recurrent Mantle Cell Lymphoma; Recurrent Marginal Zone Lymphoma; Recurrent Mycosis Fungoides/Sezary Syndrome; Recurrent Small Lymphocytic Lymphoma; Refractory Chronic Lymphocytic Leukemia; Refractory Hairy Cell Leukemia; Refractory Multiple Myeloma; Small Intestine Lymphoma; Splenic Marginal Zone Lymphoma; Stage II Multiple Myeloma; Stage III Multiple Myeloma; Testicular Lymphoma; Waldenström Macroglobulinemia

Hospital Morbidity Database for Epidemiological Studies on Churg-Strauss Syndrome.

PubMed

Kanecki, Krzysztof; Nitsch-Osuch, Aneta; Gorynski, Paweł; Tarka, Patryk; Tyszko, Piotr

2017-01-01

Churg-Strauss syndrome or more accurately eosinophilic granulomatosis with polyangiitis (EGPA) is a small-vessel necrotizing vasculitis with a characteristic late-onset allergic rhinitis and asthma. The use of hospital morbidity database is an important element of the epidemiological analysis of this rare disease. The present study was undertaken to assess the incidence of EGPA and factors related to its epidemiology in Poland; the first analysis of the kind in Poland, enabling a comparison in the European context. This is a retrospective, population-based study using hospital discharge records with EGPA diagnosis, collected for a National Institute of Public Health survey covering the period from 2008 to 2013. The group consisted of 344 patients (206 females and 138 males) with the first-time hospitalization for EGPA. The major findings are that the annual incidence of EGPA in Poland was 1.5 per million (95% confidence intervals: 1.2-1.8), with the point prevalence of 8.8 per million at the end of 2013. A greater incidence of EGPA was observed in the regions with urban predominance. We conclude that discharge records may be a useful element of epidemiological studies on EGPA.

Chronic beryllium disease: Diagnosis and management

DOE Office of Scientific and Technical Information (OSTI.GOV)

Rossman, M.D.

1996-10-01

Chronic beryllium disease is predominantly a pulmonary granulomatosis that was originally described in 1946. Symptoms usually include dyspnea and cough. Fever, anorexia, and weight loss are common. Skin lesions are the most common extrathoracic manifestation. Granulomatous hepatitis, hypercalcemia, and kidney stones can also occur. Radiographic and physiologic abnormalities are similar to those in sarcoidosis. While traditionally the pathologic changes included granulomas and cellular interstitial changes, the hallmark of the disease today is the well-formed granuloma. Immunologic studies have demonstrated a cell-mediated response to beryllium that is due to an accumulation of CD4{sup +} T cells at the site of diseasemore » activity. Diagnosis depends on the demonstration of pathologic changes (i.e., granuloma) and evidence that the granuloma was caused by a hypersensitivity to beryllium (i.e., positive lung proliferative response to beryllium). Using these criteria, the diagnosis of chronic beryllium disease can now be made before the onset of clinical symptoms. Whether, with early diagnosis, the natural course of this condition will be the same as when it was traditionally diagnosed is not known. Currently, corticosteroids are used to treat patients with significant symptoms or evidence of progressive disease. 21 refs.« less

EBV-Positive Lymphoproliferations of B- T- and NK-Cell Derivation in Non-Immunocompromised Hosts

PubMed Central

Fend, Falko

2018-01-01

The contribution of Epstein-Barr virus (EBV) to the development of specific types of benign lymphoproliferations and malignant lymphomas has been extensively studied since the discovery of the virus over the last 50 years. The importance and better understanding of the EBV-associated lymphoproliferative disorders (LPD) of B, T or natural killer (NK) cell type has resulted in the recognition of new entities like EBV+ mucocutaneous ulcer or the addition of chronic active EBV (CAEBV) infection in the revised 2016 World Health Organization (WHO) lymphoma classification. In this article, we review the definitions, morphology, pathogenesis, and evolving concepts of the various EBV-associated disorders including EBV+ diffuse large B-cell lymphoma, not otherwise specified (DLBCL, NOS), EBV+ mucocutaneous ulcer, DLBCL associated with chronic inflammation, fibrin-associated DLBCL, lymphomatoid granulomatosis, the EBV+ T and NK-cell LPD of childhood, aggressive NK leukaemia, extranodal NK/T-cell lymphoma, nasal type, and the new provisional entity of primary EBV+ nodal T- or NK-cell lymphoma. The current knowledge regarding the pathogenesis of B-cell lymphomas that can be EBV-associated including Burkitt lymphoma, plasmablastic lymphoma and classic Hodgkin lymphoma will be also explored. PMID:29518976

Donor Peripheral Stem Cell Transplant in Treating Patients With Hematolymphoid Malignancies

ClinicalTrials.gov

2016-11-17

Adult Acute Myeloid Leukemia With Inv(16)(p13;q22); Adult Acute Myeloid Leukemia With t(15;17)(q22;q12); Adult Acute Myeloid Leukemia With t(16;16)(p13;q22); Adult Acute Myeloid Leukemia With t(8;21)(q22;q22); Adult Nasal Type Extranodal NK/T-cell Lymphoma; Cutaneous B-cell Non-Hodgkin Lymphoma; Extranodal Marginal Zone B-cell Lymphoma; Hepatosplenic T-cell Lymphoma; Intraocular Lymphoma; Nodal Marginal Zone B-cell Lymphoma; Peripheral T-cell Lymphoma; Recurrent Adult Acute Lymphoblastic Leukemia; Recurrent Adult Acute Myeloid Leukemia; Recurrent Adult Burkitt Lymphoma; Recurrent Adult Diffuse Large Cell Lymphoma; Recurrent Adult Diffuse Mixed Cell Lymphoma; Recurrent Adult Diffuse Small Cleaved Cell Lymphoma; Recurrent Adult Grade III Lymphomatoid Granulomatosis; Recurrent Adult Hodgkin Lymphoma; Recurrent Adult Immunoblastic Large Cell Lymphoma; Recurrent Adult Lymphoblastic Lymphoma; Recurrent Adult T-cell Leukemia/Lymphoma; Recurrent Cutaneous T-cell Non-Hodgkin Lymphoma; Recurrent Grade 1 Follicular Lymphoma; Recurrent Grade 2 Follicular Lymphoma; Recurrent Grade 3 Follicular Lymphoma; Recurrent Mantle Cell Lymphoma; Recurrent Marginal Zone Lymphoma; Recurrent Mycosis Fungoides/Sezary Syndrome; Recurrent Small Lymphocytic Lymphoma; Refractory Chronic Lymphocytic Leukemia; Relapsing Chronic Myelogenous Leukemia; Splenic Marginal Zone Lymphoma; Waldenstrom Macroglobulinemia

Immunoglobulin light chain allelic inclusion in systemic lupus erythematosus.

PubMed

Fraser, Louise D; Zhao, Yuan; Lutalo, Pamela M K; D'Cruz, David P; Cason, John; Silva, Joselli S; Dunn-Walters, Deborah K; Nayar, Saba; Cope, Andrew P; Spencer, Jo

2015-08-01

The principles of allelic exclusion state that each B cell expresses a single light and heavy chain pair. Here, we show that B cells with both kappa and lambda light chains (Igκ and Igλ) are enriched in some patients with the systemic autoimmune disease systemic lupus erythematosus (SLE), but not in the systemic autoimmune disease control granulomatosis with polyangiitis. Detection of dual Igκ and Igλ expression by flow cytometry could not be abolished by acid washing or by DNAse treatment to remove any bound polyclonal antibody or complexes, and was retained after two days in culture. Both surface and intracytoplasmic dual light chain expression was evident by flow cytometry and confocal microscopy. We observed reduced frequency of rearrangements of the kappa-deleting element (KDE) in SLE and an inverse correlation between the frequency of KDE rearrangement and the frequency of dual light chain expressing B cells. We propose that dual expression of Igκ and Igλ by a single B cell may occur in some patients with SLE when this may be a consequence of reduced activity of the KDE. © 2015 The Authors. European Journal of Immunology published by WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Epizootic ulcerative syndrome caused by Aphanomyces invadans in captive bullseye snakehead Channa marulius collected from south Florida, USA

DOE Office of Scientific and Technical Information (OSTI.GOV)

Saylor, Ryan; Miller, Debra; Vandersea, Mark

2010-02-01

Epizootic ulcerative syndrome (EUS) caused by the oomycete Aphanomyces invadans is an invasive, opportunistic disease of both freshwater and estuarine fishes. Originally documented as the cause of mycotic granulomatosis of ornamental fishes in Japan and as the cause of EUS of fishes in southeast Asia and Australia, this pathogen is also present in estuaries and freshwater bodies of the Atlantic and gulf coasts of the USA. We describe a mass mortality event of 343 captive juvenile bullseye snakehead Channa marulius collected from freshwater canals in Miami-Dade County, Florida. Clinical signs appeared within the first 2 d of captivity and includedmore » petechiae, ulceration, erratic swimming, and inappetence. Histological examination revealed hyphae invading from the skin lesions deep into the musculature and internal organs. Species identification was confirmed using a species-specific PCR assay. Despite therapeutic attempts, 100% mortality occurred. This represents the first documented case of EUS in bullseye snakehead fish collected from waters in the USA. Future investigation of the distribution and prevalence of A. invadans within the bullseye snakehead range in south Florida may give insight into this pathogen-host system.« less

Effects of the Wegener-Bergeron-Findeisen process on global black carbon distribution

NASA Astrophysics Data System (ADS)

Qi, Ling; Li, Qinbin; He, Cenlin; Wang, Xin; Huang, Jianping

2017-06-01

We systematically investigate the effects of Wegener-Bergeron-Findeisen process (hereafter WBF) on black carbon (BC) scavenging efficiency, surface BCair, deposition flux, concentration in snow (BCsnow, ng g-1), and washout ratio using a global 3-D chemical transport model (GEOS-Chem). We differentiate riming- versus WBF-dominated in-cloud scavenging based on liquid water content (LWC) and temperature. Specifically, we implement an implied WBF parameterization using either temperature or ice mass fraction (IMF) in mixed-phase clouds based on field measurements. We find that at Jungfraujoch, Switzerland, and Abisko, Sweden, where WBF dominates in-cloud scavenging, including the WBF effect strongly reduces the discrepancies of simulated BC scavenging efficiency and washout ratio against observations (from a factor of 3 to 10 % and from a factor of 4-5 to a factor of 2). However, at Zeppelin, Norway, where riming dominates, simulation of BC scavenging efficiency, BCair, and washout ratio become worse (relative to observations) when WBF is included. There is thus an urgent need for extensive observations to distinguish and characterize riming- versus WBF-dominated aerosol scavenging in mixed-phase clouds and the associated BC scavenging efficiency. Our model results show that including the WBF effect lowers global BC scavenging efficiency, with a higher reduction at higher latitudes (8 % in the tropics and up to 76 % in the Arctic). The resulting annual mean BCair increases by up to 156 % at high altitudes and at northern high latitudes because of lower temperature and higher IMF. Overall, WBF halves the model-observation discrepancy (from -65 to -30 %) of BCair across North America, Europe, China and the Arctic. Globally WBF increases BC burden from 0.22 to 0.29-0.35 mg m-2 yr-1, which partially explains the gap between observed and previous model-simulated BC burdens over land. In addition, WBF significantly increases BC lifetime from 5.7 to ˜ 8 days. Additionally, WBF results in a significant redistribution of BC deposition in source and remote regions. Specifically, it lowers BC wet deposition (by 37-63 % at northern mid-latitudes and by 21-29 % in the Arctic), while it increases dry deposition (by 3-16 % at mid-latitudes and by 81-159 % in the Arctic). The resulting total BC deposition is lower at mid-latitudes (by 12-34 %) but higher in the Arctic (by 2-29 %). We find that WBF decreases BCsnow at mid-latitudes (by ˜ 15 %) but increases it in the Arctic (by 26 %) while improving model comparisons with observations. In addition, WBF dramatically reduces the model-observation discrepancy of washout ratios in winter (from a factor of 16 to 4). The remaining discrepancies in BCair, BCsnow and BC washout ratios suggest that in-cloud removal in mixed-phased clouds is likely still excessive over land.

RO4929097 and Capecitabine in Treating Patients With Refractory Solid Tumors

ClinicalTrials.gov

2014-11-06

Adult Grade III Lymphomatoid Granulomatosis; Adult Nasal Type Extranodal NK/T-cell Lymphoma; AIDS-related Diffuse Large Cell Lymphoma; AIDS-related Diffuse Mixed Cell Lymphoma; AIDS-related Diffuse Small Cleaved Cell Lymphoma; AIDS-related Immunoblastic Large Cell Lymphoma; AIDS-related Lymphoblastic Lymphoma; AIDS-related Peripheral/Systemic Lymphoma; AIDS-related Primary CNS Lymphoma; AIDS-related Small Noncleaved Cell Lymphoma; Anaplastic Large Cell Lymphoma; Angioimmunoblastic T-cell Lymphoma; Cutaneous B-cell Non-Hodgkin Lymphoma; Extranodal Marginal Zone B-cell Lymphoma of Mucosa-associated Lymphoid Tissue; HER2-negative Breast Cancer; HIV-associated Hodgkin Lymphoma; Intraocular Lymphoma; Male Breast Cancer; Nodal Marginal Zone B-cell Lymphoma; Post-transplant Lymphoproliferative Disorder; Primary Central Nervous System Hodgkin Lymphoma; Primary Central Nervous System Non-Hodgkin Lymphoma; Recurrent Adult Burkitt Lymphoma; Recurrent Adult Diffuse Large Cell Lymphoma; Recurrent Adult Diffuse Mixed Cell Lymphoma; Recurrent Adult Diffuse Small Cleaved Cell Lymphoma; Recurrent Adult Grade III Lymphomatoid Granulomatosis; Recurrent Adult Hodgkin Lymphoma; Recurrent Adult Immunoblastic Large Cell Lymphoma; Recurrent Adult Lymphoblastic Lymphoma; Recurrent Adult T-cell Leukemia/Lymphoma; Recurrent Breast Cancer; Recurrent Colon Cancer; Recurrent Cutaneous T-cell Non-Hodgkin Lymphoma; Recurrent Grade 1 Follicular Lymphoma; Recurrent Grade 2 Follicular Lymphoma; Recurrent Grade 3 Follicular Lymphoma; Recurrent Mantle Cell Lymphoma; Recurrent Marginal Zone Lymphoma; Recurrent Mycosis Fungoides/Sezary Syndrome; Recurrent Rectal Cancer; Recurrent Small Lymphocytic Lymphoma; Small Intestine Lymphoma; Splenic Marginal Zone Lymphoma; Stage III Adult Burkitt Lymphoma; Stage III Adult Diffuse Large Cell Lymphoma; Stage III Adult Diffuse Mixed Cell Lymphoma; Stage III Adult Diffuse Small Cleaved Cell Lymphoma; Stage III Adult Hodgkin Lymphoma; Stage III Adult Immunoblastic Large Cell Lymphoma; Stage III Adult Lymphoblastic Lymphoma; Stage III Adult T-cell Leukemia/Lymphoma; Stage III Colon Cancer; Stage III Cutaneous T-cell Non-Hodgkin Lymphoma; Stage III Grade 1 Follicular Lymphoma; Stage III Grade 2 Follicular Lymphoma; Stage III Grade 3 Follicular Lymphoma; Stage III Mantle Cell Lymphoma; Stage III Marginal Zone Lymphoma; Stage III Mycosis Fungoides/Sezary Syndrome; Stage III Rectal Cancer; Stage III Small Lymphocytic Lymphoma; Stage IIIA Breast Cancer; Stage IIIB Breast Cancer; Stage IIIC Breast Cancer; Stage IV Adult Burkitt Lymphoma; Stage IV Adult Diffuse Large Cell Lymphoma; Stage IV Adult Diffuse Mixed Cell Lymphoma; Stage IV Adult Diffuse Small Cleaved Cell Lymphoma; Stage IV Adult Hodgkin Lymphoma; Stage IV Adult Immunoblastic Large Cell Lymphoma; Stage IV Adult Lymphoblastic Lymphoma; Stage IV Adult T-cell Leukemia/Lymphoma; Stage IV Breast Cancer; Stage IV Colon Cancer; Stage IV Cutaneous T-cell Non-Hodgkin Lymphoma; Stage IV Grade 1 Follicular Lymphoma; Stage IV Grade 2 Follicular Lymphoma; Stage IV Grade 3 Follicular Lymphoma; Stage IV Mantle Cell Lymphoma; Stage IV Marginal Zone Lymphoma; Stage IV Mycosis Fungoides/Sezary Syndrome; Stage IV Rectal Cancer; Stage IV Small Lymphocytic Lymphoma; Unspecified Adult Solid Tumor, Protocol Specific; Waldenström Macroglobulinemia

Lenalidomide And Rituximab as Maintenance Therapy in Treating Patients With B-Cell Non-Hodgkin Lymphoma

ClinicalTrials.gov

2015-11-25

Adult Non-Hodgkin Lymphoma; Adult Grade III Lymphomatoid Granulomatosis; Contiguous Stage II Adult Burkitt Lymphoma; Contiguous Stage II Adult Diffuse Large Cell Lymphoma; Contiguous Stage II Adult Diffuse Mixed Cell Lymphoma; Contiguous Stage II Adult Diffuse Small Cleaved Cell Lymphoma; Contiguous Stage II Adult Immunoblastic Large Cell Lymphoma; Contiguous Stage II Adult Lymphoblastic Lymphoma; Contiguous Stage II Grade 1 Follicular Lymphoma; Contiguous Stage II Grade 2 Follicular Lymphoma; Contiguous Stage II Grade 3 Follicular Lymphoma; Contiguous Stage II Mantle Cell Lymphoma; Contiguous Stage II Marginal Zone Lymphoma; Contiguous Stage II Small Lymphocytic Lymphoma; Cutaneous B-cell Non-Hodgkin Lymphoma; Extranodal Marginal Zone B-cell Lymphoma of Mucosa-associated Lymphoid Tissue; Nodal Marginal Zone B-cell Lymphoma; Noncontiguous Stage II Adult Burkitt Lymphoma; Noncontiguous Stage II Adult Diffuse Large Cell Lymphoma; Noncontiguous Stage II Adult Diffuse Mixed Cell Lymphoma; Noncontiguous Stage II Adult Diffuse Small Cleaved Cell Lymphoma; Noncontiguous Stage II Adult Immunoblastic Large Cell Lymphoma; Noncontiguous Stage II Adult Lymphoblastic Lymphoma; Noncontiguous Stage II Grade 1 Follicular Lymphoma; Noncontiguous Stage II Grade 2 Follicular Lymphoma; Noncontiguous Stage II Grade 3 Follicular Lymphoma; Noncontiguous Stage II Mantle Cell Lymphoma; Noncontiguous Stage II Marginal Zone Lymphoma; Noncontiguous Stage II Small Lymphocytic Lymphoma; Recurrent Adult Burkitt Lymphoma; Recurrent Adult Diffuse Large Cell Lymphoma; Recurrent Adult Diffuse Mixed Cell Lymphoma; Recurrent Adult Diffuse Small Cleaved Cell Lymphoma; Recurrent Adult Grade III Lymphomatoid Granulomatosis; Recurrent Adult Immunoblastic Large Cell Lymphoma; Recurrent Adult Lymphoblastic Lymphoma; Recurrent Grade 1 Follicular Lymphoma; Recurrent Grade 2 Follicular Lymphoma; Recurrent Grade 3 Follicular Lymphoma; Recurrent Mantle Cell Lymphoma; Recurrent Marginal Zone Lymphoma; Recurrent Small Lymphocytic Lymphoma; Splenic Marginal Zone Lymphoma; Stage I Adult Burkitt Lymphoma; Stage I Adult Diffuse Large Cell Lymphoma; Stage I Adult Diffuse Mixed Cell Lymphoma; Stage I Adult Diffuse Small Cleaved Cell Lymphoma; Stage I Adult Immunoblastic Large Cell Lymphoma; Stage I Adult Lymphoblastic Lymphoma; Stage I Grade 1 Follicular Lymphoma; Stage I Grade 2 Follicular Lymphoma; Stage I Grade 3 Follicular Lymphoma; Stage I Mantle Cell Lymphoma; Stage I Marginal Zone Lymphoma; Stage I Small Lymphocytic Lymphoma; Stage III Adult Burkitt Lymphoma; Stage III Adult Diffuse Large Cell Lymphoma; Stage III Adult Diffuse Mixed Cell Lymphoma; Stage III Adult Diffuse Small Cleaved Cell Lymphoma; Stage III Adult Immunoblastic Large Cell Lymphoma; Stage III Adult Lymphoblastic Lymphoma; Stage III Grade 1 Follicular Lymphoma; Stage III Grade 2 Follicular Lymphoma; Stage III Grade 3 Follicular Lymphoma; Stage III Mantle Cell Lymphoma; Stage III Marginal Zone Lymphoma; Stage III Small Lymphocytic Lymphoma; Stage IV Adult Burkitt Lymphoma; Stage IV Adult Diffuse Large Cell Lymphoma; Stage IV Adult Diffuse Mixed Cell Lymphoma; Stage IV Adult Diffuse Small Cleaved Cell Lymphoma; Stage IV Adult Immunoblastic Large Cell Lymphoma; Stage IV Adult Lymphoblastic Lymphoma; Stage IV Grade 1 Follicular Lymphoma; Stage IV Grade 2 Follicular Lymphoma; Stage IV Grade 3 Follicular Lymphoma; Stage IV Mantle Cell Lymphoma; Stage IV Marginal Zone Lymphoma; Stage IV Small Lymphocytic Lymphoma; Waldenstrom Macroglobulinemia

Honors

NASA Astrophysics Data System (ADS)

Anonymous

2012-05-01

A number of AGU members were honored during the European Geosciences Union's (EGU) General Assembly, held on 22-27 April in Vienna. EGU Union awards were presented to the following people: Vincent Courtillot, University of Paris Diderot, France, received the 2012 Arthur Holmes Medal and EGU honorary membership for seminal contributions to geomagnetism and the geodynamics of mantle hot spots.Michael Ghil, University of California, Los Angeles, and École Normale Supérieure, France, received the 2012 Alfred Wegener Medal and EGU honorary membership for his leading contributions to theoretical climate dynamics; his innovative observational studies involving model assimilation of satellite data in meteorology, oceanography, and space physics; the breadth of his interdisciplinary studies, including macroeconomics; and his extensive supervision and mentoring of scores of graduate and postdoctoral students. Robin Clarke, Universidade Federal do Rio Grande do Sul, Brazil, received the 2012 Alexander von Humboldt Medal for fundamental contributions in statistical analysis and modeling of hydrological processes.Angioletta Coradini, Istituto Nazionale di Astrofsica, Italy, received the 2012 Jean Dominique Cassini Medal and EGU honorary membership in recognition of her important and wide range of work in planetary sciences and solar system formation and for her leading role in the development of space infrared instrumentation for planetary exploration.

Bioindikation im Grundwasser funktioniert - Erwiderung zum Kommentar von T. Scheytt zum Beitrag "Grundwasserfauna als Indikator für komplexe hydrogeologische Verhältnisse am westlichen Kaiserstuhl" von Gutjahr, S., Bork, J. & Hahn, H.J. in Grundwasser 18 (3), 173-184 (2013)

NASA Astrophysics Data System (ADS)

Hahn, Hans Jürgen; Gutjahr, Simon

2014-09-01

In seinem Kommentar schließt Traugott Scheytt die faunistische Bioindikation über die Nutzung von Grundwassermessstellen aus methodischen Gründen aus. Er postuliert auch, dass die faunistische Indikation hydrogeologischer Zusammenhänge wegen der eingeschränkten Ausbreitungsfähigkeit der Tiere in Porengrundwasserleitern nicht möglich sei und stellt grundsätzlich die Befunde unserer Untersuchungen am Kaiserstuhl in Frage. Dabei überträgt Herr Scheytt seine Erfahrungen aus der unbelebten Hydrogeologie direkt auf den Lebensraum Grundwasser. Seine Argumentation berücksichtigt dabei weder die Prinzipien der Ökologie noch den aktuellen Stand der grundwasserökologischen Forschung. Wir gehen davon aus, dass für die Untersuchungen am Kaiserstuhl sowohl unsere Arbeitshypothese wie auch die angewandten Methoden und die Interpretation der Ergebnisse der Fragestellung angemessen sind und internationalem, wissenschaftlichem Standard entsprechen. Aus den oben benannten Gründen bleiben wir dabei: Biondikation im Grundwasser funktioniert und sie bietet hervorragende Möglichkeiten, gerade auch für die Hydrogeologie.

Honors

NASA Astrophysics Data System (ADS)

2012-05-01

A number of AGU members were honored during the European Geosciences Union's (EGU) General Assembly, held on 22-27 April in Vienna. EGU Union awards were presented to the following people: Vincent Courtillot, University of Paris Diderot, France, received the 2012 Arthur Holmes Medal and EGU honorary membership for seminal contributions to geomagnetism and the geodynamics of mantle hot spots. Michael Ghil, University of California, Los Angeles, and École Normale Supérieure, France, received the 2012 Alfred Wegener Medal and EGU honorary membership for his leading contributions to theoretical climate dynamics; his innovative observational studies involving model assimilation of satellite data in meteorology, oceanography, and space physics; the breadth of his interdisciplinary studies, including macroeconomics; and his extensive supervision and mentoring of scores of graduate and postdoctoral students. Robin Clarke, Universidade Federal do Rio Grande do Sul, Brazil, received the 2012 Alexander von Humboldt Medal for fundamental contributions in statistical analysis and modeling of hydrological processes. Angioletta Coradini, Istituto Nazionale di Astrofsica, Italy, received the 2012 Jean Dominique Cassini Medal and EGU honorary membership in recognition of her important and wide range of work in planetary sciences and solar system formation and for her leading role in the development of space infrared instrumentation for planetary exploration.

A Manual Transportable Instrument Platform for Ground-Based Spectro-Directional Observations (ManTIS) and the Resultant Hyperspectral Field Goniometer System

PubMed Central

Buchhorn, Marcel; Petereit, Reinhold; Heim, Birgit

2013-01-01

This article presents and technically describes a new field spectro-goniometer system for the ground-based characterization of the surface reflectance anisotropy under natural illumination conditions developed at the Alfred Wegener Institute (AWI). The spectro-goniometer consists of a Manual Transportable Instrument platform for ground-based Spectro-directional observations (ManTIS), and a hyperspectral sensor system. The presented measurement strategy shows that the AWI ManTIS field spectro-goniometer can deliver high quality hemispherical conical reflectance factor (HCRF) measurements with a pointing accuracy of ±6 cm within the constant observation center. The sampling of a ManTIS hemisphere (up to 30° viewing zenith, 360° viewing azimuth) needs approx. 18 min. The developed data processing chain in combination with the software used for the semi-automatic control provides a reliable method to reduce temporal effects during the measurements. The presented visualization and analysis approaches of the HCRF data of an Arctic low growing vegetation showcase prove the high quality of spectro-goniometer measurements. The patented low-cost and lightweight ManTIS instrument platform can be customized for various research needs and is available for purchase.

CHAMP/GPS water vapor compared with a NWP model and with AMSU/B data

NASA Astrophysics Data System (ADS)

Johnsen, K.-P.; Miao, J.

2003-04-01

The atmospheric water vapor plays a dominant role in the hydrological cycle and in the radiative balance. It is very important for the greenhouse effect in climate modelling as well as for short term numerical weather prediction. Specific humidities derived from CHAMP/GPS are compared with the High resolution Regional weather forecast Model HRM of the Deutscher Wetterdienst over Europe during the BALTEX/Bridge baseline period (October 1999 to February 2002): The model shows slightly larger specific humidities than the radio occultation data obtained from CHAMP (decreasing with increasing height) up to about 1.5~g/kg. Vertically integrated water vapor (IWV) data derived from the CHAMP/GPS profiles are also compared with IWV data derived from AMSU/B data over Antarctica. The AMSU/B IWV data were calculated using an algorithm of Miao (1999). The mean difference between both datasets is with -0.08 kg/m2 quite low and the standard deviation is about 0.79 kg/m2.[0.3cm] Miao, J: Retrieval of Atmospheric Water Vapor Content in Polar Regions Using Spaceborne Microwave Radiometry, Ph.D. thesis, Reports on Polar Research 289, Alfred Wegener Institute for Polar and Marine Research, Bremerhaven, Germany, 1998

Supercycles, Wilson cycles and the future of Earth's oceans

NASA Astrophysics Data System (ADS)

Duarte, Joao; Schellart, Wouter; Rosas, Filipe

2014-05-01

At the dawn of the 20th Century Alfred Wegener proposed the existence of a supercontinent - Pangaea - gathering all the continental masses on Earth. Five decades later, while seeding the theory of plate tectonics, Tuzo Wilson introduced a new concept that would become known as Wilson cycles, which describes the evolution of oceans: 1) opening and spreading, 2) foundering of the passive margins and development of new subduction zones and 3) consumption and closure. Later on, in the 70's evidences for the existence of a number of other supercontinents and ancient oceans on Earth's history started to emerge. Today, concepts like supercycles, supercontinents, superoceans and Wilson cycles are loosely used. However, several important questions remain. How do subduction zones initiate in pristine oceans? Which major ocean on Earth will close to form the next supercontinent? The Atlantic (introversion), the Pacific (extroversion), or both? Are Wilson cycles of lower order than Supercycles? Are we in an abnormally long supercycle? Is there any cyclicity at all? These are some of the questions that we will tentatively address together with the proposal of several future scenarios for the evolution of Earth's oceans and continents.

Gamma-Secretase Inhibitor RO4929097 in Treating Young Patients With Relapsed or Refractory Solid Tumors, CNS Tumors, Lymphoma, or T-Cell Leukemia

ClinicalTrials.gov

2014-11-04

Childhood Atypical Teratoid/Rhabdoid Tumor; Childhood Central Nervous System Choriocarcinoma; Childhood Central Nervous System Germinoma; Childhood Central Nervous System Mixed Germ Cell Tumor; Childhood Central Nervous System Teratoma; Childhood Central Nervous System Yolk Sac Tumor; Childhood Choroid Plexus Tumor; Childhood Craniopharyngioma; Childhood Ependymoblastoma; Childhood Grade I Meningioma; Childhood Grade II Meningioma; Childhood Grade III Meningioma; Childhood Infratentorial Ependymoma; Childhood Medulloepithelioma; Childhood Mixed Glioma; Childhood Oligodendroglioma; Childhood Supratentorial Ependymoma; Gonadotroph Adenoma; Pituitary Basophilic Adenoma; Pituitary Chromophobe Adenoma; Pituitary Eosinophilic Adenoma; Prolactin Secreting Adenoma; Recurrent Childhood Acute Lymphoblastic Leukemia; Recurrent Childhood Anaplastic Large Cell Lymphoma; Recurrent Childhood Brain Stem Glioma; Recurrent Childhood Central Nervous System Embryonal Tumor; Recurrent Childhood Cerebellar Astrocytoma; Recurrent Childhood Cerebral Astrocytoma; Recurrent Childhood Ependymoma; Recurrent Childhood Grade III Lymphomatoid Granulomatosis; Recurrent Childhood Large Cell Lymphoma; Recurrent Childhood Lymphoblastic Lymphoma; Recurrent Childhood Medulloblastoma; Recurrent Childhood Pineoblastoma; Recurrent Childhood Small Noncleaved Cell Lymphoma; Recurrent Childhood Spinal Cord Neoplasm; Recurrent Childhood Subependymal Giant Cell Astrocytoma; Recurrent Childhood Supratentorial Primitive Neuroectodermal Tumor; Recurrent Childhood Visual Pathway and Hypothalamic Glioma; Recurrent Childhood Visual Pathway Glioma; Recurrent Pituitary Tumor; Recurrent/Refractory Childhood Hodgkin Lymphoma; T-cell Childhood Acute Lymphoblastic Leukemia; T-cell Large Granular Lymphocyte Leukemia; TSH Secreting Adenoma; Unspecified Childhood Solid Tumor, Protocol Specific

Dynamic OCT monitoring and quantification of light penetration enhancement for normal, benign and cancerous human lung tissues at different concentrations of glycerol

DOE Office of Scientific and Technical Information (OSTI.GOV)

Shu-wen Tan; Ying Jin; Hui Yu

2013-10-31

We have evaluated the dynamic effects of the analyte diffusion on the 1/e light penetration depths of normal, benign and cancerous human lung tissue in vitro, as well as have monitored and quantified the dynamic change in the light penetration depths of the mentioned human lung tissue after application of 25 % and 50 % glycerol solution, respectively. The light penetration depths of the analyte diffusion in the lung tissue are measured using the Fourierdomain optical coherence tomography (FD-OCT). Experimental results show that the application of glycerol as a chemical agent can significantly enhance light penetration depths into the humanmore » normal lung (NL), lung benign granulomatosis (LBG) and lung squamous cell carcinoma (LSCC) tissue. In-depth transport of the glycerol molecules in the NL, LBG and LSCC tissue at a lower glycerol concentration (25 %) are faster than those at a higher glycerol concentration (50 %), and the 1/e light penetration depths at a lower glycerol concentration (25 %) are smaller than those at a higher glycerol concentration (50 %), respectively. Their differences in the maximal 1/e light penetration depths of the NL, LBG and LSCC tissue at a higher and a lower glycerol concentrations were only 8.8 %, 6.8 % and 4.7 %, respectively. (biophotonics)« less

Pathogenetic and Clinical Aspects of Anti-Neutrophil Cytoplasmic Autoantibody-Associated Vasculitides

PubMed Central

Lamprecht, Peter; Kerstein, Anja; Klapa, Sebastian; Schinke, Susanne; Karsten, Christian M.; Yu, Xinhua; Ehlers, Marc; Epplen, Jörg T.; Holl-Ulrich, Konstanze; Wiech, Thorsten; Kalies, Kathrin; Lange, Tanja; Laudien, Martin; Laskay, Tamas; Gemoll, Timo; Schumacher, Udo; Ullrich, Sebastian; Busch, Hauke; Ibrahim, Saleh; Fischer, Nicole; Hasselbacher, Katrin; Pries, Ralph; Petersen, Frank; Weppner, Gesche; Manz, Rudolf; Humrich, Jens Y.; Nieberding, Relana; Riemekasten, Gabriela; Müller, Antje

2018-01-01

Anti-neutrophil cytoplasmic autoantibodies (ANCA) targeting proteinase 3 (PR3) and myeloperoxidase expressed by innate immune cells (neutrophils and monocytes) are salient diagnostic and pathogenic features of small vessel vasculitis, comprising granulomatosis with polyangiitis (GPA), microscopic polyangiitis, and eosinophilic GPA. Genetic studies suggest that ANCA-associated vasculitides (AAV) constitute separate diseases, which share common immunological and pathological features, but are otherwise heterogeneous. The successful therapeutic use of anti-CD20 antibodies emphasizes the prominent role of ANCA and possibly other autoantibodies in the pathogenesis of AAV. However, to elucidate causal effects in AAV, a better understanding of the complex interplay leading to the emergence of B lymphocytes that produce pathogenic ANCA remains a challenge. Different scenarios seem possible; e.g., the break of tolerance induced by a shift from non-pathogenic toward pathogenic autoantigen epitopes in inflamed tissue. This review gives a brief overview on current knowledge about genetic and epigenetic factors, barrier dysfunction and chronic non-resolving inflammation, necro-inflammatory auto-amplification of cellular death and inflammation, altered autoantigen presentation, alternative complement pathway activation, alterations within peripheral and inflamed tissue-residing T- and B-cell populations, ectopic lymphoid tissue neoformation, the characterization of PR3-specific T-cells, properties of ANCA, links between autoimmune disease and infection-triggered pathology, and animal models in AAV. PMID:29686675

Off-label use of TNF-alpha inhibitors in a dermatological university department: retrospective evaluation of 118 patients.

PubMed

Sand, Freja Lærke; Thomsen, Simon Francis

2015-01-01

Tumor necrosis factor-alpha (TNF)-alpha inhibitors are licensed for patients with severe refractory psoriasis and psoriatic arthritis. However, TNF-alpha inhibitors have also been used off-label for various recalcitrant mucocutaneous diseases. This study aimed to evaluate the efficacy and safety of TNF-alpha inhibitors used for off-label dermatological indications. We retrospectively evaluated patient records of 118 patients treated off-label with TNF-alpha inhibitors in a dermatological university department. Patients presented with severe aphthous stomatitis/genital aphthous lesions (26), chronic urticaria (25), hidradenitis suppurativa (29), acne conglobata (11), dissecting cellulitis of the scalp (two), orofacial granulomatosis (four), sarcoidosis (four), granuloma annulare (two), granulomatous rosacea (one), granuloma faciale (one), subcorneal pustulosis (one), pyoderma gangrenosum (four), Sweet's syndrome (four), Well's syndrome (one), benign familial pemphigus (one), lichen planus (one), and folliculitis decalvans (one). A significant number of these patients went into remission during therapy with TNF-alpha inhibitors. A total of 11 patients (9%) experienced severe adverse effects during therapy. Off-label therapy with TNF-alpha inhibitors may be considered for selected patients with severe recalcitrant mucocutaneous diseases. The risk of severe adverse effects signals that a thorough benefit-risk assessment should be performed before initiating off-label treatment with TNF-alpha inhibitors for these conditions. © 2015 Wiley Periodicals, Inc.

Three decades of BGR airborne geophysical surveys over the polar regions - a review

NASA Astrophysics Data System (ADS)

Damaske, Detlef

2013-04-01

The Federal Institute for Geosciences and Natural Resources (BGR) has been conducting geological polar research since 1979. A few years later BGR engaged in airborne geophysical projects. Investigation of the lithosphere of the continent and the continental margins was one of the key issues for BGR. Right from the beginning geophysical research was closely associated with the geological activities. The GANOVEX (German Antarctic North Victoria Land Expedition) program combined geological research with geophysical (mainly airborne) investigations. This proved to be a fruitful approach to many of the open questions regarding the tectonic development of the Ross Sea region. Aeromagnetic surveys evolved into a powerful tool for identifying geological structures and following them underneath the ice covered areas - not accessible to direct geological investigations. To achieve this aim it was essential to lay out these surveys with a relatively closely spaced line separation on the expense of covering large areas at the same time. Nevertheless, over many years of continues research areas of more than a just regional extent could be covered. This was, however, only possible through international collaboration. During the first years, working in the Ross Sea area, the cooperation with the US and Italian programs played a significant role, especially the GITARA (German-Italian Aeromagnetic Research in Antarctica) program has to be mentioned. GEOMAUD (Geoscientific Expedition to Dronning Maud Land) and the German-Australian joint venture PCMEGA (Prince Charles Mountains Expedition of Germany & Australia) expanded research activities to the East Antarctic shield area. In the International Polar Year (IPY), BGR played a leading role in the international project AGAP (Antarctica's GAmburtsev Province) as part of the main topic "Venture into Unknown Regions". AGAP was jointly conducted by the USA, Great Britain, Australia, China and Germany. While in the Ross Sea area even smaller scale surveys - getting close to industry standards - targeted specific geological questions, the reconnaissance type of aerogeophysical projects continued in Dronning Maud Land, now in close cooperation with the Alfred-Wegener-Institute (AWI). This very successful cooperation between the two German institutions - both working continuously in the polar regions - was already established in Arctic projects, namely in northern Greenland. Also, since the late 1990's BGR conducted together with Canada airborne surveys as part of PMAP (Polar Margins Aeromagnetic Program), thematically linked to the predominantly geological CASE (Circum Arctic Structural Events) program of BGR. A joint project of GSC (Geological Survey of Canada) and BGR in the Nares Strait was a highlight of combined geological and aeromagnetic research addressing the still widely discussed Wegener fault between Greenland and Ellesmere Island and the extent of tertiary basins in the Nares Strait itself. BGR intends to continue its successful combined geological-geophysical work in both polar regions. The increasing logistic and financial challenges to work in these extreme areas will demand not only a continuation but an intensification of national and international collaboration.

Paleomagnetism and the evolution of Pangea

NASA Astrophysics Data System (ADS)

Morel, P.; Irving, E.

1981-03-01

We present new apparent polar wandering (APW) paths for the latest Carboniferous to Middle Jurassic of Europe-northern Asia, North America, and Gondwana. The paths have been constructed by ordering the paleopoles into a time sequence and calculating running averages. Globally, this statistical analysis cannot be carried back before the latest Carboniferous, because the paleomagnetic record becomes inadequate. The polar paths have all been rotated along with the land masses from which they have been observed into the classical configuration of Wegener (Pangea A) as quantified by later workers. The mean paleopoles agree in the Early Jurassic but disagree in the latest Carboniferous, Permian, and Early Triassic. This result is insensitive to reasonable choices made regarding the arrangement of the continents within Gondwana; it is true either for results from Gondwana as a whole or from Africa and South America alone. This disagreement in APW paths suggests (but does not prove) that Pangea A lasted for only a short interval of time in the Early to Middle Jurassic (190-170 m.y.) and perhaps the latest Triassic (200 m.y.). Alternatively, we may say either that the paleomagnetic record is biassed by sampling inadequacies or by systematically incorrect age assignments, or that the earth's field has been non-dipolar. We regard these explanations as less likely, although they cannot be discounted. The polar paths can be reconciled by rotating Gondwana anticlockwise by about 35° relative to Laurasia, placing Africa beneath Europe, and South America beneath eastern North America. This configuration is called Pangea B. Pangea B could be a valid reconstruction for the latest Carboniferous and Early Permian (approximately 290-260 m.y.). Pangea B provides a statistically satisfactory resolution of the paleomagnetic problem. It also provides a symmetrical arrangement of the continents bordering the Appalachian-Hercynian fold belt for the Late Paleozoic (which Pangea A does not), it provides a satisfactory framework for the early evolution of the Gulf of Mexico, and it provides an explanation of the absence of geological evidence for a Tethys ocean in the Paleozoic. The transition between B and A cannot be accurately reconstructed from the paleomagnetic data, because the resolution of the record is as yet inadequate, but it presumably occurred by a 3500-km minimum dextral megashear between Laurasia and Gondwana during the late Permian and Triassic (approximately 250-200 m.y.), without the formation of ocean between them, and was accompanied by lesser motions between North America and Europe. The sense of megashear is the same as that invoked by Arthaud and Matte (1977) on geological grounds, but the magnitude and timing are different. Our interpretation favors the idea that continental drift is a continuous process, not confined to Jurassic and later times, but extending backwards into the Triassic and Permian. We suggest that Pangea was not an immobile configuration as envisaged by Wegener and most subsequent workers but that it evolved more or less continuously.

Sonification of Climate Data

NASA Astrophysics Data System (ADS)

Vogt, Katharina; Visda, Goudarzi

2013-04-01

Sonification is the acoustic analogue of data visualization and takes advantage of human perceptual and cognitive capabilities. The amount of data being processed today is steadily increasing, and both scientists and society need new ways to understand scientific data and their implications. Sonification is especially suited to the preliminary exploration of complex, dynamic, and multidimensional data sets, as can be found in climate science. In the research project SysSon (https://sysson.kug.ac.at/), we apply a systematic approach to design sonifications to climate data. In collaboration with the Wegener Center for Climate and Global Change (http://www.wegcenter.at/) we assessed the metaphors climate scientists use and their typical workflows, and chose data sets where sonification has high potential revealing new phenomena. This background will be used to develop an audio interface which is directly linked to the visualization interfaces for data analysis the scientists use today. The protoype will be evaluated according to its functionality, intuitivity for climate scientists, and aesthetic criteria. In the current stage of the project, conceptual links between climate science and sound have been elaborated and first sonification designs have been developed. The research is mainly carried out at the Institute of Electronic Music and Acoustics (http://iem.kug.ac.at/), which has extensive experience in interactive sonification with multidimensional data sets.

Biokompatible Metalle

NASA Astrophysics Data System (ADS)

Ha, Suk-Woo; Wintermantel, Erich

Metalle als Implantatwerkstoffe werden in der Medizin für zwei Hauptanwendungen eingesetzt: für Prothesen des totalen Gelenkersatzes wie beispielsweise Hüft-, Knie- und Schulterprothesen und für Fixationselemente zur Stabilisierung von Frakturen. Beispiele hierfür sind Osteosyntheseplatten, Marknägel, Schrauben, Drähte und Stents. Eine der ersten Anwendungen von Metallen im menschlichen Körper war die Fixation von Fragmenten eines gebrochenen Humerus (Oberarmknochen) mit einem Metalldraht durch zwei französische Physiker im Jahr 1775 [1]. Ausführliche Untersuchungen zur Verträglichkeit von Metallen im menschlichen Körper wurden bereits im frühen 19. Jahrhundert durchgeführt. Von den untersuchten Werkstoffen verursachten die edlen Metalle wie Gold, Silber und Platin aufgrund ihrer Korrosionsbeständigkeit und Körperverträglichkeit die geringsten Reizungen im menschlichen Körper. Die klinische Anwendung der Edelmetalle war jedoch wegen der geringen mechanischen Eigenschaften beschränkt. Andere Metalle wie Messing, Kupfer oder Eisen wiesen vergleichsweise höhere Festigkeitswerte auf, sie waren jedoch aufgrund der geringen Korrosionsbeständigkeit und Biokompatibilität nicht für den klinischen Einsatz geeignet. Ein weiteres Problem stellte die Gefahr der Infektion durch unsterile Instrumente und Implantate dar. Gegen Ende des 19. Jahrhunderts hielt die antiseptische Operationsmethode Einzug in die Kliniken, die z. B. erfolgreiche Operationen mit Silberdraht ermöglichte.

The local environment of ice particles in arctic mixed-phase clouds

NASA Astrophysics Data System (ADS)

Schlenczek, Oliver; Fugal, Jacob P.; Schledewitz, Waldemar; Borrmann, Stephan

2015-04-01

During the RACEPAC field campaign in April and May 2014, research flights were made with the Polar 5 and Polar 6 aircraft from the Alfred Wegener Institute in Arctic clouds near Inuvik, Northwest Territories, Canada. One flight with the Polar 6 aircraft, done on May 16, 2014, flew under precipitating, stratiform, mid-level clouds with several penetrations through cloud base. Measurements with HALOHolo, an airborne digital in-line holographic instrument for cloud particles, show ice particles in a field of other cloud particles in a local three-dimensional sample volume (~14x19x130 mm3 or ~35 cm^3). Each holographic sample volume is a snapshot of a 3-dimensional piece of cloud at the cm-scale with typically thousands of cloud droplets per sample volume, so each sample volume yields a statistically significant droplet size distribution. Holograms are recorded at a rate of six times per second, which provides one volume sample approx. every 12 meters along the flight path. The size resolution limit for cloud droplets is better than 1 µm due to advanced sizing algorithms. Shown are preliminary results of, (1) the ice/liquid water partitioning at the cloud base and the distribution of water droplets around each ice particle, and (2) spatial and temporal variability of the cloud droplet size distributions at cloud base.

Radio-echo sounding at Dome C, East Antarctica: A comparison of measured and modeled data

NASA Astrophysics Data System (ADS)

Winter, Anna; Eisen, Olaf; Steinhage, Daniel; Zirizzotti, Achille; Urbini, Stefano; Cavitte, Marie; Blankenship, Donald D.; Wolff, Eric

2016-04-01

The internal layering architecture of ice sheets, detected with radio-echo sounding (RES), contains clues to past ice-flow dynamics and mass balance. A common way of relating the recorded travel time of RES reflections to depth is by integrating a wave-speed distribution. This results in an increasing absolute error with depth. We present a synchronization of RES-internal layers of different radar systems (Alfred Wegener Institute, Center for Remote Sensing of Ice Sheets, Istituto Nazionale di Geofisica e Vulcanologia, British Antarctic Survey and University of Texas Institute for Geophysics) with ice-core records from the Antarctic deep drill site Dome C. Synthetic radar traces are obtained from measurements of ice-core density and conductivity with a 1D model of Maxwell's equations. The reflection peaks of the different radar systems' measurements are shifted by a wiggle-matching algorithm, so they match the synthetic trace. In this way, we matched pronounced internal reflections in the RES data to conductivity peaks with considerably smaller depth uncertainties, and assigned them with the ice-core age. We examine the differences in shifts and resolution of the different RES data to address the question of their comparability and combined analysis for an extensive age-depth distribution.

Seasonal sea ice predictions for the Arctic based on assimilation of remotely sensed observations

NASA Astrophysics Data System (ADS)

Kauker, F.; Kaminski, T.; Ricker, R.; Toudal-Pedersen, L.; Dybkjaer, G.; Melsheimer, C.; Eastwood, S.; Sumata, H.; Karcher, M.; Gerdes, R.

2015-10-01

The recent thinning and shrinking of the Arctic sea ice cover has increased the interest in seasonal sea ice forecasts. Typical tools for such forecasts are numerical models of the coupled ocean sea ice system such as the North Atlantic/Arctic Ocean Sea Ice Model (NAOSIM). The model uses as input the initial state of the system and the atmospheric boundary condition over the forecasting period. This study investigates the potential of remotely sensed ice thickness observations in constraining the initial model state. For this purpose it employs a variational assimilation system around NAOSIM and the Alfred Wegener Institute's CryoSat-2 ice thickness product in conjunction with the University of Bremen's snow depth product and the OSI SAF ice concentration and sea surface temperature products. We investigate the skill of predictions of the summer ice conditions starting in March for three different years. Straightforward assimilation of the above combination of data streams results in slight improvements over some regions (especially in the Beaufort Sea) but degrades the over-all fit to independent observations. A considerable enhancement of forecast skill is demonstrated for a bias correction scheme for the CryoSat-2 ice thickness product that uses a spatially varying scaling factor.

Gondwana's Apparent Polar Wander Path during the Permian-new insights from South America.

PubMed

Tomezzoli, Renata N; Tickyj, Hugo; Rapalini, Augusto E; Gallo, Leandro C; Cristallini, Ernesto O; Arzadún, Guadalupe; Chemale, Farid

2018-05-31

A long-standing debate regarding the configuration of Pangea during the Late Paleozoic has been going on among the paleomagnetic community concerning the validity of one of two significantly different Pangea reconstructions (Pangea A vs Pangea B) since the proposal of Pangea B. Although, Pangea B avoids any continental overlap marring classical Pangea A configuration (Wegener's type), it requires a Carboniferous-Permian megashear of up to 1500 km to achieve the pre-Jurassic configuration. The existence of this megashear is controversial and has led to a wide range of hypotheses, in order to avoid Pangea A continental overlaps and consequently the need for major intra-Pangea movements and to accommodate the paleomagnetic database within a Pangea A reconstruction. We present paleomagnetic results from Permian volcanic rocks of the El Centinela, La Pampa, Argentina. Undeformed volcanic rocks are not affected by any inclination bias and are, therefore, ideal to test different paleogeographic models. The presence of two different paleopole positions, at the base and the top of the same stratigraphic sequence, makes this location optimal to constrain the track of the Gondwana's path during the Late Paleozoic, which shows the transition from Pangea B during the Carboniferous-Permian, to Pangea A at the Permian - Triassic boundary.

Aerogeophysical survey over Sør Rondane Mountains and its implications for revealing the tectonic evolution of East Antarctica

NASA Astrophysics Data System (ADS)

Mieth, Matthias; Steinhage, Daniel; Ruppel, Antonia; Damaske, Detlef; Jokat, Wilfried

2013-04-01

We are presenting new magnetic and gravity data of a high-resolution aerogephysical survey over the area of the Sør Rondane Mountains in the eastern Dronning Maud Land (DML). The aircraft survey is part of the joint geological and geophysical GEA campaign (Geodynamic Evolution of East Antarctica) of the Federal Agency for Geosciences and Natural Resources (BGR) and Alfred-Wegener-Institute for Polar and Marine Research (AWI), in cooperation with the Universities of Ghent, Bremen and Bergen. It was completed during the Antarctic summer season 2012/13, covering an area of more than 100000 square kilometer with a line spacing of 5 km. The data will be correlated with geological structures exposed in the mountain range as well as matched and merged with the data sets of the eastern and southern DML (acquired by AWI during the last decade) for comparison and discussion in the greater context of the tectonic evolution of East Antarctica. Preliminary results show that the magnetic anomaly pattern over the Sør Rondane Mountains differs from the pattern found over the central DML mountains as well as from the low amplitude pattern in between both regions, indicating a significant difference in the evolution of this region, which is in accordance with latest geological findings in this region.

Short- and long-term response to corticosteroid therapy in chronic beryllium disease.

PubMed

Marchand-Adam, S; El Khatib, A; Guillon, F; Brauner, M W; Lamberto, C; Lepage, V; Naccache, J-M; Valeyre, D

2008-09-01

Chronic beryllium disease (CBD) is a granulomatous disorder that affects the lung after exposure to beryllium. The present study reports short- and long-term evolution of granulomatous and fibrotic components in eight patients with severe CBD receiving corticosteroid therapy. Eight patients with confirmed CBD were studied at baseline, after initial corticosteroid treatment (4-12 months), at relapse and at the final visit. Beryllium exposure, Glu(69) (HLA-DPB1 genes coding for glutamate at position beta69) polymorphism, symptoms, pulmonary function tests (PFT), serum angiotensin-converting enzyme (SACE) and high-resolution computed tomography (HRCT) quantification of pulmonary lesions were analysed. The CBD patients were observed for a median (range) of 69 (20-180) months. After stopping beryllium exposure, corticosteroids improved symptoms and PFT (vital capacity +26%, diffusing capacity of the lung for carbon monoxide +15%), and decreased SACE level and active lesion HRCT score. In total, 18 clinical relapses occurred after the treatment was tapered and these were associated with SACE and active lesion HRCT score impairment. At the final visit, corticosteroids had completely stabilised all parameters including both HRCT scores of active lesions and fibrotic lesions in six out of eight patients. Corticosteroids were beneficial in chronic beryllium disease. They were effective in suppressing granulomatosis lesions in all cases and in stopping the evolution to pulmonary fibrosis in six out of eight patients.

Ten-year experience of transjugular intrahepatic portosystemic shunt for noncirrhotic portal hypertension.

PubMed

Regnault, David; d'Alteroche, Louis; Nicolas, Charlotte; Dujardin, Fanny; Ayoub, Jean; Perarnau, Jean Marc

2018-05-01

Transjugular intrahepatic portosystemic shunt (TIPS) is considered to be well suited for the treatment of noncirrhotic portal hypertension (NCPHT) because of a usually severe portal hypertension (PHT) and a mild liver failure, but very less data are available. Records of patients referred for TIPS between 2004 and 2015 for NCPHT were reviewed. No patient should have clinical or biological or histological features of cirrhosis. Twenty-five patients with a wide variety of histological lesions (sinusoidal dilatations, granulomatosis, regenerative nodular hyperplasia, obliterative portal venopathy, or subnormal liver) and a wide variety of associated diseases (thrombophilia, sarcoidosis, common variable immunodeficiency, scleroderma, Castleman's disease, early primitive biliary cirrhosis, congenital liver fibrosis, chemotherapy, purinethol intake, and congenital varices) were included. Two complications occurred during the procedure: one periprosthetic hematoma and the other misposition of a covered stent. During the first month, two other patients had an early thrombosis, another had induced encephalopathy, and one died of early rebleeding. Two of these complications occurred in patients with cavernoma. With a mean follow-up of 39 months, 10 patients experienced at least one episode of spontaneous encephalopathy, with three of these patients requiring a stent reduction. Five patients had a recurrence of their initial symptoms, and one had an asymptomatic hemodynamic dysfunction. TIPS is effective in NCPHT but can be technically difficult, especially in the case of cavernoma. Good liver function does not prevent the occurrence of long-term encephalopathy.

New Insights into Eosinophilic Otitis Media.

PubMed

Kanazawa, Hiromi; Yoshida, Naohiro; Iino, Yukiko

2015-12-01

Eosinophilic otitis media (EOM) is a type of intractable otitis media that occurs mainly in patients with bronchial asthma (BA). In 2011, the diagnostic criteria for EOM were established. EOM is characterized by the presence of a highly viscous yellowish effusion containing eosinophils and immunoglobulin E (IgE), eosinophil chemoattractants, such as eosinophil cationic protein, interleukin-5, and eotaxin. Local sensitization against foreign agents such as fungi or bacteria (e.g., Staphylococcus aureus) may result in local IgE production in the middle ear and may be responsible for the severity of EOM. The clinical features of EOM closely resemble localized eosinophilic granulomatosis polyangiitis, therefore it is necessary to be vigilant to the symptoms of mononeuritis, polyneuritis, and skin purpura during diagnosis. Standard treatment for EOM is the instillation of triamcinolone acetonide into the mesotympanum. However, severe cases exhibiting strong inflammation and otorrhea are not easily controlled with antibiotics and/or corticosteroids. We proposed the introduction of a severity score to evaluate the severity of EOM. This score correlated with local IgE levels in middle ear effusion. Clinically, the risk factors associated with this severity score were body mass index, and the duration of bronchial asthma (from the onset of BA to the age of the first consultation of otitis media to our hospital). We emphasize that early diagnosis and adequate treatment are vital in preventing progressive and sudden hearing loss resulting from EOM.

Imaging manifestations of autoimmune disease-associated lymphoproliferative disorders of the lung.

PubMed

Lee, Geewon; Lee, Ho Yun; Lee, Kyung Soo; Lee, Kyung Jong; Cha, Hoon-Suk; Han, Joungho; Chung, Man Pyo

2013-10-01

Lymphoproliferative disorders (LPDs) may involve intrathoracic organs in patients with autoimmune disease, but little is known about the radiologic manifestations of autoimmune disease-associated LPDs (ALPDs) of the lungs. The purpose of our work was to identify the radiologic characteristics of pulmonary involvement in ALPDs. A comprehensive search for PubMed database was conducted with the combination of MeSH words. All articles which had original images or description on radiologic findings were included in this analysis. Also, CT images of eight patients with biopsy-proven lymphoproliferative disorder observed from our institution were added. Overall, 44 cases of ALPD were identified, and consisted of 24 cases of bronchus-associated lymphoid tissue lymphoma (BALToma), eight cases of non-Hodgkin's lymphoma (NHL), six cases of lymphoid interstitial pneumonia (LIP), two cases of nodular lymphoid hyperplasia, two cases of unclassified lymphoproliferative disorder, and one case each of lymphomatoid granulomatosis and hyperblastic BALT. Multiple nodules (n = 14, 32 %) and single mass (n = 8, 18 %) were the predominant radiologic manifestations. The imaging findings conformed to previously described findings of BALToma, NHL, or LIP. Data suggest that BALToma, NHL, and LIP are the predominant ALPDs of the lung, and ALPD generally shared common radiologic features with sporadic LPDs. Familiarity with ALPDs and their imaging findings may enable radiologists or clinicians to include the disease as a potential differential diagnosis and thus, to prompt early biopsy followed by appropriate treatment.

Using genes to triangulate the pathophysiology of granulomatous autoinflammatory disease: NOD2, PLCG2 and LACC1.

PubMed

Szymanski, Ann Marie; Ombrello, Michael J

2018-04-25

The intersection of granulomatosis and autoinflammatory disease is a rare occurrence that can be generally subdivided into purely granulomatous phenotypes and disease spectra that are inclusive of granulomatous features. NOD2 (nucleotide-binding oligomerization domain-containing protein 2)-related disease, which includes Blau syndrome and early-onset sarcoidosis, is the prototypic example of granulomatous inflammation in the context of monogenic autoinflammation. Granulomatous inflammation has also been observed in two related autoinflammatory diseases caused by mutations in PLCG2 (phospholipase Cγ2). More recently, mutations in LACC1 (laccase domain-containing protein 1) have been identified as the cause of a monogenic form of systemic juvenile idiopathic arthritis, which does not itself manifest granulomatous inflammation, but the same LACC1 mutations have also been shown to cause an early-onset, familial form of a well-known granulomatous condition, Crohn's disease (CD). Rare genetic variants of PLCG2 have also been shown to cause a monogenic form of CD, and moreover common variants of all three of these genes have been implicated in polygenic forms of CD. Additionally, common variants of NOD2 and LACC1 have been implicated in susceptibility to leprosy, a granulomatous infection. Although no specific mechanistic link exists between these three genes, they form an intriguing web of susceptibility to both monogenic and polygenic autoinflammatory and granulomatous phenotypes.

Nivolumab With or Without Varlilumab in Treating Patients With Relapsed or Refractory Aggressive B-cell Lymphomas

ClinicalTrials.gov

2018-06-11

ALK-Positive Large B-Cell Lymphoma; Atypical Burkitt/Burkitt-Like Lymphoma; Burkitt-Like Lymphoma With 11q Aberration; Diffuse Large B-Cell Lymphoma Activated B-Cell Type; Diffuse Large B-Cell Lymphoma Associated With Chronic Inflammation; Diffuse Large B-Cell Lymphoma Germinal Center B-Cell Type; Diffuse Large B-Cell Lymphoma, Not Otherwise Specified; EBV-Positive Diffuse Large B-Cell Lymphoma, Not Otherwise Specified; EBV-Positive Mucocutaneous Ulcer; High-Grade B-Cell Lymphoma With MYC, BCL2, and BCL6 Rearrangements; Human Herpesvirus 8-Positive Neoplastic Cells Present; Intravascular Large B-Cell Lymphoma; Large B-Cell Lymphoma With IRF4 Rearrangement; Plasmablastic Lymphoma; Primary Cutaneous Diffuse Large B-Cell Lymphoma; Primary Cutaneous Diffuse Large B-Cell Lymphoma, Leg Type; Primary Diffuse Large B-Cell Lymphoma of the Central Nervous System; Primary Effusion Lymphoma; Recurrent B-Cell Lymphoma, Unclassifiable, With Features Intermediate Between Diffuse Large B-Cell Lymphoma and Classic Hodgkin Lymphoma; Recurrent Burkitt Lymphoma; Recurrent Diffuse Large B-Cell Lymphoma; Recurrent Lymphomatoid Granulomatosis; Recurrent Primary Mediastinal (Thymic) Large B-Cell Cell Lymphoma; Refractory B-Cell Lymphoma, Unclassifiable, With Features Intermediate Between Diffuse Large B-Cell Lymphoma and Classic Hodgkin Lymphoma; Refractory Burkitt Lymphoma; Refractory Diffuse Large B-Cell Lymphoma; Refractory Primary Mediastinal (Thymic) Large B-Cell Cell Lymphoma; Small Intestinal High Grade B-Cell Lymphoma, Not Otherwise Specified; T-Cell/Histiocyte-Rich Large B-Cell Lymphoma

Genetically Modified Peripheral Blood Stem Cell Transplant in Treating Patients With HIV-Associated Non-Hodgkin or Hodgkin Lymphoma

ClinicalTrials.gov

2015-05-06

Adult Nasal Type Extranodal NK/T-cell Lymphoma; AIDS-related Diffuse Large Cell Lymphoma; AIDS-related Diffuse Mixed Cell Lymphoma; AIDS-related Diffuse Small Cleaved Cell Lymphoma; AIDS-related Immunoblastic Large Cell Lymphoma; AIDS-related Lymphoblastic Lymphoma; AIDS-related Peripheral/Systemic Lymphoma; AIDS-related Small Noncleaved Cell Lymphoma; Anaplastic Large Cell Lymphoma; Angioimmunoblastic T-cell Lymphoma; Cutaneous B-cell Non-Hodgkin Lymphoma; Extranodal Marginal Zone B-cell Lymphoma of Mucosa-associated Lymphoid Tissue; Hepatosplenic T-cell Lymphoma; HIV-associated Hodgkin Lymphoma; Intraocular Lymphoma; Nodal Marginal Zone B-cell Lymphoma; Noncutaneous Extranodal Lymphoma; Peripheral T-cell Lymphoma; Recurrent Adult Burkitt Lymphoma; Recurrent Adult Diffuse Large Cell Lymphoma; Recurrent Adult Diffuse Mixed Cell Lymphoma; Recurrent Adult Diffuse Small Cleaved Cell Lymphoma; Recurrent Adult Grade III Lymphomatoid Granulomatosis; Recurrent Adult Hodgkin Lymphoma; Recurrent Adult Immunoblastic Large Cell Lymphoma; Recurrent Adult Lymphoblastic Lymphoma; Recurrent Adult T-cell Leukemia/Lymphoma; Recurrent Cutaneous T-cell Non-Hodgkin Lymphoma; Recurrent Grade 1 Follicular Lymphoma; Recurrent Grade 2 Follicular Lymphoma; Recurrent Grade 3 Follicular Lymphoma; Recurrent Mantle Cell Lymphoma; Recurrent Marginal Zone Lymphoma; Recurrent Mycosis Fungoides/Sezary Syndrome; Recurrent Small Lymphocytic Lymphoma; Refractory Hairy Cell Leukemia; Small Intestine Lymphoma; Splenic Marginal Zone Lymphoma; Stage I AIDS-related Lymphoma; Stage II AIDS-related Lymphoma; Stage III AIDS-related Lymphoma; Stage IV AIDS-related Lymphoma; T-cell Large Granular Lymphocyte Leukemia; Testicular Lymphoma; Waldenström Macroglobulinemia

DNA linkage studies of degenerative retinal diseases.

PubMed

Daiger, S P; Heckenlively, J R; Lewis, R A; Pelias, M Z

1987-01-01

DNA linkage studies of human genetic diseases have led to rapid characterization of a number of otherwise intractable disease loci. Detection of a linked DNA marker, the first step in "reverse genetics", has permitted cloning of the genes for Duchenne muscular dystrophy, retinoblastoma and chronic granulomatosis disease, among others. Thus, the case for applying these techniques to retinitis pigmentosa and related diseases, and the urgency in capitalizing on molecular developments, is justified and compelling. The first major success regarding RP was in demonstrating linkage of the DNA marker DXS7 (L1.28) to XRP. For autosomal forms of the disease, conventional linkage studies have provided tentative evidence for linkage of ADRP to the Rh blood group on chromosome lp and for linkage of Usher's syndrome to Gc and 4q. These provisional assignments are, at least, an important starting point for DNA analysis. The Support Program for DNA Linkage Studies of Degenerative Retinal Diseases was established to provide access for the scientific community to appropriate families, using the resources of the Human Genetic Mutant Cell Repository to prepare, store and distribute lymphoblast lines. To date, two extensive, well-characterized families are included in the program: the autosomal dominant RP family UCLA-RP01, and the Usher's syndrome families LSU-US01. It is highly likely that rapid progress will be made in mapping and characterizing the inherited retinal dystrophies. We believe the support program will facilitate this progress.

Bortezomib and Filgrastim in Promoting Stem Cell Mobilization in Patients With Non-Hodgkin Lymphoma or Multiple Myeloma Undergoing Stem Cell Transplant

ClinicalTrials.gov

2017-05-23

Adult Grade III Lymphomatoid Granulomatosis; B-cell Chronic Lymphocytic Leukemia; Contiguous Stage II Adult Burkitt Lymphoma; Contiguous Stage II Adult Diffuse Large Cell Lymphoma; Contiguous Stage II Adult Diffuse Mixed Cell Lymphoma; Contiguous Stage II Adult Diffuse Small Cleaved Cell Lymphoma; Contiguous Stage II Adult Immunoblastic Large Cell Lymphoma; Contiguous Stage II Adult Lymphoblastic Lymphoma; Contiguous Stage II Grade 1 Follicular Lymphoma; Contiguous Stage II Grade 2 Follicular Lymphoma; Contiguous Stage II Grade 3 Follicular Lymphoma; Contiguous Stage II Mantle Cell Lymphoma; Contiguous Stage II Marginal Zone Lymphoma; Contiguous Stage II Small Lymphocytic Lymphoma; Cutaneous B-cell Non-Hodgkin Lymphoma; Extranodal Marginal Zone B-cell Lymphoma of Mucosa-associated Lymphoid Tissue; Intraocular Lymphoma; Nodal Marginal Zone B-cell Lymphoma; Noncontiguous Stage II Adult Burkitt Lymphoma; Noncontiguous Stage II Adult Diffuse Large Cell Lymphoma; Noncontiguous Stage II Adult Diffuse Mixed Cell Lymphoma; Noncontiguous Stage II Adult Diffuse Small Cleaved Cell Lymphoma; Noncontiguous Stage II Adult Immunoblastic Large Cell Lymphoma; Noncontiguous Stage II Adult Lymphoblastic Lymphoma; Noncontiguous Stage II Grade 1 Follicular Lymphoma; Noncontiguous Stage II Grade 2 Follicular Lymphoma; Noncontiguous Stage II Grade 3 Follicular Lymphoma; Noncontiguous Stage II Mantle Cell Lymphoma; Noncontiguous Stage II Marginal Zone Lymphoma; Noncontiguous Stage II Small Lymphocytic Lymphoma; Progressive Hairy Cell Leukemia, Initial Treatment; Recurrent Adult Burkitt Lymphoma; Recurrent Adult Diffuse Large Cell Lymphoma; Recurrent Adult Diffuse Mixed Cell Lymphoma; Recurrent Adult Diffuse Small Cleaved Cell Lymphoma; Recurrent Adult Grade III Lymphomatoid Granulomatosis; Recurrent Adult Immunoblastic Large Cell Lymphoma; Recurrent Adult Lymphoblastic Lymphoma; Recurrent Grade 1 Follicular Lymphoma; Recurrent Grade 2 Follicular Lymphoma; Recurrent Grade 3 Follicular Lymphoma; Recurrent Mantle Cell Lymphoma; Recurrent Marginal Zone Lymphoma; Recurrent Small Lymphocytic Lymphoma; Refractory Hairy Cell Leukemia; Refractory Multiple Myeloma; Small Intestine Lymphoma; Splenic Marginal Zone Lymphoma; Stage I Adult Burkitt Lymphoma; Stage I Adult Diffuse Large Cell Lymphoma; Stage I Adult Diffuse Mixed Cell Lymphoma; Stage I Adult Diffuse Small Cleaved Cell Lymphoma; Stage I Adult Immunoblastic Large Cell Lymphoma; Stage I Adult Lymphoblastic Lymphoma; Stage I Grade 1 Follicular Lymphoma; Stage I Grade 2 Follicular Lymphoma; Stage I Grade 3 Follicular Lymphoma; Stage I Mantle Cell Lymphoma; Stage I Marginal Zone Lymphoma; Stage I Multiple Myeloma; Stage I Small Lymphocytic Lymphoma; Stage II Multiple Myeloma; Stage III Adult Burkitt Lymphoma; Stage III Adult Diffuse Large Cell Lymphoma; Stage III Adult Diffuse Mixed Cell Lymphoma; Stage III Adult Diffuse Small Cleaved Cell Lymphoma; Stage III Adult Immunoblastic Large Cell Lymphoma; Stage III Adult Lymphoblastic Lymphoma; Stage III Grade 1 Follicular Lymphoma; Stage III Grade 2 Follicular Lymphoma; Stage III Grade 3 Follicular Lymphoma; Stage III Mantle Cell Lymphoma; Stage III Marginal Zone Lymphoma; Stage III Multiple Myeloma; Stage III Small Lymphocytic Lymphoma; Stage IV Adult Burkitt Lymphoma; Stage IV Adult Diffuse Large Cell Lymphoma; Stage IV Adult Diffuse Mixed Cell Lymphoma; Stage IV Adult Diffuse Small Cleaved Cell Lymphoma; Stage IV Adult Immunoblastic Large Cell Lymphoma; Stage IV Adult Lymphoblastic Lymphoma; Stage IV Grade 1 Follicular Lymphoma; Stage IV Grade 2 Follicular Lymphoma; Stage IV Grade 3 Follicular Lymphoma; Stage IV Mantle Cell Lymphoma; Stage IV Marginal Zone Lymphoma; Stage IV Small Lymphocytic Lymphoma; Untreated Hairy Cell Leukemia; Waldenström Macroglobulinemia

Fludarabine Phosphate, Melphalan, Total-Body Irradiation, Donor Stem Cell Transplant in Treating Patients With Hematologic Cancer or Bone Marrow Failure Disorders

ClinicalTrials.gov

2017-11-29

Accelerated Phase Chronic Myelogenous Leukemia; Acute Myeloid Leukemia With Multilineage Dysplasia Following Myelodysplastic Syndrome; Adult Acute Lymphoblastic Leukemia in Remission; Adult Acute Myeloid Leukemia in Remission; Adult Acute Myeloid Leukemia With 11q23 (MLL) Abnormalities; Adult Acute Myeloid Leukemia With Del(5q); Adult Acute Myeloid Leukemia With Inv(16)(p13;q22); Adult Acute Myeloid Leukemia With t(15;17)(q22;q12); Adult Acute Myeloid Leukemia With t(16;16)(p13;q22); Adult Acute Myeloid Leukemia With t(8;21)(q22;q22); Adult Nasal Type Extranodal NK/T-cell Lymphoma; Anaplastic Large Cell Lymphoma; Angioimmunoblastic T-cell Lymphoma; Aplastic Anemia; Atypical Chronic Myeloid Leukemia, BCR-ABL1 Negative; Childhood Acute Lymphoblastic Leukemia in Remission; Childhood Acute Myeloid Leukemia in Remission; Childhood Chronic Myelogenous Leukemia; Childhood Diffuse Large Cell Lymphoma; Childhood Immunoblastic Large Cell Lymphoma; Childhood Myelodysplastic Syndromes; Childhood Nasal Type Extranodal NK/T-cell Lymphoma; Chronic Eosinophilic Leukemia; Chronic Myelomonocytic Leukemia; Chronic Neutrophilic Leukemia; Chronic Phase Chronic Myelogenous Leukemia; de Novo Myelodysplastic Syndromes; Extranodal Marginal Zone B-cell Lymphoma of Mucosa-associated Lymphoid Tissue; Fanconi Anemia; Juvenile Myelomonocytic Leukemia; Myelodysplastic/Myeloproliferative Neoplasm, Unclassifiable; Nodal Marginal Zone B-cell Lymphoma; Noncontiguous Stage II Adult Burkitt Lymphoma; Noncontiguous Stage II Adult Diffuse Large Cell Lymphoma; Noncontiguous Stage II Adult Diffuse Mixed Cell Lymphoma; Noncontiguous Stage II Adult Diffuse Small Cleaved Cell Lymphoma; Noncontiguous Stage II Adult Immunoblastic Large Cell Lymphoma; Noncontiguous Stage II Adult Lymphoblastic Lymphoma; Noncontiguous Stage II Grade 1 Follicular Lymphoma; Noncontiguous Stage II Grade 2 Follicular Lymphoma; Noncontiguous Stage II Grade 3 Follicular Lymphoma; Noncontiguous Stage II Mantle Cell Lymphoma; Noncontiguous Stage II Marginal Zone Lymphoma; Noncontiguous Stage II Small Lymphocytic Lymphoma; Paroxysmal Nocturnal Hemoglobinuria; Previously Treated Myelodysplastic Syndromes; Primary Myelofibrosis; Recurrent Adult Acute Lymphoblastic Leukemia; Recurrent Adult Acute Myeloid Leukemia; Recurrent Adult Burkitt Lymphoma; Recurrent Adult Diffuse Large Cell Lymphoma; Recurrent Adult Diffuse Mixed Cell Lymphoma; Recurrent Adult Diffuse Small Cleaved Cell Lymphoma; Recurrent Adult Grade III Lymphomatoid Granulomatosis; Recurrent Adult Hodgkin Lymphoma; Recurrent Adult Immunoblastic Large Cell Lymphoma; Recurrent Adult Lymphoblastic Lymphoma; Recurrent Adult T-cell Leukemia/Lymphoma; Recurrent Childhood Acute Lymphoblastic Leukemia; Recurrent Childhood Acute Myeloid Leukemia; Recurrent Childhood Anaplastic Large Cell Lymphoma; Recurrent Childhood Grade III Lymphomatoid Granulomatosis; Recurrent Childhood Large Cell Lymphoma; Recurrent Childhood Lymphoblastic Lymphoma; Recurrent Childhood Small Noncleaved Cell Lymphoma; Recurrent Cutaneous T-cell Non-Hodgkin Lymphoma; Recurrent Grade 1 Follicular Lymphoma; Recurrent Grade 2 Follicular Lymphoma; Recurrent Grade 3 Follicular Lymphoma; Recurrent Mantle Cell Lymphoma; Recurrent Marginal Zone Lymphoma; Recurrent Mycosis Fungoides/Sezary Syndrome; Recurrent Small Lymphocytic Lymphoma; Recurrent/Refractory Childhood Hodgkin Lymphoma; Refractory Chronic Lymphocytic Leukemia; Refractory Multiple Myeloma; Relapsing Chronic Myelogenous Leukemia; Secondary Acute Myeloid Leukemia; Secondary Myelodysplastic Syndromes; Splenic Marginal Zone Lymphoma; Stage III Adult Diffuse Small Cleaved Cell Lymphoma; Stage III Adult Immunoblastic Large Cell Lymphoma; Stage III Adult Lymphoblastic Lymphoma; Stage III Grade 1 Follicular Lymphoma; Stage III Grade 2 Follicular Lymphoma; Stage III Grade 3 Follicular Lymphoma; Stage III Mantle Cell Lymphoma; Stage III Marginal Zone Lymphoma; Stage III Small Lymphocytic Lymphoma; Stage IV Adult Burkitt Lymphoma; Stage IV Adult Diffuse Small Cleaved Cell Lymphoma; Stage IV Adult Immunoblastic Large Cell Lymphoma; Stage IV Adult Lymphoblastic Lymphoma; Stage IV Grade 1 Follicular Lymphoma; Stage IV Grade 2 Follicular Lymphoma; Stage IV Grade 3 Follicular Lymphoma; Stage IV Mantle Cell Lymphoma; Stage IV Marginal Zone Lymphoma; Stage IV Small Lymphocytic Lymphoma; Waldenström Macroglobulinemia

Haploidentical Donor Bone Marrow Transplant in Treating Patients With High-Risk Hematologic Cancer

ClinicalTrials.gov

2017-04-10

Accelerated Phase Chronic Myelogenous Leukemia; Adult Acute Lymphoblastic Leukemia in Remission; Adult Acute Myeloid Leukemia in Remission; Adult Acute Myeloid Leukemia With 11q23 (MLL) Abnormalities; Adult Acute Myeloid Leukemia With Del(5q); Adult Acute Myeloid Leukemia With Inv(16)(p13;q22); Adult Acute Myeloid Leukemia With t(15;17)(q22;q12); Adult Acute Myeloid Leukemia With t(16;16)(p13;q22); Adult Acute Myeloid Leukemia With t(8;21)(q22;q22); Adult Nasal Type Extranodal NK/T-cell Lymphoma; Anaplastic Large Cell Lymphoma; Angioimmunoblastic T-cell Lymphoma; Childhood Acute Lymphoblastic Leukemia in Remission; Childhood Acute Myeloid Leukemia in Remission; Childhood Burkitt Lymphoma; Childhood Chronic Myelogenous Leukemia; Childhood Myelodysplastic Syndromes; Childhood Nasal Type Extranodal NK/T-cell Lymphoma; Cutaneous B-cell Non-Hodgkin Lymphoma; de Novo Myelodysplastic Syndromes; Extranodal Marginal Zone B-cell Lymphoma of Mucosa-associated Lymphoid Tissue; Hematopoietic/Lymphoid Cancer; Hepatosplenic T-cell Lymphoma; Intraocular Lymphoma; Nodal Marginal Zone B-cell Lymphoma; Peripheral T-cell Lymphoma; Post-transplant Lymphoproliferative Disorder; Previously Treated Myelodysplastic Syndromes; Recurrent Adult Burkitt Lymphoma; Recurrent Adult Diffuse Large Cell Lymphoma; Recurrent Adult Diffuse Mixed Cell Lymphoma; Recurrent Adult Diffuse Small Cleaved Cell Lymphoma; Recurrent Adult Grade III Lymphomatoid Granulomatosis; Recurrent Adult Hodgkin Lymphoma; Recurrent Adult Immunoblastic Large Cell Lymphoma; Recurrent Adult Lymphoblastic Lymphoma; Recurrent Adult T-cell Leukemia/Lymphoma; Recurrent Childhood Anaplastic Large Cell Lymphoma; Recurrent Childhood Grade III Lymphomatoid Granulomatosis; Recurrent Childhood Large Cell Lymphoma; Recurrent Childhood Lymphoblastic Lymphoma; Recurrent Childhood Small Noncleaved Cell Lymphoma; Recurrent Cutaneous T-cell Non-Hodgkin Lymphoma; Recurrent Grade 1 Follicular Lymphoma; Recurrent Grade 2 Follicular Lymphoma; Recurrent Grade 3 Follicular Lymphoma; Recurrent Mantle Cell Lymphoma; Recurrent Marginal Zone Lymphoma; Recurrent Mycosis Fungoides/Sezary Syndrome; Recurrent Small Lymphocytic Lymphoma; Recurrent/Refractory Childhood Hodgkin Lymphoma; Refractory Chronic Lymphocytic Leukemia; Refractory Multiple Myeloma; Relapsing Chronic Myelogenous Leukemia; Secondary Myelodysplastic Syndromes; Small Intestine Lymphoma; Splenic Marginal Zone Lymphoma; Stage II Multiple Myeloma; Stage III Adult Burkitt Lymphoma; Stage III Adult Diffuse Large Cell Lymphoma; Stage III Adult Diffuse Mixed Cell Lymphoma; Stage III Adult Diffuse Small Cleaved Cell Lymphoma; Stage III Adult Hodgkin Lymphoma; Stage III Adult Immunoblastic Large Cell Lymphoma; Stage III Adult Lymphoblastic Lymphoma; Stage III Adult T-cell Leukemia/Lymphoma; Stage III Childhood Hodgkin Lymphoma; Stage III Chronic Lymphocytic Leukemia; Stage III Cutaneous T-cell Non-Hodgkin Lymphoma; Stage III Grade 1 Follicular Lymphoma; Stage III Grade 2 Follicular Lymphoma; Stage III Grade 3 Follicular Lymphoma; Stage III Mantle Cell Lymphoma; Stage III Marginal Zone Lymphoma; Stage III Multiple Myeloma; Stage III Mycosis Fungoides/Sezary Syndrome; Stage III Small Lymphocytic Lymphoma; Stage IV Adult Burkitt Lymphoma; Stage IV Adult Diffuse Large Cell Lymphoma; Stage IV Adult Diffuse Mixed Cell Lymphoma; Stage IV Adult Diffuse Small Cleaved Cell Lymphoma; Stage IV Adult Hodgkin Lymphoma; Stage IV Adult Immunoblastic Large Cell Lymphoma; Stage IV Adult Lymphoblastic Lymphoma; Stage IV Adult T-cell Leukemia/Lymphoma; Stage IV Childhood Hodgkin Lymphoma; Stage IV Chronic Lymphocytic Leukemia; Stage IV Cutaneous T-cell Non-Hodgkin Lymphoma; Stage IV Grade 1 Follicular Lymphoma; Stage IV Grade 2 Follicular Lymphoma; Stage IV Grade 3 Follicular Lymphoma; Stage IV Mantle Cell Lymphoma; Stage IV Marginal Zone Lymphoma; Stage IV Mycosis Fungoides/Sezary Syndrome; Stage IV Small Lymphocytic Lymphoma; Testicular Lymphoma; Waldenström Macroglobulinemia

A Pilot Study to Evaluate the Co-Infusion of Ex Vivo Expanded Cord Blood Cells With an Unmanipulated Cord Blood Unit in Patients Undergoing Cord Blood Transplant for Hematologic Malignancies

ClinicalTrials.gov

2015-02-10

Accelerated Phase Chronic Myelogenous Leukemia; Acute Myeloid Leukemia With Multilineage Dysplasia Following Myelodysplastic Syndrome; Adult Acute Lymphoblastic Leukemia in Remission; Adult Acute Myeloid Leukemia in Remission; Adult Acute Myeloid Leukemia With 11q23 (MLL) Abnormalities; Adult Acute Myeloid Leukemia With Del(5q); Adult Acute Myeloid Leukemia With Inv(16)(p13;q22); Adult Acute Myeloid Leukemia With t(15;17)(q22;q12); Adult Acute Myeloid Leukemia With t(16;16)(p13;q22); Adult Acute Myeloid Leukemia With t(8;21)(q22;q22); Adult Nasal Type Extranodal NK/T-cell Lymphoma; Anaplastic Large Cell Lymphoma; Childhood Acute Lymphoblastic Leukemia in Remission; Childhood Acute Myeloid Leukemia in Remission; Childhood Burkitt Lymphoma; Childhood Chronic Myelogenous Leukemia; Childhood Diffuse Large Cell Lymphoma; Childhood Immunoblastic Large Cell Lymphoma; Childhood Myelodysplastic Syndromes; Childhood Nasal Type Extranodal NK/T-cell Lymphoma; Chronic Phase Chronic Myelogenous Leukemia; Contiguous Stage II Adult Burkitt Lymphoma; Contiguous Stage II Adult Diffuse Large Cell Lymphoma; Contiguous Stage II Adult Diffuse Mixed Cell Lymphoma; Contiguous Stage II Adult Immunoblastic Large Cell Lymphoma; Contiguous Stage II Adult Lymphoblastic Lymphoma; Contiguous Stage II Grade 3 Follicular Lymphoma; Contiguous Stage II Mantle Cell Lymphoma; de Novo Myelodysplastic Syndromes; Extranodal Marginal Zone B-cell Lymphoma of Mucosa-associated Lymphoid Tissue; Nodal Marginal Zone B-cell Lymphoma; Noncontiguous Stage II Adult Burkitt Lymphoma; Noncontiguous Stage II Adult Diffuse Large Cell Lymphoma; Noncontiguous Stage II Adult Diffuse Mixed Cell Lymphoma; Noncontiguous Stage II Adult Immunoblastic Large Cell Lymphoma; Noncontiguous Stage II Adult Lymphoblastic Lymphoma; Noncontiguous Stage II Grade 3 Follicular Lymphoma; Noncontiguous Stage II Mantle Cell Lymphoma; Previously Treated Myelodysplastic Syndromes; Prolymphocytic Leukemia; Recurrent Adult Burkitt Lymphoma; Recurrent Adult Diffuse Large Cell Lymphoma; Recurrent Adult Diffuse Mixed Cell Lymphoma; Recurrent Adult Grade III Lymphomatoid Granulomatosis; Recurrent Adult Immunoblastic Large Cell Lymphoma; Recurrent Adult Lymphoblastic Lymphoma; Recurrent Childhood Anaplastic Large Cell Lymphoma; Recurrent Childhood Grade III Lymphomatoid Granulomatosis; Recurrent Childhood Large Cell Lymphoma; Recurrent Childhood Lymphoblastic Lymphoma; Recurrent Grade 1 Follicular Lymphoma; Recurrent Grade 2 Follicular Lymphoma; Recurrent Grade 3 Follicular Lymphoma; Recurrent Mantle Cell Lymphoma; Recurrent Marginal Zone Lymphoma; Recurrent Small Lymphocytic Lymphoma; Refractory Anemia; Refractory Anemia With Excess Blasts; Refractory Anemia With Excess Blasts in Transformation; Refractory Chronic Lymphocytic Leukemia; Refractory Multiple Myeloma; Secondary Acute Myeloid Leukemia; Secondary Myelodysplastic Syndromes; Splenic Marginal Zone Lymphoma; Stage I Adult Burkitt Lymphoma; Stage I Adult Diffuse Large Cell Lymphoma; Stage I Adult Diffuse Mixed Cell Lymphoma; Stage I Adult Immunoblastic Large Cell Lymphoma; Stage I Adult Lymphoblastic Lymphoma; Stage I Childhood Lymphoblastic Lymphoma; Stage I Grade 3 Follicular Lymphoma; Stage I Mantle Cell Lymphoma; Stage II Childhood Lymphoblastic Lymphoma; Stage III Adult Burkitt Lymphoma; Stage III Adult Diffuse Large Cell Lymphoma; Stage III Adult Diffuse Mixed Cell Lymphoma; Stage III Adult Immunoblastic Large Cell Lymphoma; Stage III Adult Lymphoblastic Lymphoma; Stage III Childhood Lymphoblastic Lymphoma; Stage III Grade 3 Follicular Lymphoma; Stage III Mantle Cell Lymphoma; Stage IV Adult Burkitt Lymphoma; Stage IV Adult Diffuse Large Cell Lymphoma; Stage IV Adult Diffuse Mixed Cell Lymphoma; Stage IV Adult Immunoblastic Large Cell Lymphoma; Stage IV Adult Lymphoblastic Lymphoma; Stage IV Childhood Lymphoblastic Lymphoma; Stage IV Grade 3 Follicular Lymphoma; Stage IV Mantle Cell Lymphoma

Electroscavenging and Inferred Effects on Precipitation Efficiency

NASA Astrophysics Data System (ADS)

Tinsley, B. A.

2002-12-01

The evaporation of charged droplets leaves charged aerosol particles that can act as cloud condensation nuclei and ice forming nuclei. New calculations of scavenging of such charged particles by droplets have been made, that now include the effects of inertia and variable particle density, and variable cloud altitudes ranging into the stratosphere. They show that the Greenfield Gap closes for particles of low density, or for high altitude clouds, or for a few hundred elementary charges on the particles. A few tens of elementary charges on the particles gives collision efficiencies typically an order of magnitude greater than that due to phoretic forces alone. The numerical integrations show that electroscavenging of ice forming nuclei leading to contact ice nucleation is competitive with deposition ice nucleation, for cloud top temperatures in the range 0§C to -15§C and droplet size distributions extending past 10-15 mm radius. This implies that for marine stratocumulus or nimbostratus clouds with tops just below freezing temperature, where precipitation is initiated by the Wegener-Bergeron-Findeisen process, the precipitation efficiency can be affected by the amount of charge on the ice-forming nuclei. This in turn depends on the extent of the (weak) electrification of the cloud. Similarly, electroscavenging of condensation nuclei can increase the average droplet size in successive cycles of cloud evaporation and formation, and can also affect precipitation efficiency.

On the Representation of Cloud Phase in Global Climate Models, and its Importance for Simulations of Climate Forcings and Feedbacks

NASA Astrophysics Data System (ADS)

Storelvmo, Trude; Sagoo, Navjit; Tan, Ivy

2016-04-01

Despite the growing effort in improving the cloud microphysical schemes in GCMs, most of this effort has not focused on improving the ability of GCMs to accurately simulate phase partitioning in mixed-phase clouds. Getting the relative proportion of liquid droplets and ice crystals in clouds right in GCMs is critical for the representation of cloud radiative forcings and cloud-climate feedbacks. Here, we first present satellite observations of cloud phase obtained by NASA's CALIOP instrument, and report on robust statistical relationships between cloud phase and several aerosols species that have been demonstrated to act as ice nuclei (IN) in laboratory studies. We then report on results from model intercomparison projects that reveal that GCMs generally underestimate the amount of supercooled liquid in clouds. For a selected GCM (NCAR 's CAM5), we thereafter show that the underestimate can be attributed to two main factors: i) the presence of IN in the mixed-phase temperature range, and ii) the Wegener-Bergeron-Findeisen process, which converts liquid to ice once ice crystals have formed. Finally, we show that adjusting these two processes such that the GCM's cloud phase is in agreement with the observed has a substantial impact on the simulated radiative forcing due to IN perturbations, as well as on the cloud-climate feedbacks and ultimately climate sensitivity simulated by the GCM.

observation and analysis of the structure of winter precipitation-generating clouds using ground-based sensor measurements

NASA Astrophysics Data System (ADS)

Menéndez José Luis, Marcos; Gómez José Luis, Sánchez; Campano Laura, López; Ortega Eduardo, García; Suances Andrés, Merino; González Sergio, Fernández; Salvador Estíbaliz, Gascón; González Lucía, Hermida

2015-04-01

In this study, we used a 28-day database corresponding to December, January and February of 2011/2012 and 2012/2013 campaigns to analyze cloud structure that produced precipitation in the Sierra Norte near Madrid, Spain. We used remote sensing measurements, both active type like the K-band Micro Rain Radar (MRR) and passive type like the Radiometrics MP-3000A multichannel microwave radiometer. Using reflectivity data from the MRR, we determined the important microphysical parameters of Ice Water Content (IWC) and its integrated value over the atmospheric column, or Ice Water Path (IWP). Among the measurements taken by the MP-3000A were Liquid Water Path (LWP) and Integrated Water Vapor (IWV). By representing these data together, sharp declines in LWP and IWV were evident, coincident with IWP increases. This result indicates the ability of a K-band radar to measure the amount of ice in the atmospheric column, simultaneously revealing the Wegener-Bergeron-Findeisen mechanism. We also used a Present Weather Sensor (VPF-730; Biral Ltd., Bristol, UK) to determine the type and amount of precipitation at the surface. With these data, we used regression equations to establish the relationship between visibility and precipitation intensity. In addition, through theoretical precipitation visibility-intensity relationships, we estimated the type of crystal, degree of accretion (riming), and moisture content of fallen snow crystals.

Evaluating tropospheric humidity from GPS radio occultation, radiosonde, and AIRS from high-resolution time series

NASA Astrophysics Data System (ADS)

Rieckh, Therese; Anthes, Richard; Randel, William; Ho, Shu-Peng; Foelsche, Ulrich

2018-05-01

While water vapor is the most important tropospheric greenhouse gas, it is also highly variable in both space and time, and water vapor concentrations range over 3 orders of magnitude in the troposphere. These properties challenge all observing systems to accurately measure and resolve the vertical structure and variability of tropospheric humidity. In this study we characterize the humidity measurements of various observing techniques, including four separate Global Positioning System (GPS) radio occultation (RO) humidity retrievals (University Corporation for Atmospheric Research (UCAR) direct, UCAR one-dimensional variational retrieval (1D-Var), Wegener Center for Climate and Global Change (WEGC) 1D-Var, Jet Propulsion Laboratory (JPL) direct), radiosonde, and Atmospheric Infrared Sounder (AIRS) data. Furthermore, we evaluate how well the ERA-Interim reanalysis and NCEP Global Forecast System (GFS) model perform in analyzing water vapor at different levels. To investigate detailed vertical structure, we analyzed time-height cross sections over four radiosonde stations in the tropical and subtropical western Pacific for the year 2007. We found that the accuracy of RO humidity is comparable to or better than both radiosonde and AIRS humidity over 800 to 400 hPa, as well as below 800 hPa if super-refraction is absent. The various RO retrievals of specific humidity agree within 20 % in the 1000-400 hPa layer, and differences are most pronounced above 600 hPa.

From Scoresby to Nansen to Wegener: The Role of Polar History in Producing the Next Generation of High-Latitude Hydrologic and Cryospheric Scientists

NASA Astrophysics Data System (ADS)

Sturm, M.

2009-05-01

Many scientists, like myself, were first attracted to the polar regions by tales of heroic explorers. These earlier explorers were also scientists, or more correctly, naturalists. They produced maps, sketches, and studies on atmospheric, cryospheric, biological, and sociological topics alike. For many of us, reading about polar history led directly to our interests in cryospheric and hydrological science. While the age of geographical exploration is long over, replaced by Google Earth, the stories from that by-gone era may still be one of the most powerful recruiting tools for producing passionate and committed polar scientists for the next generation. I would argue for an increased emphasis in teaching our students about the history of exploration and science. If we do so, at a minimum our students will better appreciate modern clothing, transportation, data loggers, communication equipment, and computers. More importantly, it will introduce to the next generation the idea of the naturalist, whose purview is all components of the natural system. Many of the high latitude issues facing us today require a system-science approach that can be difficult to learn or master in an era of disciplinary specialization. The early naturalist-explorers understood this approach and still have much to teach us if we take the time to listen to what went before.

So, why do we still have journals?

NASA Astrophysics Data System (ADS)

Hut, R.

2014-12-01

The academic article is a relic from a bygone age. Form and style have not changed much since the days of Einstein and Wegener, nor have the institutions that publish our academic knowledge. When I google-scholar an article, I do not care if it was published in nature, PNAS, or the annals of the cambodian society of herbologists. I care about the scientific knowledge contained in the article, that I would like to use in my own work. So: why do we have journals again? The journal-based system of scientific publication is cracking under its own weight. The publish or perish culture leads to an ever increasing number of articles, each containing less actual science, because spreading over multiple papers helps your career. Journal editors complain that the average number of scientists that they approach for reviewing has gone up because there is no incentive in being a reviewer, only in being reviewed. And finally: much research money is wasted because reviewers point out fundamental flaws in experiment setups after the fact. In this talk, I will present a new way of publishing scientific knowledge. A departure of the classic systems, my way aims to keep the thoroughness of the peer reviewed system, increase the effective use of funding and make more scientific knowledge publically available. Also, it abolishes the need for journals.

First applications of the EXTASE thermal probe

NASA Astrophysics Data System (ADS)

Schröer, K.; Seiferlin, K.; Marczewski, W.; Gadomski, S.; Spohn, T.

2003-04-01

EXTASE is a spin-off project from the MUPUS (Rosetta Lander) thermal probe, both funded by DLR. The thermal probe will be tested in various environments and fields, e.g. in snow research, agriculture, permafrost, monitoring waste deposits and the heat released by decomposition, ground truth for remote sensing etc. The probe is a glass-fibre tube of 1cm diameter, about 32 cm long and carries of 16 sensors for measuring temperature profiles. Each of the sensors can also be heated for in situ measurements of the thermal diffusivity of the penetrated layers, from which we can derive the thermal conductivity. All necessary connections and the sensors itself are printed on a foil which is rolled and glued to the inner wall of the tube. This design results in the significant advantage that the measurements can be done in-situ. No excavation of material is required to measure the thermal conductivity, for instance. Presently we are concentrating on soil science and snow research.We made several measurements in different conditions with prototypes of the probe so far. Among other things, we measured soil temperatures together with meteorological boundary conditions in cooperation with the local Institute of Agrophysics in Lublin (Poland). The first measurements in snow under natural conditions were made on Svalbard (Spitzbergen) together with the Alfred-Wegener-Institute in Bremerhaven (Germany). First results of the measuring campaigns are shown.

An Exceptional Case of Suture Granuloma 30 Years Following an Open Repair of Achilles Tendon Rupture: A Case Report.

PubMed

Ergin, Ömer Naci; Demirel, Mehmet; Özmen, Emre

2017-01-01

Rupture of the Achilles' tendon is a common injury occurring particularly in middle-aged men due to sports trauma. Operative treatment is preferred generally due to lower risk of re-rupture. Possible complications of the operation include suture granulomas. Suture granulomas might represent a foreign body reaction, which itself is the end-stage response of the inflammatory wound-healing process to biomaterials. It may occur with both absorbable and non-absorbable suture materials such as silk in our case. The aim of this study is to present a case of a delayed foreign body reaction 30 years after open repair of the Achilles tendon with silk sutures. Our case is a 38-year-old male who presented to our outpatient clinic with complaints of swelling and pain around the posterior region of the ankle for the past 3 months. He had a history of open Achilles tendon repair at the age of 3 at the site of complaints. Physical examination was positive for a mass under the incision scar. Magnetic resonance imaging report was positive for a granulomatosis formation. The patient was booked for an operation to remove the mass. Suture granuloma represents a tissue reaction against the suture material. Orthopedic literature is sparse for such cases and case reports. Both because of its rarity in orthopedic literature and the amount of time between the surgery and reaction, our report is a valuable addition to the literature.

[Cholestasis and listeriosis in the third trimester of pregnancy].

PubMed

Martínez-Montero, I; Segura Ortega, V; Martínez Jiménez, L; García Jiménez, A; Unzetabarrenetxea Barrenetxea, O; Pérez Rodríguez, A F

2013-01-01

Listeriosis is an infection produced by Listeria monocytogenes. It is infrequent and affects people at extreme ages, pregnant women, immunocompromised people and, occasionally, healthy people. Its incidence has increased in recent years and shows a certain tendency to seasonality, increasing in summer. It can appear sporadically or as outbreaks. In pregnant women the infection is most frequently produced in the third trimester and the symptoms are usually light. Nonetheless, the infection of the fetus is severe, and can produce miscarriages, fetal deaths, corioamnionitis and premature births with the newborn infected, manifested in the form of granulomatosis infantiseptica with abscesses and scattered granulomas or at a later stage , as meningitis or sepsis. Intrahepatic cholestasis is a reversible form of cholestasis, its cause is unknown, it is specific to pregnancy and is more frequent in multiparous women, in the third trimester and rarely before the 26th week. It disappears following childbirth and is the second cause of jaundice in pregnancy, after hepatitis. The diagnosis of cholestasis is basically clinical. It appears as palmoplantar pruritus but can also produce nausea, vomiting and abdominal discomfort localized in the right hypochondrium. Given that listeriosis and cholestasis can have a shared symptomology, the possibility of listeriosis must be borne in mind in order for early implementation of the mechanisms of diagnostic confirmation (cultivation of sterile fluids or tissues: blood, neonatal CSF, amniotic liquid or placenta) and specific treatment. We present a case of cholestasis and listeriosis in the third trimester with a good maternofetal result.

Proteinase 3 on apoptotic cells disrupts immune silencing in autoimmune vasculitis.

PubMed

Millet, Arnaud; Martin, Katherine R; Bonnefoy, Francis; Saas, Philippe; Mocek, Julie; Alkan, Manal; Terrier, Benjamin; Kerstein, Anja; Tamassia, Nicola; Satyanarayanan, Senthil Kumaran; Ariel, Amiram; Ribeil, Jean-Antoine; Guillevin, Loïc; Cassatella, Marco A; Mueller, Antje; Thieblemont, Nathalie; Lamprecht, Peter; Mouthon, Luc; Perruche, Sylvain; Witko-Sarsat, Véronique

2015-11-02

Granulomatosis with polyangiitis (GPA) is a systemic necrotizing vasculitis that is associated with granulomatous inflammation and the presence of anti-neutrophil cytoplasmic antibodies (ANCAs) directed against proteinase 3 (PR3). We previously determined that PR3 on the surface of apoptotic neutrophils interferes with induction of antiinflammatory mechanisms following phagocytosis of these cells by macrophages. Here, we demonstrate that enzymatically active membrane-associated PR3 on apoptotic cells triggered secretion of inflammatory cytokines, including granulocyte CSF (G-CSF) and chemokines. This response required the IL-1R1/MyD88 signaling pathway and was dependent on the synthesis of NO, as macrophages from animals lacking these pathways did not exhibit a PR3-associated proinflammatory response. The PR3-induced microenvironment facilitated recruitment of inflammatory cells, such as macrophages, plasmacytoid DCs (pDCs), and neutrophils, which were observed in close proximity within granulomatous lesions in the lungs of GPA patients. In different murine models of apoptotic cell injection, the PR3-induced microenvironment instructed pDC-driven Th9/Th2 cell generation. Concomitant injection of anti-PR3 ANCAs with PR3-expressing apoptotic cells induced a Th17 response, revealing a GPA-specific mechanism of immune polarization. Accordingly, circulating CD4+ T cells from GPA patients had a skewed distribution of Th9/Th2/Th17. These results reveal that PR3 disrupts immune silencing associated with clearance of apoptotic neutrophils and provide insight into how PR3 and PR3-targeting ANCAs promote GPA pathophysiology.

Epstein-Barr virus-driven B Cell Proliferation with CD4+ T Cell Expansion: A Lymphomatoid Granulomatosis-like Disease Related to Hyperinterleukin-10 Secretion of Remarkably Favourable Outcome with Rituximab.

PubMed

Cervera, P; Guihot, A; Gorochov, G; Lassoued, K; Coppo, P

2015-12-01

Granulomatous lymphomatosis is an Epstein-Barr virus (EBV)-driven B cell proliferation associated with an exuberant CD4(+) T cell reaction with usually histopathological pictures of angiocentrism. So far, the characteristics of CD4(+) T cells in granulomatous lymphomatosis and the mechanism leading to their expansion remain poorly explored. We report a 56-year-old female with a past history of cold agglutinin disease, which was successfully treated with 4 weekly infusions of rituximab. She presented one year later with features of granulomatous lymphomatosis that resulted in severe lung and bone marrow infiltration. We provide evidence that CD4(+) T cell expansion was oligoclonal, involved anergic cells and did not result from an EBV-driven stimulation. Rather, it resulted possibly from a high production of interleukin-10 by immunoblastic EBV-positive B cells. The outcome was remarkably favourable with rituximab and steroids. Our results suggest that an EBV-driven B cell proliferation should be investigated in patients presenting with a CD4(+) T cells alveolitis or other systemic manifestations resulting from a CD4(+) T cell expansion. These features should prompt to introduce an immunosuppressive therapy including steroids and rituximab. Our results deserve further investigations to confirm our pathophysiological hypotheses in CD4(+) T cell expansions associated with EBV-driven B cell proliferations and to assess whether granulomatous lymphomatosis could result from comparable mechanisms. © 2015 The Foundation for the Scandinavian Journal of Immunology.

Proteinase 3 on apoptotic cells disrupts immune silencing in autoimmune vasculitis

PubMed Central

Millet, Arnaud; Martin, Katherine R.; Bonnefoy, Francis; Saas, Philippe; Mocek, Julie; Alkan, Manal; Terrier, Benjamin; Kerstein, Anja; Tamassia, Nicola; Satyanarayanan, Senthil Kumaran; Ariel, Amiram; Ribeil, Jean-Antoine; Guillevin, Loïc; Cassatella, Marco A.; Mueller, Antje; Thieblemont, Nathalie; Lamprecht, Peter; Mouthon, Luc; Perruche, Sylvain; Witko-Sarsat, Véronique

2015-01-01

Granulomatosis with polyangiitis (GPA) is a systemic necrotizing vasculitis that is associated with granulomatous inflammation and the presence of anti-neutrophil cytoplasmic antibodies (ANCAs) directed against proteinase 3 (PR3). We previously determined that PR3 on the surface of apoptotic neutrophils interferes with induction of antiinflammatory mechanisms following phagocytosis of these cells by macrophages. Here, we demonstrate that enzymatically active membrane-associated PR3 on apoptotic cells triggered secretion of inflammatory cytokines, including granulocyte CSF (G-CSF) and chemokines. This response required the IL-1R1/MyD88 signaling pathway and was dependent on the synthesis of NO, as macrophages from animals lacking these pathways did not exhibit a PR3-associated proinflammatory response. The PR3-induced microenvironment facilitated recruitment of inflammatory cells, such as macrophages, plasmacytoid DCs (pDCs), and neutrophils, which were observed in close proximity within granulomatous lesions in the lungs of GPA patients. In different murine models of apoptotic cell injection, the PR3-induced microenvironment instructed pDC-driven Th9/Th2 cell generation. Concomitant injection of anti-PR3 ANCAs with PR3-expressing apoptotic cells induced a Th17 response, revealing a GPA-specific mechanism of immune polarization. Accordingly, circulating CD4+ T cells from GPA patients had a skewed distribution of Th9/Th2/Th17. These results reveal that PR3 disrupts immune silencing associated with clearance of apoptotic neutrophils and provide insight into how PR3 and PR3-targeting ANCAs promote GPA pathophysiology. PMID:26436651

ESSReS-PEP-POLMAR, an international and interdisciplinary postgraduate education concept on Earth and Environmental Sciences

NASA Astrophysics Data System (ADS)

Meggers, Helge; Hanfland, Claudia; Sprengel, Claudia; Grosfeld, Klaus; Lohmann, Gerrit; Bijma, Jelle; Ladstätter-Weißenmayer, Annette; Burrows, John

2014-05-01

Postgraduate education is gaining increasing importance and has been identified as one instrument to foster quality and promote networking, both in research and in education. Exchange and co-operation between graduate programmes that have related topics produce added value for all. Students have access to a range of research facilities, course offers, and a broad scientific community from which they can start building their individual scientific network. Larger events like PhD conferences, career symposia or cost-intensive trainings are more easily tackled by joining forces of various players. The postgraduate programmes ESSReS-PEP-POLMAR are part of a larger network of marine and climate science programmes in the north-western region of Germany and together host up 180 (23 ESSReS, 130 POLMAR, 30 PEP) PhD/Master students in their respective programmes. Here, we will present a number of joint activities from this collaboration. Today, the PhD education is completely different to that from 15 years ago due to a variety of different scientific offerings including e.g. excursions, soft skill courses and special seminars. In the framework of the ESSReS-PEP-POLMAR concept the Postgraduate Programme Environmental Physics (PEP) at the University of Bremen educates the participants on the complex relationship between atmosphere, hydrosphere (ocean), cryosphere (ice region) and solid earth (land). Here, the learning of experimental methods in environmental physics at the most advanced level, numerical data analysis using supercomputers, and data interpretation via sophisticated methods prepare students for a scientific career. Within cooperation with the Ocean University of China (OUC) students are participating one year in the PEP programme during their master studies since 2006, to get finally a double degree of both universities. Two different ways to further graduation are currently possible at the Alfred Wegener Institute. The Helmholtz Graduate School for Polar and Marine Research (POLMAR) provides a coherent framework for a structured postgraduate programme. POLMAR is a trans disciplinary umbrella organization for currently 130 PhD students and combines high-level science qualification in the various disciplines of polar and marine research with other key qualifications through joint seminars, lectures and practical training. Doctoral education within POLMAR is structured systematically and adapted to the individual needs of the PhD students. The Earth System Science Research School (ESSReS) covers 23 PhD students working at the Alfred Wegener Institute, Helmholtz Center for Polar and Marine Research, the Jacobs University and the University of Bremen. The ESSReS aims at the integration of research at the interface of Biology, Physics, Geophysics, Mathematics and Informatics. It is therefore multi- and interdisciplinary in every aspect. The training, curriculum, and PhD research subjects are closely located at the interfaces between the participating disciplines. This is guaranteed by interdisciplinary supervision of the PhD project, documented by the members of the "PhD committee". The long-term goal is not only to enhance exchange and interaction between these disciplines, but to enforce a new integrated concept, where separation between disciplines becomes obsolete. Consequently, ESSReS-PEP-POLMAR provides a solid base for a new generation of excellent scientists in Earth and Environmental Sciences.

Therapeutic immunomodulation in systemic vasculitis: taking stock.

PubMed

Puéchal, Xavier; Guillevin, Loïc

2013-07-01

Current data on therapeutic immunomodulation used to treat systemic vasculitides are reviewed in this paper, which also discusses ongoing and future developments in the field. In vasculitides associated with anti-neutrophil cytoplasmic antibodies, rituximab is a validated induction treatment that can serve as an alternative to cyclophosphamide and must be followed by maintenance treatment. In addition, the usefulness of rituximab as maintenance treatment was established recently. Immunoglobulins can be helpful adjuncts, most notably in patients with severe immunodepression. Plasmapheresis is indicated in patients with severe renal failure and may have a role in the treatment of alveolar hemorrhage syndromes. Mepolizumab has produced encouraging preliminary results in eosinophilic granulomatosis with polyangiitis (Churg-Strauss). Rituximab can be used in cryoglobulinemic vasculitis associated with hepatitis C virus infection when antiviral therapy fails or the disease is severe. Very low doses of interleukin-2 may be helpful in refractory forms. Rituximab is also an option in essential mixed cryoglobulinemia with uncontrolled vasculitis despite glucocorticoid and/or immunosuppressive treatment. In polyarteritis nodosa associated with the hepatitis B virus, a combination of short-course glucocorticoids, plasmapheresis, and antiviral therapy produces excellent outcomes. Intravenous immunoglobulins are used to treat Kawasaki disease, in which they diminish the incidence of coronary artery aneurysms. Several prospective controlled trials are currently assessing tocilizumab in giant-cell arteritis. Rituximab has useful effects in systemic vasculitis associated with rheumatoid arthritis. In Goodpasture's syndrome, plasmapheresis is indicated to clear the antibodies to glomerular membrane antigen, which can induce glomerulonephritis. Copyright © 2012 Société française de rhumatologie. Published by Elsevier SAS. All rights reserved.

The Differential Diagnosis of Dry Eyes, Dry Mouth, and Parotidomegaly: A Comprehensive Review.

PubMed

Cornec, Divi; Saraux, Alain; Jousse-Joulin, Sandrine; Pers, Jacques-Olivier; Boisramé-Gastrin, Sylvie; Renaudineau, Yves; Gauvin, Yves; Roguedas-Contios, Anne-Marie; Genestet, Steeve; Chastaing, Myriam; Cochener, Béatrice; Devauchelle-Pensec, Valérie

2015-12-01

Primary Sjögren's syndrome (pSS) is a frequent autoimmune systemic disease, clinically characterized by eyes and mouth dryness in all patients, salivary gland swelling or extraglandular systemic manifestations in half of the patients, and development of lymphoma in 5 to 10 % of the patients. However, patients presenting with sicca symptoms or salivary gland swelling may have a variety of conditions that may require very different investigations, treatments, or follow-up. Eye and/or mouth dryness is a frequent complaint in clinical setting, and its frequency increases with age. When evaluating a patient with suspected pSS, the first step is to rule out its differential diagnoses, before looking for positive arguments for the disease. Knowledge of normal and abnormal lachrymal and salivary gland physiology allows the clinician to prescribe the most adapted procedures for evaluating their function and structure. New tests have been developed in recent years for evaluating these patients, notably new ocular surface staining scores or salivary gland ultrasonography. We describe the different diagnoses performed in our monocentric cohort of 240 patients with suspected pSS. The most frequent diagnoses are pSS, other systemic autoimmune diseases, idiopathic sicca syndrome and drug-induced sicca syndrome. However, other diseases are important to rule out due to their specific management, such as sarcoidosis, granulomatosis with polyangeitis, IgG4-related disease, chronic hepatitis C virus or human immunodeficiency virus infections, graft-versus-host disease, and head and neck radiation therapy. At the light of these data, we propose a core of minimal investigations to be performed when evaluating a patient with suspected pSS.

Evaluating the utility of serological testing in laryngotracheal stenosis.

PubMed

Hall, S Ryan; Allen, Clint T; Merati, Albert L; Mayerhoff, Ross M

2017-06-01

Whereas mechanical (traumatic) causes of laryngotracheal stenosis (LTS) are identified based on history, autoimmune laryngotracheal stenosis (aLTS) and idiopathic laryngotracheal stenosis (iLTS) are often more difficult to differentiate. The objective of this study was to evaluate serologic testing in a large cohort of nonmechanical LTS patients to determine which tests, if any, lead clinicians to the etiology of the LTS. Retrospective chart review. This study reviewed nonmechanical LTS patients seen at a tertiary medical center from 2007 to 2014. Data were obtained on patient demographics, associated preexisting autoimmune conditions, comorbidities, intubation history, and serologic testing. Ninety-two records were reviewed. Twenty-three (25%) patients were found to have autoimmune disease; 69 (75%) met criteria for iLTS. A history of cigarette smoking was more significant in the aLTS group than the iLTS group (P < .001). Antineutrophil cytoplasmic antibody (ANCA) was positive only in patients with known granulomatosis with polyangiitis (GPA). All other serological testing was equivocal between the two cohorts. Differentiating iLTS from aLTS has proven difficult. The lack of information about the two entities has resulted in variability in the diagnostic workup to distinguish them. This study's finding of a more significant smoking history in the aLTS group correlates with the literature, which suggests an inflammatory effect of smoking cigarettes and an association with autoimmune disease. The only significant cohort of patients in this study found to have positive serological testing correlated with a diagnosable condition responsible for LTS was GPA patients with positive ANCA. 4. Laryngoscope, 127:1408-1412, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

Employment, work disability and quality of life in patients with ANCA-associated vasculitides. The EXPOVAS study.

PubMed

Benarous, Lucas; Terrier, Benjamin; Laborde-Casterot, Hervé; Bérezné, Alice; Dunogué, Bertrand; Cohen, Pascal; Puéchal, Xavier; Mouthon, Luc; Bensefa-Colas, Lynda; Guillevin, Loic

2017-01-01

Improved therapeutic strategies for ANCA-associated vasculitis (AAV) have transformed acute and life-threatening diseases into chronic ones responsible for marked morbidity that could impact employment, work disability and quality of life (QoL). We aimed to analyse work, handicaps and QoL of AAV patients and identify their determinants. Patients with AAV were included in a cross-sectional study assessing employment, work disability and QoL. Specific and non-specific questionnaires, including SF-36, were sent to patients, and clinical-biological data that could affect QoL and their determinants were analysed. Questionnaires were completed by 189 patients. Among 94 working-age (<60 years) patients, 57% had jobs, consistent with their qualifications for 81%, 77% were stably employed; 23% of workers felt that their disease qualitatively limited the nature of their work, while 43% felt it limited the quantity of work they could do; 50% thought their disease had hindered their careers and 43% that it had led to a salary reduction. These results were comparable for the different vasculitides. QoL was significantly impaired for AAV patients compared to the general population (p<0.0001). Physical health determinants for our population were diagnosis of eosinophilic granulomatosis with polyangiitis (EGPA), long disease duration and its neurological involvement, whereas mental health determinants tended to be ear, nose and throat and cardiovascular involvement, and unemployment. Our findings showed that AAV patients' QoL was impaired compared to the general population, mainly for patients with EGPA and long-standing disease. In contrast, normal employment seemed to be preserved for the majority of the patients.

Temporary Abdominal Closure Combined With an Irrigating System Utilizing Hypochlorous Acid Solution to Decrease Abdominal Mucopurulence

PubMed Central

Matthews, Marc R.; Quan, Asia N.; Weir, Alexandra S.; Foster, Kevin N.; Caruso, Daniel M.

2018-01-01

Introduction: Leaving the abdominal cavity open is a well-described and frequently utilized technique in the treatment of severe intra-abdominal sepsis. Irrigation through a negative pressure wound therapy device is a technique employed to assist in the closure of wounds as well as the reduction of bacterial contamination. Furthermore, hypochlorous acid has been found to be safe and effective in microorganismal elimination from extremity wounds. There is no literature regarding the infusion of hypochlorous solution into the abdominal cavity for intra-abdominal sepsis or mucopurulent abscesses or biofilm. Objectives: A 47-year-old man with granulomatosis polyangiitis was started on weekly rituximab. After 4 infusions, skin sloughing, ultimately diagnosed as toxic epidermal necrolysis, developed. During the hospital course, he developed sepsis and bowel perforation necessitating an exploratory laparotomy. The abdomen was left open with a temporary abdominal closure using the Abthera open abdomen negative wound therapy device; however, the abdomen remained infected with visually diffuse, thickening mucopurulence despite multiple washouts. Therefore, a VAC Vera-Flo irrigation device was combined with the Abthera open abdomen negative wound therapy device and cyclical irrigation of hypochlorous acid. After 72 hours, the purulence visually was improved and no adverse events were recorded with the placement of intra-abdominal hypochlorous acid. Conclusions: The combination of two medical devices for the intra-abdominal instillation of irrigation is considered “off-label use” from the manufacturer's recommendations. In addition, the repeated instillation of hypochlorous acid solution has not been described but was noted to have visually decreased the contaminated effluent within the intra-abdominal fluid. PMID:29527250

A Two-Step Approach to Reduced Intensity Bone Marrow Transplant for Patients With Hematological Malignancies

ClinicalTrials.gov

2017-12-04

Adult Acute Lymphoblastic Leukemia in Remission; Adult Acute Myeloid Leukemia in Remission; Adult Acute Myeloid Leukemia With 11q23 (MLL) Abnormalities; Adult Acute Myeloid Leukemia With Del(5q); Adult Acute Myeloid Leukemia With Inv(16)(p13;q22); Adult Acute Myeloid Leukemia With t(15;17)(q22;q12); Adult Acute Myeloid Leukemia With t(16;16)(p13;q22); Adult Acute Myeloid Leukemia With t(8;21)(q22;q22); Adult Nasal Type Extranodal NK/T-cell Lymphoma; Aplastic Anemia; Childhood Acute Lymphoblastic Leukemia in Remission; Childhood Acute Myeloid Leukemia in Remission; Childhood Myelodysplastic Syndromes; Chronic Eosinophilic Leukemia; Chronic Myelomonocytic Leukemia; Chronic Neutrophilic Leukemia; Essential Thrombocythemia; Extranodal Marginal Zone B-cell Lymphoma of Mucosa-associated Lymphoid Tissue; Juvenile Myelomonocytic Leukemia; Mastocytosis; Myelodysplastic/Myeloproliferative Neoplasm, Unclassifiable; Nodal Marginal Zone B-cell Lymphoma; Polycythemia Vera; Previously Treated Myelodysplastic Syndromes; Primary Myelofibrosis; Recurrent Adult Acute Lymphoblastic Leukemia; Recurrent Adult Acute Myeloid Leukemia; Recurrent Adult Diffuse Small Cleaved Cell Lymphoma; Recurrent Adult Grade III Lymphomatoid Granulomatosis; Recurrent Adult Hodgkin Lymphoma; Recurrent Childhood Acute Lymphoblastic Leukemia; Recurrent Childhood Acute Myeloid Leukemia; Recurrent Cutaneous T-cell Non-Hodgkin Lymphoma; Recurrent Grade 1 Follicular Lymphoma; Recurrent Grade 2 Follicular Lymphoma; Recurrent Marginal Zone Lymphoma; Recurrent Mycosis Fungoides/Sezary Syndrome; Recurrent Small Lymphocytic Lymphoma; Recurrent/Refractory Childhood Hodgkin Lymphoma; Refractory Anemia; Refractory Anemia With Ringed Sideroblasts; Refractory Hairy Cell Leukemia; Refractory Multiple Myeloma; Secondary Myelodysplastic Syndromes; Splenic Marginal Zone Lymphoma; T-cell Large Granular Lymphocyte Leukemia; Waldenström Macroglobulinemia

Sorafenib in Treating Patients With Metastatic or Unresectable Solid Tumors, Multiple Myeloma, or Non-Hodgkin's Lymphoma With or Without Impaired Liver or Kidney Function

ClinicalTrials.gov

2013-01-04

Extranodal Marginal Zone B-cell Lymphoma of Mucosa-associated Lymphoid Tissue; Nodal Marginal Zone B-cell Lymphoma; Recurrent Adult Burkitt Lymphoma; Recurrent Adult Diffuse Large Cell Lymphoma; Recurrent Adult Diffuse Mixed Cell Lymphoma; Recurrent Adult Diffuse Small Cleaved Cell Lymphoma; Recurrent Adult Grade III Lymphomatoid Granulomatosis; Recurrent Adult Immunoblastic Large Cell Lymphoma; Recurrent Adult Lymphoblastic Lymphoma; Recurrent Grade 1 Follicular Lymphoma; Recurrent Grade 2 Follicular Lymphoma; Recurrent Grade 3 Follicular Lymphoma; Recurrent Mantle Cell Lymphoma; Recurrent Marginal Zone Lymphoma; Recurrent Small Lymphocytic Lymphoma; Refractory Multiple Myeloma; Splenic Marginal Zone Lymphoma; Stage II Multiple Myeloma; Stage III Adult Burkitt Lymphoma; Stage III Adult Diffuse Large Cell Lymphoma; Stage III Adult Diffuse Mixed Cell Lymphoma; Stage III Adult Diffuse Small Cleaved Cell Lymphoma; Stage III Adult Immunoblastic Large Cell Lymphoma; Stage III Adult Lymphoblastic Lymphoma; Stage III Grade 1 Follicular Lymphoma; Stage III Grade 2 Follicular Lymphoma; Stage III Grade 3 Follicular Lymphoma; Stage III Mantle Cell Lymphoma; Stage III Marginal Zone Lymphoma; Stage III Multiple Myeloma; Stage III Small Lymphocytic Lymphoma; Stage IV Adult Burkitt Lymphoma; Stage IV Adult Diffuse Large Cell Lymphoma; Stage IV Adult Diffuse Mixed Cell Lymphoma; Stage IV Adult Diffuse Small Cleaved Cell Lymphoma; Stage IV Adult Immunoblastic Large Cell Lymphoma; Stage IV Adult Lymphoblastic Lymphoma; Stage IV Grade 1 Follicular Lymphoma; Stage IV Grade 2 Follicular Lymphoma; Stage IV Grade 3 Follicular Lymphoma; Stage IV Mantle Cell Lymphoma; Stage IV Marginal Zone Lymphoma; Stage IV Small Lymphocytic Lymphoma; Unspecified Adult Solid Tumor, Protocol Specific; Waldenström Macroglobulinemia

Extranodal nasal-type NK/T-cell lymphoma of the palate and paranasal sinuses

PubMed Central

Nikolaos, Nikitakis; Grigorios, Polyzois; Konstantinos, Katoumas; Savvas, Titsinides; Vassiliki, Zolota; Alexandra, Sklavounou; Theodoros, Papadas

2012-01-01

Summary Background: Extranodal nasal-type natural killer (NK)/T-cell lymphoma represents a rare entity, typically originating in the nasal cavity, palate or midfacial region. Signs and symptoms include non-specific rhinitis and/or sinusitis, nasal obstruction, epistaxis, facial swelling and development of deep necrotic ulceration in the midline of the palate, causing an oronasal defect. Differential diagnosis includes fungal infections, Wegener’s granulomatosis, tertiary syphilis, other non-Hodgkin’s lymphomas and malignant epithelial midline tumors. Case Report: We present a case of a 40-year-old man complaining of headache, facial pain, nasal congestion and fever. Examination revealed a large deep necrotic ulcer in the middle of the palate, presenting as an oronasal defect. Endoscopic rhinoscopy revealed crusts in the nasal cavities, moderate perforation of the nasal septum cartilage and contraction of the middle and inferior conchae. Computer tomography showed occupation of the maxillary sinuses, ethmoidal cells and sphenoidal sinus by a hyperdense soft tissue mass. Laboratory investigation revealed increased erythrocyte sedimentation rate. A wide excision of the lesion was performed. Histopathological and immunohistochemical evaluation established the diagnosis of extranodal nasal-type NK/T-cell lymphoma. The patient was treated with CHOP chemotherapy, involved-field radiotherapy and autologous bone marrow transplantation. A removable partial denture with obturator was fabricated and inserted to relieve problems caused by the oronasal defect. Conclusions: Extranodal nasal-type NK/T-cell lymphoma is a very aggressive, rapidly progressing malignant neoplasm with a poor prognosis, which can be improved by early diagnosis and combined treatment. PMID:23569495

Multi-disciplinary contributions of HartRAO to global geodesy and geodynamics

NASA Astrophysics Data System (ADS)

Combrinck, Ludwig

2015-04-01

The Hartebeesthoek Radio Astronomy Observatory (South Africa) supports global initiatives in both geodesy and geodynamics through an active programme of science platform provision in Africa, the Atlantic Ocean, Indian Ocean and Antarctica. Our involvement ranges from the installation of tide gauges, Global Navigation Satellite Systems stations, seismometers and accelerometers on remote islands to the installation of radar reflectors in Antarctica which enable accurate, geo-referenced maps of the Antarctic coast line to be made. Currently we also participate in the African VLBI Network (AVN), with the aim to densify not only astronomical observatories in Africa, but to improve the geometry and distribution of advanced geodetic and geophysical equipment to facilitate development of research platforms in Africa, which can be used for geodynamics and related sciences, supporting international projects such as the WEGENER initiative. We present our multi-disciplinary activities during the last decade and sketch the way forward. Participation of Africa in the global arena of astronomy, geodesy, geodynamics and related fields will receive a major boost during the next decade. This is partially due to the development of a component of the Square Kilometre Array (SKA) in Africa but also due to the Global Geodetic Observing System (GGOS) project and the international objectives of higher geodetic accuracies and more stable reference frames. Consequent spinoffs into many disciplines relying on global reference frames and sub-cm positional accuracies stand to benefit and Africa can play a major role in improving both science and network geometries.

Modelling and intepreting the isotopic composition of water vapour in convective updrafts

NASA Astrophysics Data System (ADS)

Bolot, M.; Legras, B.; Moyer, E. J.

2012-08-01

The isotopic compositions of water vapour and its condensates have long been used as tracers of the global hydrological cycle, but may also be useful for understanding processes within individual convective clouds. We review here the representation of processes that alter water isotopic compositions during processing of air in convective updrafts and present a unified model for water vapour isotopic evolution within undiluted deep convective cores, with a special focus on the out-of-equilibrium conditions of mixed phase zones where metastable liquid water and ice coexist. We use our model to show that a combination of water isotopologue measurements can constrain critical convective parameters including degree of supersaturation, supercooled water content and glaciation temperature. Important isotopic processes in updrafts include kinetic effects that are a consequence of diffusive growth or decay of cloud particles within a supersaturated or subsaturated environment; isotopic re-equilibration between vapour and supercooled droplets, which buffers isotopic distillation; and differing mechanisms of glaciation (droplet freezing vs. the Wegener-Bergeron-Findeisen process). As all of these processes are related to updraft strength, droplet size distribution and the retention of supercooled water, isotopic measurements can serve as a probe of in-cloud conditions of importance to convective processes. We study the sensitivity of the profile of water vapour isotopic composition to differing model assumptions and show how measurements of isotopic composition at cloud base and cloud top alone may be sufficient to retrieve key cloud parameters.

BINARY: an optical freezing array for assessing temperature and time dependence of heterogeneous ice nucleation

NASA Astrophysics Data System (ADS)

Budke, C.; Koop, T.

2015-02-01

A new optical freezing array for the study of heterogeneous ice nucleation in microliter-sized droplets is introduced, tested and applied to the study of immersion freezing in aqueous Snomax® suspensions. In the Bielefeld Ice Nucleation ARraY (BINARY) ice nucleation can be studied simultaneously in 36 droplets at temperatures down to -40 °C (233 K) and at cooling rates between 0.1 and 10 K min-1. The droplets are separated from each other in individual compartments, thus preventing a Wegener-Bergeron-Findeisen type water vapor transfer between droplets as well as avoiding the seeding of neighboring droplets by formation and surface growth of frost halos. Analysis of freezing and melting occurs via an automated real-time image analysis of the optical brightness of each individual droplet. As an application ice nucleation in water droplets containing Snomax® at concentrations from 1 ng mL-1 to 1 mg mL-1 was investigated. Using different cooling rates, a small time dependence of ice nucleation induced by two different classes of ice nucleators (INs) contained in Snomax® was detected and the corresponding heterogeneous ice nucleation rate coefficient was quantified. The observed time dependence is smaller than those of other types of INs reported in the literature, suggesting that the BINARY setup is suitable for quantifying time dependence for most other INs of atmospheric interest, making it a useful tool for future investigations.

Modelling and interpreting the isotopic composition of water vapour in convective updrafts

NASA Astrophysics Data System (ADS)

Bolot, M.; Legras, B.; Moyer, E. J.

2013-08-01

The isotopic compositions of water vapour and its condensates have long been used as tracers of the global hydrological cycle, but may also be useful for understanding processes within individual convective clouds. We review here the representation of processes that alter water isotopic compositions during processing of air in convective updrafts and present a unified model for water vapour isotopic evolution within undiluted deep convective cores, with a special focus on the out-of-equilibrium conditions of mixed-phase zones where metastable liquid water and ice coexist. We use our model to show that a combination of water isotopologue measurements can constrain critical convective parameters, including degree of supersaturation, supercooled water content and glaciation temperature. Important isotopic processes in updrafts include kinetic effects that are a consequence of diffusive growth or decay of cloud particles within a supersaturated or subsaturated environment; isotopic re-equilibration between vapour and supercooled droplets, which buffers isotopic distillation; and differing mechanisms of glaciation (droplet freezing vs. the Wegener-Bergeron-Findeisen process). As all of these processes are related to updraft strength, particle size distribution and the retention of supercooled water, isotopic measurements can serve as a probe of in-cloud conditions of importance to convective processes. We study the sensitivity of the profile of water vapour isotopic composition to differing model assumptions and show how measurements of isotopic composition at cloud base and cloud top alone may be sufficient to retrieve key cloud parameters.

Simulation of the effects of aerosol on mixed-phase orographic clouds using the WRF model with a detailed bin microphysics scheme

NASA Astrophysics Data System (ADS)

Xiao, Hui; Yin, Yan; Jin, Lianji; Chen, Qian; Chen, Jinghua

2015-08-01

The Weather Research Forecast (WRF) mesoscale model coupled with a detailed bin microphysics scheme is used to investigate the impact of aerosol particles serving as cloud condensation nuclei and ice nuclei on orographic clouds and precipitation. A mixed-phase orographic cloud developed under two scenarios of aerosol (a typical continental background and a relatively polluted urban condition) and ice nuclei over an idealized mountain is simulated. The results show that, when the initial aerosol condition is changed from the relatively clean case to the polluted scenario, more droplets are activated, leading to a delay in precipitation, but the precipitation amount over the terrain is increased by about 10%. A detailed analysis of the microphysical processes indicates that ice-phase particles play an important role in cloud development, and their contribution to precipitation becomes more important with increasing aerosol particle concentrations. The growth of ice-phase particles through riming and Wegener-Bergeron-Findeisen regime is more effective under more polluted conditions, mainly due to the increased number of droplets with a diameter of 10-30 µm. Sensitivity tests also show that a tenfold increase in the concentration of ice crystals formed from ice nucleation leads to about 7% increase in precipitation, and the sensitivity of the precipitation to changes in the concentration and size distribution of aerosol particles is becoming less pronounced when the concentration of ice crystals is also increased.

Aerosol partitioning between the interstitial and the condensed phase in mixed-phase clouds

NASA Astrophysics Data System (ADS)

Verheggen, Bart; Cozic, Julie; Weingartner, Ernest; Bower, Keith; Mertes, Stephan; Connolly, Paul; Gallagher, Martin; Flynn, Michael; Choularton, Tom; Baltensperger, Urs

2007-12-01

The partitioning of aerosol particles between the cloud and the interstitial phase (i.e., unactivated aerosol) has been investigated during several Cloud and Aerosol Characterization Experiments (CLACE-3, CLACE-3? and CLACE-4) conducted in winter and summer 2004 and winter 2005 at the high alpine research station Jungfraujoch (3580 m altitude, Switzerland). Ambient air was sampled using different inlets in order to determine the activated fraction of aerosol particles, FN, defined as the fraction of the total aerosol number concentration (with particle diameter dp > 100 nm) that has been incorporated into cloud particles. The liquid and ice water content of mixed-phase clouds were characterized by analyzing multiple cloud probes. The dependence of the activated fraction on several environmental factors is discussed on the basis of more than 900 h of in-cloud observations and parameterizations for key variables are given. FN is found to increase with increasing liquid water content and to decrease with increasing particle number concentration in liquid clouds. FN also decreases with increasing cloud ice mass fraction and with decreasing temperature from 0 to -25°C. The Wegener-Bergeron-Findeisen process probably contributed to this trend, since the presence of ice crystals causes liquid droplets to evaporate, thus releasing the formerly activated particles back into the interstitial phase. Ice nucleation could also have prevented additional cloud condensation nuclei from activating. The observed activation behavior has significant implications for our understanding of the indirect effect of aerosols on climate.

Simulation of homogeneous condensation of small polyatomic systems in high pressure supersonic nozzle flows using Bhatnagar-Gross-Krook model

NASA Astrophysics Data System (ADS)

Kumar, Rakesh; Levin, Deborah A.

2011-03-01

In the present work, we have simulated the homogeneous condensation of carbon dioxide and ethanol using the Bhatnagar-Gross-Krook based approach. In an earlier work of Gallagher-Rogers et al. [J. Thermophys. Heat Transfer 22, 695 (2008)], it was found that it was not possible to simulate condensation experiments of Wegener et al. [Phys. Fluids 15, 1869 (1972)] using the direct simulation Monte Carlo method. Therefore, in this work, we have used the statistical Bhatnagar-Gross-Krook approach, which was found to be numerically more efficient than direct simulation Monte Carlo method in our previous studies [Kumar et al., AIAA J. 48, 1531 (2010)], to model homogeneous condensation of two small polyatomic systems, carbon dioxide and ethanol. A new weighting scheme is developed in the Bhatnagar-Gross-Krook framework to reduce the computational load associated with the study of homogeneous condensation flows. The solutions obtained by the use of the new scheme are compared with those obtained by the baseline Bhatnagar-Gross-Krook condensation model (without the species weighting scheme) for the condensing flow of carbon dioxide in the stagnation pressure range of 1-5 bars. Use of the new weighting scheme in the present work makes the simulation of homogeneous condensation of ethanol possible. We obtain good agreement between our simulated predictions for homogeneous condensation of ethanol and experiments in terms of the point of condensation onset and the distribution of mass fraction of ethanol condensed along the nozzle centerline.

Ground-based lidar measurements from Ny-Ålesund during ASTAR 2007: a statistical overview

NASA Astrophysics Data System (ADS)

Hoffmann, A.; Ritter, C.; Stock, M.; Shiobara, M.; Lampert, A.; Maturilli, M.; Orgis, T.; Neuber, R.; Herber, A.

2009-07-01

During the Arctic Study of Tropospheric Aerosol, Clouds and Radiation (ASTAR) in March and April 2007, measurements obtained at the AWIPEV Research station in Ny-Ålesund, Spitsbergen (operated by the Alfred-Wegener-Institute for Polar and Marine Research and the Institut polaire français Paul-Emile Victor), supported the airborne campaign. This included Lidar data from the Koldewey Aerosol Raman Lidar (KARL) and the Micro Pulse Lidar (MPL), located in the atmospheric observatory as well as photometer data and the daily launched radiosonde. The MPL features nearly continuous measurements; the KARL was switched on whenever weather conditions allowed observations (145 h in 61 days). From 1 March to 30 April, 71 meteorological balloon soundings were performed and compared with the corresponding MPL measurements; photometer measurements are available from 18 March. For the KARL data, a statistical overview based on the optical properties backscatter ratio and volume depolarization can be given. The altitudes of the occurrence of the named features (subvisible and visible ice and water as well as mixed-phase clouds, aerosol layers) as well as their dependence on different air mass origins are analyzed. Although the spring 2007 was characterized by rather clean conditions, diverse case studies of cloud and aerosol occurrence during March and April 2007 are presented in more detail, including temporal development and main optical properties as backscatter, depolarization and extinction coefficients. Links between air mass origins and optical properties can be presumed but need further evidence.

Evidence for biological shaping of hair ice

NASA Astrophysics Data System (ADS)

Hofmann, D.; Preuss, G.; Mätzler, C.

2015-07-01

An unusual ice type, called hair ice, grows on the surface of dead wood of broad-leaf trees at temperatures slightly below 0 °C. We describe this phenomenon and present physical, chemical, and biological investigations to gain insight in the properties and processes related to hair ice. Tests revealed that the biological activity of a winter-active fungus is required in the wood for enabling the growth of hair ice. We confirmed the fungus hypothesis originally suggested by Wegener (1918) by reproducing hair ice on wood samples. Treatment by heat and fungicide suppresses the formation of hair ice. Fruiting bodies of Asco- and Basidiomycota are identified on hair-ice-carrying wood. One species, Exidiopsis effusa (Ee), was present on all investigated samples. Both hair-ice-producing wood samples and those with killed fungus show essentially the same temperature variation, indicating that the heat produced by fungal metabolism is very small, that the freezing rate is not influenced by the fungus activity, and that ice segregation is the common mechanism of ice growth on the wood surface. The fungus plays the role of shaping the ice hairs and preventing them from recrystallisation. Melted hair ice indicates the presence of organic matter. Chemical analyses show a complex mixture of several thousand CHO(N,S) compounds similar to fulvic acids in dissolved organic matter (DOM). The evaluation reveals decomposed lignin as being the main constituent. Further work is needed to clarify its role in hair-ice growth and to identify the recrystallisation inhibitor.

Evidence for biological shaping of hair ice

NASA Astrophysics Data System (ADS)

Hofmann, D.; Preuss, G.; Mätzler, C.

2015-04-01

An unusual ice type, called hair ice, grows on the surface of dead wood of broad-leaf trees at temperatures slightly below 0 °C. We describe this phenomenon and present physical, chemical, and biological investigations to gain insight in the properties and processes related to hair ice. Tests revealed that the biological activity of a winter-active fungus is required in the wood for enabling the growth of hair ice. We confirmed the fungus hypothesis originally suggested by Wegener (1918) by reproducing hair ice on wood samples. Treatment by heat and fungicide, respectively, suppresses the formation of hair ice. Fruiting bodies of Asco- and Basidiomycota are identified on hair-ice carrying wood. One species, Exidiopsis effusa (Ee), has been present on all investigated samples. Both hair-ice producing wood samples and those with killed fungus show essentially the same temperature variation, indicating that the heat produced by fungal metabolism is very small, that the freezing rate is not influenced by the fungus activity and that ice segregation is the common mechanism of ice growth at the wood surface. The fungus plays the role of shaping the ice hairs and to prevent them from recrystallisation. Melted hair ice indicates the presence of organic matter. Chemical analyses show a complex mixture of several thousand CHO(N,S)-compounds similar to fulvic acids in dissolved organic matter (DOM). The evaluation reveals decomposed lignin as the main constituent. Further work is needed to clarify its role in hair-ice growth and to identify the recrystallisation inhibitor.

ATLAS - A new Lagrangian transport and mixing model with detailed stratospheric chemistry

NASA Astrophysics Data System (ADS)

Wohltmann, I.; Rex, M.; Lehmann, R.

2009-04-01

We present a new global Chemical Transport Model (CTM) with full stratospheric chemistry and Lagrangian transport and mixing called ATLAS. Lagrangian models have some crucial advantages over Eulerian grid-box based models, like no numerical diffusion, no limitation of the time step of the model by the CFL criterion, conservation of mixing ratios by design and easy parallelization of code. The transport module is based on a trajectory code developed at the Alfred Wegener Institute. The horizontal and vertical resolution, the vertical coordinate system (pressure, potential temperature, hybrid coordinate) and the time step of the model are flexible, so that the model can be used both for process studies and long-time runs over several decades. Mixing of the Lagrangian air parcels is parameterized based on the local shear and strain of the flow with a method similar to that used in the CLaMS model, but with some modifications like a triangulation that introduces no vertical layers. The stratospheric chemistry module was developed at the Institute and includes 49 species and 170 reactions and a detailed treatment of heterogenous chemistry on polar stratospheric clouds. We present an overview over the model architecture, the transport and mixing concept and some validation results. Comparison of model results with tracer data from flights of the ER2 aircraft in the stratospheric polar vortex in 1999/2000 which are able to resolve fine tracer filaments show that excellent agreement with observed tracer structures can be achieved with a suitable mixing parameterization.

Comprehensive analysis of immune, extracellular matrices and pathogens profile in lung granulomatosis of unexplained etiology.

PubMed

da Costa Souza, Paola; Dondo, Patrícia Suemi; Souza, Gabriela; Lopes, Deborah; Moscardi, Marcel; de Miranda Martinho, Vinicius; de Mattos Lourenço, Rodolfo Daniel; Prieto, Tabatha; Balancin, Marcelo Luiz; Assato, Aline Kawassaki; Teodoro, Walcy Rosolia; Rodrigues, Silvia; Lima, Mariana; Castellano, Maria Vera; Coletta, Ester; Parra, Edwin Roger; Capelozzi, Vera Luiza

2018-05-01

This study analyzed the type 1 and type 2T helper (Th1/Th2) cytokines (including interleukins), immune cellular, matrix profile, and pathogens in granulomas with unexplained etiology compared to those with infectious and noninfectious etiology. Surgical lung biopsies from 108 patients were retrospectively reviewed. Histochemistry, immunohistochemistry, immunofluorescence, morphometry and polymerase chain reaction were used, respectively, to evaluate total collagen and elastin fibers, collagen I and III, immune cells, cytokines, matrix metalloproteinase-9, myofibroblasts, and multiple usual and unusual pathogens. No relevant polymerase chain reaction expression was found in unexplained granulomas. A significant difference was found between the absolute number of eosinophils, macrophages, and lymphocytes within granulomas compared to uninvolved lung tissue. Granulomas with unexplained etiology (UEG) presented increased number of eosinophils and high expression of interleukins (ILs) IL-4/IL-5 and transforming growth factor-β. In sarcoidosis, CD4/CD8 cell number was significantly higher within and outside granulomas, respectively; the opposite was detected in hypersensitivity pneumonitis. Again, a significant difference was found between the high number of myofibroblasts and matrix metalloproteinase-9 in UEG, hypersensitivity pneumonitis, and sarcoidosis compared to granulomas of tuberculosis. Granulomas of paracoccidioisis exhibited increased type I collagen and elastic fibers. Th1 immune cellular profile was similar among granulomas with unexplained, infectious, and noninfectious etiology. In contrast, modulation of Th2 and matrix remodeling was associated with more fibroelastogenesis and scarring of lung tissue in UEG compared to infectious and noninfectious. We concluded that IL-4/IL-5 and transforming growth factor-β might be used as surrogate markers of early fibrosis, reducing the need for genotyping, and promise therapeutic target in unexplained granulomas. Copyright © 2018 Elsevier Inc. All rights reserved.

[A young woman with granulomatous mastitis: a corynebacteria may be involved in the pathogenesis of these disease].

PubMed

Kieffer, P; Dukic, R; Hueber, M; Kieffer, C; Bouhala, M; Riegel, P; Wilhelm, J-M

2006-07-01

The granulomatous mastitis is an inflammatory pseudotumor of the breast of which evolution benign but likely to generate important morphological after-effects among young women. This anatomoclinic entity of dubious etiology until these last years poses a problem of differential diagnosis with other etiologies of granulomatosis and especially with inflammatory carcinoma of the breast. The infectious theory is actually based on solid arguments and mainly explains the physiopathology of this affection. A 26 years old young woman developed an inflammatory tumor of the left breast of which the catch of load by surgery and an antibiotherapy had shown trailing local continuations and of the esthetic after-effects. One year later, a very inflammatory repetition on the level of the right breast was dealt with in a different way: by steroids and immunomodulating drugs associated with iterative punctures with the purulent collections, the objective being to be less dilapidating that left side. The initial answer was rather favorable and encouraging but the purulent reappearance bulky granulomas with sinus way made reconsider the therapeutic attitude and antibiotics were undertaken after description of a lipophilic corynebactery in the material of puncture (Corynebacteria kroppenstedtii). The effectiveness of the amoxicilline introduced on the data of the antibiogram was undeniable. This observation illustrates the therapeutic and diagnostic difficulties of an exceptional affection. Potentially accessible to antibiotics it generally requires a joint surgical assumption of responsibility, at the same time to ensure the histological diagnosis but also with a therapeutic aim. The interest of steroids and the immunomodulation by methotrexate is debatable, these treatments cannot however be conceived without antibiotherapy and sometimes surgery.

Major Histopathologic Diagnoses of Chronic Wounds.

PubMed

Turi, George K; Donovan, Virginia; DiGregorio, Julie; Criscitelli, Theresa M; Kashan, Benjamin; Barrientos, Stephan; Balingcongan, Jose Ramon; Gorenstein, Scott; Brem, Harold

2016-08-01

To clarify the histopathology of acute osteomyelitis, chronic osteomyelitis, primary vasculitis, and secondary-type vasculitis. This continuing education activity is intended for physicians and nurses with an interest in skin and wound care. After participating in this educational activity, the participant should be better able to:1. Describe the parameters and significance of this study.2. Identify chronic wound diagnosis and treatment.3. Differentiate the histopathology of osteomyelitis and vasculitis. The presence of a chronic wound can result in significant morbidity/mortality. Understanding the pathological alterations of wound tissue that are refractory to standard wound therapy is essential for effective wound management and healing. The authors describe 4 wound etiologies, specifically, acute osteomyelitis, chronic osteomyelitis, primary vasculitis, and secondary-type vasculitis. A tertiary care hospital. A retrospective review of 1392 wound operations performed during a 24-month period at a tertiary care hospital was conducted. Tissue specimens reviewed included soft tissue infections of the lower extremity, sacrum, hip/pelvis, trunk, perineum, and buttocks. Acute osteomyelitis is defined as bone tissue with a predominance of polymorphonuclear leukocytes, evidence of osteoclast bone resorption with scalloping of the cortical bone edges, and bone detritus. Chronic osteomyelitis is defined as bone tissue with a significant amount of fibrosis surrounding devitalized tissue and heavy infiltration of lymphocytes and plasma cells. Primary-type vasculitis is defined primarily as inflammation and necrosis of blood vessel walls. In cutaneous lesions of granulomatosis with polyangiitis, ulceration with numerous inflammatory granulomas is seen in the papillary dermis. Secondary vasculitis is defined by vessel wall infiltration by inflammatory cells and fibrinoid necrosis of the small vessel wall. Pathologies of these 4 types of wounds can complicate standard algorithms designed for diagnosis and treatment, and accurate diagnosis through histopathologic analysis can help tailor targeted treatment.

Listériose humaine : Expériences cliniques avec cette zoonose chez 12 patients en Estrie, Québec sur une période de 19 ans (1976 à 1995)

PubMed Central

Maziade, Pierre-Jean; Marcoux, J André

1997-01-01

Une étude rétrospective a été faite dans le but de réviser l’épidémiologie, les facteurs de risque, les manifestations cliniques et l’évolution des cas d’infection à Listeria monocytogenes en Estrie, Québec de 1976–1995. Les patients ont été repérés à partir des cultures positives et du diagnostic donné par le Service des maladies infectieuses du Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Québec. Un total de 12 patients ont fait partie de l’étude. La septicémie non reliée à la grossesse (4/12) et la méningite (6/12) ont été les deux présentations cliniques majeures. Il y avait 1 cas de listériose de grossesse et 1 cas de granulomatosis infanti septica. Dix patients avaient au moins une condition prédisposante. Un seul décès a été attribué à l’infection à L monocytogenes. Des séquelles neurologiques ont été observées chez la moitié des patients avec méningite tandis qu’aucune séquelle a été notée chez ceux avec septicémie. En conclusion, la listériose est une maladie de patients âgés et immunocompromis. La présentation clinique et l’évolution ne sont pas différentes de ce qui a déjà été rapporté dans d’autres régions industrialisées. PMID:22514474

Churg-Strauss syndrome.

PubMed

Greco, Antonio; Rizzo, Maria Ida; De Virgilio, Armando; Gallo, Andrea; Fusconi, Massimo; Ruoppolo, Giovanni; Altissimi, Giancarlo; De Vincentiis, Marco

2015-04-01

Churg-Strauss syndrome (CSS), alternatively known as eosinophilic granulomatosis with polyangiitis (EGPA), was first described in 1951 by Churg and Strauss as a rare disease characterized by disseminated necrotizing vasculitis with extravascular granulomas occurring exclusively among patients with asthma and tissue eosinophilia. EGPA is classified as a small-vessel vasculitis associated with antineutrophil cytoplasmic antibodies (ANCAs) and the hypereosinophilic syndromes (HESs) in which vessel inflammation and eosinophilic proliferation are thought to contribute to organ damage. Although still considered an idiopathic condition, EGPA is classically considered a Th2-mediated disease. Emerging clinical observations provide compelling evidence that ANCAs are primarily and directly involved in the pathogenesis of AASVs, although recent evidence implicates B cells and the humoral response as further contributors to EGPA pathogenesis. EGPA has traditionally been described as evolving through a prodromic phase characterized by asthma and rhino-sinusitis, an eosinophilic phase marked by peripheral eosinophilia and organ involvement, and a vasculitic phase with clinical manifestations due to small-vessel vasculitis. The American College of Rheumatology defined the classification criteria to distinguish the different types of vasculitides and identified six criteria for EGPA. When four or more of these criteria are met, vasculitis can be classified as EGPA. The French Vasculitis Study Group has identified five prognostic factors that make up the so-called five-factor score (FFS). Patients without poor prognosis factors (FFS=0) have better survival rates than patients with poor prognosis factors (FFS≥1). The treatment of patients with CSS must be tailored to individual patients according to the presence of poor prognostic factors. A combination of high-dose corticosteroids and cyclophosphamide is still the gold standard for the treatment of severe cases, but the use of biological agents such as rituximab or mepolizumab seems to be a promising therapeutic alternative. Copyright © 2015 Elsevier B.V. All rights reserved.

Contribution of dot-blot assay to the diagnosis and management of myositis: a three-year practice at a university hospital centre.

PubMed

Martel, Clothilde; Vignaud, Guillaume; Liozon, Eric; Magy, Laurent; Gallouedec, Gael; Ly, Kim; Bezanahary, Holly; Cypierre, Anne; Lapébie, François-Xavier; Palat, Sylvain; Gondran, Guillaume; Jauberteau, Marie-Odile; Fauchais, Anne-Laure

2016-01-01

Idiopathic inflammatory myopathies (IIM) are heterogeneous autoimmune diseases with wide clinical spectrum that may lead to delayed diagnosis. The aim of this study was to examine the impact of IIM-specific dot-blot assay on diagnostic process of patients presenting with muscular or systemic symptoms evocating of IIM. We collected all the prescriptions of an IIM specific dot-blot assay (8 autoantigens including Jo-1, PL-7, PL-12, SRP, Mi-2, Ku, PM/Scl and Scl-70) over a 38-month period. 316 myositis dot-blot assays (MSD) were performed in 274 patients (156 women, mean age 53±10.6 years) referring for muscular and/or systemic symptoms suggesting IIM. The timing of dot prescription through the diagnostic process was highly variable: without (35%), concomitantly (16%) or after electromyographic studies (35%). Fifty-nine patients (22%) had IIM according to Bohan and Peter's criteria. Among them, 29 (49%) had positive dot (8 Jo-1, 6 PM-Scl, 5 PL-12, 5 SRP, 2 Mi-2, 2 PL-7 and 1 Ku). Various other diagnoses were performed including 35 autoimmune disease or granulomatosis (12%), 19 inflammatory rheumatic disease (7%), 16 non inflammatory muscular disorders (6%), 10 drug-induced myalgia (4%), 11 infectious myositis (4%). Except 11 borderline SRP results and one transient PM-Scl, MSD was positive only in one case of IIM. Dot allowed clinicians to correct diagnosis in 4 cases and improved the diagnosis of IIM subtypes in 4 cases. This study reflects the interest of myositis dot in the rapid diagnosis process of patients with non-specific muscular symptoms leading to various diagnoses including IIM.

Experience With Direct-to-Patient Recruitment for Enrollment Into a Clinical Trial in a Rare Disease: A Web-Based Study

PubMed Central

2017-01-01

Background The target sample size for clinical trials often necessitates a multicenter (center of excellence, CoE) approach with associated added complexity, cost, and regulatory requirements. Alternative recruitment strategies need to be tested against this standard model. Objectives The aim of our study was to test whether a Web-based direct recruitment approach (patient-centric, PC) using social marketing strategies provides a viable option to the CoE recruitment method. Methods PC recruitment and Web-based informed consent was compared with CoE recruitment for a randomized controlled trial (RCT) of continuing versus stopping low-dose prednisone for maintenance of remission of patients with granulomatosis with polyangiitis (GPA). Results The PC approach was not as successful as the CoE approach. Enrollment of those confirmed eligible by their physician was 10 of 13 (77%) and 49 of 51 (96%) in the PC and CoE arms, respectively (P=.05). The two approaches were not significantly different in terms of eligibility with 34% of potential participants in the CoE found to be ineligible as compared with 22% in the PC arm (P=.11) nor in provider acceptance, 22% versus 26% (P=.78). There was no difference in the understanding of the trial as reflected in the knowledge surveys of individuals in the PC and CoE arms. Conclusions PC recruitment was substantially less successful than that achieved by the CoE approach. However, the PC approach was good at confirming eligibility and was as acceptable to providers and as understandable to patients as the CoE approach. The PC approach should be evaluated in other clinical settings to get a better sense of its potential. PMID:28246067

Serum proteins reflecting inflammation, injury and repair as biomarkers of disease activity in ANCA-associated vasculitis

PubMed Central

Monach, Paul A; Warner, Roscoe L; Tomasson, Gunnar; Specks, Ulrich; Stone, John H; Ding, Linna; Fervenza, Fernando C; Fessler, Barri J; Hoffman, Gary S; Iklé, David; Kallenberg, Cees GM; Krischer, Jeffrey; Langford, Carol A; Mueller, Mark; Seo, Philip; St. Clair, E William; Spiera, Robert; Tchao, Nadia; Ytterberg, Steven R; Johnson, Kent J; Merkel, Peter A

2016-01-01

Objective To identify circulating proteins that distinguish between active anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) and remission in a manner complementary to markers of systemic inflammation. Methods Twenty-eight serum proteins representing diverse aspects of the biology of AAV were measured before and 6 months after treatment in a large clinical trial of AAV. Subjects (n=186) enrolled in the Rituximab in ANCA-Associated Vasculitis (RAVE) trial were studied. Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels were available for comparison. The primary outcome was the ability of markers to distinguish severe AAV (Birmingham Vasculitis Activity Score for Wegener’s granulomatosis (BVAS/WG)≥3 at screening) from remission (BVAS/WG=0 at month 6), using areas under receiver operating characteristic (ROC) curve (AUC). Results All subjects had severe active vasculitis (median BVAS/WG=8) at screening. In the 137 subjects in remission at month 6, 24 of the 28 markers showed significant declines. ROC analysis indicated that levels of CXCL13 (BCA-1), matrix metalloproteinase-3 (MMP-3) and tissue inhibitor of metalloproteinases-1 (TIMP-1) best discriminated active AAV from remission (AUC>0.8) and from healthy controls (AUC>0.9). Correlations among these markers and with ESR or CRP were low. Conclusions Many markers are elevated in severe active AAV and decline with treatment, but CXCL13, MMP-3 and TIMP-1 distinguish active AAV from remission better than the other markers studied, including ESR and CRP. These proteins are particularly promising candidates for future studies to address unmet needs in the assessment of patients with AAV. PMID:22975753

Rituximab versus Cyclophosphamide for ANCA-Associated Vasculitis

PubMed Central

Stone, John H.; Merkel, Peter A.; Spiera, Robert; Seo, Philip; Langford, Carol A.; Hoffman, Gary S.; Kallenberg, Cees G.M.; St. Clair, E. William; Turkiewicz, Anthony; Tchao, Nadia K.; Webber, Lisa; Ding, Linna; Sejismundo, Lourdes P.; Mieras, Kathleen; Weitzenkamp, David; Ikle, David; Seyfert-Margolis, Vicki; Mueller, Mark; Brunetta, Paul; Allen, Nancy B.; Fervenza, Fernando C.; Geetha, Duvuru; Keogh, Karina A.; Kissin, Eugene Y.; Monach, Paul A.; Peikert, Tobias; Stegeman, Coen; Ytterberg, Steven R.; Specks, Ulrich

2011-01-01

BACKGROUND Cyclophosphamide and glucocorticoids have been the cornerstone of remission-induction therapy for severe antineutrophil cytoplasmic antibody (ANCA)–associated vasculitis for 40 years. Uncontrolled studies suggest that rituximab is effective and may be safer than a cyclophosphamide-based regimen. METHODS We conducted a multicenter, randomized, double-blind, double-dummy, noninferiority trial of rituximab (375 mg per square meter of body-surface area per week for 4 weeks) as compared with cyclophosphamide (2 mg per kilogram of body weight per day) for remission induction. Glucocorticoids were tapered off; the primary end point was remission of disease without the use of prednisone at 6 months. RESULTS Nine centers enrolled 197 ANCA-positive patients with either Wegener’s granulomatosis or microscopic polyangiitis. Baseline disease activity, organ involvement, and the proportion of patients with relapsing disease were similar in the two treatment groups. Sixty-three patients in the rituximab group (64%) reached the primary end point, as compared with 52 patients in the control group (53%), a result that met the criterion for noninferiority (P<0.001). The rituximab-based regimen was more efficacious than the cyclophosphamide-based regimen for inducing remission of relapsing disease; 34 of 51 patients in the rituximab group (67%) as compared with 21 of 50 patients in the control group (42%) reached the primary end point (P = 0.01). Rituximab was also as effective as cyclophosphamide in the treatment of patients with major renal disease or alveolar hemorrhage. There were no significant differences between the treatment groups with respect to rates of adverse events. CONCLUSIONS Rituximab therapy was not inferior to daily cyclophosphamide treatment for induction of remission in severe ANCA-associated vasculitis and may be superior in relapsing disease. (Funded by the National Institutes of Allergy and Infectious Diseases, Genentech, and Biogen; ClinicalTrials.gov number, NCT00104299.) PMID:20647199

Biotherapies in inflammatory ocular disorders: Interferons, immunoglobulins, monoclonal antibodies.

PubMed

Saadoun, D; Bodaghi, B; Bienvenu, B; Wechsler, B; Sene, D; Trad, S; Abad, S; Cacoub, P; Kodjikian, L; Sève, P

2013-05-01

Biotherapies used in clinical practice for the treatment of ophthalmologic manifestations of systemic diseases include interferons (IFN), intravenous immunoglobulins (IVIG) and monoclonal antibodies (anti-TNF, anakinra, tocilizumab and rituximab). Several open prospective studies have shown the effectiveness of IFN-α (78 to 98% complete remission) for the treatment of severe uveitis in Behcet's disease. IFN is capable of inducing prolonged remission and continued after his arrest, in 20-40% of patients. Side effects (flu-like, psychological effects) limit its use in practice. Anti-TNFα (infliximab and adalimumab) represents an attractive alternative therapeutic in severe uveitis refractory to immunosuppressants, especially in Behcet's disease. They are almost always (>90% of cases) and rapidly effective but their action is often suspensive. Anti-TNFα requires an extended prescription or takes over from another immunosuppressant once ocular inflammation has been controlled. IVIG are used for the treatment of Kawasaki disease and Birdshot disease. Several open or retrospective studies showed their effectiveness for the treatment of severe and refractory cicatricial pemphigoid. Tolerance of IVIG is good but their efficacy is transient. Rituximab showed an efficacy in few observations of various inflammatory eye diseases (uveitis, scleritis and idiopathic inflammatory pseudo-tumors or associated with granulomatosis with polyangiitis) and cicatricial pemphigoid. The risk of infection associated with this biotherapy limits its use in refractory diseases to conventional therapy. Anakinra (a soluble antagonist of IL-1R) showed interesting results in terms of efficiency in one small open study in Behcet's disease. Its safety profile is good and with a quick action that could be interesting for the treatment of severe uveitis. Copyright © 2013 Elsevier B.V. All rights reserved.

Serum soluble interleukin-2 receptor level is more sensitive than angiotensin-converting enzyme or lysozyme for diagnosis of sarcoidosis and may be a marker of multiple organ involvement.

PubMed

Thi Hong Nguyen, Chuyen; Kambe, Naotomo; Kishimoto, Izumi; Ueda-Hayakawa, Ikuko; Okamoto, Hiroyuki

2017-07-01

Skin lesions in sarcoidosis are often the initial symptoms that enable the dermatologist to be the first to diagnose this granulomatosis. However, diagnosis is sometimes very problematic. In 2015, the diagnostic criteria for sarcoidosis were updated in Japan, with elevated serum soluble interleukin-2 receptor (sIL-2R) replacing negative tuberculin reaction. Therefore, we assessed the clinical utility of sIL-2R compared with two other common markers, angiotensin-converting enzyme (ACE) and lysozyme, in patients who visited the dermatology clinic. Data from 72 patients showed that sIL-2R was more sensitive than both ACE and lysozyme in supporting a diagnosis of sarcoidosis (52.8%) compared with ACE (29%) and lysozyme (26.4%). Additionally, the sIL-2R level was significantly higher in patients with multiple organ involvement and parenchymal infiltration. Patients with elevated sIL-2R levels had higher serum ACE and lysozyme levels, a higher incidence of pulmonary involvement, more severe chest radiographic stage and a high incidence of expression-specific signs by imaging analysis. Receiver-operator curve analysis showed that sIL-2R was a better marker at the threshold cut-off point compared with ACE and lysozyme for identifying patients with multiple organ involvement, detecting patients with pulmonary disease and parenchymal infiltration as well as predicting the presence of specific signs in the diagnosis of sarcoidosis. Moreover, the kinetics of sIL-2R levels correlated closely with clinical manifestations, in contrast to the modest changes of ACE and lysozyme levels during the follow-up period. In conclusion, sIL-2R may be considered a good marker for diagnosis and a potential indicator of disease activity. © 2017 Japanese Dermatological Association.

Serum proteomic profiling in granumomatosis with polyangiitis using two-dimensional gel electrophoresis along with matrix assisted laser desorption ionization time of flight mass spectrometry.

PubMed

Rani, Lekha; Minz, Ranjana W; Arora, Amit; Kannan, Monica; Sharma, Aman; Anand, Shashi; Gupta, Dheeraj; Panda, Naresh K; Sakhuja, Vinay K

2014-11-01

The present study is a proteomic approach to find differentially expressed proteins in sera of limited and systemic subsets of active disease versus their remitting state in patients with granulomatosis with polyangiitis (GPA) and their correlation with disease activity. Eighteen patients with GPA in active as well as in remitting state and four healthy controls (HC) were included in the study. For proteomics analysis, two-dimensional gel electrophoresis along with matrix-assisted laser desorption ionization time-of-flight mass spectrometry were performed. A total of 14 gels were run from pooled patients' sera from active GPA and remission as well as pooled HC serum. There was significant differential expression of proteins in limited versus systemic GPA and between active systemic versus remitting patients of systemic disease. We identified nine maximally differentially expressed and five proteins which were not detected in HC. Among nine proteins, one (Prolow density lipoprotein receptor-related protein 1) was downregulated and four proteins (haptoglobin Hp, Hp2, vitamin D binding protein, killer cell lectin-like receptor subfamily F member 2), were up-regulated in both limited and systemic active disease, two proteins like Ig gamma-4 chain C region protein and serum albumin were up-regulated in limited active GPA and two proteins, that is, cysteine rich secretory protein LCCL domain-containing 2 precursor and serine-threonine-protein kinase A-Raf were up-regulated in systemic active disease. Levels of interleukin-17 and vitamin-D binding protein (VDBP) by enzyme-linked immunosorbent assay could distinctly demarcate active disease versus remission. Our study provides potential protein markers of active disease versus remission in GPA. © 2014 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd.

Single or Double Donor Umbilical Cord Blood Transplant in Treating Patients With High-Risk Hematologic Malignancies

ClinicalTrials.gov

2016-07-13

Accelerated Phase Chronic Myelogenous Leukemia; Acute Myeloid Leukemia With Multilineage Dysplasia Following Myelodysplastic Syndrome; Adult Acute Lymphoblastic Leukemia in Remission; Adult Acute Myeloid Leukemia in Remission; Adult Acute Myeloid Leukemia With 11q23 (MLL) Abnormalities; Adult Acute Myeloid Leukemia With Inv(16)(p13;q22); Adult Acute Myeloid Leukemia With t(15;17)(q22;q12); Adult Acute Myeloid Leukemia With t(16;16)(p13;q22); Adult Acute Myeloid Leukemia With t(8;21)(q22;q22); Adult Nasal Type Extranodal NK/T-cell Lymphoma; Anaplastic Large Cell Lymphoma; Angioimmunoblastic T-cell Lymphoma; Blastic Phase Chronic Myelogenous Leukemia; Cutaneous B-cell Non-Hodgkin Lymphoma; de Novo Myelodysplastic Syndromes; Extranodal Marginal Zone B-cell Lymphoma of Mucosa-associated Lymphoid Tissue; Hepatosplenic T-cell Lymphoma; Intraocular Lymphoma; Myelodysplastic/Myeloproliferative Neoplasm, Unclassifiable; Nodal Marginal Zone B-cell Lymphoma; Noncutaneous Extranodal Lymphoma; Peripheral T-cell Lymphoma; Post-transplant Lymphoproliferative Disorder; Previously Treated Myelodysplastic Syndromes; Recurrent Adult Acute Lymphoblastic Leukemia; Recurrent Adult Acute Myeloid Leukemia; Recurrent Adult Burkitt Lymphoma; Recurrent Adult Diffuse Large Cell Lymphoma; Recurrent Adult Diffuse Mixed Cell Lymphoma; Recurrent Adult Diffuse Small Cleaved Cell Lymphoma; Recurrent Adult Grade III Lymphomatoid Granulomatosis; Recurrent Adult Hodgkin Lymphoma; Recurrent Adult Immunoblastic Large Cell Lymphoma; Recurrent Adult Lymphoblastic Lymphoma; Recurrent Adult T-cell Leukemia/Lymphoma; Recurrent Cutaneous T-cell Non-Hodgkin Lymphoma; Recurrent Grade 1 Follicular Lymphoma; Recurrent Grade 2 Follicular Lymphoma; Recurrent Grade 3 Follicular Lymphoma; Recurrent Mantle Cell Lymphoma; Recurrent Marginal Zone Lymphoma; Recurrent Mycosis Fungoides/Sezary Syndrome; Recurrent Small Lymphocytic Lymphoma; Refractory Chronic Lymphocytic Leukemia; Refractory Hairy Cell Leukemia; Refractory Multiple Myeloma; Relapsing Chronic Myelogenous Leukemia; Secondary Acute Myeloid Leukemia; Secondary Myelodysplastic Syndromes; Small Intestine Lymphoma; Splenic Marginal Zone Lymphoma; T-cell Large Granular Lymphocyte Leukemia; Testicular Lymphoma; Waldenström Macroglobulinemia

Lenalidomide Maintenance Therapy After High Dose BEAM With or Without Rituximab

ClinicalTrials.gov

2018-01-13

Adult Nasal Type Extranodal NK/T-cell Lymphoma; Anaplastic Large Cell Lymphoma; Angioimmunoblastic T-cell Lymphoma; Extranodal Marginal Zone B-cell Lymphoma of Mucosa-associated Lymphoid Tissue; Nodal Marginal Zone B-cell Lymphoma; Peripheral T-cell Lymphoma; Recurrent Adult Burkitt Lymphoma; Recurrent Adult Diffuse Large Cell Lymphoma; Recurrent Adult Diffuse Mixed Cell Lymphoma; Recurrent Adult Diffuse Small Cleaved Cell Lymphoma; Recurrent Adult Grade III Lymphomatoid Granulomatosis; Recurrent Adult Immunoblastic Large Cell Lymphoma; Recurrent Adult Lymphoblastic Lymphoma; Recurrent Cutaneous T-cell Non-Hodgkin Lymphoma; Recurrent Grade 1 Follicular Lymphoma; Recurrent Grade 2 Follicular Lymphoma; Recurrent Grade 3 Follicular Lymphoma; Recurrent Mantle Cell Lymphoma; Recurrent Marginal Zone Lymphoma; Recurrent Mycosis Fungoides/Sezary Syndrome; Recurrent Small Lymphocytic Lymphoma; Splenic Marginal Zone Lymphoma; Stage III Adult Burkitt Lymphoma; Stage III Adult Diffuse Large Cell Lymphoma; Stage III Adult Diffuse Mixed Cell Lymphoma; Stage III Adult Diffuse Small Cleaved Cell Lymphoma; Stage III Adult Immunoblastic Large Cell Lymphoma; Stage III Adult Lymphoblastic Lymphoma; Stage III Cutaneous T-cell Non-Hodgkin Lymphoma; Stage III Grade 1 Follicular Lymphoma; Stage III Grade 2 Follicular Lymphoma; Stage III Grade 3 Follicular Lymphoma; Stage III Mantle Cell Lymphoma; Stage III Marginal Zone Lymphoma; Stage III Mycosis Fungoides/Sezary Syndrome; Stage III Small Lymphocytic Lymphoma; Stage IV Adult Burkitt Lymphoma; Stage IV Adult Diffuse Large Cell Lymphoma; Stage IV Adult Diffuse Mixed Cell Lymphoma; Stage IV Adult Diffuse Small Cleaved Cell Lymphoma; Stage IV Adult Immunoblastic Large Cell Lymphoma; Stage IV Adult Lymphoblastic Lymphoma; Stage IV Cutaneous T-cell Non-Hodgkin Lymphoma; Stage IV Grade 1 Follicular Lymphoma; Stage IV Grade 2 Follicular Lymphoma; Stage IV Grade 3 Follicular Lymphoma; Stage IV Mantle Cell Lymphoma; Stage IV Marginal Zone Lymphoma; Stage IV Mycosis Fungoides/Sezary Syndrome; Stage IV Small Lymphocytic Lymphoma; Waldenström Macroglobulinemia

The Outcomes of Patients with ESRD and ANCA-Associated Vasculitis in Australia and New Zealand

PubMed Central

Tang, Wen; Bose, Bhadran; McDonald, Stephen P.; Hawley, Carmel M.; Badve, Sunil V.; Boudville, Neil; Brown, Fiona G.; Clayton, Philip A.; Campbell, Scott B.; Peh, Chen Au

2013-01-01

Summary Background and objectives This study aimed to evaluate dialysis and transplant outcomes of patients with ESRD secondary to ANCA-associated vasculitis (AAV). Design, setting, participants, & measurements All ESRD patients who commenced renal replacement therapy in Australia and New Zealand between 1996 and 2010 were included. Outcomes were assessed by Kaplan–Meier, multivariable Cox regression, and competing-risks regression survival analyses. Results Of 36,884 ESRD patients, 228 had microscopic polyangiitis (MPA) and 221 had granulomatosis with polyangiitis (GPA). Using competing-risks regression, compared with other causes of ESRD, MPA patients (hazard ratio [HR], 0.89; 95% confidence interval [95% CI], 0.73–1.08; P=0.24) and GPA patients (HR, 0.94; 95% CI, 0.74–1.19; P=0.62) experienced comparable survival on dialysis. Forty-six MPA patients (21%) and 47 GPA (20%) patients received 98 renal allografts. Respective 10-year first graft survival rates in MPA, GPA, and non-AAV patients were 50%, 62%, 70%, whereas patient survival rates were 68%, 85% and 83%, respectively. Compared with non-AAV patients, MPA transplant recipients had higher risks of graft failure (HR, 1.87; 95% CI, 1.07–3.25; P=0.03) and death (HR, 1.94; 95% CI, 1.02–3.69; P=0.04), whereas GPA transplant recipients experienced comparable renal allograft survival (HR, 0.91; 95% CI, 0.43–1.93; P=0.81) and patient survival (HR, 0.58; 95% CI, 0.23–2.27; P=0.58). AAV recurrence was observed in two renal allografts (2%). Conclusions Compared with ESRD patients without AAV, those with GPA have comparable renal replacement therapy outcomes, whereas MPA patients have comparable dialysis survival but poorer renal transplant allograft and patient survival rates. PMID:23349331

Isolated lung transplantation for end-stage lung disease: a viable therapy.

PubMed

Egan, T M; Westerman, J H; Lambert, C J; Detterbeck, F C; Thompson, J T; Mill, M R; Keagy, B A; Paradowski, L J; Wilcox, B R

1992-04-01

Since January 1990, we have performed 29 isolated lung transplantations in 28 patients with end-stage lung disease (12 single, 16 bilateral). Recipient diagnoses were: cystic fibrosis (11), chronic obstructive pulmonary disease (6), pulmonary fibrosis (6), eosinophilic granulomatosis (1), postinfectious lung disease (1), adult respiratory distress syndrome (1), and primary pulmonary hypertension (2). There have been four deaths, two in patients with pulmonary fibrosis and two in patients with primary pulmonary hypertension. Four patients have undergone transplantation while on ventilatory support for respiratory failure (2 with cystic fibrosis, 1 having redo lung transplantation with cystic fibrosis, and 1 with adult respiratory distress syndrome); all of these have survived. Six patients required cardiopulmonary bypass, which was associated with increased transfusion requirement. All patients 2 months after discharge have returned to an active life-style, except for 2 patients who currently await retransplantation. Preoperative pulmonary rehabilitation has resulted in significant improvement in exercise performance in all patients. Immunosuppression consists of cyclosporine, azathioprine, and antilymphoblast globulin (University of Minnesota), withholding systemic steroids in the early postoperative period. We have employed bronchial omentopexy in all but four transplants; there has been one partial bronchial dehiscence, two instances of bronchomalacia requiring internal stenting, and one airway stenosis. Cytomegalovirus disease has been seen frequently (15 cases), but has responded well to treatment with ganciclovir. Other complication shave included one drug-related prolonged postoperative ventilation, thrombosis of a left lung after bilateral lung transplantation requiring retransplantation, five episodes of unilateral phrenic nerve palsy after bilateral lung transplantation (4 resolved), and the requirement of massive transfusion (greater than 10 units) in 5 patients.(ABSTRACT TRUNCATED AT 250 WORDS)

HOLIMO II: a digital holographic instrument for ground-based in-situ observations of microphysical properties of mixed-phase clouds

NASA Astrophysics Data System (ADS)

Henneberger, J.; Fugal, J. P.; Stetzer, O.; Lohmann, U.

2013-05-01

Measurements of the microphysical properties of mixed-phase clouds with high spatial resolution are important to understand the processes inside these clouds. This work describes the design and characterization of the newly developed ground-based field instrument HOLIMO II (HOLographic Imager for Microscopic Objects II). HOLIMO II uses digital in-line holography to in-situ image cloud particles in a well defined sample volume. By an automated algorithm, two-dimensional images of single cloud particles between 6 and 250 μm in diameter are obtained and the size spectrum, the concentration and water content of clouds are calculated. By testing the sizing algorithm with monosized beads a systematic overestimation near the resolution limit was found, which has been used to correct the measurements. Field measurements from the high altitude research station Jungfraujoch, Switzerland, are presented. The measured number size distributions are in good agreement with parallel measurements by a fog monitor (FM-100, DMT, Boulder USA). The field data shows that HOLIMO II is capable of measuring the number size distribution with a high spatial resolution and determines ice crystal shape, thus providing a method of quantifying variations in microphysical properties. A case study over a period of 8 h has been analyzed, exploring the transition from a liquid to a mixed-phase cloud, which is the longest observation of a cloud with a holographic device. During the measurement period, the cloud does not completely glaciate, contradicting earlier assumptions of the dominance of the Wegener-Bergeron-Findeisen (WBF) process.

HOLIMO II: a digital holographic instrument for ground-based in situ observations of microphysical properties of mixed-phase clouds

NASA Astrophysics Data System (ADS)

Henneberger, J.; Fugal, J. P.; Stetzer, O.; Lohmann, U.

2013-11-01

Measurements of the microphysical properties of mixed-phase clouds with high spatial resolution are important to understand the processes inside these clouds. This work describes the design and characterization of the newly developed ground-based field instrument HOLIMO II (HOLographic Imager for Microscopic Objects II). HOLIMO II uses digital in-line holography to in situ image cloud particles in a well-defined sample volume. By an automated algorithm, two-dimensional images of single cloud particles between 6 and 250 μm in diameter are obtained and the size spectrum, the concentration and water content of clouds are calculated. By testing the sizing algorithm with monosized beads a systematic overestimation near the resolution limit was found, which has been used to correct the measurements. Field measurements from the high altitude research station Jungfraujoch, Switzerland, are presented. The measured number size distributions are in good agreement with parallel measurements by a fog monitor (FM-100, DMT, Boulder USA). The field data shows that HOLIMO II is capable of measuring the number size distribution with a high spatial resolution and determines ice crystal shape, thus providing a method of quantifying variations in microphysical properties. A case study over a period of 8 h has been analyzed, exploring the transition from a liquid to a mixed-phase cloud, which is the longest observation of a cloud with a holographic device. During the measurement period, the cloud does not completely glaciate, contradicting earlier assumptions of the dominance of the Wegener-Bergeron-Findeisen (WBF) process.

On the Representation of Ice Nucleation in Global Climate Models, and its Importance for Simulations of Climate Forcings and Feedbacks

NASA Astrophysics Data System (ADS)

Storelvmo, T.

2015-12-01

Substantial improvements have been made to the cloud microphysical schemes used in the latest generation of global climate models (GCMs), however, an outstanding weakness of these schemes lies in the arbitrariness of their tuning parameters. Despite the growing effort in improving the cloud microphysical schemes in GCMs, most of this effort has not focused on improving the ability of GCMs to accurately simulate phase partitioning in mixed-phase clouds. Getting the relative proportion of liquid droplets and ice crystals in clouds right in GCMs is critical for the representation of cloud radiative forcings and cloud-climate feedbacks. Here, we first present satellite observations of cloud phase obtained by NASA's CALIOP instrument, and report on robust statistical relationships between cloud phase and several aerosols species that have been demonstrated to act as ice nuclei (IN) in laboratory studies. We then report on results from model intercomparison projects that reveal that GCMs generally underestimate the amount of supercooled liquid in clouds. For a selected GCM (NCAR 's CAM5), we thereafter show that the underestimate can be attributed to two main factors: i) the presence of IN in the mixed-phase temperature range, and ii) the Wegener-Bergeron-Findeisen process, which converts liquid to ice once ice crystals have formed. Finally, we show that adjusting these two processes such that the GCM's cloud phase is in agreement with the observed has a substantial impact on the simulated radiative forcing due to IN perturbations, as well as on the cloud-climate feedbacks and ultimately climate sensitivity simulated by the GCM.

Local Interactions of Hydrometeors by Diffusion in Mixed-Phase Clouds

NASA Astrophysics Data System (ADS)

Baumgartner, Manuel; Spichtinger, Peter

2017-04-01

Mixed-phase clouds, containing both ice particles and liquid droplets, are important for the Earth-Atmosphere system. They modulate the radiation budget by a combination of albedo effect and greenhouse effect. In contrast to liquid water clouds, the radiative impact of clouds containing ice particles is still uncertain. Scattering and absorption highly depends in microphysical properties of ice crystals, e.g. size and shape. In addition, most precipitation on Earth forms via the ice phase. Thus, better understanding of ice processes as well as their representation in models is required. A key process for determining shape and size of ice crystals is diffusional growth. Diffusion processes in mixed-phase clouds are highly uncertain; in addition they are usually highly simplified in cloud models, especially in bulk microphysics parameterizations. The direct interaction between cloud droplets and ice particles, due to spatial inhomogeneities, is ignored; the particles can only interact via their environmental conditions. Local effects as supply of supersaturation due to clusters of droplets around ice particles are usually not represented, although they form the physical basis of the Wegener-Bergeron-Findeisen process. We present direct numerical simulations of the interaction of single ice particles and droplets, especially their local competition for the available water vapor. In addition, we show an approach to parameterize local interactions by diffusion. The suggested parameterization uses local steady-state solutions of the diffusion equations for water vapor for an ice particle as well as a droplet. The individual solutions are coupled together to obtain the desired interaction. We show some results of the scheme as implemented in a parcel model.

Daily precipitation grids for Austria since 1961—development and evaluation of a spatial dataset for hydroclimatic monitoring and modelling

NASA Astrophysics Data System (ADS)

Hiebl, Johann; Frei, Christoph

2018-04-01

Spatial precipitation datasets that are long-term consistent, highly resolved and extend over several decades are an increasingly popular basis for modelling and monitoring environmental processes and planning tasks in hydrology, agriculture, energy resources management, etc. Here, we present a grid dataset of daily precipitation for Austria meant to promote such applications. It has a grid spacing of 1 km, extends back till 1961 and is continuously updated. It is constructed with the classical two-tier analysis, involving separate interpolations for mean monthly precipitation and daily relative anomalies. The former was accomplished by kriging with topographic predictors as external drift utilising 1249 stations. The latter is based on angular distance weighting and uses 523 stations. The input station network was kept largely stationary over time to avoid artefacts on long-term consistency. Example cases suggest that the new analysis is at least as plausible as previously existing datasets. Cross-validation and comparison against experimental high-resolution observations (WegenerNet) suggest that the accuracy of the dataset depends on interpretation. Users interpreting grid point values as point estimates must expect systematic overestimates for light and underestimates for heavy precipitation as well as substantial random errors. Grid point estimates are typically within a factor of 1.5 from in situ observations. Interpreting grid point values as area mean values, conditional biases are reduced and the magnitude of random errors is considerably smaller. Together with a similar dataset of temperature, the new dataset (SPARTACUS) is an interesting basis for modelling environmental processes, studying climate change impacts and monitoring the climate of Austria.

Climate Change at the Poles: Research Immersion Experience at Bellingshausen, Antarctica

NASA Astrophysics Data System (ADS)

Alexeev, V. A.; Repina, I. A.; Baeseman, J. L.; Fernandoy, F.; Bart, S.

2010-12-01

We brought a party of 15 scientists, graduate students, and educators to King George Island, the largest of the South Shetland Islands, just off the Antarctic Peninsula, for an international workshop on Antarctica and global climate change in January 2010. Participants included professors, young scientists and graduate students from the Obukhov Institute of Atmospheric Physics, the University of Maryland, the University of Wisconsin, and the Michigan Technological University. Lindsay Bartholomew, an education and outreach specialist at the Museum of Science and Industry in Chicago connected the workshop via video and Internet with an audience of museum visitors. Scientists living and working at Bellingshausen, including Hans-Ulrich Peter, an eminent ecologist from Jena University (Germany), and Bulat Movlyudov (Institute of Geography, Moscow), a distinguished glaciologist, participated in the workshop. Field trips led by Peter and Movlyudov and others were made by day and lectures were held by night. Professors and graduate students made cutting-edge presentations on such subjects as permafrost, glaciology, and global climate models. Three workshop teams conducted field research projects at the foot of the Bellingshausen Dome icecap - two on carbon cycling and one on permafrost. Major funding sources for the workshop included the Russian Foundation for Basic Research (Russia), Wilderness Research Foundation (USA), NSF, University of Wisconsin at Stevens Point, Alfred Wegener Institute (Germany) and Museum for Science and Industry (Chicago). INACH, the Chilean Antarctic Institute, and IAU, the Uruguayan Antarctic Institute, provided air charter services. On King George Island, our group was billeted at Russia’s Bellingshausen science station.

A study of the stable boundary layer in strong gap flows in northwest Greenland using a research aircraft

NASA Astrophysics Data System (ADS)

Heinemann, Günther; Drüe, Clemens

2016-04-01

Gap flows and the stable boundary layer (SBL) were studied in northwest Greenland during the aircraft-based experiment IKAPOS (Investigation of Katabatic winds and Polynyas during Summer) in June 2010. The measurements were performed using the research aircraft POLAR 5 of Alfred Wegener Institute (AWI, Bremerhaven). Besides navigational and basic meteorological instrumentation, the aircraft was equipped with radiation and surface temperature sensors, two laser altimeters, and video and digital cameras. In order to determine turbulent heat and momentum fluxes, POLAR 5 was instrumented with a turbulence measurement system collecting data on a nose boom with a sampling rate of 100 Hz. In the area of the Nares Strait a stable, but fully turbulent boundary layer with strong winds of 15 m s-1 to 20 m s-1 was found during conditions of relatively warm synoptically induced northerly winds through the Nares Strait. Strong surface inversions were present in the lowest 100 m to 200 m. As a consequence of channeling effects a well-pronounced low-level jet (LLJ) system was documented. The channeling process is consistent with gap flow theory and can be shown to occur at the topographic gap between Greenland and Canada represented by the Smith Sound. While the flow through the gap and over the surrounding mountains leads to the lowering of isotropic surfaces and the acceleration of the flow, the strong turbulence associated with the LLJ leads to the development of an internal thermal SBL past the gap. Turbulence statistics in this fully turbulent SBL can be shown to follow the local scaling behaviour.

Ground-based lidar measurements from Ny-Ålesund during ASTAR 2007

NASA Astrophysics Data System (ADS)

Hoffmann, A.; Ritter, C.; Stock, M.; Shiobara, M.; Lampert, A.; Maturilli, M.; Orgis, T.; Neuber, R.; Herber, A.

2009-11-01

During the Arctic Study of Tropospheric Aerosol, Clouds and Radiation (ASTAR) in March and April 2007, measurements obtained at the AWIPEV Arctic Research Base in Ny-Ålesund, Spitsbergen at 78.9° N, 11.9° E (operated by the Alfred Wegener Institute for Polar and Marine Research - AWI and the Institut polaire français Paul-Emile Victor - IPEV), supported the airborne campaign. This included lidar data from the Koldewey Aerosol Raman Lidar (KARL) and the Micro Pulse Lidar (MPL), located in the atmospheric observatory as well as photometer data and the daily launched radiosonde. The MPL features nearly continuous measurements; the KARL was switched on whenever weather conditions allowed observations (145 h in 61 days). From 1 March to 30 April, 71 meteorological balloon soundings were performed and compared with the concurrent MPL measurements; photometer measurements are available from 18 March. For the KARL data, a statistical overview of particle detection based on their optical properties backscatter ratio and volume depolarization can be given. The altitudes of the occurrence of the named features (subvisible and visible ice and water as well as mixed-phase clouds, aerosol layers) as well as their dependence on different air mass origins are analyzed. Although the spring 2007 was characterized by rather clean conditions, diverse case studies of cloud and aerosol occurrence during March and April 2007 are presented in more detail, including temporal development and main optical properties as depolarization, backscatter and extinction coefficients. Links between air mass origins and optical properties can be presumed but need further evidence.

Dynamic statistical optimization of GNSS radio occultation bending angles: advanced algorithm and performance analysis

NASA Astrophysics Data System (ADS)

Li, Y.; Kirchengast, G.; Scherllin-Pirscher, B.; Norman, R.; Yuan, Y. B.; Fritzer, J.; Schwaerz, M.; Zhang, K.

2015-08-01

We introduce a new dynamic statistical optimization algorithm to initialize ionosphere-corrected bending angles of Global Navigation Satellite System (GNSS)-based radio occultation (RO) measurements. The new algorithm estimates background and observation error covariance matrices with geographically varying uncertainty profiles and realistic global-mean correlation matrices. The error covariance matrices estimated by the new approach are more accurate and realistic than in simplified existing approaches and can therefore be used in statistical optimization to provide optimal bending angle profiles for high-altitude initialization of the subsequent Abel transform retrieval of refractivity. The new algorithm is evaluated against the existing Wegener Center Occultation Processing System version 5.6 (OPSv5.6) algorithm, using simulated data on two test days from January and July 2008 and real observed CHAllenging Minisatellite Payload (CHAMP) and Constellation Observing System for Meteorology, Ionosphere, and Climate (COSMIC) measurements from the complete months of January and July 2008. The following is achieved for the new method's performance compared to OPSv5.6: (1) significant reduction of random errors (standard deviations) of optimized bending angles down to about half of their size or more; (2) reduction of the systematic differences in optimized bending angles for simulated MetOp data; (3) improved retrieval of refractivity and temperature profiles; and (4) realistically estimated global-mean correlation matrices and realistic uncertainty fields for the background and observations. Overall the results indicate high suitability for employing the new dynamic approach in the processing of long-term RO data into a reference climate record, leading to well-characterized and high-quality atmospheric profiles over the entire stratosphere.

Subscales measuring symptoms of non-specific depression, anhedonia, and anxiety in the Edinburgh Postnatal Depression Scale.

PubMed

Tuohy, Alan; McVey, Cynthia

2008-06-01

There has been considerable research and clinical interest in the comorbidity of anxiety and depression in the post-partum period, and specifically in the possibility that the commonly used Edinburgh Postnatal Depression Scale (EPDS) incorporates an anxiety component. We hypothesized that the recommended version of factor analysis (Fabrigar, Wegener, MacCallum, & Strahan, 1999) would identify such covert dimensions more reliably than the commonly used principal components analysis with varimax rotation and eigenvalues greater than 1. Principal axis factor extraction with parallel analysis and oblique (direct quartimin) factor rotation was applied to the 10 EPDS items. The study used a sample of recent mothers recruited and assessed via e-mail and the Internet (N=440). In addition to the EPDS, the Hospital Anxiety and Depression Scale (HADS) and the Positive and Negative Affect Scales (PANAS) were also administered. Three factors were found, which were identified as 'non-specific depressive symptoms', 'anhedonia', and 'anxietal symptoms' subscales, respectively. These subscales were regressed on the HADS anxiety and depression and the PANAS positive and negative affectivity scales, with results substantially consistent with current structural models of the taxonomy of the emotional disorders. The data were obtained from a self-selected non-clinical sample. In addition, it is known that the use of computer-based assessment may tend to inflate self-report scores. It was concluded that there is now sufficient evidence that clinicians should not assume the EPDS to be unidimensional, but should assess all three subscales when screening for susceptibility to post-partum depression and/or post-partum anxiety.

Ophiolites in ocean-continent transitions: From the Steinmann Trinity to sea-floor spreading

NASA Astrophysics Data System (ADS)

Bernoulli, Daniel; Jenkyns, Hugh C.

2009-05-01

Before the theory of plate tectonics took hold, there was no coherent model for ocean-continent transitions that included both extant continental margins and fragmentary ancient examples preserved in orogenic belts. Indeed, during the early 1900, two strands of thought developed, one relying on the antiquity and permanence of continents and oceans, advocated by the mainstream of the scientific community and one following mobilist concepts derived from Wegener's hypothesis (1915) of continental drift. As an illustration of the prevailing North-American view, the different composition and thickness of continental and oceanic crust and the resulting isostatic response showed "how improbable it would be to suppose that a continent could founder or go to oceanic depth or that ocean floor at ± 3000 fathoms could ever have been a stable land area since the birth of the oceans" [H.H. Hess, Trans. R. Soc. London, A 222 (1954) 341-348]. Because of the perceived permanence of oceans and continents, mountain chains were thought to originate from narrow, elongated, unstable belts, the geosynclines, circling the continents or following "zones of crustal weakness" within them, from which geanticlines and finally mountain belts would develop. This teleological concept, whereby a geosyncline would inevitably evolve into a mountain chain, dominated geological interpretations of orogenic belts for several decades in the mid-twentieth century. However, the concept of permanence of oceans and continents and the concept of the geosyncline had already met with the critiques of Suess and others. As early as 1905, Steinmann considered the association of peridotite, "diabase" (basalt/dolerite) and radiolarite (a typical ocean-continent transition assemblage), present in the Alps and Apennines, as characteristic of the deep-ocean floor and Bailey (1936) placed Steinmann's interpretation into the context of continental drift and orogeny. Indeed, in both authors' writings, the concept of ophiolites as ocean crust is apparent. Between 1920 and 1930, the stage was thus potentially set for modern mobilist concepts that were, however, to prove attractive to only a small circle of Alpine and peri-Gondwanian geologists. After the Second World War, the 1950s saw the rapid progress of the geophysical and geological exploration of oceans and continental margins that provided the data for a reevaluation of the geosynclinal concept. Actualistic models now equated the former preorogenic miogeosyncline of Stille (1940) and Kay (1951) with passive continental margins [C.L. Drake, M. Ewing, G.H. Sutton, Continental margin and geosynclines: the east coast of North America, north of Cape Hatteras, in: L. Ahrens, et al. (Eds.), Physics and Chemistry of the Earth 3, Pergamon Press, London, 1959, pp. 110-189], the (American version of the) eugeosyncline and its igneous rocks with "collapsing continental rises" [R.S. Dietz, J. Geol. 71 (1963) 314-333] and the ophiolites, the Steinmann Trinity, of the (European) eugeosyncline with fragments of oceanic lithosphere [H.H. Hess, History of ocean basins, in: Petrologic Studies: a Volume to Honor A.F. Buddington, Geol. Soc. Am., New York. 1962, pp. 599-620]. The concept of sea-floor spreading [H.H. Hess, History of ocean basins, in: Petrologic Studies: a Volume to Honor A.F. Buddington, Geol. Soc. Am., New York. 1962, pp. 599-620; H.H. Hess, Mid-oceanic ridges and tectonics of the sea-floor, in: W.F. Whittard, R. Bradshaw (Eds), Submarine Geology and Geophysics, Colston Papers 17, Butterworths, London, 1965, pp. 317-333] finally eliminated the weaknesses in Wegener's hypothesis and, with the coming of the "annus mirabilis" of 1968, the concept of the geosyncline could be laid to rest. Ocean-continent transitions of modern oceans, as revealed by seismology and deep-sea drilling, could now be compared with the remnants of their ancient counterparts preserved in the Alps and elsewhere.

Surface energy balance measurements and modeling on the ice cap of King George Island, West Antarctica

NASA Astrophysics Data System (ADS)

Falk, U.; Braun, M.; Sala, H.; Menz, G.

2012-04-01

The Antarctic Peninsula is amongst the fastest warming places on Earth and further temperature increase is to be expected. It has undergone rapid environmental changes in the past decades. Exceptional rates of surface air temperature increases (2.5K in 50 years) are concurrent with retreating glacier fronts, an increase in melt areas, surface lowering and rapid retreat, break-up and disintegration of ice shelves. The South Shetland Islands are located on the northern tip of the Peninsula and are especially vulnerable to climate change due to their maritime climate. For King George Island we have compiled a unique data set comprising direct measurements of evaporation and sensible heat flux by eddy covariance on the Warszawa Icefield for the austral summers November 2010 to March 2011 and January to February 2012 in combination with a fully equipped automated weather station measuring long- and short-wave radiation components, profiles of temperature, humidity and wind velocities as well as glacier ice temperatures in profile. The combination with the eddy covariance data allows for analysis of variability and seasonality of surface energy balance components on a glacier for an entire year. Repeat measurements of surface lowering at different locations on King George Island are used for analysis of multi-sensor satellite data to identify melt patterns and bare ice areas during summer. In combination with long-term time series of weather data, these data give indication of the sensitivity of the inland ice cap to the ongoing changes. This research is part of the ESF project IMCOAST funded by BMBF. Field work was carried out at the Dallmann laboratory (Jubany, King George Island) in cooperation of the Instituto Antartico Argentino (Argentina) and the Alfred-Wegener Institute (German).

Numerical Simulation of the 2004 Indian Ocean Tsunami: Accurate Flooding and drying in Banda Aceh

NASA Astrophysics Data System (ADS)

Cui, Haiyang; Pietrzak, Julie; Stelling, Guus; Androsov, Alexey; Harig, Sven

2010-05-01

The Indian Ocean Tsunami on December 26, 2004 caused one of the largest tsunamis in recent times and led to widespread devastation and loss of life. One of the worst hit regions was Banda Aceh, which is the capital of the Aceh province, located in the northern part of Sumatra, 150km from the source of the earthquake. A German-Indonesian Tsunami Early Warning System (GITEWS) (www.gitews.de) is currently under active development. The work presented here is carried out within the GITEWS framework. One of the aims of this project is the development of accurate models with which to simulate the propagation, flooding and drying, and run-up of a tsunami. In this context, TsunAWI has been developed by the Alfred Wegener Institute; it is an explicit, () finite element model. However, the accurate numerical simulation of flooding and drying requires the conservation of mass and momentum. This is not possible in the current version of TsunAWi. The P1NC - P1element guarantees mass conservation in a global sense, yet as we show here it is important to guarantee mass conservation at the local level, that is within each individual cell. Here an unstructured grid, finite volume ocean model is presented. It is derived from the P1NC - P1 element, and is shown to be mass and momentum conserving. Then a number of simulations are presented, including dam break problems flooding over both a wet and a dry bed. Excellent agreement is found. Then we present simulations for Banda Aceh, and compare the results to on-site survey data, as well as to results from the original TsunAWI code.

Microphysical processing of aerosol particles in orographic clouds

NASA Astrophysics Data System (ADS)

Pousse-Nottelmann, S.; Zubler, E. M.; Lohmann, U.

2015-01-01

An explicit and detailed treatment of cloud-borne particles allowing for the consideration of aerosol cycling in clouds has been implemented in the regional weather forecast and climate model COSMO. The effects of aerosol scavenging, cloud microphysical processing and regeneration upon cloud evaporation on the aerosol population and on subsequent cloud formation are investigated. For this, two-dimensional idealized simulations of moist flow over two bell-shaped mountains were carried out varying the treatment of aerosol scavenging and regeneration processes for a warm-phase and a mixed-phase orographic cloud. The results allowed to identify different aerosol cycling mechanisms. In the simulated non-precipitating warm-phase cloud, aerosol mass is incorporated into cloud droplets by activation scavenging and released back to the atmosphere upon cloud droplet evaporation. In the mixed-phase cloud, a first cycle comprises cloud droplet activation and evaporation via the Wegener-Bergeron-Findeisen process. A second cycle includes below-cloud scavenging by precipitating snow particles and snow sublimation and is connected to the first cycle via the riming process which transfers aerosol mass from cloud droplets to snow flakes. In the simulated mixed-phase cloud, only a negligible part of the total aerosol mass is incorporated into ice crystals. Sedimenting snow flakes reaching the surface remove aerosol mass from the atmosphere. The results show that aerosol processing and regeneration lead to a vertical redistribution of aerosol mass and number. However, the processes not only impact the total aerosol number and mass, but also the shape of the aerosol size distributions by enhancing the internally mixed/soluble accumulation mode and generating coarse mode particles. Concerning subsequent cloud formation at the second mountain, accounting for aerosol processing and regeneration increases the cloud droplet number concentration with possible implications for the ice crystal number concentration.

Scavenging of black carbon in mixed phase clouds at the high alpine site Jungfraujoch

NASA Astrophysics Data System (ADS)

Cozic, J.; Verheggen, B.; Mertes, S.; Connolly, P.; Bower, K.; Petzold, A.; Baltensperger, U.; Weingartner, E.

2007-04-01

The scavenging of black carbon (BC) in liquid and mixed phase clouds was investigated during intensive experiments in winter 2004, summer 2004 and winter 2005 at the high alpine research station Jungfraujoch (3580 m a.s.l., Switzerland). Aerosol residuals were sampled behind two well characterized inlets; a total inlet which collected cloud particles (droplets and ice particles) as well as interstitial (unactivated) aerosol particles; an interstitial inlet which collected only interstitial aerosol particles. BC concentrations were measured behind each of these inlets along with the submicrometer aerosol number size distribution, from which a volume concentration was derived. These measurements were complemented by in-situ measurements of cloud microphysical parameters. BC was found to be scavenged into the condensed phase to the same extent as the bulk aerosol, which suggests that BC was covered with soluble material through aging processes, rendering it more hygroscopic. The scavenged fraction of BC (FScav,BC), defined as the fraction of BC that is incorporated into cloud droplets and ice crystals, decreases with increasing cloud ice mass fraction (IMF) from FScav,BC=60% in liquid phase clouds to FScav,BC~5-10% in mixed-phase clouds with IMF>0.2. This can be explained by the evaporation of liquid droplets in the presence of ice crystals (Wegener-Bergeron-Findeisen process), releasing BC containing cloud condensation nuclei back into the interstitial phase. In liquid clouds, the scavenged BC fraction is found to decrease with decreasing cloud liquid water content. The scavenged BC fraction is also found to decrease with increasing BC mass concentration since there is an increased competition for the available water vapour.

BINARY: an optical freezing array for assessing temperature and time dependence of heterogeneous ice nucleation

NASA Astrophysics Data System (ADS)

Budke, C.; Koop, T.

2014-09-01

A new optical freezing array for the study of heterogeneous ice nucleation in microliter-sized droplets is introduced, tested and applied to the study of immersion freezing in aqueous Snomax® suspensions. In the Bielefeld Ice Nucleation ARraY (BINARY) ice nucleation can be studied simultaneously in 36 droplets at temperatures down to -40 °C (233 K) and at cooling rates between 0.1 K min-1 and 10 K min-1. The droplets are separated from each other in individual compartments, thus preventing a Wegener-Bergeron-Findeisen type water vapor transfer between droplets as well as avoiding the seeding of neighboring droplets by formation and surface growth of frost halos. Analysis of freezing and melting occurs via an automated real time image analysis of the optical brightness of each individual droplet. As an application ice nucleation in water droplets containing Snomax® at concentrations from 1 ng mL-1 to 1 mg mL-1 was investigated. Using different cooling rates a minute time dependence of ice nucleation induced by Class A and Class C ice nucleators contained in Snomax® was detected. For the Class A IN a very strong increase of the heterogeneous ice nucleation rate coefficient with decreasing temperature of λ ≡ -dln(jhet)/dT = 8.7 K-1 was observed emphasizing the capability of the BINARY device. This value is larger than those of other types of IN reported in the literature, suggesting that the BINARY setup is suitable for quantifying time dependence for most other IN of atmospheric interest, making it a useful tool for future investigations.

The effects of deep convection on the concentration and size distribution of aerosol particles within the upper troposphere: A case study

NASA Astrophysics Data System (ADS)

Yin, Yan; Chen, Qian; Jin, Lianji; Chen, Baojun; Zhu, Shichao; Zhang, Xiaopei

2012-11-01

A cloud resolving model coupled with a spectral bin microphysical scheme was used to investigate the effects of deep convection on the concentration and size distribution of aerosol particles within the upper troposphere. A deep convective storm that occurred on 1 December, 2005 in Darwin, Australia was simulated, and was compared with available radar observations. The results showed that the radar echo of the storm in the developing stage was well reproduced by the model. Sensitivity tests for aerosol layers at different altitudes were conducted in order to understand how the concentration and size distribution of aerosol particles within the upper troposphere can be influenced by the vertical transport of aerosols as a result of deep convection. The results indicated that aerosols originating from the boundary layer can be more efficiently transported upward, as compared to those from the mid-troposphere, due to significantly increased vertical velocity through the reinforced homogeneous freezing of droplets. Precipitation increased when aerosol layers were lofted at different altitudes, except for the case where an aerosol layer appeared at 5.4-8.0 km, in which relatively more efficient heterogeneous ice nucleation and subsequent Wegener-Bergeron-Findeisen process resulted in more pronounced production of ice crystals, and prohibited the formation of graupel particles via accretion. Sensitivity tests revealed, at least for the cases considered, that the concentration of aerosol particles within the upper troposphere increased by a factor of 7.71, 5.36, and 5.16, respectively, when enhanced aerosol layers existed at 0-2.2 km, 2.2-5.4 km, and 5.4-8.0 km, with Aitken mode and a portion of accumulation mode (0.1-0.2μm) particles being the most susceptible to upward transport.

The sensitivities of in cloud and cloud top phase distributions to primary ice formation in ICON-LEM

NASA Astrophysics Data System (ADS)

Beydoun, H.; Karrer, M.; Tonttila, J.; Hoose, C.

2017-12-01

Mixed phase clouds remain a leading source of uncertainty in our attempt to quantify cloud-climate and aerosol-cloud climate interactions. Nevertheless, recent advances in parametrizing the primary ice formation process, high resolution cloud modelling, and retrievals of cloud phase distributions from satellite data offer an excellent opportunity to conduct closure studies on the sensitivity of the cloud phase to microphysical and dynamical processes. Particularly, the reliability of satellite data to resolve the phase at the top of the cloud provides a promising benchmark to compare model output to. We run large eddy simulations with the new ICOsahedral Non-hydrostatic atmosphere model (ICON) to place bounds on the sensitivity of in cloud and cloud top phase to the primary ice formation process. State of the art primary ice formation parametrizations in the form of the cumulative ice active site density ns are implemented in idealized deep convective cloud simulations. We exploit the ability of ICON-LEM to switch between a two moment microphysics scheme and the newly developed Predicted Particle Properties (P3) scheme by running our simulations in both configurations for comparison. To quantify the sensitivity of cloud phase to primary ice formation, cloud ice content is evaluated against order of magnitude changes in ns at variable convective strengths. Furthermore, we assess differences between in cloud and cloud top phase distributions as well as the potential impact of updraft velocity on the suppression of the Wegener-Bergeron-Findeisen process. The study aims to evaluate our practical understanding of primary ice formation in the context of predicting the structure and evolution of mixed phase clouds.

Two-moment bulk stratiform cloud microphysics in the GFDL AM3 GCM: description, evaluation, and sensitivity tests

NASA Astrophysics Data System (ADS)

Salzmann, M.; Ming, Y.; Golaz, J.-C.; Ginoux, P. A.; Morrison, H.; Gettelman, A.; Krämer, M.; Donner, L. J.

2010-08-01

A new stratiform cloud scheme including a two-moment bulk microphysics module, a cloud cover parameterization allowing ice supersaturation, and an ice nucleation parameterization has been implemented into the recently developed GFDL AM3 general circulation model (GCM) as part of an effort to treat aerosol-cloud-radiation interactions more realistically. Unlike the original scheme, the new scheme facilitates the study of cloud-ice-aerosol interactions via influences of dust and sulfate on ice nucleation. While liquid and cloud ice water path associated with stratiform clouds are similar for the new and the original scheme, column integrated droplet numbers and global frequency distributions (PDFs) of droplet effective radii differ significantly. This difference is in part due to a difference in the implementation of the Wegener-Bergeron-Findeisen (WBF) mechanism, which leads to a larger contribution from super-cooled droplets in the original scheme. Clouds are more likely to be either completely glaciated or liquid due to the WBF mechanism in the new scheme. Super-saturations over ice simulated with the new scheme are in qualitative agreement with observations, and PDFs of ice numbers and effective radii appear reasonable in the light of observations. Especially, the temperature dependence of ice numbers qualitatively agrees with in-situ observations. The global average long-wave cloud forcing decreases in comparison to the original scheme as expected when super-saturation over ice is allowed. Anthropogenic aerosols lead to a larger decrease in short-wave absorption (SWABS) in the new model setup, but outgoing long-wave radiation (OLR) decreases as well, so that the net effect of including anthropogenic aerosols on the net radiation at the top of the atmosphere (netradTOA = SWABS-OLR) is of similar magnitude for the new and the original scheme.

A numerical study of aerosol effects on the dynamics and microphysics of a deep convective cloud in a continental environment

NASA Astrophysics Data System (ADS)

Cui, Zhiqiang; Carslaw, Kenneth S.; Yin, Yan; Davies, Stewart

2006-03-01

The effects of aerosols on a deep convective cloud in a midlatitude continental environment are studied using an axisymmetric cloud model with a sectional treatment of aerosol and hydrometeor microphysical processes. Simulations are conducted using observations from the Cooperative Convective Precipitation Experiments (CCOPE). The isolated cloud occurred in an environment with low wind shear and with relatively dry air in the midtroposphere and upper troposphere. By varying the concentration of aerosol particles in the accumulation mode within realistic limits for a continental environment, the simulated cloud exhibited different properties. The overall impact as the aerosol concentration increased is that (1) the cloud development was inhibited; (2) the precipitation was suppressed; (3) the maximum values of liquid water content decreased, but the maximum values of droplet number concentration increased before the dissipating stage; (4) a clear tendency was found for ice crystals to be larger and less numerous in the anvil cloud; and (5) there was a significant reduction of the inflow in the lower 2 km of the atmosphere. In the relatively dry environment in the midtroposphere, the latent heat changes associated with the Wegener-Bergeron-Findeisen mechanism played an important role in the upper part of the cloud at altitudes below the homogeneous freezing level. In particular, immersion freezing and latent heat release were much more rapid in the base simulation than in the increased aerosol simulation. Less latent heat release and insufficient inflow together impeded the development of the cloud with the higher aerosol loading. Our simulations suggest that continental clouds existing below the homogeneous freezing level could show an opposite response of cloud top height and anvil crystal concentrations to changes in aerosol to what has previously been reported for clouds ascending to higher levels.

Two-moment bulk stratiform cloud microphysics in the GFDL AM3 GCM: description, evaluation, and sensitivity tests

NASA Astrophysics Data System (ADS)

Salzmann, M.; Ming, Y.; Golaz, J.-C.; Ginoux, P. A.; Morrison, H.; Gettelman, A.; Krämer, M.; Donner, L. J.

2010-03-01

A new stratiform cloud scheme including a two-moment bulk microphysics module, a cloud cover parameterization allowing ice supersaturation, and an ice nucleation parameterization has been implemented into the recently developed GFDL AM3 general circulation model (GCM) as part of an effort to treat aerosol-cloud-radiation interactions more realistically. Unlike the original scheme, the new scheme facilitates the study of cloud-ice-aerosol interactions via influences of dust and sulfate on ice nucleation. While liquid and cloud ice water path associated with stratiform clouds are similar for the new and the original scheme, column integrated droplet numbers and global frequency distributions (PDFs) of droplet effective radii differ significantly. This difference is in part due to a difference in the implementation of the Wegener-Bergeron-Findeisen (WBF) mechanism, which leads to a larger contribution from super-cooled droplets in the original scheme. Clouds are more likely to be either completely glaciated or liquid due to the WBF mechanism in the new scheme. Super-saturations over ice simulated with the new scheme are in qualitative agreement with observations, and PDFs of ice numbers and effective radii appear reasonable in the light of observations. Especially, the temperature dependence of ice numbers qualitatively agrees with in-situ observations. The global average long-wave cloud forcing decreases in comparison to the original scheme as expected when super-saturation over ice is allowed. Anthropogenic aerosols lead to a larger decrease in short-wave absorption (SWABS) in the new model setup, but outgoing long-wave radiation (OLR) decreases as well, so that the net effect of including anthropogenic aerosols on the net radiation at the top of the atmosphere (netradTOA = SWABS-OLR) is of similar magnitude for the new and the original scheme.

Toward the Characterization of Mixed-Phase Clouds Using Remote Sensing

NASA Astrophysics Data System (ADS)

Andronache, C.

2015-12-01

Mixed-phase clouds consist of a mixture of ice particles and liquid droplets at temperatures below 0 deg C. They are present in all seasons in many regions of the world, account for about 30% of the global cloud coverage, and are linked to cloud electrification and aircraft icing. The mix of ice particles, liquid droplets, and water vapor is unstable, and such clouds are thought to have a short lifetime. A characteristic parameter is the phase composition of mixed-phase clouds. It affects the cloud life cycle and the rate of precipitation. This parameter is important for cloud parameters retrievals by radar, lidar, and satellite and is relevant for climate modeling. The phase transformation includes the remarkable Wegener-Bergeron-Findeisen (WBF) process. The direction and the rate of the phase transformations depend on the local thermodynamic and microphysical properties. Cloud condensation nuclei (CCN) and ice nuclei (IN) particles determine to a large extent cloud microstructure and the dynamic response of clouds to aerosols. The complexity of dynamics and microphysics involved in mixed-phase clouds requires a set of observational and modeling tools that continue to be refined. Among these techniques, the remote sensing methods provide an increasing number of parameters, covering large regions of the world. Thus, a series of studies were dedicated to stratiform mixed-phase clouds revealing longer lifetime than previously thought. Satellite data and aircraft in situ measurements in deep convective clouds suggest that highly supercooled water often occurs in vigorous continental convective storms. In this study, we use cases of convective clouds to discuss the feasibility of mixed-phase clouds characterization and potential advantages of remote sensing.

Scavenging of black carbon in mixed phase clouds at the high alpine site Jungfraujoch

NASA Astrophysics Data System (ADS)

Cozic, J.; Verheggen, B.; Mertes, S.; Connolly, P.; Bower, K.; Petzold, A.; Baltensperger, U.; Weingartner, E.

2006-11-01

The scavenging of black carbon (BC) in liquid and mixed phase clouds was investigated during intensive experiments in winter 2004, summer 2004 and winter 2005 at the high alpine research station Jungfraujoch (3580 m a.s.l., Switzerland). Aerosol residuals were sampled behind two well characterized inlets; a total inlet which collected cloud particles (drops and ice particles) as well as interstitial aerosol particles; an interstitial inlet which collected only interstitial (unactivated) aerosol particles. BC concentrations were measured behind each of these inlets along with the submicrometer aerosol number size distribution, from which a volume concentration was derived. These measurements were complemented by in-situ measurements of cloud microphysical parameters. BC was found to be scavenged into the cloud phase to the same extent as the bulk aerosol, which suggests that BC was covered with soluble material through aging processes, rendering it more hygroscopic. The scavenged fraction of BC (FScav,BC), defined as the fraction of BC that is incorporated into cloud droplets and ice crystals, decreases with increasing cloud ice mass fraction (IMF) from FScav,BC=60% in liquid phase clouds to FScav,BC~10% in mixed-phase clouds with IMF>0.2. This is explained by the evaporation of liquid droplets in the presence of ice crystals (Wegener-Bergeron-Findeisen process), releasing BC containing cloud condensation nuclei back into the interstitial phase. In liquid clouds, the scavenged BC fraction is found to decrease with decreasing cloud liquid water content. The scavenged BC fraction is also found to decrease with increasing BC mass concentration since there is an increased competition for the available water vapour.

Gondwana Tales: an inquiry approach to plate tectonics

NASA Astrophysics Data System (ADS)

Domènech Casal, Jordi

2014-05-01

Plate tectonics and its effects on the constitution of seas and continents are key models in science education. Fossil evidences are usually taught in demostrative key when Wegener's discoverings about Pangea are introduced. In order to introduce inquiry-based science education (IBSE) approaches to this topic, we propose "Gondwana Tales", an activity where students are asked to use fossil data to reconstruct the geologic history of an imaginary planet. Grouped in independent teams, each team is furnished with stratigraphic columns from several sites containing faunistic successions of real organisms existing in the past in Earth. Students are told to reconstruct a model of the evolution of the continents, by making calculations of relative ages of the fossils, and relating each fossil to a geologic era. The different teams have incomplete and complementary information. After a first step where they have to propose a partial model based on incomplete data, each team receives a "visitor scientist" from another team, this implying an informal scientific communication event. This process is performed several times, engaging a discussion in each team and getting a final consensus model created by the whole class. Correct answer is not given to the students, even at the end of the activity, to keep the activity under the parameters of real scientific experience, where there is not a "correct answer" to compare. Instead of this, and following the IBSE standards, a reflection on the process is proposed to students. The lack of complete information and the need to collaborate are part of classroom dynamics focused to the understanding of the process of creation of the scientific knowledge. This activity is part of the C3 Project on Creation of Scientific Knowledge that is being applied in the school.

Erratum: Erratum to: The Quadrennial Ozone Symposium 2016

NASA Astrophysics Data System (ADS)

Godin-Beekmann, Sophie; Petropavlovskikh, Irina; Reis, Stefan; Newman, Paul; Steinbrecht, Wolfgang; Rex, Markus; Santee, Michelle L.; Eckman, Richard S.; Zheng, Xiangdong; Tully, Matthew B.; Stevenson, David S.; Young, Paul; Pyle, John; Weber, Mark; Tamminen, Johanna; Mills, Gina; Bais, Alkiviadis F.; Heaviside, Clare; Zerefos, Christos

2018-03-01

The Quadrennial Ozone Symposium 2016 Sophie GODIN-BEEKMANN*1, Irina PETROPAVLOVSKIKH2, Stefan REIS3,20, Paul NEWMAN4, Wolfgang STEINBRECHT5, Markus REX6, Michelle L. SANTEE7, Richard S. ECKMAN8, Xiangdong ZHENG9, Matthew B. TULLY10, David S. STEVENSON11, Paul YOUNG12, John PYLE13, Mark WEBER14, Johanna TAMMINEN15, Gina MILLS16, Alkiviadis F. BAIS17, Clare HEAVISIDE18, and Christos ZEREFOS19 1 Observatoire de Versailles Saint-Quentin en Yvelines, Université de Versailles Saint-Quentin-en-Yvelines, CNRS, 78280 Guyancourt, France 2 CIRES, University of Colorado, Boulder, CO 80309, USA 3 NERC Centre for Ecology & Hydrology, Edinburgh EH26 0QB, UK 4 Goddard Space Flight Center, NASA, Greenbelt, MD 20771, USA 5 Hohenpeissenberg Meteorological Observatory, Deutscher Wetterdienst, 82383 Hohenpeissenberg, Germany 6 Alfred Wegener Institute, 14401 Potsdam, Germany 7 Jet Propulsion Laboratory, California Institute of Technology, CA 91109, USA 8 NASA Headquarters, Earth Science Division, Washington, DC, USA 9 Chinese Academy of Meteorological Sciences, Beijing, 100081, China 10 Bureau of Meteorology, Melbourne, Victoria 3001, Australia 11 University of Edinburgh, School of GeoSciences, Edinburgh EH9 3FE, UK 12 Lancaster Environment Centre, Lancaster University, Lancaster LA1 4YQ, UK 13 University of Cambridge, Department of Chemistry, Cambridge CB2 1EW, UK 14 University of Bremen, Institute of Environmental Physics, 28359 Bremen, Germany 15 Finnish Meteorological Institute, Earth Observation, FI-00101 Helsinki, Finland 16 NERC Centre for Ecology and Hydrology, Bangor, Gwynedd LL57 2UW, Wales, UK 17 Aristotle University of Thessaloniki, Thessaloniki, Greece 18 Public Health England, Centre for Radiation, Chemical and Environmental Hazards, London, UK 19 Research Center for Atmospheric Physics & Climatology, Academy of Athens, Athens 10680, Greece 20 University of Exeter Medical School, Truro TR1 3HD, UK

The Evolution of REM Sleep Behavior Disorder in Early Parkinson Disease

PubMed Central

Sixel-Döring, Friederike; Zimmermann, Johannes; Wegener, Andrea; Mollenhauer, Brit; Trenkwalder, Claudia

2016-01-01

Study Objectives: To investigate the development of REM sleep behavior disorder (RBD) and REM sleep behavioral events (RBE) not yet fulfilling diagnostic criteria for RBD as markers for neurodegeneration in a cohort of Parkinson disease (PD) patients between their de novo baseline assessment and two-year follow-up in comparison to healthy controls (HC). Methods: Clinically confirmed PD patients and HC with video-supported polysomnography (vPSG) data at baseline were re-investigated after two years. Diagnostic scoring for RBE and RBD was performed in both groups and related to baseline findings. Results: One hundred thirteen PD patients and 102 healthy controls (HC) were included in the study. Within two years, the overall occurrence of behaviors during REM sleep in PD patients increased from 50% to 63% (P = 0.02). RBD increased from 25% to 43% (P < 0.001). Eleven of 29 (38%) RBE positive PD patients and 10/56 (18%) patients with normal REM sleep at baseline converted to RBD. In HC, the occurrence of any REM behavior increased from 17% to 20% (n.s.). RBD increased from 2% to 4% (n.s.). One of 15 (7%) RBE positive HC and 1/85 (1%) HC with normal REM at baseline converted to RBD. Conclusions: RBD increased significantly in PD patients from the de novo state to two-year follow-up. We propose RBE being named “prodromal RBD” as it may follow a continuous evolution in PD possibly similar to the spreading of Lewy bodies in PD patients. RBD itself was shown as a robust and stable marker of early PD. Citation: Sixel-Döring F, Zimmermann J, Wegener A, Mollenhauer B, Trenkwalder C. The evolution of REM sleep behavior disorder in early Parkinson disease. SLEEP 2016;39(9):1737–1742. PMID:27306265

Arctic and Antarctic Sea-Ice Freeboard and Thickness Retrievals from CryoSat-2 and EnviSat

NASA Astrophysics Data System (ADS)

Ricker, Robert; Hendricks, Stefan; Schwegmann, Sandra; Helm, Veit; Rinne, Eero

2016-04-01

The CryoSat-2 satellite is now in the 6th year of data acquisition. With its synthetic aperture radar altimeter, CryoSat-2 achieves great improvements in the along track resolution compared to previous radar altimeter missions like ERS or Envisat. The latitudinal coverage contains major parts of the Arctic marine ice fields where previous missions left a big data gap around the North Pole and especially over the multiyear ice zone north of Greenland. With this unique data set, changes in sea-ice thickness can be investigated in the context of the rapid reduction of the Arctic sea-ice cover which has been observed during the last decades. We present the current state of the CryoSat-2 Arctic sea-ice thickness retrieval that is processed at the Alfred Wegener Institute and available via seaiceportal.de (originally: meereisportal.de). Though biases in sea-ice thickness may occur due to the interpretation of waveforms, airborne and ground-based validation measurements give confidence that the retrieval algorithm enables us to capture the actual distributions of sea-ice regimes. Nevertheless, long time series of data retrievals are essential to estimate trends in sea-ice thickness and volume. Today, more than 20 years of radar altimeter data are potentially available and capable to derive sea ice thickness. However, data originate from satellites with different sensor characteristics. Therefore, it is crucial to study the consistency between single sensors to derive long and consistent time series. We present results from the tested consistency between Antarctic freeboard measurements of the radar altimeters on-board of Envisat and CryoSat-2 for their overlap period in 2011.

From Engineering Hydrology to Earth System Science: Milestones in the Transformation of Hydrologic Science (Alfred Wegener Medal Lecture)

NASA Astrophysics Data System (ADS)

Sivapalan, Murugesu

2017-04-01

Hydrologic science has undergone almost transformative changes over the past 50 years. Huge strides have been made in the transition from early empirical approaches to rigorous approaches based on the fluid mechanics of water movement on and below the land surface. However, further progress has been hampered by problems posed by the presence of heterogeneity, especially subsurface heterogeneity, at all scales. The inability to measure or map subsurface heterogeneity everywhere prevented further development of balance equations and associated closure relations at the scales of interest, and has led to the virtual impasse we are presently in, in terms of development of physically based models needed for hydrologic predictions. An alternative to the mapping of subsurface heterogeneity everywhere is a new earth system science view, which sees the heterogeneity as the end result of co-evolutionary hydrological, geomorphological, ecological and pedological processes, each operating at a different rate, which have helped to shape the landscapes that we see in nature, including the heterogeneity below that we do not see. The expectation is that instead of specifying exact details of the heterogeneity in our models, we can replace it, without loss of information, with the ecosystem function they perform. Guided by this new earth system science perspective, development of hydrologic science is now guided by altogether new questions and new approaches to address them, compared to the purely physical, fluid mechanics based approaches that we inherited from the past. In the emergent Anthropocene, the co-evolutionary view is expanded further to involve interactions and feedbacks with human-social processes as well. In this lecture, I will present key milestones in the transformation of hydrologic science from Engineering Hydrology to Earth System Science, and what this means for hydrologic observations, theory development and predictions.

Evaluation of the efficiency of a new hollow fiber plasmapheresis filter.

PubMed

Orlandini, G C; Margaria, R

1983-07-01

Plasma separation for plasma exchange or plasma treatment has, until now, been obtained prevalently by centrifugal separators. Recently, filters capable of continuously separating the plasma have been proposed. We have evaluated, both in vivo and ex vivo, the efficiency of a plasma separating filter (BT 900, Dideco, Mirandola, Italy) incorporating polypropylene hollow fibers with a pore size of 0.55 micron (PS 510 W, Membrana, Wuppertal, Germany) and an effective surface of 0.23 m2, using two hemodialysis blood pumps. Ex vivo, (bovine blood) at a blood flow (QB) of 100 ml/min, 47 +/- 2.8 ml/min of plasma were obtained in the first hour and 34 +/- 3.1 ml/min in the second hour. The Sieving coefficient was 100 for albumin and IgG, 98.4 for IgA and 92.3 for IgM. Neither hemolysis nor platelet contamination were observed. In vivo, 35 treatment were performer on 19 patients affected with mixed essential cryoglobulinemia, autoimmune glomerulonephritis, Wegener disease, thrombotic thrombocytopenic microangiopathy and rheumatoid arthritis. There were no clinical complications and the treatment was always well tolerated. A mean of 2064 +/- 400 ml of plasma was obtained in 103.7 +/- 29 minutes. The plasma flow was correlated (p less than 0.001) with the blood flow (13.4 ml/min at QB = 30 ml/min; 29 ml/min at QB = 100 ml/min). In some cases, immune complexes were found in the plasma removed by the filter (conglutinin method), confirming the membrane permeability to these high weight molecules. The use of hollow fibers to separate formed elements of blood from plasma has a brief history (1, 5).(ABSTRACT TRUNCATED AT 250 WORDS)

The Dark Side of the Earth

NASA Astrophysics Data System (ADS)

Frankel, Henry

1986-10-01

Wood's The Dark Side of the Earth is another addition to the growing list of books on the recent revolution in the earth sciences. Wood rightly points out that any new book on the topic should break new ground. In the preface, he writes of himself and his book that he has benefited from previous accounts by saving himself research time, and that his book, unlike others, “attempts to tell one complete story of the study of the Earth, geologists, geophysicists, dreamers and all” (p. vi). Wood is ambitious, for his work covers much of 19th-century geology as well as the development, reception, rejection, and eventual acceptance of mobilist ideas. Before discussing the work of the German meteorologist and geophysicist Alfred L. Wegener, American glacial geomorphologist Frank Taylor, and several of their predecessors who proposed “mobilist” ideas, he manages to string together brief descriptions of the contributions of (among others) German mineralogist Abraham Gottlob Werner, British geologists James Hutten and John Playfair, British engineer William Smith, British geologist Charles Lyell, American geologists James Hall and James Dwight Dana, British volcanologist William Lowthian Green, American geologist Grove Karl Gilbert, French geologist Elie de Beaumont, British geologist and mathematician Osmond Fisher, American geologist Clarence Dutton, British mathematician and physicist Lord Kelvin, Austrian geologist Eduard Suess, French geologist Marcel Bertrand, and American geologist Thomas Chrowder Chamberlin. Moreover, Wood offers an interesting thesis about the revolution in the earth sciences. He claims that the real revolution was not the replacement of fixist views with the mobilist ones of sea floor spreading and plate tectonics, but rather the replacement of geology with the new discipline of the earth sciences in which geophysics and geochemistry play the central role.

An Outrageous Geological Hypothesis for the Early Mars Hydro-climatic Conundrum

NASA Astrophysics Data System (ADS)

Baker, V. R.

2016-12-01

Nearly a century ago a Science paper by W. M. Davis described the role for an "outrageous geological hypothesis" (OGH) as encouraging, "…a contemplation deliberate enough to seek out what conditions would make the outrage seem permissible and reasonable." Davis even advocated in 1926 that Earth scientists seriously consider "the Wegener outrage of wandering continents"- the OGH that ultimately led to the most important unifying concept for understanding the nature of Earthlike planets. Does this concept of a mobile lithosphere, manifesting itself on Earth as plate tectonics, have relevance for understanding the nature of early Mars? Conceptual arguments have been presented claiming that Mars could never have had an early phase of lithospheric dynamics similar to that associated with Earth's plate tectonics. Nevertheless, a total rejection of this OGH precludes any possibility of considering (1) the conditions that might make such dynamics possible, and (2) connections among the many phenomena that can be collectively accounted for by the OGH. While all scientific arguments are intrinsically fallible, nature presents us with absolute realities. For Mars the latter consist of the numerous anomalies related to planetary evolution that either can be explained piecemeal by ad hoc hypotheses, or, alternatively, might be viewed as part of something to be explained by a unifying, working hypothesis that may seem outrageous in the light of current theory. Briefly stated, the Early Mars OGH envisions a pre-Late Heavy Bombardment (> 4 Ga) phase of lithospheric subduction that helped generate the very powerful core dynamo while also emplacing near the core-mantle boundary a reservoir of volatiles that subsequently influenced the later Mars history of punctuated evolution, involving episodic volcanism and transient states of a denser atmosphere with associated, active hydrological cycling, including the temporary surficial expressions of oceans, lakes, glaciers, and rivers.

A Query Language for Handling Big Observation Data Sets in the Sensor Web

NASA Astrophysics Data System (ADS)

Autermann, Christian; Stasch, Christoph; Jirka, Simon; Koppe, Roland

2017-04-01

The Sensor Web provides a framework for the standardized Web-based sharing of environmental observations and sensor metadata. While the issue of varying data formats and protocols is addressed by these standards, the fast growing size of observational data is imposing new challenges for the application of these standards. Most solutions for handling big observational datasets currently focus on remote sensing applications, while big in-situ datasets relying on vector features still lack a solid approach. Conventional Sensor Web technologies may not be adequate, as the sheer size of the data transmitted and the amount of metadata accumulated may render traditional OGC Sensor Observation Services (SOS) unusable. Besides novel approaches to store and process observation data in place, e.g. by harnessing big data technologies from mainstream IT, the access layer has to be amended to utilize and integrate these large observational data archives into applications and to enable analysis. For this, an extension to the SOS will be discussed that establishes a query language to dynamically process and filter observations at storage level, similar to the OGC Web Coverage Service (WCS) and it's Web Coverage Processing Service (WCPS) extension. This will enable applications to request e.g. spatial or temporal aggregated data sets in a resolution it is able to display or it requires. The approach will be developed and implemented in cooperation with the The Alfred Wegener Institute, Helmholtz Centre for Polar and Marine Research whose catalogue of data compromises marine observations of physical, chemical and biological phenomena from a wide variety of sensors, including mobile (like research vessels, aircrafts or underwater vehicles) and stationary (like buoys or research stations). Observations are made with a high temporal resolution and the resulting time series may span multiple decades.

Brentuximab Vedotin + Rituximab as Frontline Therapy for Pts w/ CD30+ and/or EBV+ Lymphomas

ClinicalTrials.gov

2015-04-28

Adult Grade III Lymphomatoid Granulomatosis; Adult Nasal Type Extranodal NK/T-cell Lymphoma; Anaplastic Large Cell Lymphoma; Angioimmunoblastic T-cell Lymphoma; Contiguous Stage II Adult Burkitt Lymphoma; Contiguous Stage II Adult Diffuse Large Cell Lymphoma; Contiguous Stage II Adult Diffuse Mixed Cell Lymphoma; Contiguous Stage II Adult Diffuse Small Cleaved Cell Lymphoma; Contiguous Stage II Adult Immunoblastic Large Cell Lymphoma; Contiguous Stage II Adult Lymphoblastic Lymphoma; Contiguous Stage II Grade 1 Follicular Lymphoma; Contiguous Stage II Grade 2 Follicular Lymphoma; Contiguous Stage II Grade 3 Follicular Lymphoma; Contiguous Stage II Mantle Cell Lymphoma; Contiguous Stage II Marginal Zone Lymphoma; Contiguous Stage II Small Lymphocytic Lymphoma; Cutaneous B-cell Non-Hodgkin Lymphoma; Epstein-Barr Virus Infection; Extranodal Marginal Zone B-cell Lymphoma of Mucosa-associated Lymphoid Tissue; Hepatosplenic T-cell Lymphoma; Intraocular Lymphoma; Nodal Marginal Zone B-cell Lymphoma; Noncontiguous Stage II Adult Burkitt Lymphoma; Noncontiguous Stage II Adult Diffuse Large Cell Lymphoma; Noncontiguous Stage II Adult Diffuse Mixed Cell Lymphoma; Noncontiguous Stage II Adult Diffuse Small Cleaved Cell Lymphoma; Noncontiguous Stage II Adult Immunoblastic Large Cell Lymphoma; Noncontiguous Stage II Adult Lymphoblastic Lymphoma; Noncontiguous Stage II Grade 1 Follicular Lymphoma; Noncontiguous Stage II Grade 2 Follicular Lymphoma; Noncontiguous Stage II Grade 3 Follicular Lymphoma; Noncontiguous Stage II Mantle Cell Lymphoma; Noncontiguous Stage II Marginal Zone Lymphoma; Noncontiguous Stage II Small Lymphocytic Lymphoma; Noncutaneous Extranodal Lymphoma; Peripheral T-cell Lymphoma; Post-transplant Lymphoproliferative Disorder; Progressive Hairy Cell Leukemia, Initial Treatment; Recurrent Adult Burkitt Lymphoma; Recurrent Adult Diffuse Mixed Cell Lymphoma; Recurrent Adult Diffuse Small Cleaved Cell Lymphoma; Recurrent Adult Grade III Lymphomatoid Granulomatosis; Recurrent Adult Hodgkin Lymphoma; Recurrent Adult Immunoblastic Large Cell Lymphoma; Recurrent Adult Lymphoblastic Lymphoma; Recurrent Adult T-cell Leukemia/Lymphoma; Recurrent Cutaneous T-cell Non-Hodgkin Lymphoma; Recurrent Grade 1 Follicular Lymphoma; Recurrent Grade 2 Follicular Lymphoma; Recurrent Grade 3 Follicular Lymphoma; Recurrent Mantle Cell Lymphoma; Recurrent Marginal Zone Lymphoma; Recurrent Mycosis Fungoides/Sezary Syndrome; Recurrent Small Lymphocytic Lymphoma; Refractory Hairy Cell Leukemia; Small Intestine Lymphoma; Splenic Marginal Zone Lymphoma; Stage I Adult Burkitt Lymphoma; Stage I Adult Diffuse Large Cell Lymphoma; Stage I Adult Diffuse Mixed Cell Lymphoma; Stage I Adult Diffuse Small Cleaved Cell Lymphoma; Stage I Adult Hodgkin Lymphoma; Stage I Adult Immunoblastic Large Cell Lymphoma; Stage I Adult Lymphoblastic Lymphoma; Stage I Adult T-cell Leukemia/Lymphoma; Stage I Cutaneous T-cell Non-Hodgkin Lymphoma; Stage I Grade 1 Follicular Lymphoma; Stage I Grade 2 Follicular Lymphoma; Stage I Grade 3 Follicular Lymphoma; Stage I Mantle Cell Lymphoma; Stage I Marginal Zone Lymphoma; Stage I Small Lymphocytic Lymphoma; Stage IA Mycosis Fungoides/Sezary Syndrome; Stage IB Mycosis Fungoides/Sezary Syndrome; Stage II Adult Hodgkin Lymphoma; Stage II Adult T-cell Leukemia/Lymphoma; Stage II Cutaneous T-cell Non-Hodgkin Lymphoma; Stage IIA Mycosis Fungoides/Sezary Syndrome; Stage IIB Mycosis Fungoides/Sezary Syndrome; Stage III Adult Burkitt Lymphoma; Stage III Adult Diffuse Large Cell Lymphoma; Stage III Adult Diffuse Mixed Cell Lymphoma; Stage III Adult Diffuse Small Cleaved Cell Lymphoma; Stage III Adult Hodgkin Lymphoma; Stage III Adult Immunoblastic Large Cell Lymphoma; Stage III Adult Lymphoblastic Lymphoma; Stage III Adult T-cell Leukemia/Lymphoma; Stage III Cutaneous T-cell Non-Hodgkin Lymphoma; Stage III Grade 1 Follicular Lymphoma; Stage III Grade 2 Follicular Lymphoma; Stage III Grade 3 Follicular Lymphoma; Stage III Mantle Cell Lymphoma; Stage III Marginal Zone Lymphoma; Stage III Small Lymphocytic Lymphoma; Stage IIIA Mycosis Fungoides/Sezary Syndrome; Stage IIIB Mycosis Fungoides/Sezary Syndrome; Stage IV Adult Burkitt Lymphoma; Stage IV Adult Diffuse Large Cell Lymphoma; Stage IV Adult Diffuse Mixed Cell Lymphoma; Stage IV Adult Diffuse Small Cleaved Cell Lymphoma; Stage IV Adult Hodgkin Lymphoma; Stage IV Adult Immunoblastic Large Cell Lymphoma; Stage IV Adult Lymphoblastic Lymphoma; Stage IV Adult T-cell Leukemia/Lymphoma; Stage IV Cutaneous T-cell Non-Hodgkin Lymphoma; Stage IV Grade 1 Follicular Lymphoma; Stage IV Grade 2 Follicular Lymphoma; Stage IV Grade 3 Follicular Lymphoma; Stage IV Mantle Cell Lymphoma; Stage IV Marginal Zone Lymphoma; Stage IV Small Lymphocytic Lymphoma; Stage IVA Mycosis Fungoides/Sezary Syndrome; Stage IVB Mycosis Fungoides/Sezary Syndrome; T-cell Large Granular Lymphocyte Leukemia; Testicular Lymphoma; Untreated Hairy Cell Leukemia; Waldenström Macroglobulinemia

Vorinostat, Tacrolimus, and Methotrexate in Preventing GVHD After Stem Cell Transplant in Patients With Hematological Malignancies

ClinicalTrials.gov

2015-10-13

Accelerated Phase Chronic Myelogenous Leukemia; Adult Acute Myeloid Leukemia in Remission; Adult Acute Myeloid Leukemia With 11q23 (MLL) Abnormalities; Adult Acute Myeloid Leukemia With Del(5q); Adult Acute Myeloid Leukemia With Inv(16)(p13;q22); Adult Acute Myeloid Leukemia With t(15;17)(q22;q12); Adult Acute Myeloid Leukemia With t(16;16)(p13;q22); Adult Acute Myeloid Leukemia With t(8;21)(q22;q22); Adult Grade III Lymphomatoid Granulomatosis; B-cell Chronic Lymphocytic Leukemia; Chronic Myelogenous Leukemia, BCR-ABL1 Positive; Chronic Myelomonocytic Leukemia; Chronic Phase Chronic Myelogenous Leukemia; Contiguous Stage II Adult Burkitt Lymphoma; Contiguous Stage II Adult Diffuse Large Cell Lymphoma; Contiguous Stage II Adult Diffuse Mixed Cell Lymphoma; Contiguous Stage II Adult Diffuse Small Cleaved Cell Lymphoma; Contiguous Stage II Adult Immunoblastic Large Cell Lymphoma; Contiguous Stage II Adult Lymphoblastic Lymphoma; Contiguous Stage II Grade 1 Follicular Lymphoma; Contiguous Stage II Grade 2 Follicular Lymphoma; Contiguous Stage II Grade 3 Follicular Lymphoma; Contiguous Stage II Mantle Cell Lymphoma; Contiguous Stage II Marginal Zone Lymphoma; Contiguous Stage II Small Lymphocytic Lymphoma; Cutaneous B-cell Non-Hodgkin Lymphoma; Extranodal Marginal Zone B-cell Lymphoma of Mucosa-associated Lymphoid Tissue; Graft Versus Host Disease; Intraocular Lymphoma; Myelodysplastic Syndrome With Isolated Del(5q); Myelodysplastic/Myeloproliferative Neoplasm, Unclassifiable; Nodal Marginal Zone B-cell Lymphoma; Noncontiguous Stage II Adult Burkitt Lymphoma; Noncontiguous Stage II Adult Diffuse Large Cell Lymphoma; Noncontiguous Stage II Adult Diffuse Mixed Cell Lymphoma; Noncontiguous Stage II Adult Diffuse Small Cleaved Cell Lymphoma; Noncontiguous Stage II Adult Immunoblastic Large Cell Lymphoma; Noncontiguous Stage II Adult Lymphoblastic Lymphoma; Noncontiguous Stage II Grade 1 Follicular Lymphoma; Noncontiguous Stage II Grade 2 Follicular Lymphoma; Noncontiguous Stage II Grade 3 Follicular Lymphoma; Noncontiguous Stage II Mantle Cell Lymphoma; Noncontiguous Stage II Marginal Zone Lymphoma; Noncontiguous Stage II Small Lymphocytic Lymphoma; Post-transplant Lymphoproliferative Disorder; Primary Central Nervous System Hodgkin Lymphoma; Primary Central Nervous System Non-Hodgkin Lymphoma; Recurrent Adult Acute Myeloid Leukemia; Recurrent Adult Burkitt Lymphoma; Recurrent Adult Diffuse Large Cell Lymphoma; Recurrent Adult Diffuse Mixed Cell Lymphoma; Recurrent Adult Diffuse Small Cleaved Cell Lymphoma; Recurrent Adult Grade III Lymphomatoid Granulomatosis; Recurrent Adult Hodgkin Lymphoma; Recurrent Adult Immunoblastic Large Cell Lymphoma; Recurrent Adult Lymphoblastic Lymphoma; Recurrent Grade 1 Follicular Lymphoma; Recurrent Grade 2 Follicular Lymphoma; Recurrent Grade 3 Follicular Lymphoma; Recurrent Mantle Cell Lymphoma; Recurrent Marginal Zone Lymphoma; Recurrent Small Lymphocytic Lymphoma; Refractory Anemia; Refractory Anemia With Excess Blasts; Refractory Anemia With Ringed Sideroblasts; Refractory Chronic Lymphocytic Leukemia; Refractory Cytopenia With Multilineage Dysplasia; Refractory Hairy Cell Leukemia; Relapsing Chronic Myelogenous Leukemia; Secondary Central Nervous System Hodgkin Lymphoma; Secondary Central Nervous System Non-Hodgkin Lymphoma; Small Intestine Lymphoma; Splenic Marginal Zone Lymphoma; Stage I Adult Burkitt Lymphoma; Stage I Adult Diffuse Large Cell Lymphoma; Stage I Adult Diffuse Mixed Cell Lymphoma; Stage I Adult Diffuse Small Cleaved Cell Lymphoma; Stage I Adult Hodgkin Lymphoma; Stage I Adult Immunoblastic Large Cell Lymphoma; Stage I Adult Lymphoblastic Lymphoma; Stage I Chronic Lymphocytic Leukemia; Stage I Grade 1 Follicular Lymphoma; Stage I Grade 2 Follicular Lymphoma; Stage I Grade 3 Follicular Lymphoma; Stage I Mantle Cell Lymphoma; Stage I Marginal Zone Lymphoma; Stage I Small Lymphocytic Lymphoma; Stage II Adult Hodgkin Lymphoma; Stage II Chronic Lymphocytic Leukemia; Stage III Adult Burkitt Lymphoma; Stage III Adult Diffuse Large Cell Lymphoma; Stage III Adult Diffuse Mixed Cell Lymphoma; Stage III Adult Diffuse Small Cleaved Cell Lymphoma; Stage III Adult Hodgkin Lymphoma; Stage III Adult Immunoblastic Large Cell Lymphoma; Stage III Adult Lymphoblastic Lymphoma; Stage III Chronic Lymphocytic Leukemia; Stage III Grade 1 Follicular Lymphoma; Stage III Grade 2 Follicular Lymphoma; Stage III Grade 3 Follicular Lymphoma; Stage III Mantle Cell Lymphoma; Stage III Marginal Zone Lymphoma; Stage IV Adult Burkitt Lymphoma; Stage IV Adult Diffuse Large Cell Lymphoma; Stage IV Adult Diffuse Mixed Cell Lymphoma; Stage IV Adult Diffuse Small Cleaved Cell Lymphoma; Stage IV Adult Hodgkin Lymphoma; Stage IV Adult Immunoblastic Large Cell Lymphoma; Stage IV Adult Lymphoblastic Lymphoma; Stage IV Chronic Lymphocytic Leukemia; Stage IV Grade 1 Follicular Lymphoma; Stage IV Grade 2 Follicular Lymphoma; Stage IV Grade 3 Follicular Lymphoma; Stage IV Mantle Cell Lymphoma; Stage IV Marginal Zone Lymphoma; Stage IV Small Lymphocytic Lymphoma; Testicular Lymphoma; Waldenström Macroglobulinemia

Cholestatic Liver Disease after Rituximab and Adalimumab and the Possible Role of Cross-Reacting Antibodies to Fab 2 Fragments

PubMed Central

Koetter, Ina; Schwab, Matthias; Fritz, Peter; Kimmel, Martin; Alscher, M. Dominik; Braun, Niko

2013-01-01

Background Millions of patients are treated with therapeutic monoclonal antibodies (Tmabs) for miscellaneous diseases. We investigated sera from six patients who received immune globulin, from one patient with refractory anti-neutrophil-cytoplasmic antibody (ANCA)-associated granulomatosis with polyangiitis (GPA) who developed two episodes of acute cholestatic liver disease, one after treatment with rituximab and a second after adalimumab and a healthy control group. Methods Three sera from the patient and six sera from patients who received immune globulin were analyzed for antibodies to rituximab and adalimumab by ELISA. Additionally, sera from the patients and from nine healthy blood donors were coated with the Fab fragment of an unrelated humanized monoclonal antibody, with human Fc proteins as well as a mouse IgG globulin. Results Viral serology for hepatitis A, B, C and autoantibodies specific for autoimmune liver disorders were negative. In all three sera from the patient antibodies to rituximab could be detected, but also antibodies to adalimumab were present even at time points when the patient had not yet received adalimumab, indicating cross reactivity between both substances. Testing against an unrelated human Fab fragment revealed positive results, indicating that the patient had antibodies against human Fab fragments in general. The Fc proteins were negative, and patients’ sera did also not react with mouse IgG globulins. Remarkably, 2 out of 5 patients which were treated with immune globulin had antibodies against human Fab fragments in general whereas in none of the samples from healthy controls antibodies to Fab fragment could be detected. Conclusion This is the first study demonstrating cholestatic liver disease induced by two different Tmabs. Cross - reacting antibodies to Fab2 fragments in general are probably involved. Further studies must show if these Fab2 antibodies in general are related with drug-induced side effects and accelerated drug clearance in patients on Tmab therapy. PMID:24244376

Rituximab as an immunosuppressant in antineutrophil cytoplasmic antibody-associated vasculitis

PubMed Central

McGregor, JulieAnne G.; Hogan, Susan L.; Kotzen, Elizabeth S.; Poulton, Caroline J.; Hu, Yichun; Negrete-Lopez, Roberto; Kidd, Jason M.; Katsanos, Suzanne L.; Bunch, Donna O.; Nachman, Patrick H.; Falk, Ronald J.

2015-01-01

Background Rituximab has been used in antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) since 2003. Our objective was to describe outcomes and adverse events following rituximab since that time in an inception cohort. Methods Patients with AAV (diagnosed 1991–2012) who received rituximab (n = 120) were evaluated and incidence per person-year (PPY) with 95% confidence interval was calculated for relapse and infections. Time to remission and relapse by number of rituximab infusions given per treatment course (≤2 versus >2) and by ever having been exposed to cyclophosphamide were compared using Kaplan–Meier curves. Rituximab-treated patients were characterized in comparison with AAV patients treated with cyclophosphamide but not exposed to rituximab (n = 351) using Fisher's exact or rank tests. Results Rituximab resulted in 86% achieving remission and 41% having a subsequent relapse in a median of 19 months (range 9–29). Time to remission and relapse were similar between rituximab infusion courses (≤2 versus >2; remission P = 0.86 and relapse P = 0.78, respectively). Incidence of relapse was 0.22 PPY (0.14, 0.31) and of severe infection was 0.12 PPY (0.08, 0.24). Time to relapse was shorter in those never exposed to cyclophosphamide (n = 20): 50% by 8 months versus 50% by 24 and 30 months for those with prior or concurrent exposure to cyclophosphamide (n = 100). Compared with those who never received rituximab, rituximab-treated patients were younger (P < 0.001), more likely to have granulomatosis with polyangiitis (P = 0.001) and had more upper airway (P = 0.01) and less kidney involvement (P = 0.007). Conclusions Rituximab is beneficial when prescribed outside of a trial setting. Response to treatment and relapse is similar regardless of infusion number. Rituximab without cyclophosphamide may result in a shorter time to relapse supporting combination of these therapies. PMID:25805743

Comparison of individually tailored versus fixed-schedule rituximab regimen to maintain ANCA-associated vasculitis remission: results of a multicentre, randomised controlled, phase III trial (MAINRITSAN2).

PubMed

Charles, Pierre; Terrier, Benjamin; Perrodeau, Élodie; Cohen, Pascal; Faguer, Stanislas; Huart, Antoine; Hamidou, Mohamed; Agard, Christian; Bonnotte, Bernard; Samson, Maxime; Karras, Alexandre; Jourde-Chiche, Noémie; Lifermann, François; Gobert, Pierre; Hanrotel-Saliou, Catherine; Godmer, Pascal; Martin-Silva, Nicolas; Pugnet, Grégory; Matignon, Marie; Aumaitre, Olivier; Viallard, Jean-François; Maurier, François; Meaux-Ruault, Nadine; Rivière, Sophie; Sibilia, Jean; Puéchal, Xavier; Ravaud, Philippe; Mouthon, Luc; Guillevin, Loïc

2018-04-25

To compare individually tailored, based on trimestrial biological parameter monitoring, to fixed-schedule rituximab reinfusion for remission maintenance of antineutrophil cytoplasm antibody (ANCA)-associated vasculitides (AAVs). Patients with newly diagnosed or relapsing granulomatosis with polyangiitis (GPA) or microscopic polyangiitis (MPA) in complete remission after induction therapy were included in an open-label, multicentre, randomised controlled trial. All tailored-arm patients received a 500 mg rituximab infusion at randomisation, with rituximab reinfusion only when CD19+B lymphocytes or ANCA had reappeared or ANCA titre rose markedly based on trimestrial testing until month 18. Controls received a fixed 500 mg rituximab infusion on days 0 and 14 postrandomisation, then 6, 12 and 18 months after the first infusion. The primary endpoint was the number of relapses (new or reappearing symptom(s) or worsening disease with Birmingham Vasculitis Activity Score (BVAS)>0) at month 28 evaluated by an independent Adjudication Committee blinded to treatment group. Among the 162 patients (mean age: 60 years; 42% women) included, 117 (72.2%) had GPA and 45 (27.8%) had MPA. Preinclusion induction therapy included cyclophosphamide for 100 (61.7%), rituximab for 61 (37.6%) and methotrexate for 1 (0.6%). At month 28, 21 patients had suffered 22 relapses: 14/81 (17.3%) in 13 tailored-infusion recipients and 8/81 (9.9%) in 8 fixed-schedule patients (p=0.22). The tailored-infusion versus fixed-schedule group, respectively, received 248 vs 381 infusions, with medians (IQR) of 3 (2-4) vs 5 (5-5) administrations. AAV relapse rates did not differ significantly between individually tailored and fixed-schedule rituximab regimens. Individually tailored-arm patients received fewer rituximab infusions. NCT01731561; Results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Modulation of MMP-2 and MMP-9 in Churg-Strauss syndrome respiratory mucosa: potential monitoring parameters.

PubMed

Leone, A; Uzzo, M L; Gerbino, A; Tortorici, S; Tralongo, P; Cappello, F; Incandela, S; Spatola, G F; Jurjus, A R

2014-01-01

Churg-Strauss (CSS) syndrome is rare and of unknown etiology. It is associated with vasculitis, blood eosinophilia and granulomatosis, and affects multiple organs and systems at various stages of the disease. Specific diagnostic and monitoring tests are not yet available. This study aims to assess the changes in MMP-2 and MMP-9 along with the histopathological alterations in two cases of CSS, as possible potential diagnostic and monitoring criteria. Two adult male patients were diagnosed with CSS in the otorhinolaryngology clinic in the University of Palermo, based on multiple clinical and histopathologic criteria. Biopsies of respiratory mucosa were taken after the consent of the patients, processed for routine histopathology and immunohistochemistry as well as quantitative polymerase chain reaction (qPCR). Similar biopsies were also taken from a non- CSS patient. The Assessment of MMP-2 and MMP-9 was performed using both immunohistochemistry and qPCR techniques. Histopathological alterations in the respiratory mucosa were consistent with vasculitis and granulomatous tissue formation, in addition to inflammatory cell infiltration with abundance of eosinophils. Immunohistochemistry assay performed on the samples derived from the two CSS patients showed a relative and remarkable increase of both MMP-2 and MMP-9 compared to controls. Such an increase was consistent with the qPCR results which depicted a significant increase between 20 and 30% for both MMP-2 and MMP-9, respectively. Since the secretion of MMPs is an essential step in angiogenesis, could these enzymatic factors be used as parameters to diagnose or monitor the evolution of CSS? The small number of samples analyzed in this study does not allow us to suggest a general statement correlating the increase in expression of MMP-2 and MMP-9 to the appearance or evolution of vasculitis; it is only speculative.

Clinical presentation and outcome prediction of clinical, serological, and histopathological classification schemes in ANCA-associated vasculitis with renal involvement.

PubMed

Córdova-Sánchez, Bertha M; Mejía-Vilet, Juan M; Morales-Buenrostro, Luis E; Loyola-Rodríguez, Georgina; Uribe-Uribe, Norma O; Correa-Rotter, Ricardo

2016-07-01

Several classification schemes have been developed for anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV), with actual debate focusing on their clinical and prognostic performance. Sixty-two patients with renal biopsy-proven AAV from a single center in Mexico City diagnosed between 2004 and 2013 were analyzed and classified under clinical (granulomatosis with polyangiitis [GPA], microscopic polyangiitis [MPA], renal limited vasculitis [RLV]), serological (proteinase 3 anti-neutrophil cytoplasmic antibodies [PR3-ANCA], myeloperoxidase anti-neutrophil cytoplasmic antibodies [MPO-ANCA], ANCA negative), and histopathological (focal, crescenteric, mixed-type, sclerosing) categories. Clinical presentation parameters were compared at baseline between classification groups, and the predictive value of different classification categories for disease and renal remission, relapse, renal, and patient survival was analyzed. Serological classification predicted relapse rate (PR3-ANCA hazard ratio for relapse 2.93, 1.20-7.17, p = 0.019). There were no differences in disease or renal remission, renal, or patient survival between clinical and serological categories. Histopathological classification predicted response to therapy, with a poorer renal remission rate for sclerosing group and those with less than 25 % normal glomeruli; in addition, it adequately delimited 24-month glomerular filtration rate (eGFR) evolution, but it did not predict renal nor patient survival. On multivariate models, renal replacement therapy (RRT) requirement (HR 8.07, CI 1.75-37.4, p = 0.008) and proteinuria (HR 1.49, CI 1.03-2.14, p = 0.034) at presentation predicted renal survival, while age (HR 1.10, CI 1.01-1.21, p = 0.041) and infective events during the induction phase (HR 4.72, 1.01-22.1, p = 0.049) negatively influenced patient survival. At present, ANCA-based serological classification may predict AAV relapses, but neither clinical nor serological categories predict renal or patient survival. Age, renal function and proteinuria at presentation, histopathology, and infectious complications constitute the main outcome predictors and should be considered for individualized management.

Treatment of Benign Tracheal Stenosis Using Endoluminal Spray Cryotherapy.

PubMed

Bhora, Faiz Y; Ayub, Adil; Forleiter, Craig M; Huang, Chyun-Yin; Alshehri, Khalid; Rehmani, Sadiq; Al-Ayoubi, Adnan M; Raad, Wissam; Lebovics, Robert S

2016-11-01

Tracheal stenosis is a debilitating disorder with heterogeneity in terms of disease characteristics and management. Repeated recurrences substantially alter patients' quality of life. There is limited evidence for the use of spray cryotherapy (SCT) in the management of benign airway disease. To report our early results for the use of SCT in patients with benign tracheal stenosis. Data were extracted from the medical records of a consecutive series of patients with benign airway stenosis secondary to granulomatosis with polyangiitis (GPA) (n = 13), prior tracheotomy or tracheal intubation (n = 8), and idiopathic strictures (n = 5) treated from September 1, 2013, to September 30, 2015, at a tertiary care hospital. Airway narrowing was quantified on a standard quartile grading scale. Response to treatment was assessed by improvement in airway caliber and the time interval for reintervention. Delivery of 4 5-second SCT cycles and 2 balloon dilatations. Twenty-six patients (median [range] age, 53 [16-83] years; 20 [77%] female) underwent 48 SCT sessions. Spray cryotherapy was successfully used without any substantial intraoperative or postoperative complications in all patients. In a median (range) follow-up of 11 (1-26) months, all patients had improvement in symptoms. Before the institution of SCT, 23 patients (88%) had grade III or IV stenosis. At the last evaluation after induction of SCT, 4 (15%) had grade III or IV stenosis, with a mean (SD) change of 1.39 (0.51) (P < .001). Patients with GPA required significantly fewer SCT procedures (mean [SD], 1.38 [0.96] vs 2.31 [1.18]; P = .03) during the study period. Spray cryotherapy was a safe adjunct modality to accomplish airway patency in patients with benign tracheal stenosis. Although efficacy evidence is limited for SCT, it may be useful for patients who have experienced treatment failure with conventional modalities. Further analysis of this cohort will determine the physiologic durability of the reported short-term changes. Additional trials are warranted for further evaluation of this modality.

HTLV-1 seroprevalance in sarcoidosis. A clinical and laboratory study in northeast of Iran.

PubMed

Saghafi, Massoud; Rezaieyazdi, Zahra; Nabavi, Shima; Mirfeizi, Zahra; Sahebari, Maryam; Salari, Masoumeh

2018-06-01

Sarcoidosis is an autoimmune multiorgan granulomatosis disease with unknown origin. Some environmental factors such as viruses may induce the disease in genetically susceptible individuals. Human T cell lymphotropic virus type 1 (HTLV-1) can dysregulate the human immune system and the role of this virus in the pathogenesis of autoimmune diseases has been investigated and documented, such as in uveitis. In this study, we have focused on the seroprevalence of HTLV-1 in sarcoidosis in comparison to the normal population in the northeast of Iran, an endemic area for HTLV-1. This cross-sectional study enrolled 125 patients with established sarcoidosis to evaluate the frequency of HTLV-1 and compare it with the normal population of Mashhad, Iran. Participants' blood samples were analyzed for HTLV-1 antibody by an enzyme-linked immunosorbent assay kit. Positive results were confirmed by polymerase chain reaction method. Finally, data were analyzed using SPSS 11. Among sarcoidosis patients 106 (84.8%) patients had a history of acute course and 19 (15.2%) had chronic sarcoidosis. Four percent of the patients versus 2.12% of the Mashhad population were HTLV-1 positive with no statistical difference (P = 0.201). In age- and sex-matched selected controls, 3.6% were HTLV-1 positive again with no statistical difference by sarcoidosis group (P = 0.52). There was no statistical difference between arthritis, erythema nodusom, uveitis, constitutional symptoms, abnormal chest radiography (parahilar lymphadenopathy) and computed tomography scan findings, respiratory symptoms, sex, the course of the sarcoidosis in HTLV-1 positive and negative sarcoidosis patients. The frequency of HTLV-1 in 125 sarcoidosis patients was 4%. In comparison with prevalence of HTLV-1 in Mashhad, HTLV-1 seroprevalence did not show any significant difference. © 2017 Asia Pacific League of Associations for Rheumatology and John Wiley & Sons Australia, Ltd.

Predicting Future Morphological Changes of Lesions from Radiotracer Uptake in 18F-FDG-PET Images

PubMed Central

Bagci, Ulas; Yao, Jianhua; Miller-Jaster, Kirsten; Chen, Xinjian; Mollura, Daniel J.

2013-01-01

We introduce a novel computational framework to enable automated identification of texture and shape features of lesions on 18F-FDG-PET images through a graph-based image segmentation method. The proposed framework predicts future morphological changes of lesions with high accuracy. The presented methodology has several benefits over conventional qualitative and semi-quantitative methods, due to its fully quantitative nature and high accuracy in each step of (i) detection, (ii) segmentation, and (iii) feature extraction. To evaluate our proposed computational framework, thirty patients received 2 18F-FDG-PET scans (60 scans total), at two different time points. Metastatic papillary renal cell carcinoma, cerebellar hemongioblastoma, non-small cell lung cancer, neurofibroma, lymphomatoid granulomatosis, lung neoplasm, neuroendocrine tumor, soft tissue thoracic mass, nonnecrotizing granulomatous inflammation, renal cell carcinoma with papillary and cystic features, diffuse large B-cell lymphoma, metastatic alveolar soft part sarcoma, and small cell lung cancer were included in this analysis. The radiotracer accumulation in patients' scans was automatically detected and segmented by the proposed segmentation algorithm. Delineated regions were used to extract shape and textural features, with the proposed adaptive feature extraction framework, as well as standardized uptake values (SUV) of uptake regions, to conduct a broad quantitative analysis. Evaluation of segmentation results indicates that our proposed segmentation algorithm has a mean dice similarity coefficient of 85.75±1.75%. We found that 28 of 68 extracted imaging features were correlated well with SUVmax (p<0.05), and some of the textural features (such as entropy and maximum probability) were superior in predicting morphological changes of radiotracer uptake regions longitudinally, compared to single intensity feature such as SUVmax. We also found that integrating textural features with SUV measurements significantly improves the prediction accuracy of morphological changes (Spearman correlation coefficient = 0.8715, p<2e-16). PMID:23431398

RTopo-2: A global high-resolution dataset of ice sheet topography, ice shelf cavity geometry and ocean bathymetry

NASA Astrophysics Data System (ADS)

Timmermann, Ralph; Schaffer, Janin

2016-04-01

The RTopo-1 data set of Antarctic ice sheet/shelf geometry and global ocean bathymetry has proven useful not only for modelling studies of ice-ocean interaction in the southern hemisphere. Following the spirit of this data set, we introduce a new product (RTopo-2) that contains consistent maps of global ocean bathymetry, upper and lower ice surface topographies for Greenland and Antarctica, and global surface height on a spherical grid with now 30 arc seconds resolution. We used the General Bathymetric Chart of the Oceans (GEBCO_2014) as the backbone and added the International Bathymetric Chart of the Arctic Ocean version 3 (IBCAOv3) and the International Bathymetric Chart of the Southern Ocean (IBCSO) version 1. To achieve a good representation of the fjord and shelf bathymetry around the Greenland continent, we corrected data from earlier gridded products in the areas of Petermann Glacier, Hagen Bræ and Helheim Glacier assuming that sub-ice and fjord bathymetries roughly follow plausible Last Glacial Maximum ice flow patterns. For the continental shelf off northeast Greenland and the floating ice tongue of Nioghalvfjerdsfjorden Glacier at about 79°N, we incorporated a high-resolution digital bathymetry model including all available multibeam survey data for the region. Radar data for ice surface and ice base topographies of the floating ice tongues of Nioghalvfjerdsfjorden Glacier and Zachariæ Isstrøm have been obtained from the data centers of Technical University of Denmark (DTU), Operation Icebridge (NASA/NSF) and Alfred Wegener Institute (AWI). For the Antarctic ice sheet/ice shelves, RTopo-2 largely relies on the Bedmap-2 product but applies corrections for the geometry of Getz, Abbot and Fimbul ice shelf cavities. The data set is available in full and in regional subsets in NetCDF format from the PANGAEA database.

Surface energy balance and turbulence measurements on Warszawa Icefield, King George Island, West Antarctica

NASA Astrophysics Data System (ADS)

Falk, U.; Sala, H.; Braun, M.

2012-12-01

The Antarctic Peninsula is amongst the fastest warming places on Earth and further temperature increase is to be expected. It has undergone rapid environmental changes in the past decades. Exceptional rates of surface air temperature increases (2.5K in 50 years) are concurrent with retreating glacier fronts, an increase in melt areas, surface lowering and rapid retreat of glaciers, break-up and disintegration of ice shelves. The South Shetland Islands are located on the northern tip of the Antarctic Peninsula and are especially vulnerable to climate change due to their maritime climate. For King George Island we have compiled a unique data set comprising direct measurements of evaporation and sensible heat flux by eddy covariance on the Warszawa Icefield over 1.5 years from November 2010 to 2012 in combination with a fully equipped automated weather station measuring long- and short-wave radiation components, profiles of temperature, humidity and wind velocities as well as glacier ice temperatures. The combination with the eddy covariance data allows for analysis of variability and seasonality of surface energy balance components on a glacier for one and a half years. Repeat measurements of snow accumulation and surface lowering along transects on the glacier and at different locations on King George Island are used for analysis of multi-sensor satellite data to identify melt patterns and bare ice areas during summer within the source area of the ground measurements. In combination with long-term time series of weather data, these data give indication of the sensitivity of the ice cap to the ongoing changes. This research is part of the ESF project IMCOAST funded by BMBF. Field work was carried out at the Dallmann laboratory (Carlini station, King George Island/Isla 25 de Mayo) in cooperation of the Instituto Antartico Argentino (Argentina) and the Alfred-Wegener Institute of Marine and Polar Research (Germany).

Testing cloud microphysics parameterizations in NCAR CAM5 with ISDAC and M-PACE observations

NASA Astrophysics Data System (ADS)

Liu, Xiaohong; Xie, Shaocheng; Boyle, James; Klein, Stephen A.; Shi, Xiangjun; Wang, Zhien; Lin, Wuyin; Ghan, Steven J.; Earle, Michael; Liu, Peter S. K.; Zelenyuk, Alla

2011-01-01

Arctic clouds simulated by the National Center for Atmospheric Research (NCAR) Community Atmospheric Model version 5 (CAM5) are evaluated with observations from the U.S. Department of Energy (DOE) Atmospheric Radiation Measurement (ARM) Indirect and Semi-Direct Aerosol Campaign (ISDAC) and Mixed-Phase Arctic Cloud Experiment (M-PACE), which were conducted at its North Slope of Alaska site in April 2008 and October 2004, respectively. Model forecasts for the Arctic spring and fall seasons performed under the Cloud-Associated Parameterizations Testbed framework generally reproduce the spatial distributions of cloud fraction for single-layer boundary-layer mixed-phase stratocumulus and multilayer or deep frontal clouds. However, for low-level stratocumulus, the model significantly underestimates the observed cloud liquid water content in both seasons. As a result, CAM5 significantly underestimates the surface downward longwave radiative fluxes by 20-40 W m-2. Introducing a new ice nucleation parameterization slightly improves the model performance for low-level mixed-phase clouds by increasing cloud liquid water content through the reduction of the conversion rate from cloud liquid to ice by the Wegener-Bergeron-Findeisen process. The CAM5 single-column model testing shows that changing the instantaneous freezing temperature of rain to form snow from -5°C to -40°C causes a large increase in modeled cloud liquid water content through the slowing down of cloud liquid and rain-related processes (e.g., autoconversion of cloud liquid to rain). The underestimation of aerosol concentrations in CAM5 in the Arctic also plays an important role in the low bias of cloud liquid water in the single-layer mixed-phase clouds. In addition, numerical issues related to the coupling of model physics and time stepping in CAM5 are responsible for the model biases and will be explored in future studies.

Microphysical processing of aerosol particles in orographic clouds

NASA Astrophysics Data System (ADS)

Pousse-Nottelmann, S.; Zubler, E. M.; Lohmann, U.

2015-08-01

An explicit and detailed treatment of cloud-borne particles allowing for the consideration of aerosol cycling in clouds has been implemented into COSMO-Model, the regional weather forecast and climate model of the Consortium for Small-scale Modeling (COSMO). The effects of aerosol scavenging, cloud microphysical processing and regeneration upon cloud evaporation on the aerosol population and on subsequent cloud formation are investigated. For this, two-dimensional idealized simulations of moist flow over two bell-shaped mountains were carried out varying the treatment of aerosol scavenging and regeneration processes for a warm-phase and a mixed-phase orographic cloud. The results allowed us to identify different aerosol cycling mechanisms. In the simulated non-precipitating warm-phase cloud, aerosol mass is incorporated into cloud droplets by activation scavenging and released back to the atmosphere upon cloud droplet evaporation. In the mixed-phase cloud, a first cycle comprises cloud droplet activation and evaporation via the Wegener-Bergeron-Findeisen (WBF) process. A second cycle includes below-cloud scavenging by precipitating snow particles and snow sublimation and is connected to the first cycle via the riming process which transfers aerosol mass from cloud droplets to snowflakes. In the simulated mixed-phase cloud, only a negligible part of the total aerosol mass is incorporated into ice crystals. Sedimenting snowflakes reaching the surface remove aerosol mass from the atmosphere. The results show that aerosol processing and regeneration lead to a vertical redistribution of aerosol mass and number. Thereby, the processes impact the total aerosol number and mass and additionally alter the shape of the aerosol size distributions by enhancing the internally mixed/soluble Aitken and accumulation mode and generating coarse-mode particles. Concerning subsequent cloud formation at the second mountain, accounting for aerosol processing and regeneration increases the cloud droplet number concentration with possible implications for the ice crystal number concentration.

Air and shipborne magnetic surveys of the Antarctic into the 21st century

NASA Astrophysics Data System (ADS)

Golynsky, A.; Bell, R.; Blankenship, D.; Damaske, D.; Ferraccioli, F.; Finn, C.; Golynsky, D.; Ivanov, S.; Jokat, W.; Masolov, V.; Riedel, S.; von Frese, R.; Young, D.

2013-02-01

The Antarctic geomagnetics' community remains very active in crustal anomaly mapping. More than 1.5 million line-km of new air- and shipborne data have been acquired over the past decade by the international community in Antarctica. These new data together with surveys that previously were not in the public domain significantly upgrade the ADMAP compilation. Aeromagnetic flights over East Antarctica have been concentrated in the Transantarctic Mountains, the Prince Charles Mountains - Lambert Glacier area, and western Dronning Maud Land (DML) — Coats Land. Additionally, surveys were conducted over Lake Vostok and the western part of Marie Byrd Land by the US Support Office for Aerogeophysical Research projects and over the Amundsen Sea Embayment during the austral summer of 2004/2005 by a collaborative US/UK aerogeophysical campaign. New aeromagnetic data over the Gamburtsev Subglacial Mountains (120,000 line-km), acquired within the IPY Antarctica's Gamburtsev Province project reveal fundamental geologic features beneath the East Antarctic Ice sheet critical to understanding Precambrian continental growth processes. Roughly 100,000 line-km of magnetic data obtained within the International Collaboration for Exploration of the Cryosphere through Aerogeophysical Profiling promises to shed light on subglacial lithology and identify crustal boundaries for the central Antarctic Plate. Since the 1996/97 season, the Alfred Wegener Institute has collected 90,000 km of aeromagnetic data along a 1200 km long segment of the East Antarctic coast over western DML. Recent cruises by Australian, German, Japanese, Russian, British, and American researchers have contributed to long-standing studies of the Antarctic continental margin. Along the continental margin of East Antarctica west of Maud Rise to the George V Coast of Victoria Land, the Russian Polar Marine Geological Research Expedition and Geoscience Australia obtained 80,000 and 20,000 line-km, respectively, of integrated seismic, gravity and magnetic data. Additionally, US expeditions collected 128,000 line-km of shipborne magnetic data in the Ross Sea sector.

[Postoperative adjuvante Therapie mit einem Mistelextrakt (Viscum album ssp. album) bei Hündinnen mit Mammatumoren].

PubMed

Biegel, Ulrike; Stratmann, Nina; Knauf, Yvonne; Ruess, Katja; Reif, Marcus; Wehrend, Axel

2017-01-01

Hintergrund: Canine Mammatumoren (CMT) sind wegen ihrer Häufigkeit und hohen Malignitätsrate eine Herausforderung für die Veterinärmedizin. Bisher ist noch keine postoperative adjuvante Therapie als wirksamer Standard etabliert und in den nächsten Jahren wohl auch nicht zu erwarten. Zusätzlich ist die Frage nach der Verträglichkeit einer adjuvanten Therapie mit Erhaltung oder Verbesserung der Lebensqualität (LQ) wichtig. Die Therapie mit Mistelextrakten (Viscum album L.; VAE) ist in der Humanonkologie nach adjuvanter Tumorbasistherapie (Chemotherapie und Bestrahlung) eine sehr häufig verwendete, zusätzliche adjuvante Behandlungsmethode. Auch bei verschiedenen Tierarten werden inzwischen Mistelpräparate in der Onkologie erfolgreich angewendet. Methoden: Überprüfung von Wirkung und Nutzen einer postoperativen, adjuvanten Misteltherapie beim CMT sowie Erfassung der LQ unter der VAE-Behandlung. Ausgewertet wurden 56 Hündinnen mit Mammaadenokarzinom, 33 ausschließlich operierte Kontrolltiere und 23 operierte Tiere, die adjuvant VAE erhielten. Ergebnisse: Die mediane Überlebenszeit (MST) aller Tiere (n = 56) betrug 32 Monate (Interquartilbereich 13-51 Monate). Im deskriptiven Vergleich der Überlebenszeiten (ST) nach Kaplan-Meier waren nach 12, 24, 36 bzw. 48 Monaten noch 24, 20, 15 bzw. 5 Hündinnen (entsprechend 72,7%, 60,6%, 45,1%, 12,4%) der Kontrollgruppe sowie 19, 14, 11 und 1 Hündin (82,6%, 60,9%, 47,8%, 4,3%) der VAE-Gruppe am Leben. Die VAE-Therapie führte zu einem geringeren Gesamtversterberisiko, das statistisch nicht signifikant war (Hazard Ratio (HR) 0,530, 95%-Konfidenzintervall (KI) 0,222-1,262; p = 0,15). Tendenziell (p = 0,07) zeigte sich eine Verringerung des tumorbedingten Sterberisikos auf 25% (HR 0,251, 95%-KI 0,056-1,122). Schlussfolgerungen: Es kann eine Tendenz zur Senkung des tumorbedingten Sterberisikos der VAE-Gruppe bei guter Verträglichkeit der Therapie angenommen werden. Die LQ der Tiere blieb über die gesamte Beobachtungszeit auf hohem Niveau stabil. © 2017 S. Karger GmbH, Freiburg.

First results from a new interdisciplinary robotic vehicle for under-ice research

NASA Astrophysics Data System (ADS)

Nicolaus, M.; Katlein, C.; Schiller, M.

2016-12-01

Research at the ice-water interface below drifting sea-ice is crucial for the investigation of the fluxes of energy, momentum and matter across the atmosphere-ice-ocean boundary. Transmission of solar energy through the ice and snow layers causes warming of the upper ocean and melting of the ice itself. It is also a key factor for in and under-ice primary production, supplying the ice associated food-chain and causing carbon export to deeper water layers and the sea floor. The complex geometry of sea ice does not only cause a large spatial variability in optical properties of the ice cover, but also influences biomass accumulations and especially the hydrodynamic interaction between the ice cover and the uppermost layers of the ocean. Access to the ice underside is however still sparse, as diving operations are risky and logistically challenging. In the last decade, robotic underwater technologies have evolved significantly and enabled the first targeted large-scale observations by remotely operated and autonomous underwater vehicles. A new remotely operated vehicle was commissioned for under ice research at the Alfred Wegener Institute supported by the FRAM infrastructure program of the Helmholtz-Society. Apart from proven under-ice navigation and operation capabilities, the vehicle provides an extended interdisciplinary sensor platform supporting oceanographic, biological, biogeochemical and physical sea-ice research. Here we present the first preliminary data obtained with the new vehicle during the PS101 expedition of the German icebreaker RV Polarstern to the Central Arctic in September and October 2016. Apart from measurements of spectral light transmittance of sea ice during the autumn freeze-up, we show vertical profiles of the bio-optical and oceanographic properties of the upper water column. This data is combined with under-ice topography obtained from upward-looking multibeam sonar, still imagery and HD-video material.

New aeromagnetic data of eastern Dronning Maud Land: implications for the spatial extent of a major Early Neoproterozoic juvenile crustal province

NASA Astrophysics Data System (ADS)

Ruppel, A. S.; Jacobs, J.; Eagles, G.; Läufer, A.; Jokat, W.

2017-12-01

A long-standing collaboration between Alfred Wegener Institute, Helmholtz Centre for Polar and Marine Research (AWI) and the Federal Institute for Geosciences and Natural Resources (BGR) aims to investigate the sub-ice crustal architecture and tectonic evolution of East Antarctica. Its main emphasis is on Dronning Maud Land (DML). During the austral summers 2014 and 2015, ca. 40.000 line kilometre of new magnetic, gravity and ice-penetrating radar data were collected with 10 km line spacing. Here, we report on magnetic anomaly data to the east and south of Sør Rondane (eastern DML), analysed with several filtering techniques. These data are integrated with exposure information from Sør Rondane, the Belgica Mts., and the Yamato Mts.. The study area covers the eastern part of a major, recently revealed Early Neoproterozoic juvenile crustal block, the Tonian Oceanic Arc Super Terrane (TOAST). The western extent of the TOAST is well defined by the Forster Magnetic Anomaly and characterized by a province of subdued SE-striking parallel positive magnetic anomalies in the mostly ice-covered region of south-eastern DML (the SE DML province). Geological investigations showed that this area can be correlated with exposures in Sør Rondane and scattered nunataks west of it. U-Pb ages of ca. 1000-900 Ma, are documented from zircons of gabbro-trondhjemite-tonalite-granodiorite (GTTG) suites in both areas. Further, geochemical analyses prove a juvenile character of the GTTGs, which are interpreted as oceanic arc complexes. Glacial drift from southern Sør Rondane points to an inland continuation of the TOAST, so far of unknown dimensions. The new magnetic data constrain the southern and eastern minimum extent of the TOAST, which we think has a minimum area of 450.000 km2. The spatial extent of this major juvenile crustal province has major significance for the tectonic reconstruction of East Antarctica and its involvement in Rodinia since it is suggested having evolved outboard of it.

Meteorology and oceanography of the Atlantic sector of the Southern Ocean—a review of German achievements from the last decade

NASA Astrophysics Data System (ADS)

Hellmer, Hartmut H.; Rhein, Monika; Heinemann, Günther; Abalichin, Janna; Abouchami, Wafa; Baars, Oliver; Cubasch, Ulrich; Dethloff, Klaus; Ebner, Lars; Fahrbach, Eberhard; Frank, Martin; Gollan, Gereon; Greatbatch, Richard J.; Grieger, Jens; Gryanik, Vladimir M.; Gryschka, Micha; Hauck, Judith; Hoppema, Mario; Huhn, Oliver; Kanzow, Torsten; Koch, Boris P.; König-Langlo, Gert; Langematz, Ulrike; Leckebusch, Gregor C.; Lüpkes, Christof; Paul, Stephan; Rinke, Annette; Rost, Bjoern; van der Loeff, Michiel Rutgers; Schröder, Michael; Seckmeyer, Gunther; Stichel, Torben; Strass, Volker; Timmermann, Ralph; Trimborn, Scarlett; Ulbrich, Uwe; Venchiarutti, Celia; Wacker, Ulrike; Willmes, Sascha; Wolf-Gladrow, Dieter

2016-11-01

In the early 1980s, Germany started a new era of modern Antarctic research. The Alfred Wegener Institute Helmholtz Centre for Polar and Marine Research (AWI) was founded and important research platforms such as the German permanent station in Antarctica, today called Neumayer III, and the research icebreaker Polarstern were installed. The research primarily focused on the Atlantic sector of the Southern Ocean. In parallel, the German Research Foundation (Deutsche Forschungsgemeinschaft, DFG) started a priority program `Antarctic Research' (since 2003 called SPP-1158) to foster and intensify the cooperation between scientists from different German universities and the AWI as well as other institutes involved in polar research. Here, we review the main findings in meteorology and oceanography of the last decade, funded by the priority program. The paper presents field observations and modelling efforts, extending from the stratosphere to the deep ocean. The research spans a large range of temporal and spatial scales, including the interaction of both climate components. In particular, radiative processes, the interaction of the changing ozone layer with large-scale atmospheric circulations, and changes in the sea ice cover are discussed. Climate and weather forecast models provide an insight into the water cycle and the climate change signals associated with synoptic cyclones. Investigations of the atmospheric boundary layer focus on the interaction between atmosphere, sea ice and ocean in the vicinity of polynyas and leads. The chapters dedicated to polar oceanography review the interaction between the ocean and ice shelves with regard to the freshwater input and discuss the changes in water mass characteristics, ventilation and formation rates, crucial for the deepest limb of the global, climate-relevant meridional overturning circulation. They also highlight the associated storage of anthropogenic carbon as well as the cycling of carbon, nutrients and trace metals in the ocean with special emphasis on the Weddell Sea.

Critical Fracture Toughness Measurements of an Antarctic Ice Core

NASA Astrophysics Data System (ADS)

Christmann, Julia; Müller, Ralf; Webber, Kyle; Isaia, Daniel; Schader, Florian; Kippstuhl, Sepp; Freitag, Johannes; Humbert, Angelika

2014-05-01

Fracture toughness is a material parameter describing the resistance of a pre-existing defect in a body to further crack extension. The fracture toughness of glacial ice as a function of density is important for modeling efforts aspire to predict calving behavior. In the presented experiments this fracture toughness is measured using an ice core from Kohnen Station, Dronning Maud Land, Antarctica. The samples were sawed in an ice lab at the Alfred Wegener Institute in Bremerhaven at -20°C and had the dimensions of standard test samples with thickness 14 mm, width 28 mm and length 126 mm. The samples originate from a depth of 94.6 m to 96 m. The grain size of the samples was also identified. The grain size was found to be rather uniform. The critical fracture toughness is determined in a four-point bending approach using single edge V-notch beam samples. The initial notch length was around 2.5 mm and was prepared using a drilling machine. The experimental setup was designed at the Institute of Materials Science at Darmstadt. In this setup the force increases linearly, until the maximum force is reached, where the specific sample fractures. This procedure was done in an ice lab with a temperature of -15°C. The equations to calculate the fracture toughness for pure bending are derived from an elastic stress analysis and are given as a standard test method to detect the fracture toughness. An X-ray computer tomography (CT scanner) was used to determine the ice core densities. The tests cover densities from 843 kg m-3 to 871 kg m-3. Thereby the influence of the fracture toughness on the density was analyzed and compared to previous investigations of this material parameter. Finally the dependence of the measured toughness on thickness, width, and position in the core cross-section was investigated.

Biologie statt Philosophie? Evolutionäre Kulturerklärungen und ihre Grenzen

NASA Astrophysics Data System (ADS)

Illies, Christian

Vor über siebzig Jahren fand man in einer Höhle nahe Hohlenstein-Stadel, im heutigen Baden-Württemberg, eine Frau, die keiner bekannten Spezies und nicht einmal eindeutig den Hominiden zugeordnet werden konnte. Wegen ihres Aussehens wurde sie schon bald als "Löwenfrau“ bekannt (unterdessen wird sie als "Löwenmensch“ bezeichnet, da die in solchen Fragen Klarheit schaffenden Geschlechtsteile bei der Figur fehlen und in Zeiten von gender mainstreaming derartige Festlegungen gerne vermieden werden), denn sie hatte eine menschlich-aufrechte, unbehaarte Gestalt mit weiblichen Rundungen, aber zugleich eine Mähne, sowie Augen, Ohren und Schnauze eines Löwen. Eine sehr weitläufige Verwandte des Minotaurus, so schien es, und doch wesentlich älter als alle Bewohner des Olymps, denn vermutlich wurde die knapp 30 cm große Skulptur bereits in der Altsteinzeit vor etwa 32.000 Jahren aus Mammut-Elfenbein geschnitzt. Wir wissen nicht, ob sie kultischen Zwecken diente oder ein Kind mit ihr spielte, ob sie als Glücksbringer für die Jagd oder als Schamanin mit Löwenmaske verehrt und gefürchtet wurde. Aber die Löwenfrau legt nahe, dass der Mensch schon im Morgendämmern seiner Kultur über die eigene Nähe, aber auch Distanz zum Tier nachgedacht haben muss. Die Frage nach der menschlichen Selbstverortung begegnet uns in dieser Figur, und sie bestimmt viele Zeugnisse menschlichen Nachdenkens, welche uns die Altertumswissenschaften vorlegen. Mit dem Begriff "animal rationale“, wie er unter Bezug auf Aristoteles geprägt wurde, findet sie schließlich ihre klassische, für das Abendland lange Zeit maßgebliche Antwort: Der Mensch als Tier, dessen spezifisches Merkmal die Vernunftbegabtheit ist, die ihn zugleich von allen anderen Tieren abgrenzt und über sie stellt. Aber wo genau verläuft die Grenze? Und wie kann der Mensch beides zugleich sein? Die aristotelische Definition beantwortet diese Fragen nach der Doppelnatur nicht, sondern erhebt das offene Rätsel gleichsam zur Wesensbestimmung des Menschen.

Integrating uncertainty propagation in GNSS radio occultation retrieval: from excess phase to atmospheric bending angle profiles

NASA Astrophysics Data System (ADS)

Schwarz, Jakob; Kirchengast, Gottfried; Schwaerz, Marc

2018-05-01

Global Navigation Satellite System (GNSS) radio occultation (RO) observations are highly accurate, long-term stable data sets and are globally available as a continuous record from 2001. Essential climate variables for the thermodynamic state of the free atmosphere - such as pressure, temperature, and tropospheric water vapor profiles (involving background information) - can be derived from these records, which therefore have the potential to serve as climate benchmark data. However, to exploit this potential, atmospheric profile retrievals need to be very accurate and the remaining uncertainties quantified and traced throughout the retrieval chain from raw observations to essential climate variables. The new Reference Occultation Processing System (rOPS) at the Wegener Center aims to deliver such an accurate RO retrieval chain with integrated uncertainty propagation. Here we introduce and demonstrate the algorithms implemented in the rOPS for uncertainty propagation from excess phase to atmospheric bending angle profiles, for estimated systematic and random uncertainties, including vertical error correlations and resolution estimates. We estimated systematic uncertainty profiles with the same operators as used for the basic state profiles retrieval. The random uncertainty is traced through covariance propagation and validated using Monte Carlo ensemble methods. The algorithm performance is demonstrated using test day ensembles of simulated data as well as real RO event data from the satellite missions CHAllenging Minisatellite Payload (CHAMP); Constellation Observing System for Meteorology, Ionosphere, and Climate (COSMIC); and Meteorological Operational Satellite A (MetOp). The results of the Monte Carlo validation show that our covariance propagation delivers correct uncertainty quantification from excess phase to bending angle profiles. The results from the real RO event ensembles demonstrate that the new uncertainty estimation chain performs robustly. Together with the other parts of the rOPS processing chain this part is thus ready to provide integrated uncertainty propagation through the whole RO retrieval chain for the benefit of climate monitoring and other applications.

Double-mode Two-photon Absorption and Enhanced Photon Antibunching Due to Interference

NASA Astrophysics Data System (ADS)

Bandilla, A.; Ritze, H.-H.

Inspired by results of interfering signal and idler from a nondegenerate parametric amplifier we investigate the photon statistics of the resulting field after interference of two components subjected to double-mode two-photon absorption. This absorption process leads to a strong correlation of the participating modes, which can be used to generate fields with photon antibunching in interference experiments. In addition the photon number can be made small, which produces enhanced antibunching.Translated AbstractZwei-Photonen-Absorption aus zwei Moden und durch Interferenz verstärktes photon antibunchingDie quantenmechanische Betrachtung der Interferenz führt zu neuen Ergebnissen, wenn Felder ohne klassisches Analogon betrachtet werden. Insbesondere ergibt sich durch die Reduktion der Photonenzahl durch Interferenz eine effektive Verstärkung des Photon Antibunching, wie von den Verfassern in vorhergehenden Arbeiten gezeigt wurde. Die vorliegende Untersuchung betrachtet die Interferenz von zwei korrelierten Moden, wobei die Korrelation durch Zwei-Photonen-Absorption aus den beiden Moden zustande kommt. In jeder einzelnen Mode ergibt sich lediglich ein gewisses Bunching, wenn man mit kohärentem Licht in beiden Moden beginnt. Es wird die Interferenz der Feldstärke-Komponenten in bestimmten Polarisationsrichtungen untersucht. Zur Vereinfachung wird in den betrachteten Moden die gleiche Anfangsphotonenzahl vorausgesetzt und der Analysator auf minimale Transmittanz gebracht. Das eigentliche Signal entsteht dann durch Einführung einer endlichen Phasenverschiebung zwischen den beiden Moden. Dieses Signal zeigt Antibunching und kann in seiner Intensität beliebig variiert werden, was wegen des (1/n)-Charakters des Antibunching zu seiner Verstärkung führt. Ferner wird gezeigt, daß die zunächst für zwei linear polarisierte Moden durchgeführte Rechnung auf zwei zirkulare Moden sowie auf zwei gegenläufige Strahlen bei der dopplerfreien Zwei-Quanten-Absorption übertragen werden kann. Die Ergebnisse werden durch numerische Rechnungen gestützt und schließlich durch approximative Methoden reproduziert und erweitert.

Reconciling Paleomagnetism and Pangea

NASA Astrophysics Data System (ADS)

Domeier, M. M.; Van Der Voo, R.; Torsvik, T. H.

2011-12-01

Outside of the realm of paleomagnetic studies, it has been a long held tenet that Pangea amalgamated into and disseminated from essentially the same paleogeography, the conventional Pangea reconstruction of Alfred Wegener. There is widespread geologic and geophysical support for this re-assembly during the Late Triassic-Early Jurassic, but global paleomagnetic data have been repeatedly shown to be incompatible with this reconstruction for pre-Late Triassic time. This discrepancy, which has endured from the late 1950's to the present day, has developed into a fundamental enigma of late Paleozoic-early Mesozoic paleomagnetism. The problem stems from a large disparity in the apparent polar wander paths (APWPs) of Laurussia and Gondwana when the landmasses are restored to the conventional paleogeography. If the APWPs are made to coincide while the conventional fit is maintained, a substantial crustal misfit results; a continental overlap of approximately 10° latitude (1000+ km) occurs between Laurussia and Gondwana. To resolve this problem, alternative Pangea reconstructions have been built to accommodate the late Paleozoic-early Mesozoic paleomagnetic data, but these invariably require large-scale shearing between Laurussia and Gondwana to reach the conventional Pangea re-assembly, from which it is unanimously agreed that the Atlantic Ocean opened in the Jurassic. Evidence for a megashear between these landmasses is critically lacking. Another proposed solution invokes time-dependent non-dipole fields, but challenges the working assumption that the geomagnetic field has effectively been a geocentric axial dipole through the Phanerozoic. The final alternative is that the problem is a manifestation of artifacts/contamination in the paleomagnetic data. Previous investigations of this last hypothesis have demonstrated its theoretical plausibility, but lacked the exhaustive analysis of global paleomagnetic data necessary to assuredly dispel the problem as an enduring data-artifact. Using the most recent late Paleozoic-early Mesozoic paleomagnetic data, we examine the influence of data-quality, refined continental fits, and theoretical inclination shallowing corrections, and demonstrate that the paleomagnetic data can be reconciled with Pangea without invoking alternative reconstructions or non-dipole fields.

Tornadoes within the Czech Republic: from early medieval chronicles to the "internet society"

NASA Astrophysics Data System (ADS)

Setvák, Martin; Šálek, Milan; Munzar, Jan

This paper addresses the historical documentation of tornadoes and the awareness of tornadic events in the area of the present Czech Republic throughout the last nine centuries. The oldest records of tornado occurrence in the region can be found in chronicles from the first half of the 12th century—the two most interesting of these are presented here in translation from the original Latin texts. Several other cases of possible tornadoes and waterspouts can be found in chronicles from the 12th and 13th centuries. However, from the descriptions of the events, it is not always clear if the phenomenon was a tornado, waterspout, dust swirl, or if it was of a non-tornadic nature. From the 14th to 19th centuries, tornado records are rather scarce for the region. However, this is likely to have a non-meteorological explanation. Gregor Mendel's (1871) essay " Die Windhose vom 13. October 1870" can be considered as a distinctive "breakpoint" in the documentation history of tornadoes in the territory of the present Czech Republic, followed later by the work of Edler von Wahlburg [Das Wetter 28 (1911) 135] and Wegener [Wind-und-Wasserhosen in Europa. F. Vieweg & Sohn, Braunschweig, 1917]. During the "socialist" period, the term " tornado" was seldom used and they were poorly understood, producing a view that "tornadoes do not occur in Central Europe". The situation began to change with the works of Munzar [Tromby (tonáda) na území Èeské republiky v letech 1119-1993. Zborník Dejin Fyziky, vol. XI. Voj. Akadémia SNP, Liptovský Mikuláš, pp. 69-72, 1993 (in Czech)] and Šálek [Meteorol. Zpr. 47 (1994) 172], and new records showed that about one tornado per year occurred between 1994 and 1999. Finally, between 2000 and 2002, the number of documented tornadoes in the Czech Republic was five to eight cases per year.

Investigation of Arctic mixed-phase clouds by combining airborne remote sensing and in situ observations during VERDI, RACEPAC and ACLOUD

NASA Astrophysics Data System (ADS)

Ehrlich, André; Bierwirth, Eike; Borrmann, Stephan; Crewell, Susanne; Herber, Andreas; Hoor, Peter; Jourdan, Olivier; Krämer, Martina; Lüpkes, Christof; Mertes, Stephan; Neuber, Roland; Petzold, Andreas; Schnaiter, Martin; Schneider, Johannes; Weigel, Ralf; Weinzierl, Bernadett; Wendisch, Manfred

2016-04-01

To improve our understanding of Arctic mixed-phase clouds a series of airborne research campaigns has been initiated by a collaboration of German research institutes. Clouds in areas dominated by a close sea-ice cover were observed during the research campaign Vertical distribution of ice in Arctic mixed-phase clouds (VERDI, April/May 2012) and the Radiation-Aerosol-Cloud Experiment in the Arctic Circle (RACEPAC, April/May 2014) which both were based in Inuvik, Canada. The aircraft (Polar 5 & 6, Basler BT-67) operated by the Alfred Wegener Institute for Polar and Marine Research, Germany did cover a wide area above the Canadian Beaufort with in total 149 flight hours (62h during VERDI, 87h during RACEPAC). For May/June 2017 a third campaign ACLOUD (Arctic Clouds - Characterization of Ice, aerosol Particles and Energy fluxes) with base in Svalbard is planned within the Transregional Collaborative Research Centre TR 172 ArctiC Amplification: Climate Relevant Atmospheric and SurfaCe Processes, and Feedback Mechanisms (AC)3 to investigate Arctic clouds in the transition zone between open ocean and sea ice. The aim of all campaigns is to combine remote sensing and in-situ cloud, aerosol and trace gas measurements to investigate interactions between radiation, cloud and aerosol particles. While during VERDI remote sensing and in-situ measurements were performed by one aircraft subsequently, for RACEPAC and ACLOUD two identical aircraft are coordinated at different altitudes to horizontally collocate both remote sensing and in-situ measurements. The campaign showed that in this way radiative and microphysical processes in the clouds can by studied more reliably and remote sensing methods can be validated efficiently. Here we will illustrate the scientific strategy of the projects including the progress in instrumentation. Differences in the general synoptic and sea ice situation and related changes in cloud properties at the different locations and seasons will be addressed to illustrate the broad spectrum of the observations. Exemplary results will be highlighted.

SysSon: A Sonification Platform for Climate Data

NASA Astrophysics Data System (ADS)

Visda, Goudarzi; Hanns Holger, Rutz; Katharina, Vogt

2014-05-01

Climate data provide a challenging working basis for sonification. Both model data and measured data are assessed in collaboration with the Wegener Center for Climate and Global Change. The multi dimensionality and multi variety of climate data has a great potential for auditory displays. Furthermore, there is consensus on global climate change and the necessity of intensified climate research today in the scientific community and general public. Sonification provides a new means to communicate scientific results and inform a wider audience. SysSon is a user centered auditory platform for climate scientists to analyze data. It gives scientists broader insights by extracting hidden patterns and features from data that is not possible using a single modal visual interface. A variety of soundscapes to chose from lessens the fatigue that comes with repeated and sustained listening to long streams of data. Initial needs assessments and user tests made the work procedures and the terminology of climate scientists clear and informed the architecture of our system. Furthermore, experiments evaluated the sound design which led to a more advanced soundscape and improvement of the auditory display. We present a novel interactive sonification tool which combines a workspace for the scientists with a development environment for sonification models. The tool runs on different operating systems and is released as open source. In the standalone desktop application, multiple data sources can be imported, navigated and manipulated either via text or a graphical interface, including traditional plotting facilities. Sound models are built from unit generator graphs which are enhanced with matrix manipulation functions. They allow us to systematically experiment with elements known from the visual domain, such as range selections, scaling, thresholding, markers and labels. The models are organized in an extensible library, from which the user can choose and parametrize. Importance is given to the persistence of all configurations, in order to faithfully reproduce sonification instances. Finally, the platform is prepared to allow the composition of interactive sound installations, transitioning between the scientific lab and the gallery space.

The Multidisciplinary drifting Observatory for the Study of Arctic Climate (MOSAiC)

NASA Astrophysics Data System (ADS)

Nicolaus, M.; Rex, M.; Dethloff, K.; Shupe, M.; Sommerfeld, A.

2016-12-01

The Multidisciplinary drifting Observatory for the Study of Arctic Climate (MOSAiC) is a key international flagship initiative under the auspices of the International Arctic Science Committee (IASC). The main aim of MOSAiC is to improve our understanding of the functioning of the Arctic coupled system with a complex interplay between processes in the atmosphere, ocean, sea ice and ecosystem coupled through bio-geochemical interactions. The main objective of MOSAiC is to develop a better understanding of these important coupled-system processes so they can be more accurately represented in regional- and global-scale weather- and climate models. Observations covering a full annual cycle over the Arctic Ocean of many critical parameters such as cloud properties, surface energy fluxes, atmospheric aerosols, small-scale sea-ice and oceanic processes, biological feedbacks with the sea-ice ice and ocean, and others have never been made in the central Arctic in all seasons, and certainly not in a coupled system fashion. The main scientific goals focus on data assimilation for numerical weather prediction models, improved sea ice forecasts and climate models, ground truth for satellite remote sensing, energy budget and fluxes through interfaces, sources, sinks and cycles of chemical species, boundary layer processes, habitat conditions and primary productivity and stakeholder services. The MOSAiC Observatory will be deployed in, and drift with, the Arctic sea-ice pack for a full annual cycle, starting in fall 2019 and ending in fall 2020. Initial drift plans are to start in the newly forming fall sea-ice in the East Siberian Sea and follow the Transpolar Drift. The German Alfred Wegener Institute Helmholtz Centre for Polar and Marine Research will made a huge contribution with the icebreaker Polarstern to serve as the central drifting observatory for this year long drift, and the US Department of Energy has committed a comprehensive atmospheric measurement suite. Many other nations and agencies have expressed interest in participation and in gaining access to this unprecedented observational dataset.

[Cardiac involvement in Churg-Strauss syndrome].

PubMed

Brucato, Antonio; Maestroni, Silvia; Masciocco, Gabriella; Ammirati, Enrico; Bonacina, Edgardo; Pedrotti, Patrizia

2015-09-01

Churg-Strauss syndrome, recently renamed eosinophilic granulomatosis with polyangiitis (EGPA), is a rare form of systemic vasculitis, characterized by disseminated necrotizing vasculitis with extravascular granulomas occurring among patients with asthma and tissue eosinophilia. EGPA is classified as a small and medium-sized vessel vasculitis associated with antineutrophil cytoplasmic antibodies (ANCA) and the hypereosinophilic syndrome. Typical clinical features include asthma, sinusitis, transient pulmonary infiltrates and neuropathy. Blood eosinophils are often >1500/µl or more than 10% on the differential leukocyte count. Blood eosinophils should always be tested in unexplained cardiac disorders, and may normalize even after low doses of corticosteroids. ANCA are positive in 40-60% of cases, mainly anti-myeloperoxidase. Heart involvement occurs in approximately 15-60% of EGPA patients, especially those who are ANCA negative. Any cardiac structure can be involved, and patients present with myocarditis, heart failure, pericarditis, arrhythmia, coronary arteritis, valvulopathy, intracavitary cardiac thrombosis. Although cardiovascular involvement is usually an early manifestation, it can also occur later in the course of the disease. A significant proportion of patients with cardiac involvement is asymptomatic. In the absence of symptoms and major ECG abnormalities, cardiac involvement may be detected in nearly 40% of the patients. All patients with EGPA should be studied not only with a detailed history of cardiac symptoms and ECG, but also with echocardiography; if abnormalities are detected, a cardiac magnetic resonance study should be performed. Coronary angiography and endomyocardial biopsy should be reserved to selected cases. Heart involvement carries a poor prognosis and causes 50% of the deaths of these patients. It is often insidious and underestimated. Optimal therapy is therefore important and based on high-dose corticosteroids plus immunosuppressive agents, particularly cyclophosphamide in case of myocardial inflammation. Thus, early diagnosis of cardiac involvement and subsequent therapy may prevent progression of cardiac disease. At present, the role of troponin and brain natriuretic peptide in monitoring and therapy remains unclear. Orthotopic heart transplantation is feasible in case of severe disease, even if the experience is limited in -EGPA, and optimal post-transplantation immunosuppressive strategy has yet to be defined.

Xanthogranulomatous hypophysitis: a rare and often mistaken pituitary lesion

PubMed Central

Gopal-Kothandapani, Jaya Sujatha; Bagga, Veejay; Wharton, Stephen B; Connolly, Daniel J; Sinha, Saurabh

2015-01-01

Summary Xanthogranulomatous hypophysitis (XGH) is a very rare form of pituitary hypophysitis that may present both clinically and radiologically as a neoplastic lesion. It may either be primary with an autoimmune aetiology and can occur in isolation or as a part of autoimmune systemic disease or secondary as a reactive degenerative response to an epithelial lesion (e.g. craniopharyngioma (CP), Rathke's cleft cyst, germinoma and pituitary adenomas) or as a part of a multiorgan systemic involvement such as tuberculosis, sarcoidosis or granulomatosis. It may also present with a variation of symptoms in children and adults. Our case series compares the paediatric and adult presentations of XGH and the differential diagnoses considered in one child and two adult patients, highlighting the wide spectrum of this condition. Endocrine investigations suggested panhypopituitarism in all three patients and imaging revealed a suprasellar mass compressing the optic chiasm suggestive of CP or Rathke's cleft cyst in one patient and non-functioning pituitary macroadenoma in two patients. Magnetic resonance imaging (MRI) demonstrated mixed signal intensities on T1- and T2-weighted sequences. Following endoscopic transsphenoidal surgery, histological analysis revealed necrotic material with a xanthogranulomatous reaction confirming XGH in two patients and a necrobiotic granulomatous chronic inflammatory infiltrate with neutrophils in one patient, which is not typical of current descriptions of this disorder. This case series describes the wide spectrum of XGH disease that is yet to be defined. Mixed signal intensities on T1- and T2-weighted MRI sequences may indicate XGH and diagnosis is confirmed by histology. Histological variation may indicate an underlying systemic process. Learning points XGH is a rare form of pituitary hypophysitis with a wide clinical and histological spectrum and can mimic a neoplastic lesion.XGH primarily presents with growth arrest in children and pubertal arrest in adolescents. In adults, the presentation may vary.A combination of hypopituitarism and mixed signal intensity lesion on MRI is suggestive of XGH and should be considered in the differential diagnosis of sellar lesions.Radical surgery is the treatment of choice and carries an excellent prognosis with no recurrence. PMID:25759759

Diabetes insipidus.

PubMed

Leroy, Clara; Karrouz, Wassila; Douillard, Claire; Do Cao, Christine; Cortet, Christine; Wémeau, Jean-Louis; Vantyghem, Marie-Christine

2013-12-01

Diabetes insipidus (DI) is characterized by hypotonic polyuria greater than 3 liters/24 hours in adults and persisting even during water deprivation. It is mostly due to a defect in arginin-vasopressin (AVP) synthesis (central DI); other causes are: AVP resistance (nephrogenic DI), abnormal thirst regulation (primary polydipsia) or early destruction of AVP by placental enzymes (gestational DI). A thorough medical history is warranted to investigate nocturnal persistence of polyuria (night waking being a good sign of its organic nature) to specify the onset and duration of the trouble, the medication use and the potential hereditary nature of the disorder. The next step is based on weight and blood pressure measurements and especially the quantification of beverages and diuresis over a 24-hour cycle. Assessment of signs of dehydration, bladder distention, pituitary hormone hyper- or hyposecretion, tumor chiasmatic syndrome, granulomatosis and cancer is required. The diagnosis is based on biological assessment, pituitary magnetic resonance imaging (MRI) and results of a desmopressin test. In severe forms of DI, urine osmolality remains below 250 mOsmol/kg and serum sodium greater than 145 mmol/L. In partial forms of DI (urine osmolality between 250 and 750), the water deprivation test demonstrating the incapacity to obtain a maximal urine concentration is valuable, together with vasopressin or copeptin measurement. The pituitary MRI is done to investigate the lack of spontaneous hyperintensity signal in the posterior pituitary, which marks the absence of AVP and supports the diagnosis of central DI rather than primary polydipsia (although not absolute); it can also recognize lesions of the pituitary gland or pituitary stalk. Acquired central DI of sudden onset should suggest a craniopharyngioma or germinoma if it occurs before the age of 30 years, and metastasis after the age of 50 years. Fifteen to 20% of head trauma lead to hypopituitarism, including DI in 2% of cases. Transient or permanent DI is present in 8-9% of endoscopic transphenoidal surgeries. Current advances in DI concern the etiological work-up, with in particular the identification of IgG4-related hypophysitis or many genetic abnormalities, opening the field of targeted therapies in the years to come. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

Compatibility of the totally replaced hip. Reduction of wear by amorphous diamond coating.

PubMed

Santavirta, Seppo

2003-12-01

Particulate wear debris in totally replaced hips causes adverse local host reactions. The extreme form of such a reaction, aggressive granulomatosis, was found to be a distinct condition and different from simple aseptic loosening. Reactive and adaptive tissues around the totally replaced hip were made of proliferation of local fibroblast like cells and activated macrophages. Methylmethacrylate and high-molecular-weight polyethylene were shown to be essentially immunologically inert implant materials, but in small particulate form functioned as cellular irritants initiating local biological reactions leading to loosening of the implants. Chromium-cobalt-molybdenum is the most popular metallic implant material; it is hard and tough, and the bearings of this metal are partially self-polishing. In total hip implants, prerequisites for longevity of the replaced hip are good biocompatibility of the materials and sufficient tribological properties of the bearings. The third key issue is that the bearing must minimize frictional shear at the prosthetic bone-implant interface to be compatible with long-term survival. Some of the approaches to meet these demands are alumina-on-alumina and metal-on-metal designs, as well as the use of highly crosslinked polyethylene for the acetabular component. In order to avoid the wear-based deleterious properties of the conventional total hip prosthesis materials or coatings, the present work included biological and tribological testing of amorphous diamond. Previous experiments had demonstrated that a high adhesion of tetrahedral amorphous carbon coatings to a substrate can be achieved by using mixing layers or interlayers. Amorphous diamond was found to be biologically inert, and simulator testing indicated excellent wear properties for conventional total hip prostheses, in which either the ball or both bearing surfaces were coated with hydrogen-free tetrahedral amorphous diamond films. Simulator testing with such total hip prostheses showed no measurable wear or detectable delamination after 15,000,000 test cycles corresponding to 15 years of clinical use. The present work clearly shows that wear is one of the basic problems with totally replaced hips. Diamond coating of the bearing surfaces appears to be an attractive solution to improve longevity of the totally replaced hip.

Experience With Direct-to-Patient Recruitment for Enrollment Into a Clinical Trial in a Rare Disease: A Web-Based Study.

PubMed

Krischer, Jeffrey; Cronholm, Peter F; Burroughs, Cristina; McAlear, Carol A; Borchin, Renee; Easley, Ebony; Davis, Trocon; Kullman, Joyce; Carette, Simon; Khalidi, Nader; Koening, Curry; Langford, Carol A; Monach, Paul; Moreland, Larry; Pagnoux, Christian; Specks, Ulrich; Sreih, Antoine G; Ytterberg, Steven; Merkel, Peter A

2017-02-28

The target sample size for clinical trials often necessitates a multicenter (center of excellence, CoE) approach with associated added complexity, cost, and regulatory requirements. Alternative recruitment strategies need to be tested against this standard model. The aim of our study was to test whether a Web-based direct recruitment approach (patient-centric, PC) using social marketing strategies provides a viable option to the CoE recruitment method. PC recruitment and Web-based informed consent was compared with CoE recruitment for a randomized controlled trial (RCT) of continuing versus stopping low-dose prednisone for maintenance of remission of patients with granulomatosis with polyangiitis (GPA). The PC approach was not as successful as the CoE approach. Enrollment of those confirmed eligible by their physician was 10 of 13 (77%) and 49 of 51 (96%) in the PC and CoE arms, respectively (P=.05). The two approaches were not significantly different in terms of eligibility with 34% of potential participants in the CoE found to be ineligible as compared with 22% in the PC arm (P=.11) nor in provider acceptance, 22% versus 26% (P=.78). There was no difference in the understanding of the trial as reflected in the knowledge surveys of individuals in the PC and CoE arms. PC recruitment was substantially less successful than that achieved by the CoE approach. However, the PC approach was good at confirming eligibility and was as acceptable to providers and as understandable to patients as the CoE approach. The PC approach should be evaluated in other clinical settings to get a better sense of its potential. ©Jeffrey Krischer, Peter F Cronholm, Cristina Burroughs, Carol A McAlear, Renee Borchin, Ebony Easley, Trocon Davis, Joyce Kullman, Simon Carette, Nader Khalidi, Curry Koening, Carol A Langford, Paul Monach, Larry Moreland, Christian Pagnoux, Ulrich Specks, Antoine G Sreih, Steven Ytterberg, Peter A Merkel, Vasculitis Clinical Research Consortium. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 28.02.2017.

PXD101 and 17-N-Allylamino-17-Demethoxygeldanamycin in Treating Patients With Metastatic or Unresectable Solid Tumors or Lymphoma

ClinicalTrials.gov

2013-05-15

Adult Nasal Type Extranodal NK/T-cell Lymphoma; Anaplastic Large Cell Lymphoma; Angioimmunoblastic T-cell Lymphoma; Extranodal Marginal Zone B-cell Lymphoma of Mucosa-associated Lymphoid Tissue; Intraocular Lymphoma; Nodal Marginal Zone B-cell Lymphoma; Post-transplant Lymphoproliferative Disorder; Recurrent Adult Burkitt Lymphoma; Recurrent Adult Diffuse Large Cell Lymphoma; Recurrent Adult Diffuse Mixed Cell Lymphoma; Recurrent Adult Diffuse Small Cleaved Cell Lymphoma; Recurrent Adult Grade III Lymphomatoid Granulomatosis; Recurrent Adult Hodgkin Lymphoma; Recurrent Adult Immunoblastic Large Cell Lymphoma; Recurrent Adult Lymphoblastic Lymphoma; Recurrent Adult T-cell Leukemia/Lymphoma; Recurrent Cutaneous T-cell Non-Hodgkin Lymphoma; Recurrent Grade 1 Follicular Lymphoma; Recurrent Grade 2 Follicular Lymphoma; Recurrent Grade 3 Follicular Lymphoma; Recurrent Mantle Cell Lymphoma; Recurrent Marginal Zone Lymphoma; Recurrent Mycosis Fungoides/Sezary Syndrome; Recurrent Small Lymphocytic Lymphoma; Small Intestine Lymphoma; Splenic Marginal Zone Lymphoma; Stage III Adult Burkitt Lymphoma; Stage III Adult Diffuse Large Cell Lymphoma; Stage III Adult Diffuse Mixed Cell Lymphoma; Stage III Adult Diffuse Small Cleaved Cell Lymphoma; Stage III Adult Hodgkin Lymphoma; Stage III Adult Immunoblastic Large Cell Lymphoma; Stage III Adult Lymphoblastic Lymphoma; Stage III Adult T-cell Leukemia/Lymphoma; Stage III Cutaneous T-cell Non-Hodgkin Lymphoma; Stage III Grade 1 Follicular Lymphoma; Stage III Grade 2 Follicular Lymphoma; Stage III Grade 3 Follicular Lymphoma; Stage III Mantle Cell Lymphoma; Stage III Marginal Zone Lymphoma; Stage III Mycosis Fungoides/Sezary Syndrome; Stage III Small Lymphocytic Lymphoma; Stage IV Adult Burkitt Lymphoma; Stage IV Adult Diffuse Large Cell Lymphoma; Stage IV Adult Diffuse Mixed Cell Lymphoma; Stage IV Adult Diffuse Small Cleaved Cell Lymphoma; Stage IV Adult Hodgkin Lymphoma; Stage IV Adult Immunoblastic Large Cell Lymphoma; Stage IV Adult Lymphoblastic Lymphoma; Stage IV Adult T-cell Leukemia/Lymphoma; Stage IV Cutaneous T-cell Non-Hodgkin Lymphoma; Stage IV Grade 1 Follicular Lymphoma; Stage IV Grade 2 Follicular Lymphoma; Stage IV Grade 3 Follicular Lymphoma; Stage IV Mantle Cell Lymphoma; Stage IV Marginal Zone Lymphoma; Stage IV Mycosis Fungoides/Sezary Syndrome; Stage IV Small Lymphocytic Lymphoma; Unspecified Adult Solid Tumor, Protocol Specific; Waldenström Macroglobulinemia

Graduate training in Earth science across borders and disciplines: ArcTrain -"Processes and impacts of climate change in the North Atlantic Ocean and the Canadian Arctic"

NASA Astrophysics Data System (ADS)

Stein, Rüdiger; Kucera, Michal; Walter, Maren; de Vernal, Anne

2015-04-01

Due to a complex set of feedback processes collectively known as "polar amplification", the Arctic realm is expected to experience a greater-than-average response to global climate forcing. The cascades of feedback processes that connect the Arctic cryosphere, ocean and atmosphere remain incompletely constrained by observations and theory and are difficult to simulate in climate models. Our capacity to predict the future of the region and assess the impacts of Arctic change processes on global and regional environments hinges on the availability of interdisciplinary experts with strong international experience and understanding of the science/society interface. This is the basis of the International Research Training Group "Processes and impacts of climate change in the North Atlantic Ocean and the Canadian Arctic - ArcTrain", which was initiated in 2013. ArcTrain aims to educate PhD students in an interdisciplinary environment that combines paleoclimatology, physical oceanography, remote sensing and glaciology with comprehensive Earth system modelling, including sea-ice and ice-sheet components. The qualification program for the PhD students includes joint supervision, mandatory research residences at partner institutions, field courses on land and on sea (Floating University), annual meetings and training workshops and a challenging structured training in expert skills and transferrable skills. Its aim is to enhance the career prospects and employability of the graduates in a challenging international job market across academic and applied sectors. ArcTrain is a collaborative project at the University of Bremen and the Alfred Wegener Institute for Polar and Marine Research in Bremerhaven. The German part of the project is designed to continue for nine years and educate three cohorts of twelve PhD students each. The Canadian partners comprise a consortium of eight universities led by the GEOTOP cluster at the Université du Québec à Montréal and including Dalhousie University, McGill University, Memorial University of Newfoundland, University of Alberta, University of British Columbia, University of Calgary and Université du Québec à Rimouski. Further details about ArcTrain are available at: https://www.marum.de/ArcTrain.html

Observations and Model Simulations of Orographic Mixed-Phase Clouds at Mountain Range Site

NASA Astrophysics Data System (ADS)

Lohmann, U.; Henneberg, O. C.; Henneberger, J.

2014-12-01

Aerosol-cloud interactions constitute the highest uncertainties in forcing estimation. Especially uncertainties due to mixed clouds (MPCs) have a large impact on the radiative balance and precipitation prediction. Due to Wegener-Bergeron-Findeisen-process (WBF) which describes glaciation of MPCs due to the lower saturation over ice than over water, MPCs are mostly expected as short lived clouds. In contrast to the theory of the WBF, in-situ measurements have shown that MPCs can persist over longer time. But only a small number of measurements of MPCs is available. In addition modeling studies about MPCs are difficult as their processes of the three-phase-system are on the micro scale and therefore not resolved in models. We present measurements obtained at the high-altitude research station Jungfraujoch (JFJ, 3580 m asl) in the Swiss Alps partly taken during the CLoud-Aerosol Interaction Experiments (CLACE). During the winter season, the JFJ has a high frequency of super-cooled clouds and is considered representative for being in the free troposphere. In-situ measurements of the microstructure of MPCs have been obtained with the digital imager HOLIMO, that delivers phase-resolved size distributions, concentrations, and water contents. The data set of MPCs at JFJ shows that for northerly wind cases partially-glaciated MPCs are more frequently observed than for southerly wind cases. The higher frequency of these intermediate states of MPCs suggests either higher updraft velocities, and therefore higher water-vapor supersaturations, or the absence of sufficiently high IN concentrations to quickly glaciate the MPC. Because of the limitation of in-situ information, i.e. point measurements and missing measurements of vertical velocities at JFJ, the mechanism of the long persistence of MPCs cannot be fully understood. Therefore, in addition to measurements we will investigate the JFJ region with a model study with the non-hydrostatic model COSMO-ART-M7. Combination of km-scale simulation with measurements allows to systematically study the effect of vertical velocity and temperatures on MPCs at JFJ, the synoptic conditions, origins of air masses, aerosol and IN concentrations. Comparison between in-situ measurements will also help to improve parametrization of microphysical processes in the model.

Constraining Aerosol-Cloud-Precipitation Interactions of Orographic Mixed-Phase Clouds with Trajectory Budgets

NASA Astrophysics Data System (ADS)

Glassmeier, F.; Lohmann, U.

2016-12-01

Orographic precipitation is prone to strong aerosol-cloud-precipitation interactions because the time for precipitation development is limited to the ascending section of mountain flow. At the same time, cloud microphysical development is constraint by the strong dynamical forcing of the orography. In this contribution, we discuss how changes in the amount and composition of droplet- and ice-forming aerosols influence precipitation in idealized simulations of stratiform orographic mixed-phase clouds. We find that aerosol perturbations trigger compensating responses of different precipitation formation pathways. The effect of aerosols is thus buffered. We explain this buffering by the requirement to fulfill aerosol-independent dynamical constraints. For our simulations, we use the regional atmospheric model COSMO-ART-M7 in a 2D setup with a bell-shaped mountain. The model is coupled to a 2-moment warm and cold cloud microphysics scheme. Activation and freezing rates are parameterized based on prescribed aerosol fields that are varied in number, size and composition. Our analysis is based on the budget of droplet water along trajectories of cloud parcels. The budget equates condensation as source term with precipitation formation from autoconversion, accretion, riming and the Wegener-Bergeron-Findeisen process as sink terms. Condensation, and consequently precipitation formation, is determined by dynamics and largely independent of the aerosol conditions. An aerosol-induced change in the number of droplets or crystals perturbs the droplet budget by affecting precipitation formation processes. We observe that this perturbation triggers adjustments in liquid and ice water content that re-equilibrate the budget. As an example, an increase in crystal number triggers a stronger glaciation of the cloud and redistributes precipitation formation from collision-coalescence to riming and from riming to vapor deposition. We theoretically confirm the dominant effect of water content adjustments over number changes by estimating susceptibilities d ln P / d ln N of precipitation formation P to droplet or crystal number N from the budget equation. The susceptibility analysis also reveals that aerosol perturbations to droplet and crystal number compensate each other.

Classification of Arctic, Mid-Latitude and Tropical Clouds in the Mixed-Phase Temperature Regime

NASA Astrophysics Data System (ADS)

Costa, Anja; Afchine, Armin; Luebke, Anna; Meyer, Jessica; Dorsey, James R.; Gallagher, Martin W.; Ehrlich, André; Wendisch, Manfred; Krämer, Martina

2016-04-01

The degree of glaciation and the sizes and habits of ice particles formed in mixed-phase clouds remain not fully understood. However, these properties define the mixed clouds' radiative impact on the Earth's climate and thus a correct representation of this cloud type in global climate models is of importance for an improved certainty of climate predictions. This study focuses on the occurrence and characteristics of two types of clouds in the mixed-phase temperature regime (238-275K): coexistence clouds (Coex), in which both liquid drops and ice crystals exist, and fully glaciated clouds that develop in the Wegener-Bergeron-Findeisen regime (WBF clouds). We present an extensive dataset obtained by the Cloud and Aerosol Particle Spectrometer NIXE-CAPS, covering Arctic, mid-latitude and tropical regions. In total, we spent 45.2 hours within clouds in the mixed-phase temperature regime during five field campaigns (Arctic: VERDI, 2012 and RACEPAC, 2014 - Northern Canada; mid-latitude: COALESC, 2011 - UK and ML-Cirrus, 2014 - central Europe; tropics: ACRIDICON, 2014 - Brazil). We show that WBF and Coex clouds can be identified via cloud particle size distributions. The classified datasets are used to analyse temperature dependences of both cloud types as well as range and frequencies of cloud particle concentrations and sizes. One result is that Coex clouds containing supercooled liquid drops are found down to temperatures of -40 deg C only in tropical mixed clouds, while in the Arctic and mid-latitudes no liquid drops are observed below about -20 deg C. In addition, we show that the cloud particles' aspherical fractions - derived from polarization signatures of particles with diameters between 20 and 50 micrometers - differ significantly between WBF and Coex clouds. In Coex clouds, the aspherical fraction of cloud particles is generally very low, but increases with decreasing temperature. In WBF clouds, where all cloud particles are ice, about 20-40% of the cloud particles are nevertheless classified as spherical for all temperatures, possibly indicating columnar ice crystals (see Järvinen et al, submitted to JAS 2016).

Vertical distribution of microphysical properties of Arctic springtime low-level mixed-phase clouds over the Greenland and Norwegian seas

NASA Astrophysics Data System (ADS)

Mioche, Guillaume; Jourdan, Olivier; Delanoë, Julien; Gourbeyre, Christophe; Febvre, Guy; Dupuy, Régis; Monier, Marie; Szczap, Frédéric; Schwarzenboeck, Alfons; Gayet, Jean-François

2017-10-01

This study aims to characterize the microphysical and optical properties of ice crystals and supercooled liquid droplets within low-level Arctic mixed-phase clouds (MPCs). We compiled and analyzed cloud in situ measurements from four airborne spring campaigns (representing 18 flights and 71 vertical profiles in MPCs) over the Greenland and Norwegian seas mainly in the vicinity of the Svalbard archipelago. Cloud phase discrimination and representative vertical profiles of the number, size, mass and shape of ice crystals and liquid droplets are established. The results show that the liquid phase dominates the upper part of the MPCs. High concentrations (120 cm-3 on average) of small droplets (mean values of 15 µm), with an averaged liquid water content (LWC) of 0.2 g m-3 are measured at cloud top. The ice phase dominates the microphysical properties in the lower part of the cloud and beneath it in the precipitation region (mean values of 100 µm, 3 L-1 and 0.025 g m-3 for diameter, particle concentration and ice water content (IWC), respectively). The analysis of the ice crystal morphology shows that the majority of ice particles are irregularly shaped or rimed particles; the prevailing regular habits found are stellars and plates. We hypothesize that riming and diffusional growth processes, including the Wegener-Bergeron-Findeisen (WBF) mechanism, are the main growth mechanisms involved in the observed MPCs. The impact of larger-scale meteorological conditions on the vertical profiles of MPC properties was also investigated. Large values of LWC and high concentration of smaller droplets are possibly linked to polluted situations and air mass origins from the south, which can lead to very low values of ice crystal size and IWC. On the contrary, clean situations with low temperatures exhibit larger values of ice crystal size and IWC. Several parameterizations relevant for remote sensing or modeling studies are also determined, such as IWC (and LWC) - extinction relationship, ice and liquid integrated water paths, ice concentration and liquid water fraction according to temperature.

Towards evaluating the intensity of convective systems by using GPS radio occultation profiles

NASA Astrophysics Data System (ADS)

Biondi, Riccardo; Steiner, Andrea K.; Kirchengast, Gottfried

2015-04-01

Deep convective systems, also more casually often just called storms, are destructive weather phenomena causing every year many deaths, injuries and damages and accounting for major economic losses in several countries. The number and intensity of such phenomena increased over the last decades in some areas of the globe, including Europe. Damages are mostly caused by strong winds and heavy rain and these parameters are strongly connected to the structure of the storm. Convection over land is usually stronger and deeper than over the ocean and some convective systems, known as supercells, also develop tornadoes through processes which are still mostly unclear. The intensity forecast and monitoring of convective systems is one of the major challenges for meteorology because in-situ measurements during extreme events are too sparse or not reliable and most ongoing satellite missions do not provide suitable time/space coverage. With this study we propose a new method for detecting the convection intensity in terms of rain rate and surface wind speed by using meteorological surface measurements in combination with atmospheric profiles from Global Positioning System (GPS) radio occultation observations, which are available in essentially all weather conditions and with global coverage. The analysis of models indicated a relationship between the cloud top altitude and the intensity of a storm. We thus use GPS radio occultation bending angle profiles for detecting the storm's cloud top altitude and we correlate this value to the rain rate and wind speed measured by meteorological station networks in two different regions, the WegenerNet climate station network (South-Eastern Styria, Austria) and the Atmospheric Radiation Measurement site (ARM, Southern Great Plains, USA), respectively. The results show a good correlation between the cloud top altitude and the maximum rain rate in the monitored areas, while this is not found for maximum wind speed. We conclude from this initial study that for land convective systems the cloud top altitude is strongly connected to the rain intensity and that GPS radio occultation observations show encouraging potential to improve the intensity nowcasting and detection of such kind of severe weather phenomena.

From the scala naturae to the symbiogenetic and dynamic tree of life.

PubMed

Kutschera, Ulrich

2011-06-30

All living beings on Earth, from bacteria to humans, are connected through descent from common ancestors and represent the summation of their corresponding, ca. 3500 million year long evolutionary history. However, the evolution of phenotypic features is not predictable, and biologists no longer use terms such as "primitive" or "perfect organisms". Despite these insights, the Bible-based concept of the so-called "ladder of life" or Scala Naturae, i.e., the idea that all living beings can be viewed as representing various degrees of "perfection", with humans at the very top of this biological hierarchy, was popular among naturalists until ca. 1850 (Charles Bonnet, Jean Lamarck and others). Charles Darwin is usually credited with the establishment of a branched evolutionary "Tree of Life". This insight of 1859 was based on his now firmly corroborated proposals of common ancestry and natural selection. In this article I argue that Darwin was still influenced by "ladder thinking", a theological view that prevailed throughout the 19th century and is also part of Ernst Haeckel's famous Oak tree (of Life) of 1866, which is, like Darwin's scheme, static. In 1910, Constantin Mereschkowsky proposed an alternative, "anti-selectionist" concept of biological evolution, which became known as the symbiogenesis-theory. According to the symbiogenesis-scenario, eukaryotic cells evolved on a static Earth from archaic prokaryotes via the fusion and subsequent cooperation of certain microbes. In 1929, Alfred Wegener published his theory of continental drift, which was later corroborated, modified and extended. The resulting theory of plate tectonics is now the principal organizing concept of geology. Over millions of years, plate tectonics and hence the "dynamic Earth" has caused destructive volcanic eruptions and earthquakes. At the same time, it created mountain ranges, deep oceans, novel freshwater habitats, and deserts. As a result, these geologic processes destroyed numerous populations of organisms, and produced the environmental conditions for new species of animals, plants and microbes to adapt and evolve. In this article I propose a tree-like "symbiogenesis, natural selection, and dynamic Earth (synade)-model" of macroevolution that is based on these novel facts and data.

The First Paleomagnetic Polar Wander Path

NASA Astrophysics Data System (ADS)

Creer, K. M.

2004-12-01

At the end of 1952, having completed my work on the Cambridge astatic magnetometer, I was motivated to embark on a "Preliminary Paleomagnetic Survey of Rocks from the British Isles" by exciting results obtained by two fellow research students:- Jan Hospers' proposal of the axial dipole hypothesis and Ted Irving's discovery of strongly oblique Pre-Cambrian paleomagnetic directions, substantiated by the oblique Triassic directions obtained by John Clegg's group. Geologists advised me to collect from palaeontologically well dated rock formations. But these turned out to be very weakly magnetized and thereafter I concentrated on purple and dark red coloured rock formations. By the end of July 1954 I had compiled a table of nine Period-mean paleomagnetic directions spanning the last 600 Myr. I passed a copy to Keith Runcorn to include in a talk (co-authors Creer and Irving) scheduled for the August 1954 Rome Assembly of IAGA. Meanwhile, background reading took me to Gutenberg's "Internal Constitution of the Earth (1951)" where I came across (Fig 12) paths of the north pole proposed by Kreichgauer (1902) and by Koppen and Wegener (1924). This prompted me to calculate a paleomagnetic polar wander path. I presented this at the Annual Meeting of the British Association for the Advancement of Science held at Oxford on September 8th. An artist's representation of it was published in Time Magazine of September 24th 1954 where the accompanying text records that I stressed that similar work on other continents would be necessary to distinguish whether the continents had drifted independently or whether the sole mechanism had been polar wander. On my return to Cambridge, Maurice Hill informally suggested that I should indicate precision, so for each pole I calculated semi-major and minor axes of the ellipse of confidence corresponding to the radius of confidence of each mean direction. These were shown in my Ph.D. thesis, where also I calculated a paleomagnetic pole for John Graham's North American Silurian Rose Hill Formation and argued tentatively that it's location, somewhat to the east of the British Silurian pole, is qualitatively consistent withWegnerian drift.

P-wave velocity models of continental shelf of East Siberian Sea using the Laplace-domain full waveform inversion

NASA Astrophysics Data System (ADS)

Kang, S. G.; Hong, J. K.; Jin, Y. K.; Jang, U.; Niessen, F.; Baranov, B.

2017-12-01

2016 IBRV ARAON Arctic Cruise Leg-2, Expedition ARA07C was a multidisciplinary undertaking carried out in the East Siberian Sea (ESS) from August 25 to September 10, 2016. The program was conducted as a collaboration between the Korea Polar Research Institute (KOPRI), P.P. Shirshov Institute of Oceanology (IORAS), and Alfred Wegener Institute (AWI). During this expedition, the multi-channel seismic (MCS) data were acquired on the continental shelf and the upper slope of the ESS, totaling 3 lines with 660 line-kilometers. The continental shelf of ESS is one of the widest shelf seas in the world and it is believed to cover the largest area of sub-sea permafrost in the Arctic. According to the present knowledge of the glacial history of the western Arctic Ocean, it is likely that during the LGM with a sea level approximately 120 m below present, the entire shelf area of the ESS was exposed to very cold air temperatures so that thick permafrost should have formed. Indeed, in water depths shallower than 80 m, sub-bottom profiles in the ESS recorded from the shelf edge to a latitude of 74°30' N in 60 m water depth exhibited acoustic facies, suggesting that at least relicts of submarine permafrost are present. In order to identify the existence and/or non-existence of subsea permafrost in our study area, we analyze the MCS data using the Laplace domain full waveform inversion (FWI). In case of the Canadian continental shelf of the Beaufort Sea, subsea permafrost has high seismic velocity values (over 2.6 km/sec) and strong refraction events were found in the MCS shotgathers. However, in the EES our proposed P-wave velocity models derived from FWI have neither found high velocity structures (over 2.6 km/sec) nor indicate strong refraction events by subsea permafrost. Instead, in 300 m depth below sea floor higher P-wave velocity structures (1.8 2.2 km/s) than normal subsea sediment layers were found, which are interpreted as cemented strata by glaciation activities.

Insights into aerosols, chemistry, and clouds from NETCARE: Observations from the Canadian Arctic in summer 2014

NASA Astrophysics Data System (ADS)

Abbatt, J.

2015-12-01

The Canadian Network on Aerosols and Climate: Addressing Key Uncertainties in Remote Canadian Regions (or NETCARE) was established in 2013 to study the interactions between aerosols, chemistry, clouds and climate. The network brings together Canadian academic and government researchers, along with key international collaborators. Attention is being given to observations and modeling of Arctic aerosol, with the goal to understand underlying processes and so improve predictions of aerosol climate forcing. Motivation to understand the summer Arctic atmosphere comes from the retreat of summer sea ice and associated increase in marine influence. To address these goals, a suite of measurements was conducted from two platforms in summer 2014 in the Canadian Arctic, i.e. an aircraft-based campaign on the Alfred Wegener Institute POLAR 6 and an ocean-based campaign from the CGCS Amundsen icebreaker. NETCARE-POLAR was based out of Resolute Bay, Nunavut during an initial period of little transport and cloud-free conditions and a later period characterized by more transport with potentially biomass burning influence. Measurements included particle and cloud droplet numbers and size distributions, aerosol composition, cloud nuclei, and levels of gaseous tracers. Ultrafine particle events were more frequently observed in the marine boundary layer than above, with particle growth observed in some cases to cloud condensation nucleus sizes. The influence of biological processes on atmospheric constituents was also assessed from the ship during NETCARE-AMUNDSEN, as indicated by high measured levels of gaseous ammonia, DMS and oxygenated VOCs, as well as isolated particle formation and growth episodes. The cruise took place in Baffin Bay and through the Canadian archipelago. Interpretation of the observations from both campaigns is enhanced through the use of chemical transport and particle dispersion models. This talk will provide an overview of NETCARE Arctic observational and related modeling activities, focusing on 2014 Arctic activities and highlighting upcoming presentations within the session and the work of individual research teams. An attempt will be made to synthesize the observations and model results, drawing connections of aerosol sources through to cloud formation and deposition processes.

Spatio Temporal Variability of the Global Transmittance During the Arctic POLARSTERN Expedition 106/1 Ice Floe Station

NASA Astrophysics Data System (ADS)

Barrientos Velasco, C.; Macke, A.; Griesche, H.; Engelmann, R.; Deneke, H.; Seifert, P.

2017-12-01

The Arctic is warming at a higher rate than the rest of the planet. This has been leading to a dramatically decrease of snow coverage and sea ice thickness in recent years and several studies have suggested that a similar trend is expected in the upcoming years. Large uncertainties in predicting the Arctic climate arise from our lack of understanding the role clouds play in sea ice / atmosphere interaction. During summer the shortwave radiation dominates and clouds have a net cooling effect at the surface. The strength of this cooling critically depends on cloud phase, composition and height. Clouds interactions with aerosols, and its sensitivity to surface properties further complicates their role in the Arctic system. Scattering between the surface and cloud layers amplifies the cloud shortwave contribution, especially over a highly reflective surface such as snow or ice. Therefore, to comprehend how the Arctic's surface is significantly modulated by solar radiation is necessary to more clearly understand the cloud-induced spatio-temporal variability at process relevant scales. Irradiance variability may also have an effect on the biological productivity of various plankton species below the ice. The present study provides an overview of spatio-temporal variability at spatial scales ranging from several decameters to 1 kilometer of the global transmittance derived from 15 pyranometer stations installed at an ice floe station (June 4-16 2017) during the POLARSTERN expedition PS106/1. Specific irradiance statistics under clear sky, broken clouds and overcast conditions will be described considering the combination of a Cloud Radar Mira 35 and a Polly Raman polarization Lidar. Ultimately, radiative closure studies will be performed to quantify our abilities to reproduce realistic cloud solar radiative forcing under Arctic conditions. Acknowledgements. This research is funded by Deutsche Forschunsgemeinschaft (DFG) and involves the active participation of Leibniz Institut für Troposphärenforschung (TROPOS), Universität Leipzig Institut für Meteorologie (LIM), Universitäat Bremen, Universität zu Köln and Alfred-Wegener-Institut, Helmholtz Zentrum für Polar - und Meeresforschung (AWI).

Distribution of late Pleistocene ice-rich syngenetic permafrost of the Yedoma Suite in east and central Siberia, Russia

USGS Publications Warehouse

Grosse, Guido; Robinson, Joel E.; Bryant, Robin; Taylor, Maxwell D.; Harper, William; DeMasi, Amy; Kyker-Snowman, Emily; Veremeeva, Alexandra; Schirrmeister, Lutz; Harden, Jennifer

2013-01-01

This digital database is the product of collaboration between the U.S. Geological Survey, the Geophysical Institute at the University of Alaska, Fairbanks; the Los Altos Hills Foothill College GeoSpatial Technology Certificate Program; the Alfred Wegener Institute for Polar and Marine Research, Potsdam, Germany; and the Institute of Physical Chemical and Biological Problems in Soil Science of the Russian Academy of Sciences. The primary goal for creating this digital database is to enhance current estimates of soil organic carbon stored in deep permafrost, in particular the late Pleistocene syngenetic ice-rich permafrost deposits of the Yedoma Suite. Previous studies estimated that Yedoma deposits cover about 1 million square kilometers of a large region in central and eastern Siberia, but these estimates generally are based on maps with scales smaller than 1:10,000,000. Taking into account this large area, it was estimated that Yedoma may store as much as 500 petagrams of soil organic carbon, a large part of which is vulnerable to thaw and mobilization from thermokarst and erosion. To refine assessments of the spatial distribution of Yedoma deposits, we digitized 11 Russian Quaternary geologic maps. Our study focused on extracting geologic units interpreted by us as late Pleistocene ice-rich syngenetic Yedoma deposits based on lithology, ground ice conditions, stratigraphy, and geomorphological and spatial association. These Yedoma units then were merged into a single data layer across map tiles. The spatial database provides a useful update of the spatial distribution of this deposit for an approximately 2.32 million square kilometers land area in Siberia that will (1) serve as a core database for future refinements of Yedoma distribution in additional regions, and (2) provide a starting point to revise the size of deep but thaw-vulnerable permafrost carbon pools in the Arctic based on surface geology and the distribution of cryolithofacies types at high spatial resolution. However, we recognize that the extent of Yedoma deposits presented in this database is not complete for a global assessment, because Yedoma deposits also occur in the Taymyr lowlands and Chukotka, and in parts of Alaska and northwestern Canada.

Analysis of migrating diurnal tides detected in FORMOSAT-3/COSMIC temperature data

NASA Astrophysics Data System (ADS)

Pirscher, B.; Foelsche, U.; Borsche, M.; Kirchengast, G.; Kuo, Y.-H.

2010-07-01

The characteristics of atmospheric tides in the upper troposphere and lower stratosphere region are investigated using radio occultation (RO) measurements performed by the Formosa Satellite Mission-3/Constellation Observing System for Meteorology, Ionosphere, and Climate (FORMOSAT-3/COSMIC) satellite constellation and compared to tides observed in short-term forecast model fields of European Centre for Medium-Range Weather Forecasts (ECMWF) and National Centers for Environmental Prediction (NCEP). Spectral analysis of 2 years of monthly data (2007 to 2008) yields the migrating diurnal tide to be the largest spectral component. This diurnal tide shows similar temporal, latitudinal, and altitudinal characteristics in all data sets equatorward of 50°. Beyond 50°, COSMIC local time sampling is insufficient within 1 month, which prevents space-time spectral analysis from isolating atmospheric waves. Diurnal tides of temperature are characterized by largest amplitudes in the tropics (0.8 K to 1.0 K at an altitude of 30 km). Amplitudes of diurnal tides analyzed in model data are more pronounced by ˜20%. An annual cycle of the amplitudes, characteristically linked to the movement of the intertropical convergence zone, is clearly revealed. Tropical diurnal phase features downward progression of waves fronts with a vertical wavelength of 20 km. Extratropical diurnal tides are most pronounced in the model data sets with amplitudes of up to 0.5 K at 30 km. In this analysis we also see the influence of high-altitude initialization of RO data by background information in using data processed by two different centers (University Corporation for Atmospheric Research (UCAR) and Wegener Center (WEGC)). UCAR data, initialized by a climatology without tidal information, exhibit no appreciable extratropical diurnal tides, while WEGC data, initialized by ECMWF forecasts, show more pronounced ones. Overall the results underpin the utility of the local-time resolving COSMIC RO constellation data for monitoring diurnal tide dynamics in the stratosphere. The agreement between observational and model data further confirms that the tidal dynamics is appropriately captured in the models, which is important for other (middle/upper) atmosphere models relying on ECMWF or NCEP dynamics.

CarboPerm: An interdisciplinary Russian-German project on the formation, turnover and release of carbon in Siberian permafrost landscapes

NASA Astrophysics Data System (ADS)

Zubrzycki, S.; Bolshiyanov, D.; Eliseev, A. V.; Evgrafova, S.; Fedorova, I.; Glagolev, M.; Grigoriev, M.; Hubberten, H. W.; Knoblauch, C.; Kunitsky, V.; Kutzbach, L.; Reichstein, M.; Rethemeyer, J.; Schirrmeister, L.; Wagner, D.; Zimov, S. A.; Pfeiffer, E.

2013-12-01

Permafrost-affected soils of the northern hemisphere have accumulated large pools of organic carbon (OC) since continuous low temperatures in the permafrost prevented organic carbon decomposition. According to recent estimates these soils contain 1670 Pg of OC, or about 2.5-times the carbon within the global vegetation. Rising arctic temperatures will result in increased permafrost thawing resulting in a mobilization of formerly frozen OC. The degradation of the newly available OC will result in an increased formation of trace gases such as methane and carbon dioxide which can be released to the atmosphere. Rising trace gas concentrations due to permafrost thawing would thereby form a positive feedback on climate warming. CarboPerm, is a joint German-Russian research project funded by the German Federal Ministry of Education and Research. It comprises multi-disciplinary investigations on the formation, turnover and release of OC in Siberian permafrost. It aims to gain increased understanding of how permafrost-affected landscapes will respond to global warming and how this response will influence the local, regional and global trace gas balance. Permafrost scientists from Russia and Germany will work together at different key sites in the Siberian Arctic. These sites are: the coast and islands at the Dmitry Laptev Strait, the Lena River Delta, and the Kolyma lowlands close to Cherskii. The scientific work packages comprise studies on (i) the origin, properties, and dynamics of fossil carbon, (ii) the age and quality of organic matter, (iii) the recent carbon dynamics in permafrost landscapes, (iv) the microbial transformation of organic carbon in permafrost, and (v) process-driven modeling of soil carbon dynamics in permafrost areas. The coordination will be at the University of Hamburg (scientific), the Alfred Wegener Institute, Helmholtz Centre for Polar and Marine Research in Potsdam (logistic) and the Arctic and Antarctic Research Institute in St. Petersburg. CarboPerm will strengthen permafrost research in underrepresented areas which are hardly accessible to international researchers. The obtained results will improve our understanding of the future development of the sensitive and economically relevant arctic permafrost regions.

Numerical Aspects of Nonhydrostatic Implementations Applied to a Parallel Finite Element Tsunami Model

NASA Astrophysics Data System (ADS)

Fuchs, A.; Androsov, A.; Harig, S.; Hiller, W.; Rakowsky, N.

2012-04-01

Based on the jeopardy of devastating tsunamis and the unpredictability of such events, tsunami modelling as part of warning systems is still a contemporary topic. The tsunami group of Alfred Wegener Institute developed the simulation tool TsunAWI as contribution to the Early Warning System in Indonesia. Although the precomputed scenarios for this purpose qualify for satisfying deliverables, the study of further improvements continues. While TsunAWI is governed by the Shallow Water Equations, an extension of the model is based on a nonhydrostatic approach. At the arrival of a tsunami wave in coastal regions with rough bathymetry, the term containing the nonhydrostatic part of pressure, that is neglected in the original hydrostatic model, gains in importance. In consideration of this term, a better approximation of the wave is expected. Differences of hydrostatic and nonhydrostatic model results are contrasted in the standard benchmark problem of a solitary wave runup on a plane beach. The observation data provided by Titov and Synolakis (1995) serves as reference. The nonhydrostatic approach implies a set of equations that are similar to the Shallow Water Equations, so the variation of the code can be implemented on top. However, this additional routines cause a lot of issues you have to cope with. So far the computations of the model were purely explicit. In the nonhydrostatic version the determination of an additional unknown and the solution of a large sparse system of linear equations is necessary. The latter constitutes the lion's share of computing time and memory requirement. Since the corresponding matrix is only symmetric in structure and not in values, an iterative Krylov Subspace Method is used, in particular the restarted Generalized Minimal Residual Algorithm GMRES(m). With regard to optimization, we present a comparison of several combinations of sequential and parallel preconditioning techniques respective number of iterations and setup/application time. Since the used software package pARMS 3.2, that provides solving and preconditioning techniques, works via MPI parallelism, in an auxiliary branch we adapted TsunAWI and switched from OpenMP to MPI with attached importance to internal partition management.

Exploring hydrological uncertainties and thresholds of a drought vulnerable region in Austria

NASA Astrophysics Data System (ADS)

Hohmann, Clara; Kirchengast, Gottfried; Birk, Steffen

2015-04-01

In the region of South-Eastern Styria, Austria, a strong increase of summer temperature over the last decades was recognized by Kabas et. al. (Meteorol. Z./ 20 (3), 277-289, 2011). With climate change the temperature will further increase, so that the possibility for more frequent droughts in summer will rise. This leads to the question if, for example, a steppe climate similar to that in the neighboring Hungarian Pussta can evolve in this region. Drastic climatic changes will be accompanied by strong changes in the hydrological balance. Since the region is strongly influenced by agriculture and other non-climatic factors as well, these human impacts on the water cycle must be considered. The Wegener Center, University of Graz is studying the Raab catchment in South-Eastern Styria, Austria, as an example of a small catchment of the climate-sensitive southern Alpine foothills. The available data indicate that the region is vulnerable to droughts in summer, signalled by a strong temperature increase over the recent decades and a tendency of precipitation decrease. The main goals of this study are to explore how the water balance in the region is going to change in the future, what the most significant uncertainties are and where there might be thresholds towards drastic changes. In this poster we report on the first steps, which is to build up a hydrological model for the Styrian Raab valley based on the Water balance Simulation Model (WaSiM) of ETH Zurich, Switzerland. Within the calibration the focus is on low flow conditions in summer. Given that the model shows good results for the well observed recent decades, a sensitivity analysis for changes in specific (control) parameters of the surface water balance is conducted. This will include anomalies of temperature and precipitation, water use for irrigation, and others. This enables to explore how warmer temperatures or changes in irrigation and crops affect the catchment. Model analyses do not only focus on flow conditions but also on internal variables, such as the soil moisture, which has a significant impact on the water balance and the drought vulnerability of the region.

Amphibian Seismological Studies in the Ross Sea, Antarctica

NASA Astrophysics Data System (ADS)

Schmidt-Aursch, Mechita; Kuk Hong, Jong; Lee, Won Sang; Geissler, Wolfram; Yun, Sukyoung; Gohl, Karsten; Park, Yongcheol; Yoo, Hyun Jae

2016-04-01

The Antarctic Ross Sea is one of the key regions for polar research activities. Research stations from several countries located at the coast are the base for inland expeditions. Even in the austral summer, the Ross Sea is party covered with drifting ice fields; this requires an icebreaker for all marine explorations. Therefore, large geophysical surveys in the Ross Sea are difficult. But the area is of special interest for seismologists: The Terror Rift in the western Ross Sea is a prominent neotectonic structure of the West Antarctic Rift System (WARS). It is located near the coast in the Victoria Land Basin and extends parallel to the Transantarctic Mountains. The rifting processes and the accompanying active onshore volcanism lead to increased seismicity in the region. The annual waxing and waning of the sea-ice and the dynamics of the large Ross Ice Shelf and nearby glaciers generate additional seismic signals. Investigation on seismological activities associated with the WARS and the cryogenic signals simultaneously would give us an unprecedented opportunity to have a better understanding of the Evolution of the WARS (EWARS) and the rapid change in the cryospheric environment nearby. The Korea Polar Research Institute (KOPRI) and the Alfred-Wegener-Institut (AWI) have conducted a pilot study off the Korean Jang Bogo research station in the Terra Nova Bay by developing a collaborative research program (EWARS) since 2011 to explore seismicity and seismic noise in this region. Four broadband ocean-bottom seismometers (OBS) from the German DEPAS pool were deployed in January 2012 with the Korean research icebreaker RV Araon. Three instruments could successfully be recovered after 13 months, the fourth OBS was not accessible due to local sea-ice coverage. We have successfully completed a second recovery operation in January 2014. All stations recorded data of good quality, one station stopped after 8 months due to a recorder error. The OBS recovered in 2014 recorded more than 17 months of data until the batteries were discharged. In this contribution, we present data and first results including temporal variation of seismic ambient noise, receiver functions, local seismicity, and noise correlation functions through examining the OBS data incorporating with the onshore seismic observation data.

Deriving evaluation indicators for knowledge transfer and dialogue processes in the context of climate research

NASA Astrophysics Data System (ADS)

Treffeisen, Renate; Grosfeld, Klaus; Kuhlmann, Franziska

2017-12-01

Knowledge transfer and dialogue processes in the field of climate science have captured intensive attention in recent years as being an important part of research activities. Therefore, the demand and pressure to develop a set of indicators for the evaluation of different activities in this field have increased, too. Research institutes are being asked more and more to build up structures in order to map these activities and, thus, are obliged to demonstrate the success of these efforts. This paper aims to serve as an input to stimulate further reflection on the field of evaluation of knowledge transfer and dialogue processes in the context of climate sciences. The work performed in this paper is embedded in the efforts of the German Helmholtz Association in the research field of earth and environment and is driven by the need to apply suitable indicators for knowledge transfer and dialogue processes in climate research center evaluations. We carry out a comparative analysis of three long-term activities and derive a set of indicators for measuring their output and outcome by balancing the wide diversity and range of activity contents as well as the different tools to realize them. The case examples are based on activities which are part of the regional Helmholtz Climate Initiative Regional Climate Change (REKLIM) and the Climate Office for Polar Regions and Sea Level Rise at the Alfred Wegener Institute Helmholtz Centre for Polar and Marine Research. Both institutional units have been working on a wide range of different knowledge transfer and dialogue processes since 2008/2009. We demonstrate that indicators for the evaluation must be based on the unique objectives of the individual activities and the framework they are embedded in (e.g., research foci which provide the background for the performed knowledge transfer and dialogue processes) but can partly be classified in a principle two-dimensional scheme. This scheme might serve as a usable basis for climate research center evaluation in the future. It, furthermore, underlines the need for further development of proper mechanisms to evaluate scientific centers, in particular with regard to knowledge transfer and dialogue processes.

PANGAEA® - Data Publisher for Earth & Environmental Science - Research data enters scholarly communication and big data analysis

NASA Astrophysics Data System (ADS)

Diepenbroek, Michael; Schindler, Uwe; Riedel, Morris; Huber, Robert

2014-05-01

The ISCU World Data Center PANGAEA is an information system for acquisition, processing, long term storage, and publication of geo-referenced data related to earth science fields. Storing more than 350.000 data sets from all fields of geosciences it belongs to the largest archives for observational earth science data. Standard conform interfaces (ISO, OGC, W3C, OAI) enable access from a variety of data and information portals, among them the search engine of PANGAEA itself ((www.pangaea.de) and e.g. GBIF. All data sets in PANGAEA are citable, fully documented, and can be referenced via persistent identifiers (Digital Object Identifier - DOI) - a premise for data publication. Together with other ICSU World Data Centers (www.icsu-wds.org) and the Technical Information Library in Germany (TIB) PANGAEA had a share in the implementation of a DOI based registry for scientific data, which by now is supported by a worldwide consortium of libraries (www.datacite.org). A further milestone was building up strong co-operations with science publishers as Elsevier, Springer, Wiley, AGU, Nature and others. A common web service allows to reference supplementary data in PANGAEA directly from an articles abstract page (e.g. Science Direct). The next step with science publishers is to further integrate the editorial process for the publication of supplementary data with the publication procedures on the journal side. Data centric research efforts such as environmental modelling or big data analysing approaches represent new challenges for PANGAEA. Integrated data warehouse technologies are used for highly efficient retrievals and compilations of time slices or surface data matrixes on any measurement parameters out of the whole data continuum. Further, new and emerging big data approaches are currently investigated within PANGAEA to e.g. evaluate its usability for quality control or data clustering. PANGAEA is operated as a joint long term facility by MARUM at the University Bremen and the Alfred Wegener Institute for Polar and Marine Research (AWI). More than 80% of the funding results from project data management and the implementation of spatial data infrastructures (more than 160 International to national projects since the last 15 years - www.pangaea.de/projects).

Public understanding of geoscientific topics

NASA Astrophysics Data System (ADS)

Münch, Ute; Lauterjung, Jörn

2014-05-01

Geoscientific topics and their consequences for the society are becoming more and more important for our daily life. Natural hazards such as flood and storm or the consequences of the climate change are urgent tasks and great challenges we have to tackle. Cascading natural hazards or environmental risks, can't be evaluated as single events by one scientific discipline, they rather need the expertise of different experts. The same applies for slowly progressive processes such as the climate change and its different aftereffects. More than ever politicians, decision makers, but also the public are asking for comprehensive background information and data to discuss activity options and to develop sustainable solutions. The improvement of public knowledge about science, their assets and drawbacks, chances and risks is getting crucial. To paint a comprehensive picture of different factors, correlations and dependencies the pooling of expertise is required. Thus eight research centres of the research field "Earth and Environment" of the Helmholtz-Association, Germany's largest scientific research organisation are currently building up a knowledge platform. Scientists of different disciplines will provide background information and explain their latest findings in an understandable way. Infographics, maps and animations will be applied to simplify and interpret complicated facts and findings. In addition to the web presence target group-specific products and activities will be organized. To meet the expectations of the different stakeholders an intensive dialog is aspired: round table discussions, exhibitions in museums and public places, tweeds are envisaged. In the beginning the partners will concentrate on the topics "consequences of the climate change", "pollutant dispersion" and "natural hazards/meteorological extreme events". The project is called Earth System Knowledge Platform (ESKP) coordinated by the German Research Centre for Geosciences (GFZ) and the Helmholtz Centre Geesthacht, Centre for Materials and Coastal Research (HZG). Further participating centres are: the Alfred-Wegener-Institute for Polar and Marine Research (AWI), the German Aerospace Center (DLR), the Research Centre Jülich (FZJ), the Helmholtz-Centre for Ocean Sciences (GEOMAR), the Karlsruher Institute for Technology (KIT) and the Helmholtz Centre for Environmental Research (UFZ). The webpage will be accessible at www.eskp.de.