Anti-Ri-associated paraneoplastic ophthalmoplegia-ataxia syndrome in a woman with breast cancer. A case report and review of the literature

Background: Breast cancer is the most common cancer in women. However, in the management of breast cancer, paraneoplastic neurological syndromes represent a diagnostic and therapeutic challenge. The diagnosis of paraneoplastic neurological syndromes is difficult due to the heterogeneity of symptoms, the timing of presentation, and the absence of antibodies, and it generally occurs before the diagnosis of breast cancer in 80% of patients who develop paraneoplastic neurological syndromes. We describe a 72-year-old woman with subacute ophthalmoplegia-ataxia syndrome who was subsequently diagnosed as having breast cancer and anti-Ri antibodies. Case presentation: A 72-year-old post-menopausal Caucasian woman, with a positive medical history for diabetes mellitus and hypertension, presented with a 3-month onset of blurred vision, diplopia, and progressive gait disturbance. Serological tests were positive for well-characterized onconeural antibodies (anti-Ri). A whole-body computed tomography scan revealed a nodular opacity under her left nipple and axillary adenopathy. A biopsy of her left breast was performed, and histological examination showed ductal carcinoma. She underwent a superoexternal quadrantectomy with left axillary dissection. The final diagnosis showed infiltrating ductal carcinoma of the breast (T1c N1 M0, stage IIA) associated with paraneoplastic ophthalmoplegia-ataxia syndrome. At a 6-month follow-up, she showed no clinical or instrumental evidence of neoplastic recurrence with partial clinical improvement of neurological symptoms, such as ataxia and diplopia. Conclusion: The diagnosis of paraneoplastic neurological syndromes is often late, as in this patient, but treatment at an early stage may provide a good prognosis. Furthermore, this is one of several cases of an anti-Ri paraneoplastic neurological syndrome not associated with myoclonus, which reinforces the belief that opsoclonus myoclonus syndrome is not pathognomonic of the associated anti-Ri paraneoplastic neurological syndromes

Single QTL effects, epistasis, and pleiotropy account for two-thirds of the phenotypic F(2) variance of growth and obesity in DU6i x DBA/2 mice

Genes influencing body weight and composition and serum concentrations of leptin, insulin, and insulin-like growth factor I (IGF-I) in nonfasting animals were mapped in an intercross of the extreme high-growth mouse line DU6i and the inbred line DBA/2. Significant loci with major effects (F > 7.07) for body weight, obesity, and muscle weight were found on chromosomes 1, 4, 5, 7, 11, 12, 13, and 17, for leptin on chromosome 14, for insulin on chromosome 4, and for IGF-I on chromosome 10 at the Igf1 gene locus itself and on chromosome 18. Significant interaction between different quantitative trait loci (QTL) positions was observed (P < 0.01). Evidence was found that loci having small direct effect on growth or obesity contribute to the obese phenotype by gene–gene interaction. The effects of QTLs, epistasis, and pleiotropy account for 64% and 63% of the phenotypic variance of body weight and fat accumulation and for over 32% of muscle weight and serum concentrations of leptin, and IGF-I in the F2 population of DU6i x DBA/2 mice. [The quantitative trait loci described in this paper have been submitted to the Mouse Genome Database.

Explicit Evidence Systems with Common Knowledge

Justification logics are epistemic logics that explicitly include justifications for the agents' knowledge. We develop a multi-agent justification logic with evidence terms for individual agents as well as for common knowledge. We define a Kripke-style semantics that is similar to Fitting's semantics for the Logic of Proofs LP. We show the soundness, completeness, and finite model property of our multi-agent justification logic with respect to this Kripke-style semantics. We demonstrate that our logic is a conservative extension of Yavorskaya's minimal bimodal explicit evidence logic, which is a two-agent version of LP. We discuss the relationship of our logic to the multi-agent modal logic S4 with common knowledge. Finally, we give a brief analysis of the coordinated attack problem in the newly developed language of our logic

Towards Designing an Integrated Earth Observation System for the Provision of Solar Energy Resource and Assessment

The GEOSS strategic plan specifically targets the area of improved energy resource management due to the importance of these to the economic and social viability of every nation of the world. With the world s increasing demand for energy resources, the need for new alternative energy resources grows. This paper overviews a new initiative within the International Energy Agency that addresses needs to better manage and develop solar energy resources worldwide. The goal is to provide the solar energy industry, the electricity sector, governments, and renewable energy organizations and institutions with the most suitable and accurate information of the solar radiation resources at the Earth's surface in easily-accessible formats and understandable quality metrics. The scope of solar resource assessment information includes historic data sets and currently derived data products using satellite imagery and other means. Thus, this new task will address the needs of the solar energy sector while at the same time will serve as a model that satisfies GEOSS objectives and goals

40Ar/39Ar ages of CAMP in North America: implications for the Triassic-Jurassic boundary and the 40K decay constant bias

The Central Atlantic magmatic province (CAMP) is one of the largest igneous provinces on Earth (>107 km²) and spanning four continents. Recent high-precision 40Ar/39Ar dating of mineral separates has provided important constraints on the age, duration, and geodynamic history of CAMP. Yet, the North American CAMP is strikingly under-represented in this dating effort. Here we present 13 new statistically robust plateau, mini-plateau and isochron ages obtained on plagioclase and sericite separates from lava flows from the Fundy (n = 10; Nova Scotia, Canada) and Hartford and Deerfield (n = 3; U.S.A.) basins. Ages mostly range from 198.6 ± 1.1 to 200.1 ± 1.4 Ma (2σ), with 1 date substantially younger at 190.6 ± 1.0 Ma. Careful statistical regression shows that ages from the upper (199.7.0 ± 1.5 Ma) and bottom (200.1 ± 0.9 Ma) units of the lava pile in the Fundy basin are statistically indistinguishable, confirming a short duration emplacement (<< 1.8 Ma; ≤1 Ma). Three ages obtained on the Hartford (198.6 ± 2.0 Ma and 199.8 ± 1.1 Ma) and Deerfield (199.3 ± 1.2 Ma) basins were measured on sericite from the upper lava flow units. We interpret these dates as reflecting synemplacement hydrothermal activity within these units. Collectively, CAMP ages gathered so far suggest a short duration of the main magmatic activity (2-3 Ma), but also suggest the possibility of a temporal migration of the active magmatic centers from north to south. Such a migration challenges a plume model that would postulate a radial outward migration of the magmatism and is more compatible with other models such as the supercontinent global warming hypothesis. When compared to the age of the Triassic-Jurassic boundary, the filtered CAMP age database suggests that the onset of the magmatic activity precedes the limit by at least few hundred thousand years, therefore suggesting a causal relationship between CAMP and the end of Triassic mass extinction. An age at 191 Ma possibly suggests a minor CAMP late tailing activity (190-194 Ma) which has already observed for dykes and sills in Africa and Brazil. We speculate that, if real, this late activity can be due to a major extensional event, possibly heralding the oceanisation process at ~190 Ma. Comparison between high quality U/Pb and 40Ar/39Ar ages of pegmatite lenses from the North Mountain basalts confirms a ~1% bias between the two chronometers. This discrepancy is likely attributed to the miscalibration of the 40K decay constants, in particular the electron capture branch

Synchronous collecting duct carcinoma and papillary renal cell carcinoma: A case report and review of the literature

The coexistence of multiple and synchronous primary neoplasms in the same organ (including kidney) has only rarely been described in the literature. We herein present a case of collecting duct carcinoma (CDC) combined with papillary renal carcinoma (RCC) having a 57-month disease-free survival. CDC is a rather rare and aggressive neoplasm of the kidney. Sharing probably the same embryological origin, synchronous or metachronous association with in situ or papillary transitional cell carcinoma (TCC) may be found; association with RCC has been only once reported in the literature. The high incidence of c-erbB-2 oncogene amplification in CDC further characterizes this tumor as a separate entity from renal cell carcinoma, and shows some genetic characteristics in common with TCC. The histohgical diagnosis of Bellini CDC can be confirmed by the positive immuno-histochemical staining with a collecting duct marker and distal tubule marker and negative staining with a proximal tubule marker

Tephrochronology in faulted Middle Pleistocene tephra layer in the Val d’Agri area (Southern Italy)

The High Agri River Valley is a Quaternary Basin located along the hinge of the Southern Apennines fold-andthrust belt. The inner margin of the orogen has been affected by intense transtensional and normal faulting, which accompanied vigorous volcanism during the Quaternary. Marker tephra layers are distributed across the whole of Southern Italy and provide a powerful tool to constrain both the size of eruptions and the regional activity of extensional faults controlling basin evolution. Paleoseismological trenching within the Monti della Maddalena range, that borders the Agri River Valley to the south-west, has exposed a faulted stratigraphic sequence and recovered a 10 cm thick tephra layer involved in deformation. This is the first tephra horizon recognized in the high Agri Valley, which, based on the stratigraphic study of the trench, lies in a primary position. 40Ar/39Ar dating constrain its age to 266 ka and provide an important marker for the Middle Pleistocene tephrochronology of the region. Together with dating, geochemical analysis suggests a possible volcanic source in the Campanian region

Latest Triassic onset of the Central Atlantic Magmatic Province (CAMP) volcanism in the Fundy Basin (Nova Scotia): New stratigraphic constraints

In this paper we investigate the stratigraphic relationship between the emplacement of the CAMP basalts and the Triassic–Jurassic (Tr–J) boundary in the Fundy Basin (Nova Scotia, Canada). This is one of the best exposed of the synrift basins of eastern North America (ENA) formed as a consequence of the rifting that led to the formation of the Atlantic Ocean. The Triassic palynological assemblages found in the sedimentary rocks below (uppermost Blomidon Formation) and just above the North Mountain Basalt (Scots Bay Member of the McCoy Brook Formation) indicate that CAMP volcanism, at least in Nova Scotia, is entirely of Triassic age, occurred in a very short time span, and may have triggered the T–J boundary biotic and environmental crisis. The palynological assemblage from the Blomidon Formation is characterised by the dominance of the Circumpolles group (e.g. Gliscopollis meyeriana, Corollina murphyae, Classopollis torosus) which crosses the previously established Tr–J boundary.The Triassic species Patinasporites densus disappears several centimetres below the base of the North Mountain basalt, near the previously interpreted Tr–J boundary. The lower strata of the Scots Bay Member yielded a palynological assemblage dominated by Triassic bisaccate pollens (e.g Lunatisporites acutus, L. rhaeticus Lueckisporites sp., Alisporites parvus) with minor specimens of the Circumpolles group. Examination of the state of preservation and thermal alteration of organic matter associated with the microfloral assemblages precludes the possibility of recycling of the Triassic sporomorphs from the older strata. Our data argue against the previous definition of the Tr–J boundary in the ENA basins, which was based mainly on the last occurrence of P. densus. Consequently, it follows that the late Triassic magnetostratigraphic correlations should be revised considering that chron E23r, which is correlated with the last occurrence of P. densus in the Newark basin, does not occur at the Tr–J boundary but marks rather a late Triassic (probably Rhaetian) reversal