Stones, Bones, and Groans with Cancerous Overtones - A Rare Case of Diffuse Large B Cell Lymphoma Presenting as Hypercalcemia

Diffuse large B cell lymphoma (DLBCL) is a type of non-Hodgkin lymphoma that can present in a variety of ways including fever, weight loss, weakness, and drenching night sweats. Uncommonly, hypercalcemia of malignancy can be associated with DLBCL through multiple mechanisms that include synthesis of parathyroid hormone related peptide (PTHrP) or elevated calcitriol levels. It is estimated that hypercalcemia in the setting of DLBCL is present in 18% of newly diagnosed cases. This report details a case of an 80-year-old man with history of chronic anemia and CKD stage 3b that presented with weakness, decreased oral intake, and self-reported weight loss. Initial labs showed a corrected calcium of 14.1 mg/dL and normal phosphorous and alkaline phosphatase levels. PTH was decreased at 4 pg/mL. Serum protein electrophoresis and skeletal survey were unremarkable. A continued anemia of 8.1 g/dL in the setting of hypercalcemia prompted further investigation with endoscopy and colonoscopy which showed a large malignant-appearing mass in the mid gastric body. Pathology identified the mass as DLBCL germinal center type. Labs taken after endoscopy reported elevated 1,25-dihydroxyvitamin D levels, consistent with vitamin-D induced hypercalcemia seen in DLBCL. This case report highlights an uncommon yet important presentation of DLBCL. It is imperative that a differential diagnosis for undifferentiated hypercalcemia in an older patient should include malignancies such as DLBCL and workup should include extrarenal causes of hypercalcemia such as PTHrP production and calcitriol levels

Initial Results of the Software-Driven Navigation for Station Experiment

To enable the next generation of robotic and human exploration of the solar system, improvements are needed to enable robust and accurate autonomous navigation. The purpose of this work is to take advantage of the growth in and use of software-defined platforms to incorporate additional navigation capability on existing assets, while also incorporating with new vehicle designs. The Software-driven Navigation for Station Experiment focuses on implementing two soft solutions to this: transmitting pseudolite signals to perform ranging and Doppler measurements as part of the signal coding (similar to underlying Global Navigation Satellite System approaches), and the Multi-spacecraft Autonomous Positioning System, which uses existing communication protocols to embed navigation and timing information to be shared among all assets in a peer-to-peer network. These technologies were implemented on the SCaN Testbed onboard the International Space Station and exercised over the course of mid-June and late-July 2018. This paper will discuss the operational architecture, experiment plan, and initial results from the data collected. One of the key conclusions of this work is the strong need for stable accurate clock synchronization across the dispersed space network

How is the Reionization Epoch Defined?

We study the effect of a prolonged epoch of reionization on the angular power spectrum of the Cosmic Microwave Background. Typically reionization studies assume a sudden phase transition, with the intergalactic gas moving from a fully neutral to a fully ionized state at a fixed redshift. Such models are at odds, however, with detailed investigations of reionization, which favor a more extended transition. We have modified the code CMBFAST to allow the treatment of more realistic reionization histories and applied it to data obtained from numerical simulations of reionization. We show that the prompt reionization assumed by CMBFAST in its original form heavily contaminates any constraint derived on the reionization redshift. We find, however, that prompt reionization models give a reasonable estimate of the epoch at which the mean cosmic ionization fraction was ~50%, and provide a very good measure of the overall Thomson optical depth. The overall differences in the temperature (polarization) angular power spectra between prompt and extended models with equal optical depths are less than 1% (10%).Comment: 5 pages, 3 figures; accepted on MNRA

Cell Cycle Phase-Specific Surface Expression of Nerve Growth Factor Receptors TrkA and p75NTR

[EN]Expression of the nerve growth factor (NGF) receptors TrkA and p75NTR was found to vary at the surface of PC12 cells in a cell cycle phase-specific manner. This was evidenced by using flow cytometric and microscopic analysis of cell populations labeled with antibodies to the extracellular domains of both receptors. Differential expression of these receptors also was evidenced by biotinylation of surface proteins and Western analysis, using antibodies specific for the extracellular domains of TrkA and p75NTR. TrkA is expressed most strongly at the cell surface in M and early G1 phases, whereas p75NTR is expressed mainly in late G1, S, and G2 phases. This expression reflects the molecular and cellular responses to NGF in specific phases of the cell cycle; in the G1 phase NGF elicits both the anti-mitogenic effect, i.e., inhibition of the G1 to S transition, and the differentiation response whereas a survival effect is provoked elsewhere in the cell cycle. A model is proposed relating these responses to the surface expression of the two receptors. These observations open the way for novel approaches to the investigation of the mechanism of NGF signal transduction

Transverse Sizes of CIV Absorption Systems Measured from Multiple QSO Sightlines

We present tomography of the circum-galactic metal distribution at redshift 1.7 to 4.5 derived from echellete spectroscopy of binary quasars. We find CIV systems at similar redshifts in paired sightlines more often than expected for sightline-independent redshifts. As the separation of the sightlines increases from 36 kpc to 907 kpc, the amplitude of this clustering decreases. At the largest separations, the CIV systems cluster similar to Lyman-break galaxies (Adelberger et al. 2005a). The CIV systems are significantly less correlated than these galaxies, however, at separations less than R_1 ~ 0.42 +/- 0.15 h-1 comoving Mpc. Measured in real space, i.e., transverse to the sightlines, this length scale is significantly smaller than the break scale estimated from the line-of-sight correlation function in redshift space (Scannapieco et al. 2006a). Using a simple model, we interpret the new real-space measurement as an indication of the typical physical size of enriched regions. We adopt this size for enriched regions and fit the redshift-space distortion in the line-of-sight correlation function. The fitted velocity kick is consistent with the peculiar velocity of galaxies as determined by the underlying mass distribution and places an upper limit on the outflow (or inflow) speed of metals. The implied time scale for dispersing metals is larger than the typical stellar ages of Lyman-break galaxies (Shapley et al. 2001), and we argue that enrichment by galaxies at z > 4.3 played a greater role in dispersing metals. To further constrain the growth of enriched regions, we discuss empirical constraints on the evolution of the CIV correlation function with cosmic time. This study demonstrates the potential of tomography for measuring the metal enrichment history of the circum-galactic medium.Comment: 22 pages, 15 figures, 1 tabl

CO Emission in Low Luminosity, HI Rich Galaxies

We present 12CO 1-0 observations of eleven low luminosity M_B > -18), HI--rich dwarf galaxies. Only the three most metal-rich galaxies, with 12+log(O/H) ~ 8.2, are detected. Very deep CO spectra of six extremely metal-poor systems (12+log(O/H) < 7.5) yield only low upper limits on the CO surface brightness, I_CO < 0.1 K km/s. Three of these six have never before been observed in a CO line, while the others now have much more stringent upper limits. For the very low metallicity galaxy Leo A, we do not confirm a previously reported detection in CO, and the limits are consistent with another recent nondetection. We combine these new observations with data from the literature to form a sample of dwarf galaxies which all have CO observations and measured oxygen abundances. No known galaxies with 12+log(O/H) < 7.9 (Z < 0.1 solar) have been detected in CO. Most of the star-forming galaxies with higher (12+log(O/H) > 8.1) metallicities are detected at similar or higher I_CO surface brightnesses. The data are consistent with a strong dependence of the I_CO/M_H_2 = X_CO conversion factor on ambient metallicity. The strikingly low upper limits on some metal-poor galaxies lead us to predict that the conversion factor is non-linear, increasing sharply below approximately 1/10 of the solar metallicity (12+log(O/H) < 7.9).Comment: 25 pages, 4 figures, 3 tables. Accepted for publication in AJ Tables replaced -- now formated for landscape orientatio