Vasculitis manifested with multiple mass lesions in kidneys, lungs and soft tissue, mimicking malignant tumors

We report a case of granulomatosis with polyangiitis (GPA) (Wegner's granulomatosis) who presented with multiple mass lesions in kidneys and lung lobes, as well as neck soft tissue, mimicking malignancies. This 71-year-old woman initially presented with sudden right foot drop, left calf pain and right eye vision loss. She was treated with corticosteroid for the diagnosis of possible temporal arteritis. Months after steroid was tapered to 2 mg per day, she developed increasing fatigue, weight loss, and shortness of breath. CT scan showed lung mass lesions in left upper lobe (3.8 × 2.4 cm), right mid lung with pleural extension (3.4 × 3.3 cm), and right lower lobe (1.1 × 1.0 cm); right neck (3.3 × 2.6 cm), right kidney (2.3 × 1.8 cm) and left kidney (2.0 × 1.6 cm). Right quadriceps muscle biopsy shows focal granulomatous inflammation. Lung biopsy showed necrotizing and poorly formed granulomatous inflammation. Biopsies of kidney mass lesions showed necrotizing and non-necrotizing granulomatous inflammation. No crescentic or necrotizing glomerular lesions were observed in the total 40 sampled glomeruli. No malignancy was identified in any of the biopsies. Her c-ANCA was found to be positive and PR3-ANCA antibody was 6.88 U/ml (normal 0–0.90 U/ml). She was diagnosed with granulomatosis with polyangiitis and treated with high dose corticosteroid and rituximab. Eight months later, follow-up showed resolved mass lesions by chest X-ray and CT and stable renal function. The case highlights the atypical clinical presentation of vasculitis and the significance of considering this possibility in differential diagnosis when confronting mass lesions present in multiple organ systems. Biopsy is critical for the correct diagnosis to initiate timely and appropriate treatment, and also important to avoid unnecessary surgical resection

Intuitive statistical inferences about diffuse hypotheses

When data are sampled from a population and subjects revise probability estimates about which population is being sampled, their revisions are less than the optimal amount calculated by using Bayes's theorem; they are conservative. The experiments reported here used binomial populations with proportions that were either defined precisely by a display or defined diffusely by a sample of data. The experimenter randomly selected one of two populations and then sampled data from the selected population. The subjects made very nearly Bayesian revisions on the basis of the first datum sampled, but became markedly conservative when the task required aggregating evidence across a sequence of data. This result was independent of whether population proportions were defined precisely or diffusely.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/33215/1/0000604.pd

Rhomboid family member 2 regulates cytoskeletal stress-associated Keratin 16.

Keratin 16 (K16) is a cytoskeletal scaffolding protein highly expressed at pressure-bearing sites of the mammalian footpad. It can be induced in hyperproliferative states such as wound healing, inflammation and cancer. Here we show that the inactive rhomboid protease RHBDF2 (iRHOM2) regulates thickening of the footpad epidermis through its interaction with K16. K16 expression is absent in the thinned footpads of irhom2-/- mice compared with irhom2+/+mice, due to reduced keratinocyte proliferation. Gain-of-function mutations in iRHOM2 underlie Tylosis with oesophageal cancer (TOC), characterized by palmoplantar thickening, upregulate K16 with robust downregulation of its type II keratin binding partner, K6. By orchestrating the remodelling and turnover of K16, and uncoupling it from K6, iRHOM2 regulates the epithelial response to physical stress. These findings contribute to our understanding of the molecular mechanisms underlying hyperproliferation of the palmoplantar epidermis in both physiological and disease states, and how this 'stress' keratin is regulated

Carbon Stars in the Hamburg/ESO Survey: Abundances

We have carried out a detailed abundance analysis for a sample of 16 carbon stars found among candidate extremely metal-poor (EMP) stars from the Hamburg/ESO Survey. We find that the Fe-metallicities for the cooler C-stars (Teff ~ 5100K) have been underestimated by a factor of ~10 by the standard HES survey tools. The results presented here provided crucial supporting data used by Cohen et al (2006) to derive the frequency of C-stars among EMP stars. C-enhancement in these EMP C-stars appears to be independent of Fe-metallicity and approximately constant at ~1/5 the solar C/H. The mostly low C12/C13 ratios (~4) and the high N abundances in many of these stars suggest that material which has been through proton burning via the CN cycle comprises most of the stellar envelope. C-enhancement is associated with strong enrichment of heavy nuclei beyond the Fe-peak for 12 of the 16 stars. The remaining C-stars from the HES, which tend to be the most Fe-metal poor, show no evidence for enhancement of the heavy elements. Very high enhancements of lead are detected in some of the C-stars with highly enhanced Ba. (We show that) the s-process is responsible for the enhancement of the heavy elements for the majority of the C-stars in our sample. We suggest that both the s-process rich and Ba-normal C-stars result from phenomena associated with mass transfer in binary systems. This leads directly to the progression from C-stars to CH stars and then to Ba stars as the Fe-metallicity increases. (abridged and slightly edited to shorten)Comment: AJ, in press, submitted 13 Dec, 2005, accepted 21 March 200

Oscillator Strengths and Damping Constants for Atomic Lines in the J and H Bands

We have built a line list in the near-infrared J and H bands (1.00-1.34, 1.49-1.80 um) by gathering a series of laboratory and computed line lists. Oscillator strengths and damping constants were computed or obtained by fitting the solar spectrum. The line list presented in this paper is, to our knowledge, the most complete one now available, and supersedes previous lists.Comment: Accepted, Astrophysical Journal Supplement, tentatively scheduled for the Sep. 1999 Vol. 124 #1 issue. Text and tables also available at http://www.iagusp.usp.br/~jorge

Decision theory applied to image quality control in radiology

This is an Open Access article distributed under the terms of the Creative Commons Attribution Licens

The solar photospheric nitrogen abundance. Analysis of atomic transitions with 3D and 1D model atmospheres

CONTEXT: In recent years, the solar chemical abundances have been studied in considerable detail because of discrepant values of solar metallicity inferred from different indicators, i.e., on the one hand, the "sub-solar" photospheric abundances resulting from spectroscopic chemical composition analyses with the aid of 3D hydrodynamical models of the solar atmosphere, and, on the other hand, the high metallicity inferred by helioseismology. AIMS: After investigating the solar oxygen abundance using a CO5BOLD 3D hydrodynamical solar model in previous work, we undertake a similar approach studying the solar abundance of nitrogen, since this element accounts for a significant fraction of the overall solar metallicity, Z. METHOD: We used a selection of atomic spectral lines to determine the solar nitrogen abundance, relying mainly on equivalent width measurements in the literature. We investigate the influence on the abundance analysis, of both deviations from local thermodynamic equilibrium ("NLTE effects") and photospheric inhomogeneities ("granulation effects"). RESULTS: We recommend use of a solar nitrogen abundance of A(N)=7.86+-0.12 whose error bar reflects the line-to-line scatter. CONCLUSION: The solar metallicity implied by the CO5BOLD-based nitrogen and oxygen abundances is in the range 0.0145<= Z <= 0.0167. This result is a step towards reconciling photospheric abundances with helioseismic constraints on Z. Our most suitable estimates are Z=0.0156 and Z/X=0.0213.Comment: To be published on A&

Evaluation of two dairy herd reproductive performance indicators that are adjusted for voluntary waiting period

<p>Abstract</p> <p>Background</p> <p>Overall reproductive performance of dairy herds is monitored by various indicators. Most of them do not consider all eligible animals and do not consider different management strategies at farm level. This problem can be alleviated by measuring the proportion of pregnant cows by specific intervals after their calving date or after a fixed time period, such as the voluntary waiting period. The aim of this study was to evaluate two reproductive performance indicators that consider the voluntary waiting period at the herd. The two indicators were: percentage of pregnant cows in the herd after the voluntary waiting period plus 30 days (PV30) and percentage of inseminated cows in the herd after the voluntary waiting period plus 30 days (IV30). We wanted to assess how PV30 and IV30 perform in a simulation of herds with different reproductive management and physiology and to compare them to indicators of reproductive performance that do not consider the herd voluntary waiting period.</p> <p>Methods</p> <p>To evaluate the reproductive indicators we used the SimHerd-program, a stochastic simulation model, and 18 scenarios were simulated. The scenarios were designed by altering the reproductive management efficiency and the status of reproductive physiology of the herd. Logistic regression models, together with receiver operating characteristics (ROC), were used to examine how well the reproductive performance indicators could discriminate between herds of different levels of reproductive management efficiency or reproductive physiology.</p> <p>Results</p> <p>The logistic regression models with the ROC analysis showed that IV30 was the indicator that best discriminated between different levels of management efficiency followed by PV30, calving interval, 200-days not-in calf-rate (NotIC200), in calf rate at100-days (IC100) and a fertility index. For reproductive physiology the ROC analysis showed that the fertility index was the indicator that best discriminated between different levels, followed by PV30, NotIC200, IC100 and the calving interval. IV30 could not discriminate between the two levels.</p> <p>Conclusion</p> <p>PV30 is the single best performance indicator for estimating the level of both herd management efficiency and reproductive physiology followed by NotIC200 and IC100. This indicates that PV30 could be a potential candidate for inclusion in dairy herd improvement schemes.</p

A Comprehensive Spectral and Variability Study of Narrow-Line Seyfert 1 Galaxies Observed by ASCA: II. Spectral Analysis and Correlations

(Abridged) I present a comprehensive and uniform analysis of 25 {\it ASCA} observations from 23 Narrow-line Seyfert 1 galaxies. The spectral analysis and correlations are presented in this paper, Part 2; the reduction and time series analysis is presented in the companion paper, Part 1.Comment: 73 pages, 31 figures, accepted for publication in ApJS. Report also available at http://www.astro.columbia.edu/~leighly/research.htm