Splenic infarction: an update on William Osler\u27s observations.

BACKGROUND: Osler taught that splenic infarction presents with left upper abdominal quadrant pain, tenderness and swelling accompanied by a peritoneal friction rub. Splenic infarction is classically associated with bacterial endocarditis and sickle cell disease. OBJECTIVES: To describe the contemporary experience of splenic infarction. METHODS: We conducted a chart review of inpatients diagnosed with splenic infarction in a Jerusalem hospital between 1990 and 2003. RESULTS: We identified 26 cases with a mean age of 52 years. Common causes were hematologic malignancy (six cases) and intracardiac thrombus (five cases). Only three cases were associated with bacterial endocarditis. In 21 cases the splenic infarction brought a previously undiagnosed underlying disease to attention. Only half the subjects complained of localized left-sided abdominal pain, 36% had left-sided abdominal tenderness; 31% had no signs or symptoms localized to the splenic area, 36% had fever, 56% had leukocytosis and 71% had elevated lactate dehydrogenase levels. One splenectomy was performed and all patients survived to discharge. A post hoc analysis demonstrated that single infarcts were more likely to be associated with fever (20% vs. 63%, p \u3c 0.05) and leukocytosis (75% vs. 33%, P = 0.06) CONCLUSIONS: The clinical presentation of splenic infarction in the modern era differs greatly from the classical teaching, regarding etiology, signs and symptoms. In patients with unexplained splenic infarction, investigation frequently uncovers a new underlying diagnosis

Defining the clinical role of adapted digital light field photography in the treatment of HIV-induced Kaposi\u27s sarcoma lesions

Kaposi’s sarcoma (KS): a vascular tumor associated with HHV8 and HIV infection KS burden at Maputo Central Hospital (MCH): •Referral center for all of southern Mozambique, 1500 beds, \u3e65% HIV+ patients on medical services •Dermatology ward: 50 beds, \u3e30% of admitted patients suffer from Kaposi’s sarcoma and its complications •10-15 cases/month admitted with advanced KS; additional 15-20 cases/month treated outpatient •KS is the most common form of malignancy seen at MCH among men, second most frequent among women Current KS standard of care: •First line treatment: chemo- and concomitant antiretroviral-therapy •Pre-treatment photographs rarely taken to establish a baseline for therapeutic monitoring •Post-therapy improvement is based on gross examination and clinical judgment •Tracking correlation between therapy dosing and shrinkage of lesion size is difficult due to variation and number of lesions Aim of the study: determine the utility of adapted digital light field photography in a resource-limited setting and establish best clinical practice for future KS monitoring via photograph

Gabriel N. Hortobagyi, MD, Oral History Interview, January 23, 2013

Major Topics Covered: The World Summit Against Cancer The Breast Cancer Research Group Breast cancer treatments and service: evolution at MD Andersonhttps://openworks.mdanderson.org/mchv_interviewsessions/1215/thumbnail.jp

OncoLog, Volume 52, Number 09, September 2007

Sparing Life and Limb Can a Common Spice Be Use to Treat Cancer? House Call: Your First Colonoscopy: Here\u27s What You Can Expect DiaLog: Targeted Therapies Are Here to Stay, by Gabriel N. Hortobagyi, MDhttps://openworks.mdanderson.org/oncolog/1165/thumbnail.jp

Gabriel N. Hortobagyi, MD, Oral History Interview, January 28, 2013

Major Topics Covered: Patient centered service, evolution of at MD Anderson Leadership and mentoring experiences and principles Educating breast medical oncologistshttps://openworks.mdanderson.org/mchv_interviewsessions/1216/thumbnail.jp

Gabriel N. Hortobagyi, MD, Oral History Interview, March 15, 2013

Major Topics Covered: Overview of breast medical oncology: as a field; history of at MD Anderson Service to organizations and projects in the United States and abroad Views on MD Anderson presidentshttps://openworks.mdanderson.org/mchv_interviewsessions/1217/thumbnail.jp

Gabriel N. Hortobagyi, MD, Oral History Interview, November 30, 2012

Major Topics Covered: Personal and educational background The Department of Developmental Therapeutics; Emil J Freireich, MDhttps://openworks.mdanderson.org/mchv_interviewsessions/1213/thumbnail.jp

CTCF mediates chromatin looping via N-terminal domain-dependent cohesin retention

The DNA-binding protein CCCTC-binding factor (CTCF) and the cohesin complex function together to shape chromatin architecture in mammalian cells, but the molecular details of this process remain unclear. Here, we demonstrate that a 79-aa region within the CTCF N terminus is essential for cohesin positioning at CTCF binding sites and chromatin loop formation. However, the N terminus of CTCF fused to artificial zinc fingers was not sufficient to redirect cohesin to non-CTCF binding sites, indicating a lack of an autonomously functioning domain in CTCF responsible for cohesin positioning. BORIS (CTCFL), a germline-specific paralog of CTCF, was unable to anchor cohesin to CTCF DNA binding sites. Furthermore, CTCF-BORIS chimeric constructs provided evidence that, besides the N terminus of CTCF, the first two CTCF zinc fingers, and likely the 3D geometry of CTCF-DNA complexes, are also involved in cohesin retention. Based on this knowledge, we were able to convert BORIS into CTCF with respect to cohesin positioning, thus providing additional molecular details of the ability of CTCF to retain cohesin. Taken together, our data provide insight into the process by which DNA-bound CTCF constrains cohesin movement to shape spatiotemporal genome organization