A rare presentation of the Klinefelter's syndrome

A 16 years old boy with Chronic Renal Failure (CRF) was not suspected of having Klinefelter's syndrome until he complained of painful gynecomastia. He was under haemodialysis for 2 years. At first, he was in an approximately full pubertal development (P5, G5), but he had a small and a firm testis (length 2.2cm) and some degree of facial male pattern hair. He also had a decreased upper to lower body segment ratio and despite having chronic renal failure, he was taller than his parents and siblings. His laboratory tests showed high levels of FSH and normal levels of LH and testosterone. With regards to all these findings, we suspected that there might be an occult Klinefelter's syndrome. So, we made his karyotype that showed a 47XXY pattern. Because there are only a few number of cases that have occult Klinefelter's syndrome in the basis of chronic renal failure, we decided to report this case

Invalidation clues for database scalability services

10.1109/ICDE.2007.367877Proceedings - International Conference on Data Engineering316-32

Exploiting locality for data management in systems of limited bandwidth

This paper deals with data management in computer systems in which the computing nodes are connected by a relatively sparse network. We consider the problem of placing and accessing a set of shared objects that are read and written from the nodes in the network. These objects are, e.g., global variables in a parallel program, pages or cache lines in a virtual shared memory system, shared files in a distributed file system, or pages in the World Wide Web. A data management strategy consists of a placement strategy that maps the objects (possibly dynamically and with redundancy) to the nodes, and an access strategy that describes how reads and writes are handled by the system (including the routine). We investigate static and dynamic data management strategies. In the static model, we assume that we are given an application for which the rates of read and write accesses for all node-object pairs are known. The goal is to calculate a static placement of the objects to the nodes in the network and to specifiy the routing such that the network congestion is minimized. We introduce efficient algorithms that calculate optimal or close-to-optimal solutions for tree-connected networks, meshes of arbitrary dimension, and internet-like clustered networks. These algorithms take time only linear in the input size. In the dynamic model, we assume now knowledge about the access pattern. An adversary specifies accesses at runtime. Here we develop dynamic caching strategies that also aim to minimize the congestion on trees, meshes, and clustered networks. These strategies are investigated in a competitive model. For example, we achieve competitive ratio 3 for tree-connected networks and competitive ratio O(d x log n) for d-dimensional meshes of size n. Further, we present an #OMEGA#(log n/d) lower bound for the competitive ratio for on-line routing in meshes, which implies that the achieved upper bound on the competitive ratio for meshes of constant dimension is optimal. (orig.)SIGLEAvailable from TIB Hannover: RR 6673(45) / FIZ - Fachinformationszzentrum Karlsruhe / TIB - Technische InformationsbibliothekDEGerman