Oligoclonal reconstitution masquerading as myeloma relapse

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Oligoclonal reconstitution masquerading as myeloma relapse

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Common association of haemolytic uraemic syndrome with invasive Streptococcus pneumoniae infection in five Chinese paediatric patients

Haemolytic uraemic syndrome is an important cause of acute renal impairment in childhood. We review the incidence, and clinical and laboratory features of haemolytic uraemic syndrome in a Chinese population. Five patients were identified from 2006 to 2008. All patients were young children with associated invasive Streptococcus pneumoniae pulmonary infection. Serotypes 3, 14, and 19A were confirmed in four patients. The classical post-diarrhoeal form associated with Escherichia coli (O157:H7) infection was not seen. One patient died of acute respiratory failure. Streptococcus pneumoniae infection, as an associated condition in haemolytic uraemic syndrome, is important and relatively common in Chinese patients, especially among children. The acute clinical picture is similar to that reported in the western literature, except for an uncommon association with meningitis. The medium-term renal outcome of the Chinese population appears to be more favourable than the Caucasians. Widespread vaccination against Streptococcus pneumoniae may have resulted in changes in bacterial epidemiology and clinicians should be continuously aware of this severe disease. The use of washed blood components for transfusion in the acute stage requires further study.published_or_final_versio

Simultaneous pancreas and kidney transplantation as the standard surgical treatment for diabetes mellitus patients with end-stage renal disease

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Epigenetic silencing of a long non-coding RNA KIAA0495 in multiple myeloma

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Modelling Techniques for the Quantification of Some Electron Beam Induced Phenomena

This paper presents simulation models for quantifying the voltage contrast, cathodoluminescence and indirect specimen charging phenomena in the scanning electron microscope (SEM). The voltage contrast model comprises an electric field computation program using the finite-element approach, and a secondary electron trajectory tracking algorithm employing a linear electric field assumption. This trajectory tracking algorithm is more accurate than the conventional electron trajectory tracking algorithms which make use of a constant electric field assumption within each computation step. Using this model, results of qualitative voltage contrast effects on secondary electron trajectories in the specimen chamber of the SEM are shown. This model can also be used for quantitative voltage studies for designing low error voltage energy analysers. The cathodoluminescence (CL) model consists of programs for simulating the electron beam-specimen interaction via Monte Carlo analysis, excess carrier generation and distribution, and optical losses of the CL emission. This model has been used to simulate the CL intensity as a function of surface recombination velocity, diffusion length, and absorption coefficient. A model has also been developed to simulate indirect charging of specimens in the SEM. This model uses the finite-element method to solve for the self-consistent electric field due to the imposed boundary conditions, trapped and moving charges. Secondary electrons are tracked using the trajectory tracking scheme developed

Sustained and repeated response of relapsed acute promyelocytic leukemia (APL) to arsenic therapy

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The Influence of Analyser Geometry Effects in Scanning Electron Microscope Voltage Contrast Measurements

A computer simulation model used to study specimen dependent and analyser geometry dependent effects is described in this paper. With this model, the influence of the specimen dependent effect on quantitative voltage contrast measurements can be isolated from the analyser geometry dependent effect. Linearization error voltages in quantitative voltage contrast measurements arising from the individual influences of the specimen dependent and analyser geometry dependent effects are presented. The results show that the error component due to very narrow analysers dominate the total linearization error. The same situation arises when the voltage measurement point on the specimen is very near to the edge of the analyser

An Energy Dependent Model for Type I Magnetic Contrast in the Scanning Electron Microscope

The modelling of the magnetic contrast phenomenon in the scanning electron microscope (SEM) is important in understanding the physics of the contrast mechanism and the associated signal detection. In this paper, we report an improved analytical model for Type I magnetic contrast calculations using an approximate form of the Chung and Everhart secondary electron (SE) energy distribution. Previous studies have neglected this factor by assuming a mono-energetic model in order to simplify the calculations. This new model can be used to study different material specimens by appropriate choice of the work function and field-distance integral. The effect of energy filtering on the Type I magnetic contrast and quality factor can also be studied with the improved model by substituting the low and high energy limits of the filtered SE distribution into the closed-form analytical expressions obtained. Results of the above-mentioned effects and the effect of collector aperturing are reported in this paper using the new improved energy dependent model

Genetic and pharmacological relationship between P-Glycoprotein and increased cardiovascular risk associated with clarithromycin prescription:An Epidemiological and Genomic Population-Based Cohort Study in Scotland, UK

BackgroundThere are conflicting reports regarding the association of the macrolide antibiotic clarithromycin with cardiovascular (CV) events. A possible explanation may be that this risk is partly mediated through drug-drug interactions and only evident in at-risk populations. To the best of our knowledge, no studies have examined whether this association might be mediated via P-glycoprotein (P-gp), a major pathway for clarithromycin metabolism. The aim of this study was to examine CV risk following prescription of clarithromycin versus amoxicillin and in particular, the association with P-gp, a major pathway for clarithromycin metabolism.Methods and findingsWe conducted an observational cohort study of patients prescribed clarithromycin or amoxicillin in the community in Tayside, Scotland (population approximately 400,000) between 1 January 2004 and 31 December 2014 and a genomic observational cohort study evaluating genotyped patients from the Genetics of Diabetes Audit and Research Tayside Scotland (GoDARTS) study, a longitudinal cohort study of 18,306 individuals with and without type 2 diabetes recruited between 1 December 1988 and 31 December 2015. Two single-nucleotide polymorphisms associated with P-gp activity were evaluated (rs1045642 and rs1128503 -AA genotype associated with lowest P-gp activity). The primary outcome for both analyses was CV hospitalization following prescription of clarithromycin versus amoxicillin at 0-14 days, 15-30 days, and 30 days to 1 year. In the observational cohort study, we calculated hazard ratios (HRs) adjusted for likelihood of receiving clarithromycin using inverse proportion of treatment weighting as a covariate, whereas in the pharmacogenomic study, HRs were adjusted for age, sex, history of myocardial infarction, and history of chronic obstructive pulmonary disease. The observational cohort study included 48,026 individuals with 205,227 discrete antibiotic prescribing episodes (34,074 clarithromycin, mean age 73 years, 42% male; 171,153 amoxicillin, mean age 74 years, 45% male). Clarithromycin use was significantly associated with increased risk of CV hospitalization compared with amoxicillin at both 0-14 days (HR 1.31; 95% CI 1.17-1.46, p ConclusionsIn this study, we observed that the increased risk of CV events with clarithromycin compared with amoxicillin was associated with an interaction with P-glycoprotein