Spontaneous bleeding in a patient with malignant lymphoma: A case of acquired hemophilia

Background: Acquired hemophilia is a rare condition which can be associated with lymphoproliferative disease. Case Report: Eleven yea rs after the diagnosis of immunocytoma had been made, a 72-year-old man developed a high-titer factor VIII inhibitor. At this time, the lymphoma was without significant progress and there was no paraprotein in the serum. Partial thromboplastin time (PTT) was 83 a, factor-VIII clotting activity was <1%, and inhibitor level was 50.4 Bethesda units. The patient presented with spontaneous hematomas in the skin and musculature of the extremities. Following combination chemotherapy with cyclophosphamide, vincristine and prednisolone (COP), there was a prompt disappearance of the inhibitor and normalization of coagulation; however, the patient developed serious infectious complications. When the inhibitor recurred he was treated with low-dose cyclophosphamide and prednisolone. This time there was a more delayed response, but the inhibitor disappeared again completely. Two months after cessation of therapy, there was again relapse. Conclusion: Causal relationship between lymphoma and acquired hemophilia remains speculative. At least in some cases of factor VIII inhibitors associated with malignant disease, immunosuppressive therapy may be sufficient to suppress the inhibitor

Advanced head and neck cancer: Long-term results of chemo-radiotherapy, complications and induction of second malignancies

Background: Chemo-radiotherapy is superior to radiotherapy alone in the treatment of advanced, inoperable head and neck cancer. The long-term treatment results, the induction of second malignant tumors, and other long-term toxicities are not well defined. Patients and Methods: 100 consecutive patients with advanced head and neck cancer who were treated at our center were studied. Treatment results, survival, the occurrence of late complications, and second malignant tumors (SMT) were investigated. 78 patients were treated with a protocol combining cisplatinum, 5-fluorouracil, folinic acid and hyper-fractionated irradiation. 22 patients were treated with other chemo-radiotherapy protocols. The relative risk of developing an SMT was compared with that within the normal population. Results: The cumulative total probability of survival was 51.1% at 2 years and 38.7% at 4 years. The probability of relapse-free survival was 39.9% at 2 years and 36.7% at 4 years. A total of 7 patients developed SMT (4 cases of lung cancer, 2 colon cancers, 1 skin cancer). After 6 years, a cumulative risk of SMT of 8.7% was observed. The relative risk of developing an SMT was significantly increased (4.45-fold in males) compared with a normal population. 13 of 38 evaluable patients (34.2%) had severe late complications like fibrosis of soft tissues, nerve lesions, or were dependent on tracheal cannulas. Conclusions: The treatment results and long-term prognoses in our population of unselected high-risk patients are unsatisfactory, but comparable to those from multicenter studies. About 35% of patients become long-term (> 4 years) survivors. SMT generally occur early, have a poor prognosis and, most likely, are not treatment-related. Approximately 30% of long-term survivors have severe, often incapacitating late effects. The treatment and - if possible - prevention of these late effects is important for the quality of life of patients who survived advanced head and neck cancer

CliCTD: A monolithic HR-CMOS sensor chip for the CLIC silicon tracker

The CLIC Tracker Detector (CLICTD) is a monolithic pixelated sensor chip produced in a 180 nm imaging CMOS process built on a high-resistivity epitaxial layer. The chip, designed in the context of the CLIC tracking detector study, comprises a matrix of 16 x 128 elongated pixels, each measuring 300 x 30 μm$^{2}$. To ensure prompt charge collection, every elongated pixel is segmented in eight sub-pixels, each containing a collection diode and a separate analog front-end. A simultaneous 8-bit time measurement with 10 ns time bins and 5-bit energy measurement with programmable range is performed in the on-pixel digital logic. The main design aspects as well as the first results from laboratory measurements with the CLICTD chip are presented

Von Bezold assimilation effect reverses in stereoscopic conditions

Lightness contrast and lightness assimilation are opposite phenomena: in contrast, grey targets appear darker when bordering bright surfaces (inducers) rather than dark ones; in assimilation, the opposite occurs. The question is: which visual process favours the occurrence of one phenomenon over the other? Researchers provided three answers to this question. The first asserts that both phenomena are caused by peripheral processes; the second attributes their occurrence to central processes; and the third claims that contrast involves central processes, whilst assimilation involves peripheral ones. To test these hypotheses, an experiment on an IT system equipped with goggles for stereo vision was run. Observers were asked to evaluate the lightness of a grey target, and two variables were systematically manipulated: (i) the apparent distance of the inducers; and (ii) brightness of the inducers. The retinal stimulation was kept constant throughout, so that the peripheral processes remained the same. The results show that the lightness of the target depends on both variables. As the retinal stimulation was kept constant, we conclude that central mechanisms are involved in both lightness contrast and lightness assimilation

A new concurrent chemotherapy with vinorelbine and mitomycin C in combination with radiotherapy in patients with locally advanced squamous cell carcinoma of the head and neck

Objective: The purpose of this pilot study was to evaluate the feasibility and toxicity of concurrent chemotherapy with vinorelbine and mitomycin C in combination with accelerated radiotherapy (RT) in patients with locally advanced cancer of the head and neck. Patients and Methods: Between January 2003 and March 2004, 15 patients with T4/N2-3 squamous cell carcinoma (12/15) and with N3 cervical lymph node metastases of carcinoma of unknown primary (3/15) were treated with chemotherapy and simultaneous accelerated RT. Results: 11 patients completed therapy without interruption or dose reduction. Grade 3 - 4 acute mucosal toxicity was observed in 9/15 patients, grade 4 hematologic toxicity in 6/15 patients. At a median follow-up of 7.5 months, 2 patients have died of intercurrent disease, 2 patients have experienced local relapse; 5 patients are alive with no evidence of disease at the primary tumor site. Discussion: The described regimen is highly effective, but led to remarkable side effects

Does Perceptual Belongingness Affect Lightness Constancy?

Scientists have shown that two equal grey patches may differ in lightness when belonging to different reflecting surfaces. We extend this investigation to the constancy domain. In a CRT simulation of a bipartite field of illumination, we manipulated the arrangement of twelve patches: six squares and six diamonds. Patches of the same shape could be placed: (i) all within the same illumination field; or (ii) forming a row across the illumination fields. Furthermore, we manipulated proximity between the innermost patches and the illumination edge. The patches could be (i) touching (forming an X-junction); or (ii) not touching (not forming an X-junction). Observers were asked to perform a lightness match between two additional patches, one illuminated and the other in shadow. We found better lightness constancy when the patches of the same shape formed a row across the fields, with no effect of X-junctions

Design and characterisation of the CLICTD pixelated monolithic sensor chip

A novel monolithic pixelated sensor and readout chip, the CLIC Tracker Detector (CLICTD) chip, is presented. The CLICTD chip was designed targeting the requirements of the silicon tracker development for the experiment at the Compact Linear Collider (CLIC), and has been fabricated in a modified 180 nm CMOS imaging process with charge collection on a high-resistivity p-type epitaxial layer. The chip features a matrix of 16×128 elongated channels, each measuring 300×30 μm2. Each channel contains 8 equidistant collection electrodes and analog readout circuits to ensure prompt signal formation. A simultaneous 8-bit Time-of-Arrival (with 10 ns time bins) and 5-bit Time-over-Threshold measurement is performed on the combined digital output of the 8 sub-pixels in every channel. The chip has been fabricated in two process variants and characterised in laboratory measurements using electrical test pulses and radiation sources. Results show a minimum threshold between 135 and 180 e‾ and a noise of about 14 e‾ RMS. The design aspects and characterisation results of the CLICTD chip are presented