Castleman's Disease and Neutropenic Enterocolitis Presenting as Crohn’s Disease

A rare case of Castleman's disease presenting as Crohn's disease is described. This 21-year-old male with chronic neutropenia for one year presented with recurrent right lower quadrant pain of two years' duration. Small bowel follow-through suggested Crohn's of the terminal ileum. Colonoscopy confirmed ulcerations in the terminal ileum and cecum, with biopsies showing necrosis and inflammation. Treatment was initiated with prednisone, 5-aminosalicylate and granulocyte colony-stimulating factor for neutropenia. Symptoms recurred one year later, and repeat colonoscopy showed a focal cecal ulceration. Two years after presentation a resection was planned. Laparotomy revealed a normal ileocecal region and a large retroperitoneal mass of lymphadenopathy. Biopsies confirmed reactive hyperplasia, consistent with the plasma cell variant of Castleman's disease. Chemotherapy has resulted in improvement of symptoms and decrease in mass size, but cecal ulceration persisted. This case illustrates a variant presentation of Castleman's disease with neutropenia and manifestations in the gastrointestinal tract

Histogram of oriented gradients front end processing: an FPGA based processor approach

The Field Programmable Gate Array (FPGA) implementation of the commonly used Histogram of Oriented Gradients (HOG) algorithm is explored. The HOG algorithm is employed to extract features for object detection. A key focus has been to explore the use of a new FPGA-based processor which has been targeted at image processing. The paper gives details of the mapping and scheduling factors that influence the performance and the stages that were undertaken to allow the algorithm to be deployed on FPGA hardware, whilst taking into account the specific IPPro architecture features. We show that multi-core IPPro performance can exceed that of against state-of-the-art FPGA designs by up to 3.2 times with reduced design and implementation effort and increased flexibility all on a low cost, Zynq programmable system

Mycophenolate Mofetil for the Treatment of Autoimmune Hepatitis in Patients Refractory to Standard Therapy

There are limited therapeutic options available for patients with autoimmune hepatitis in whom conventional treatment fails. A case series of five patients unresponsive to or unable to take azathioprine, 6-mercaptopurine or corticosteroids who were treated with mycophenolate mofetil (MMF) is reported. While on MMF, alanine aminotransferase normalized or remained normal in all patients. MMF had a steroid-sparing effect and histological remission was demonstrated in one patient after seven months of MMF. One patient experienced an uncomplicated episode of pyelonephritis. In conclusion, MMF can effectively induce and maintain remission in refractory autoimmune hepatitis patients

The chromium site in doped glassy lithium tetraborate

Using extended X-ray absorption fine structure (EXAFS) spectroscopy, we find that Cr substitutes primarily in the Liþ site as a dopant in lithium tetraborate Li2B4O7 glasses, in this case 98.4Li2B4O7e1.6Cr2O3 or nominally Li1.98Cr0.025B4O7. This strong preference for a single site is nonetheless accompanied by site distortions and some site disorder, helping explain the optical properties of chromium doped Li2B4O7 glasses. The resulting O coordination shell has a contraction of the Cr-O bond lengths as compared to the Li-O bond lengths. There is also an increase in the O coordination number

The chromium site in doped glassy lithium tetraborate

Using extended X-ray absorption fine structure (EXAFS) spectroscopy, we find that Cr substitutes primarily in the Liþ site as a dopant in lithium tetraborate Li2B4O7 glasses, in this case 98.4Li2B4O7e1.6Cr2O3 or nominally Li1.98Cr0.025B4O7. This strong preference for a single site is nonetheless accompanied by site distortions and some site disorder, helping explain the optical properties of chromium doped Li2B4O7 glasses. The resulting O coordination shell has a contraction of the Cr-O bond lengths as compared to the Li-O bond lengths. There is also an increase in the O coordination number

Rare Earth Dopant (Nd, Gd, Dy, and Er) Hybridization in Lithium Tetraborate

The four dopants (Nd, Gd, Dy, and Er) substitutionally occupy the Li+ sites in lithium tetraborate (Li2B4O7: RE) glasses as determined by analysis of the extended X-ray absorption fine structure. The dopants are coordinated by 6-8 oxygen at a distance of 2.3 to 2.5 Å, depending on the rare earth. The inverse relationship between the RE-O coordination distance and rare earth (RE) atomic number is consistent with the expected lanthanide atomic radial contraction with increased atomic number. Through analysis of the X-ray absorption near edge structure, the rare earth dopants adopt the RE3+ valence state. There are indications of strong rare earth 5d hybridization with the trigonal and tetrahedral formations of BO3 and BO4 based on the determination of the rare earth substitutional Li+ site occupancy from the X-ray absorption near edge structure data. The local oxygen disorder around the RE3+ luminescence centers evident in the structural determination of the various glasses, and the hybridization of the RE3+ dopants with the host may contribute to the asymmetry evident in the luminescence emission spectral lines. The luminescence emission spectra are indeed characteristic of the expected f-to-f transitions; however, there is an observed asymmetry in some emission lines

Rituximab for the Treatment of Patients with Autoimmune Hepatitis Who are Refractory or Intolerant to Standard Therapy

BACKGROUND: Although most patients with autoimmune hepatitis (AIH) respond to treatment with prednisone and/or azathioprine, some patients are intolerant or refractory to standard therapy. Rituximab is an anti-CD20 monoclonal antibody that depletes B cells and has demonstrated efficacy in other autoimmune conditions

Validation of the Model of End-Stage Liver Disease for Liver Transplant Allocation in Alberta: Implications for Future Directions in Canada

Background. Since 2002, the Model of End-Stage Liver Disease (MELD) has been used for allocation of liver transplants (LT) in the USA. In Canada, livers were allocated by the CanWAIT algorithm. The aim of this study was to compare the abilities of MELD, Child-Pugh (CP), and CanWAIT status to predict 3-month and 1-year mortality before LT in Canadian patients and to describe the use of MELD in Canada. Methods. Validation of MELD was performed in 320 patients listed for LT in Alberta (1998–2002). In October 2014, a survey of MELD use by Canadian LT centers was conducted. Results. Within 1 year of listing, 47 patients were removed from the waiting list (29 deaths, 18 too ill for LT). Using logistic regression, the MELD and CP were better than the CanWAIT at predicting 3-month (AUROC: 0.79, 0.78, and 0.59; p=0.0002) and 1-year waitlist mortality (AUROC: 0.70, 0.70, and 0.55; p=0.0023). Beginning in 2004, MELD began to be adopted by Canadian LT programs but its use was not standardized. Conclusions. Compared with the CanWAIT system, the MELD score was significantly better at predicting LT waitlist mortality. MELD-sodium (MELD-Na) has now been adopted for LT allocation in Canada