Congenital giant melanocytic nevi

Nevi are common skin tumors caused by abnormal overgrowth of cells from the epidermal and dermal layers of the skin. Most nevi are benign, but some pre-cancerous nevi must be monitored or removed. The giant congenital nevus is greater than 10 cm in size, pigmented and often hairy. Between 4% and 6% of these lesions will develop into a malignant melanoma. Since approximately 50% of the melanoma develop by the age of two, and 80% by the age of seven, early removal is recommended. The objective of this paper is to present a unique case of giant nevi and their surgical management

Frequency and antimicrobial susceptibility of Shigella species isolated in Children Medical Center Hospital, Tehran, Iran, 2001-2006

AbstractAppropriate antimicrobial treatment of shigellosis depends on identifying its changing resistance pattern over time. We evaluated 15,255 stool culture submitted from July 2001 to June 2006 to the Laboratory of Children Medical Center Hospital. Specimen culture, bacterial identification, and disk diffusion susceptibility testing were performed according to National Committee for Clinical Laboratory Standards guidelines. From 15,255 stool samples, 682 (4.5%) were positive for Shigella species. The most common species of Shigella were S. flexneri (48%) and S. sonnei (45%); other results were S. dysenteriae (5%) and S. boydii (2%). The rate of Sensitivity to ceftriaxone (95%), ceftizoxime (94%), and nalidixic acid (84%) were among our isolates. Resistance to co-trimoxazole and ampicillin was 87% and 86%, respectively. S. flexneri was more multiresistant than other species (47.9%). Our isolates are overall most sensitive to ceftriaxone, ceftazidime, and nalidixic acid (> 84%). They were most resistant to co-trimoxazole and ampicillin (> 86%). Because resistance varies according to specific location, continuous local monitoring of resistance patterns is necessary for the appropriate selection of empirical antimicrobial therapy

Spectral arbitrariness for trees fails spectacularly

If $G$ is a graph and $\mathbf{m}$ is an ordered multiplicity list which is realizable by at least one symmetric matrix with graph $G$, what can we say about the eigenvalues of all such realizing matrices for $\mathbf{m}$? It has sometimes been tempting to expect, especially in the case that $G$ is a tree, that any spacing of the multiple eigenvalues should be realizable. In 2004, however, F. Barioli and S. Fallat produced the first counterexample: a tree on 16 vertices and an ordered multiplicity list for which every realizing set of eigenvalues obeys a nontrivial linear constraint. We extend this by giving an infinite family of trees and ordered multiplicity lists whose sets of realizing eigenvalues are very highly constrained, with at most 5 degrees of freedom, regardless of the size of the tree in this family. In particular, we give the first examples of multiplicity lists for a tree which impose nontrivial nonlinear eigenvalue constraints and produce an ordered multiplicity list which is achieved by a unique set of eigenvalues, up to shifting and scaling.Comment: 45 page

Rigid linkages and partial zero forcing

Connections between vital linkages and zero forcing are established. Specifically, the notion of a rigid linkage is introduced as a special kind of unique linkage and it is shown that spanning forcing paths of a zero forcing process form a spanning rigid linkage and thus a vital linkage. A related generalization of zero forcing that produces a rigid linkage via a coloring process is developed. One of the motivations for introducing zero forcing is to provide an upper bound on the maximum multiplicity of an eigenvalue among the real symmetric matrices described by a graph. Rigid linkages and a related notion of rigid shortest linkages are utilized to obtain bounds on the multiplicities of eigenvalues of this family of matrices.Comment: 23 page

Prognostic implications of immunohistochemically detected YKL-40 expression in breast cancer

BACKGROUND: YKL-40 has been implicated as a mediator of collagen synthesis and extracellular matrix re-modeling as well as mitogenesis. Elevated serum levels of YKL-40 have been associated with worse survival in a variety of malignancies including breast cancer. We wished to determine if immunohistochemically detected expression had prognostic implications in breast cancer. METHODS: A prospectively collected database of breast cancer patients treated at the University Hospital of Newark was used for analysis. Immunohistochemistry was performed on archived tumor tissue from 109 patients for whom full clinical information and follow up was available. RESULTS: YKL-40 expression was noted in 37 patients (34%). YKL-40 immunoreactivity significantly correlated with larger tumor size, poorer tumor differentiation, and a greater likelihood of being estrogen and/or progesterone receptor negative. No significant correlation was demonstrated between YKL-40 status and nodal stage. At a mean follow up of 3.2 years, disease-free survival was significantly worse in the subset of patients whose tumors demonstrated YKL-40 expression compared to the non-expressors. In multivariate analysis, YKL-40 status was independent of T-stage and N-stage in predicting disease recurrence. CONCLUSION: Immunoreactivity for YKL-40 was a significant predictor of breast cancer relapse in this subset of patients. This was independent of T or N-stage and suggests that tumor immunohistochemistry for this protein may be a valuable prognostic marker in breast cancer